808 results match your criteria: "Queen Charlotte's and Chelsea Hospital.[Affiliation]"

Purpose: To determine the level of uptake of telemedicine among postgraduate obstetrics and gynaecology (O&G) trainees in London, and how they perceive its impact on their training.

Methods: A mixed-methods survey aimed at exploring trainee perspectives of telemedicine use in clinical practice and its implications for training. Study participants were O&G specialist doctors on the London (UK) training programme.

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Updated premature ovarian insufficiency guideline.

Climacteric

December 2024

Monash Centre for Health Research and Implementation (MCHRI), Monash University, Clayton, VIC, Australia.

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Evidence-based guideline: premature ovarian insufficiency.

Hum Reprod Open

December 2024

Monash Centre for Health Research and Implementation (MCHRI), Monash University, Clayton, Australia.

Study Question: How should premature/primary ovarian insufficiency (POI) be diagnosed and managed based on the best available evidence from published literature?

Summary Answer: The current guideline provides 145 recommendations on symptoms, diagnosis, causation, sequelae, and treatment of POI.

What Is Known Already: Premature ovarian insufficiency (POI) presents a significant challenge to women's health, with far-reaching implications, both physically and emotionally. The potential implications include adverse effects on quality of life; fertility; and bone, cardiovascular, and cognitive health.

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Evidence-based guideline: Premature Ovarian Insufficiency.

Fertil Steril

December 2024

Monash Centre for Health Research and Implementation (MCHRI), Monash University, Clayton, Australia.

Study Question: How should premature/primary ovarian insufficiency (POI) be diagnosed and managed, based on the best available evidence from published literature?

Summary Answer: The current guideline provides 145 recommendations on symptoms, diagnosis, causation, sequelae and treatment of POI.

What Is Known Already: Premature ovarian insufficiency (POI) presents a significant challenge to women's health, with far-reaching implications, both physically and emotionally. The potential implications include adverse effects on quality of life; fertility; and bone, cardiovascular and cognitive health.

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Evidence-based guideline: premature ovarian insufficiency.

Climacteric

December 2024

Monash Centre for Health Research and Implementation (MCHRI), Monash University, Clayton, VIC, Australia.

Study Question: How should premature/primary ovarian insufficiency (POI) be diagnosed and managed, based on the best available evidence from published literature?

Summary Answer: The current guideline provides 145 recommendations on symptoms, diagnosis, causation, sequelae and treatment of POI.

What Is Known Already: POI presents a significant challenge to women's health, with far-reaching implications, both physically and emotionally. The potential implications include adverse effects on quality of life, on fertility and on bone, cardiovascular and cognitive health.

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To understand whether there was an association between very young oocyte donors and adverse outcomes, this was a single centre retrospective study (Lister Fertility Clinic, London) examining data collected between 1st January 2010 and 31st December 2021. A total of 1,182 oocyte donors were included in the final analysis. Data was categorised by donor age in years; ≤22, 23-25, 26-28, 29-31, 32-34.

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Familial chylomicronaemia syndrome in pregnancy - report of two cases managed with plasma exchange.

Obstet Med

September 2024

Professor of Obstetric Medicine and Consultant Obstetric Physician, Guy's and St Thomas' NHS Foundation Trust, London, UK.

Familial chylomicronaemia syndrome (FCS) is a rare genetic disorder characterised by significantly elevated triglyceride levels which increases the risk of acute pancreatitis. Due to the changes in lipid metabolism during pregnancy, triglyceride levels may rise further, particularly in the third trimester, and cause challenges in the management of these patients. Apart from strict dietary restriction of all fats, there is limited evidence on the efficacy of pharmacological treatment with omega-3 fatty acids and fibrates in maintaining triglyceride levels below the desired threshold of 10 mmol/L.

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An umbrella review of meta-analyses regarding the incidence of female-specific malignancies after fertility treatment.

