Dear Editor, In a valuable review on androgens and postmenopausal women, I was concerned that in the section defining female sexual dysfunction, the authors chose to rely upon the USbased Diagnostic and Statistical Manual of Mental Disorders (DSM–5), and within that manual it includes a controversial diagnosis combining sexual interest and arousal. Within a review article, where in general the reader will be unfamiliar with classifications of the various sexual dysfunctions, an authoritative source of information is paramount. In my opinion, this review should have included prominent reference to the more contemporary World Health Organization (WHO) International Classification of Diseases (ICD)-11 classification. This classification system has removed most sexual (and gender-based) problems and dysfunction out of the mental health classification chapters and into a new chapter (17) – Conditions related to sexual health. The ICD is also the more widely used system within the NHS for clinical coding (albeit still ICD-10). It is unfortunate that such a significant omission is within this otherwise valuable and informative review.
{"title":"Re: Androgens in postmenopausal women","authors":"Kevan Wylie","doi":"10.1111/tog.12877","DOIUrl":"https://doi.org/10.1111/tog.12877","url":null,"abstract":"Dear Editor, In a valuable review on androgens and postmenopausal women, I was concerned that in the section defining female sexual dysfunction, the authors chose to rely upon the USbased Diagnostic and Statistical Manual of Mental Disorders (DSM–5), and within that manual it includes a controversial diagnosis combining sexual interest and arousal. Within a review article, where in general the reader will be unfamiliar with classifications of the various sexual dysfunctions, an authoritative source of information is paramount. In my opinion, this review should have included prominent reference to the more contemporary World Health Organization (WHO) International Classification of Diseases (ICD)-11 classification. This classification system has removed most sexual (and gender-based) problems and dysfunction out of the mental health classification chapters and into a new chapter (17) – Conditions related to sexual health. The ICD is also the more widely used system within the NHS for clinical coding (albeit still ICD-10). It is unfortunate that such a significant omission is within this otherwise valuable and informative review.","PeriodicalId":51862,"journal":{"name":"Obstetrician & Gynaecologist","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46451772","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Complete uterine rupture typically occurs during labour at term amongst women who have had a previous caesarean birth. Atypical rupture, occurring pre-labour, preterm or in women with unscarred uteri, is less common but may be associated with severe morbidity and mortality. The aim of this study was to bring together data from UKOSS with similar data from other countries in the International Network of Obstetric Survey Systems (INOSS: Austria, Belgium, Denmark, Finland, France, Germany, Italy, the Netherlands and Sweden) to describe atypical cases of uterine rupture, namely, uterine rupture occurring in unscarred, preterm or prelabour uteri. A total of 357 atypical uterine ruptures were identified among 3 064 923 women giving birth. Estimated incidence was 0.2 ruptures in unscarred uteri per 10 000 women (95% CI 0.2–0.3), 0.5 (95% CI 0.5–0.6) preterm ruptures per 10 000 women, 0.7 (95% CI 0.6–0.8) prelabour ruptures per 10 000 women, and 0.5 (95% CI 0.4–0.5) ruptures with no previous caesarean per 10 000 in women. Atypical uterine rupture resulted inperipartumhysterectomy in 66 women (18.5%, 95% CI 14.3–23.5%), three maternal deaths (0.84%, 95% CI 0.17–2.5%) and perinatal death in 62 infants (19.7%, 95% CI 15.1–25.3%). Most preterm uterine ruptures occurred in caesareanscarred uteri and most prelabour uterine ruptures in ‘otherwise’ scarred uteri. This study shows that preterm or prelabour uterine ruptures or those occurring in unscarred uteri are extremely uncommon but were associated with severe maternal and perinatal outcomes. This study may increase awareness among clinicians of the possibility of uterine rupture under these less expected conditions.
