Beta-human chorionic gonadotrophin point of care testing for the management of pregnancy of unknown location.

Research Question: Does a commercially available quantitative beta-human chorionic gonadotrophin (BHCG) point of care testing (POCT) device improve workflow management in early pregnancy by performing comparably to gold standard laboratory methods, and is the performance of a validated pregnancy of unknown location (PUL) triage strategy maintained using POCT BHCG results?

Design: Women classified with a PUL between 2018 and 2021 at three early pregnancy units were included. The linear relationship of untreated whole-blood POCT and serum laboratory BHCG values was defined using coefficients and regression. Paired serial BHCG values were then incorporated into the validated M6 multinomial logistic regression model to stratify the PUL as at high risk or at low risk of clinical complications.

Ambulatory human chorionic gonadotrophin (hCG) testing: a verification of two hCG point of care devices.

Objectives: Quantitative human chorionic gonadotropin (hCG) measurements are used to manage women classified with a pregnancy of unknown location (PUL). Two point of care testing (POCT) devices that quantify hCG are commercially available. We verified the i-STAT 1 (Abbott) and the AQT 90 FLEX (Radiometer) prior to use in PUL triage.

The characteristic ultrasound features of specific types of ovarian pathology (review).

Characterizing ovarian masses enables patients with malignancy to be appropriately triaged for treatment by subspecialist gynecological oncologists, which has been shown to optimize care and improve survival. Furthermore, correctly classifying benign masses facilitates the selection of patients with ovarian pathology that may either not require intervention, or be suitable for minimal access surgery if intervention is required. However, predicting whether a mass is benign or malignant is not the only clinically relevant information that we need to know before deciding on appropriate treatment.

Heparin for assisted reproduction: summary of a Cochrane review.

It is suggested that heparin given in the peri-implantation period may improve clinical outcomes in women undergoing assisted reproduction techniques (ART). This systematic review evaluates the use of heparin in subfertile women undergoing ART.

Heparin for assisted reproduction.

Background: Heparin as an adjunct in assisted reproduction (peri-implantation heparin) is given at or after egg collection or at embryo transfer during assisted reproduction. Heparin has been advocated to improve embryo implantation and clinical outcomes.  It has been proposed that heparin enhances the intra-uterine environment by improving decidualisation with an associated activation of growth factors and a cytokine expression profile in the endometrium that is favourable to pregnancy.

A novel technique for the semi-automated measurement of embryo volume: an intraobserver reliability study.

The aim was to assess intraobserver reliability of a new semi-automated technique of embryo volumetry. Power calculations suggested 46 subjects with viable, singleton pregnancies were required for reliability analysis. Crown rump length (CRL) of each embryo was analyzed using 2-D and a 3-D dataset acquired using transvaginal ultrasound.

The management of miscarriage.

Women diagnosed with incomplete and delayed miscarriage are faced with three options for their subsequent management: expectant, medical or surgical. Health-care practitioners must empower patients to make educated decisions about their own management by providing them with sufficient information in a readily understandable format. This can be difficult both for the patient and the staff in what is often an understandably, highly emotional situation.

How good are emergency department Senior House Officers at interpreting X-rays following radiographers' triage?

Objective: To assess the accuracy of Senior House Officers at interpreting plain X-rays following their triage by radiographers in an emergency department.

Method: We collected 2593 patients' records by systematic sampling of all those seen by emergency physicians between January 2002 and April 2002 (ca 10 000 patients) in a UK emergency department. The variables recorded included evidence of X-ray investigations and, when present, the Senior House Officer's diagnosis, the presence (abnormal) or absence of a radiographers red dot and the reference standard diagnosis.

Does discussion of possible scar rupture influence preferred mode of delivery after a caesarean section?

Using retrospective and prospective analyses of antenatal records, it was found that by 2003, discussions about the options for delivery after one lower segment caesarean section (LSCS) were almost always documented in antenatal notes, compared with only rare entries in 1993; specific mention of the risks of scar rupture were made in just under 50% in 2003. There was a considerable reduction in the proportion of women whose preference was to labour in 2003 compared with 1993 and also in the number who ultimately delivered vaginally. There was, however, no evidence that those women with whom possible scar rupture had been discussed were discouraged from attempting vaginal delivery.