Fertil Steril

November 2024

Department of Public Health and Primary Care, University of Leuven, Leuven, Belgium; Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom.

Article Synopsis
  • Understanding the risks of fertility treatments (FTs) is crucial for making informed clinical decisions and providing patient counseling regarding women's health issues, particularly cancer.
  • This study aimed to analyze the relationship between FTs and the incidence of specific female-related cancers such as ovarian, endometrial, breast, and cervical cancers, using systematic reviews and meta-analyses.
  • Results indicated a significant increase in ovarian cancer and borderline ovarian tumors among women undergoing FTs compared to those not treated, especially with certain fertility drug regimens like clomiphene citrate and human menopausal gonadotropin.
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Reducing inequalities in preconception health and care is critical to improving the health and life chances of current and future generations. A hybrid workshop was held at the 2023 UK Preconception Early and Mid-Career Researchers (EMCR) Network conference to co-develop recommendations on ways to address inequalities in preconception health and care. The workshop engaged multi-disciplinary professionals across diverse career stages and people with lived experience (total = 69).

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Conflicts of interest (COIs) between clinical obligations and other roles and responsibilities occur throughout health care, including anesthetic practice. In some circumstances, these conflicts are unavoidable. This article describes some of the potential conflicts and explores approaches to managing them in 3 key areas: relationships with industry, responsibility to the health care system, and obligations in research.

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Article Synopsis
  • Digital vaginal examination (DVE) is the standard method for checking labor progress, but it can be painful and subjective, with variability in results; this study aims to compare DVE to intrapartum transperineal ultrasound (TPUS).
  • Conducted at a London maternity unit, the study involved nulliparous women in active labor, where TPUS measurements were taken after DVE, allowing for comparisons between the two methods. The study incorporated repeated ultrasound assessments when possible.
  • Out of 206 women, complete data from 110 showed that 34% had no difference between TPUS and DVE measurements, while a mean difference of -0.9 cm was observed, indicating
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Importance: Safe and effective nonhormonal treatments for menopausal vasomotor symptoms (VMS) are needed.

Objective: To evaluate the efficacy and safety of elinzanetant, a selective neurokinin-1,3 receptor antagonist, for the treatment of moderate to severe menopausal vasomotor symptoms.

Design, Setting, And Participants: Two randomized double-blind phase 3 trials (OASIS 1 and 2) included postmenopausal participants aged 40 to 65 years experiencing moderate to severe vasomotor symptoms (OASIS 1: 77 sites in the US, Europe, and Israel from August 27, 2021, to November 27, 2023, and OASIS 2: 77 sites in the US, Canada, and Europe from October 29, 2021, to October 10, 2023).

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The placenta and umbilical cord in prenatal care: Unseen, overlooked and misunderstood.

BJOG

January 2025

Division of Maternal Fetal Medicine, Department of Obstetrics and Gynaecology, Beth Israel Deaconess Medical School, Harvard Medical School, Boston, Massachusetts, USA.

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Objectives: To develop a deep learning (DL)-model using convolutional neural networks (CNN) to automatically identify the fetal head position at transperineal ultrasound in the second stage of labor.

Material And Methods: Prospective, multicenter study including singleton, term, cephalic pregnancies in the second stage of labor. We assessed the fetal head position using transabdominal ultrasound and subsequently, obtained an image of the fetal head on the axial plane using transperineal ultrasound and labeled it according to the transabdominal ultrasound findings.

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Predictors of successful expectant and medical management of miscarriage: A systematic review.

Acta Obstet Gynecol Scand

December 2024

Department of Metabolism, Digestion and Reproduction, Imperial College, London, UK.

Article Synopsis
  • 15.3% of pregnancies result in miscarriage, and various management options exist (expectant, medical, surgical), but individual patient factors complicate decision-making.
  • The systematic review analyzed data from multiple databases up to April 2023, focusing on defined predictors for successful miscarriage management while excluding low-quality studies.
  • Key findings suggest that demographics, ultrasound features, and biochemical markers influence management outcomes, with incomplete miscarriages showing a higher success rate for expectant or medical management, highlighting the need for more extensive and standardized research to aid in personalized patient care.
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Use of interleukin-6 receptor antibodies in the second and third trimester of pregnancy: a retrospective cohort study.