{"title":"UKOSS update","authors":"M. Knight","doi":"10.1111/tog.12883","DOIUrl":"https://doi.org/10.1111/tog.12883","url":null,"abstract":"Complete uterine rupture typically occurs during labour at term amongst women who have had a previous caesarean birth. Atypical rupture, occurring pre-labour, preterm or in women with unscarred uteri, is less common but may be associated with severe morbidity and mortality. The aim of this study was to bring together data from UKOSS with similar data from other countries in the International Network of Obstetric Survey Systems (INOSS: Austria, Belgium, Denmark, Finland, France, Germany, Italy, the Netherlands and Sweden) to describe atypical cases of uterine rupture, namely, uterine rupture occurring in unscarred, preterm or prelabour uteri. A total of 357 atypical uterine ruptures were identified among 3 064 923 women giving birth. Estimated incidence was 0.2 ruptures in unscarred uteri per 10 000 women (95% CI 0.2–0.3), 0.5 (95% CI 0.5–0.6) preterm ruptures per 10 000 women, 0.7 (95% CI 0.6–0.8) prelabour ruptures per 10 000 women, and 0.5 (95% CI 0.4–0.5) ruptures with no previous caesarean per 10 000 in women. Atypical uterine rupture resulted inperipartumhysterectomy in 66 women (18.5%, 95% CI 14.3–23.5%), three maternal deaths (0.84%, 95% CI 0.17–2.5%) and perinatal death in 62 infants (19.7%, 95% CI 15.1–25.3%). Most preterm uterine ruptures occurred in caesareanscarred uteri and most prelabour uterine ruptures in ‘otherwise’ scarred uteri. This study shows that preterm or prelabour uterine ruptures or those occurring in unscarred uteri are extremely uncommon but were associated with severe maternal and perinatal outcomes. This study may increase awareness among clinicians of the possibility of uterine rupture under these less expected conditions.","PeriodicalId":51862,"journal":{"name":"Obstetrician & Gynaecologist","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43413331","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The Obstetrician & GynaecologistVolume 25, Issue 3 p. 244-244 Letters and emails Authors' reply re: Androgens in postmenopausal women Kugajeevan Vigneswaran MBBS MRCOG, Corresponding Author Kugajeevan Vigneswaran MBBS MRCOG [email protected] orcid.org/0000-0002-8683-7922 Subspecialty Trainee in Reproductive Medicine, King's College Hospital, Denmark Hill, London, SE5 9RS UKSearch for more papers by this authorHaitham Hamoda MBChB MD FRCOG, Haitham Hamoda MBChB MD FRCOG Consultant Gynaecologist and Subspecialist in Reproductive Medicine and Surgery, King's College Hospital, Denmark Hill, London, SE5 9RS UKSearch for more papers by this author Kugajeevan Vigneswaran MBBS MRCOG, Corresponding Author Kugajeevan Vigneswaran MBBS MRCOG [email protected] orcid.org/0000-0002-8683-7922 Subspecialty Trainee in Reproductive Medicine, King's College Hospital, Denmark Hill, London, SE5 9RS UKSearch for more papers by this authorHaitham Hamoda MBChB MD FRCOG, Haitham Hamoda MBChB MD FRCOG Consultant Gynaecologist and Subspecialist in Reproductive Medicine and Surgery, King's College Hospital, Denmark Hill, London, SE5 9RS UKSearch for more papers by this author First published: 18 July 2023 https://doi.org/10.1111/tog.12879Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL No abstract is available for this article. Reference 1Vigneswaran K, Hamoda, H. Androgens in postmenopausal women. The Obstetrician & Gynaecologist 2022; 24: 228– 41. Volume25, Issue3July 2023Pages 244-244 ReferencesRelatedInformation
{"title":"Authors' reply re: Androgens in postmenopausal women","authors":"Kugajeevan Vigneswaran, Haitham Hamoda","doi":"10.1111/tog.12879","DOIUrl":"https://doi.org/10.1111/tog.12879","url":null,"abstract":"The Obstetrician & GynaecologistVolume 25, Issue 3 p. 244-244 Letters and emails Authors' reply re: Androgens in postmenopausal women Kugajeevan Vigneswaran MBBS MRCOG, Corresponding Author Kugajeevan Vigneswaran MBBS MRCOG [email protected] orcid.org/0000-0002-8683-7922 Subspecialty Trainee in Reproductive Medicine, King's College Hospital, Denmark Hill, London, SE5 9RS UKSearch for more papers by this authorHaitham Hamoda MBChB MD FRCOG, Haitham Hamoda MBChB MD FRCOG Consultant Gynaecologist and Subspecialist in Reproductive Medicine and Surgery, King's College Hospital, Denmark Hill, London, SE5 9RS UKSearch for more papers by this author Kugajeevan Vigneswaran MBBS MRCOG, Corresponding Author Kugajeevan Vigneswaran MBBS MRCOG [email protected] orcid.org/0000-0002-8683-7922 Subspecialty Trainee in Reproductive Medicine, King's College Hospital, Denmark Hill, London, SE5 9RS UKSearch for more papers by this authorHaitham Hamoda MBChB MD FRCOG, Haitham Hamoda MBChB MD FRCOG Consultant Gynaecologist and Subspecialist in Reproductive Medicine and Surgery, King's College Hospital, Denmark Hill, London, SE5 9RS UKSearch for more papers by this author First published: 18 July 2023 https://doi.org/10.1111/tog.12879Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL No abstract is available for this article. Reference 1Vigneswaran K, Hamoda, H. Androgens in postmenopausal women. The Obstetrician & Gynaecologist 2022; 24: 228– 41. Volume25, Issue3July 2023Pages 244-244 ReferencesRelatedInformation","PeriodicalId":51862,"journal":{"name":"Obstetrician & Gynaecologist","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135509351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
CPD credits can be claimed for the following questions online via the TOG CPD submission system in the RCOG CPD ePortfolio. You must be a registered CPD participant of the RCOG CPD programme (available in the UK and worldwide) in order to submit your answers. Completion of TOG true/false questions can be claimed as a Specific Learning Event. Participants can claim two credits per set of questions if at least 70% of questions have been answered correctly. CPD participants are advised to consider whether the articles are still relevant for their CPD, in particular if there are more recent articles on the same topic available and if clinical guidelines have been updated since publication. Please direct all questions or problems to the CPD Office. Tel: +44 (0)20 7772 6307 or email: cpd@rcog.org.uk. The blue symbol denotes which source the questions refer to including the RCOG journals, TOG and BJOG, and RCOG guidance, such as Green-top Guidelines (GTGs) and Scientific Impact Papers (SIPs). All of the above sources are available to RCOG Members and Fellows via the RCOG website. RCOG Members, Fellows and Associates have full access to TOG content via the Wiley Online Library app (available for iOS and Android).
{"title":"CPD questions for volume 25 issue 3","authors":"","doi":"10.1111/tog.12889","DOIUrl":"https://doi.org/10.1111/tog.12889","url":null,"abstract":"CPD credits can be claimed for the following questions online via the TOG CPD submission system in the RCOG CPD ePortfolio. You must be a registered CPD participant of the RCOG CPD programme (available in the UK and worldwide) in order to submit your answers. Completion of TOG true/false questions can be claimed as a Specific Learning Event. Participants can claim two credits per set of questions if at least 70% of questions have been answered correctly. CPD participants are advised to consider whether the articles are still relevant for their CPD, in particular if there are more recent articles on the same topic available and if clinical guidelines have been updated since publication. Please direct all questions or problems to the CPD Office. Tel: +44 (0)20 7772 6307 or email: cpd@rcog.org.uk. The blue symbol denotes which source the questions refer to including the RCOG journals, TOG and BJOG, and RCOG guidance, such as Green-top Guidelines (GTGs) and Scientific Impact Papers (SIPs). All of the above sources are available to RCOG Members and Fellows via the RCOG website. RCOG Members, Fellows and Associates have full access to TOG content via the Wiley Online Library app (available for iOS and Android).","PeriodicalId":51862,"journal":{"name":"Obstetrician & Gynaecologist","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41288461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Raveendran, A. Keepanasseril, Ravi Kumar Balu, A. Shetty, M. Chetty
Tuberculosis (TB) is an important global cause of maternal and neonatal morbidity and mortality. With increasing migration, cases of tuberculosis in pregnancy or the puerperium are increasing in resource‐rich nations with advanced health care systems. Diagnosis may be delayed given the overlap of some of the symptoms with that of pregnancy. Timely diagnosis is essential to initiate appropriate treatment and prevent maternal and neonatal morbidity and mortality.