Lancet Rheumatol

September 2024

Department of Obstetric Medicine, St Thomas' Hospital, London, UK; Department of Women and Children's Health, King's College London, London, UK. Electronic address:

Article Synopsis
  • A study examined the outcomes of 25 pregnant women treated with IL-6 receptor antibodies for COVID-19 during their pregnancies at two hospitals in London from March 2020 to September 2022.
  • Most women were in critical condition; 16 were treated in the third trimester, and all required multiple medications.
  • Results indicated no serious maternal health issues, with all pregnancies resulting in live births, although there were complications, including 16 preterm births and one neonatal death due to severe prematurity.
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Does the use of angiogenic biomarkers for the management of preeclampsia and fetal growth restriction improve outcomes?: Challenging the current status quo.

Eur J Obstet Gynecol Reprod Biol

September 2024

Department of Metabolism, Digestion and Reproduction, Imperial College London, London, United Kingdom; Centre for Fetal Care, Queen Charlotte's and Chelsea Hospital, Imperial College Healthcare NHS Trust, London, United Kingdom; Department of Development and Regeneration, Katholieke Universiteit Leuven, Leuven, Belgium.

Monitoring and timing of delivery in preterm preeclampsia and fetal growth restriction is one of the biggest challenges in Obstetrics. Finding the optimal time of delivery of these fetuses usually involves a trade-off between the severity of the disease and prematurity. So far, most clinical guidelines recommend the use of a combination between clinical, laboratory and ultrasound markers to guide the time of delivery.

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Background: To evaluate the efficacy of SIMBA as an educational intervention for both HCPs and people with either PCOS or adrenal conditions and to study the change in knowledge of people with PCOS or adrenal conditions about the conditions and expectations from the HCPs involved in their  care following SIMBA-PPI sessions.

Methods: Two SIMBA-PPI sessions (SIMBA-PPI Polycystic ovary syndrome (SIMBA-PCOS) and SIMBA-PPI Adrenal conditions (SIMBA-Adrenal conditions)) were conducted in September 2021 and March 2022. In both sessions, HCPs interacted with moderators on patient management through WhatsApp.

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Postpartum haemorrhage (PPH) is a leading cause of maternal mortality and morbidity on a global scale. Ethnic background is known to be a determinant of variation in the outcomes of women receiving maternity care across the world. Despite free maternity healthcare in the UK National Health Service, women with an ethnic minority background giving birth have an increased risk of PPH, even when other characteristics of the mother, the baby and the care received are considered.

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Introduction: In October 2020, rapid prenatal exome sequencing (pES) was introduced into routine National Health Service (NHS) care in England, requiring the coordination of care from specialist genetics, fetal medicine (FM) and laboratory services. This mixed methods study explored the experiences of professionals involved in delivering the pES service during the first 2 years of its delivery in the NHS.

Methods: A survey ( = 159) and semi-structured interviews ( = 63) with healthcare professionals, including clinical geneticists, FM specialists, and clinical scientists (interviews only) were used to address: 1) Views on the pES service; 2) Capacity and resources involved in offering pES; 3) Awareness, knowledge, and educational needs; and 4) Ambitions and goals for the future.

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Article Synopsis
  • - This paper explores the causes of cervical head entrapment during vaginal breech births, outlining three distinct types: unpredictable, manageable, and preventable.
  • - Each type is illustrated with examples, focusing on their impacts on different fetal conditions, like preterm or growth-restricted fetuses, along with complications like uterine prolapse.
  • - The authors suggest both traditional and new strategies for managing and preventing cervical head entrapment, highlighting the need for further research in this area.
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