{"title":"Tuberculosis in pregnancy","authors":"A. Raveendran, A. Keepanasseril, Ravi Kumar Balu, A. Shetty, M. Chetty","doi":"10.1111/tog.12888","DOIUrl":"https://doi.org/10.1111/tog.12888","url":null,"abstract":"Tuberculosis (TB) is an important global cause of maternal and neonatal morbidity and mortality. With increasing migration, cases of tuberculosis in pregnancy or the puerperium are increasing in resource‐rich nations with advanced health care systems. Diagnosis may be delayed given the overlap of some of the symptoms with that of pregnancy. Timely diagnosis is essential to initiate appropriate treatment and prevent maternal and neonatal morbidity and mortality.","PeriodicalId":51862,"journal":{"name":"Obstetrician & Gynaecologist","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2023-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46397700","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Postpartum haemorrhage accounts for 27% of all maternal deaths. Incorrect quantification of blood loss can lead to unnecessary interventions, such as the transfusion of blood products, which is not without risk. During pregnancy, cardiovascular changes may explain how blood loss can occur rapidly, with pregnant women tolerating large volumes of blood loss before a change in clinical signs is seen. Several methods are used to quantify blood loss, such as visual estimation, volumetric, gravimetric, colorimetric and photometric. The Obstetric Bleeding Strategy for Wales (OBS Cymru) project, which standardised management of obstetric haemorrhage in Wales using a four‐stage approach, showed a statistically significant improvement in outcomes. Different definitions of postpartum haemorrhage make it difficult to compare available evidence. Further studies are required combining the use of point‐of‐care tests and quantitative techniques to help improve morbidity and mortality associated with obstetric haemorrhage.
{"title":"Quantification of blood loss in obstetric haemorrhage: implications on intervention and transfusion","authors":"Noreen Haque, R. Roberts, B. Kumar","doi":"10.1111/tog.12886","DOIUrl":"https://doi.org/10.1111/tog.12886","url":null,"abstract":"Postpartum haemorrhage accounts for 27% of all maternal deaths. Incorrect quantification of blood loss can lead to unnecessary interventions, such as the transfusion of blood products, which is not without risk. During pregnancy, cardiovascular changes may explain how blood loss can occur rapidly, with pregnant women tolerating large volumes of blood loss before a change in clinical signs is seen. Several methods are used to quantify blood loss, such as visual estimation, volumetric, gravimetric, colorimetric and photometric. The Obstetric Bleeding Strategy for Wales (OBS Cymru) project, which standardised management of obstetric haemorrhage in Wales using a four‐stage approach, showed a statistically significant improvement in outcomes. Different definitions of postpartum haemorrhage make it difficult to compare available evidence. Further studies are required combining the use of point‐of‐care tests and quantitative techniques to help improve morbidity and mortality associated with obstetric haemorrhage.","PeriodicalId":51862,"journal":{"name":"Obstetrician & Gynaecologist","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2023-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44939639","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Lipid and triglyceride levels increase in pregnancy and do not pose problems for most women. However, pregnancy‐specific factors and genetic aberrations, especially mutations, may result in supraphysiological hypercholesterolaemia (HC) and severe hypertriglyceridaemia (sHTG). HC and sHTG are associated with complications in pregnancy, including acute pancreatitis, hyperviscosity syndrome and pre‐eclampsia. Abnormally high levels of lipids and triglycerides also affect fetal growth and the onset of gestational diabetes. The clinical presentation and diagnosis of HC and sHTG are varied. Management options include lifestyle and dietary restriction/modification, omega‐3, bile‐acid sequestrants, fenofibrate, statins and plasmapheresis.
{"title":"Hyperlipidaemia and severe hypertriglyceridaemia in pregnancy","authors":"M. Bashir, O. Navti, B. Ahmed, J. Konje","doi":"10.1111/tog.12887","DOIUrl":"https://doi.org/10.1111/tog.12887","url":null,"abstract":"Lipid and triglyceride levels increase in pregnancy and do not pose problems for most women. However, pregnancy‐specific factors and genetic aberrations, especially mutations, may result in supraphysiological hypercholesterolaemia (HC) and severe hypertriglyceridaemia (sHTG). HC and sHTG are associated with complications in pregnancy, including acute pancreatitis, hyperviscosity syndrome and pre‐eclampsia. Abnormally high levels of lipids and triglycerides also affect fetal growth and the onset of gestational diabetes. The clinical presentation and diagnosis of HC and sHTG are varied. Management options include lifestyle and dietary restriction/modification, omega‐3, bile‐acid sequestrants, fenofibrate, statins and plasmapheresis.","PeriodicalId":51862,"journal":{"name":"Obstetrician & Gynaecologist","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2023-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41679670","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Studies reveal a high prevalence of mental health issues around the menopause transition. Menopausal symptoms are influenced by personal and environmental factors. Beneficial effects of estrogen for menopausal depression have been reported. An integrated care model for the management of mental health symptoms is recommended. Evidence‐based management options include considering the impact of lifestyle changes, hormone replacement therapy (HRT) and cognitive behavioural therapy.
{"title":"Menopause and mental health","authors":"Ajay Swaminathan, P. Lepping, G. Kumar","doi":"10.1111/tog.12885","DOIUrl":"https://doi.org/10.1111/tog.12885","url":null,"abstract":"Studies reveal a high prevalence of mental health issues around the menopause transition. Menopausal symptoms are influenced by personal and environmental factors. Beneficial effects of estrogen for menopausal depression have been reported. An integrated care model for the management of mental health symptoms is recommended. Evidence‐based management options include considering the impact of lifestyle changes, hormone replacement therapy (HRT) and cognitive behavioural therapy.","PeriodicalId":51862,"journal":{"name":"Obstetrician & Gynaecologist","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2023-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46864949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Stuart Mires, Arun Raychoudhury, T. Overton, C. Skerritt, K. Eastwood
Congenital anomalies affect more than 2% of fetuses in the UK, with 70% noncardiac in origin. Around 10% are gastrointestinal anomalies such as abdominal wall defects and intestinal atresias. Most gastrointestinal anomalies require postnatal surgical management. Obstetricians must understand the key features of diagnosis and management of common gastrointestinal anomalies. Clinically relevant and evidence‐based information helps facilitate parental reproductive autonomy through timely and informed counselling, planning for delivery and optimising perinatal outcomes. Management of pregnancies complicated by congenital gastrointestinal anomalies requires a multidisciplinary approach with specialist input.
{"title":"Gastrointestinal congenital anomalies requiring surgery: diagnosis, counselling, and management","authors":"Stuart Mires, Arun Raychoudhury, T. Overton, C. Skerritt, K. Eastwood","doi":"10.1111/tog.12884","DOIUrl":"https://doi.org/10.1111/tog.12884","url":null,"abstract":"Congenital anomalies affect more than 2% of fetuses in the UK, with 70% noncardiac in origin. Around 10% are gastrointestinal anomalies such as abdominal wall defects and intestinal atresias. Most gastrointestinal anomalies require postnatal surgical management. Obstetricians must understand the key features of diagnosis and management of common gastrointestinal anomalies. Clinically relevant and evidence‐based information helps facilitate parental reproductive autonomy through timely and informed counselling, planning for delivery and optimising perinatal outcomes. Management of pregnancies complicated by congenital gastrointestinal anomalies requires a multidisciplinary approach with specialist input.","PeriodicalId":51862,"journal":{"name":"Obstetrician & Gynaecologist","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2023-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48070287","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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