A. McDougall, Amelie Morin, T. Kuzmich, F. Odejinmi
Although extremely rare, advanced abdominal pregnancy (AAP) is associated with considerable maternal and fetal morbidity and mortality. However, when diagnosed early and managed appropriately, it is possible to have successful outcomes. There are no specific criteria to diagnose AAP and it may be missed on ultrasound. Magnetic resonance imaging is the gold standard for evaluating placental implantation and preoperative planning. Management depends on the gestational age at diagnosis, with consideration of termination, preterm delivery and conservative management until further fetal maturation. Multidisciplinary preoperative planning is paramount for optimal outcome. Delivery is recommended in a tertiary centre with access to interventional radiology. Management of the placenta depends on the degree of penetration and the organ in which it embeds. Where the risk of removal increases the risk of maternal morbidity, it may be left in situ.
{"title":"Advanced abdominal pregnancy: challenges, update and review of current management","authors":"A. McDougall, Amelie Morin, T. Kuzmich, F. Odejinmi","doi":"10.1111/tog.12808","DOIUrl":"https://doi.org/10.1111/tog.12808","url":null,"abstract":"Although extremely rare, advanced abdominal pregnancy (AAP) is associated with considerable maternal and fetal morbidity and mortality. However, when diagnosed early and managed appropriately, it is possible to have successful outcomes. There are no specific criteria to diagnose AAP and it may be missed on ultrasound. Magnetic resonance imaging is the gold standard for evaluating placental implantation and preoperative planning. Management depends on the gestational age at diagnosis, with consideration of termination, preterm delivery and conservative management until further fetal maturation. Multidisciplinary preoperative planning is paramount for optimal outcome. Delivery is recommended in a tertiary centre with access to interventional radiology. Management of the placenta depends on the degree of penetration and the organ in which it embeds. Where the risk of removal increases the risk of maternal morbidity, it may be left in situ.","PeriodicalId":51862,"journal":{"name":"Obstetrician & Gynaecologist","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2022-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48845270","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}
I. Offiah, Rosie Campbell, A. Dua, L. Bombieri, R. Freeman
Bladder pain syndrome (BPS) presents as a spectrum of urological symptoms with poorly understood pathophysiology. Bladder mucosal injury secondary to low grade sub‐clinical infection is a possible trigger, leading to nociceptive upregulation and, subsequently, central sensitisation. Brain abnormalities associated with BPS suggest that neuropathological brain alterations exist, which may contribute to the perceived pain. Central sensitisation plays a role in the disease pathophysiology via an augmentation in the responsiveness of the central pain signalling neurons. The urinary microbiome is implicated as a trigger for the development and maintenance of BPS. Future directions to improve treatment strategies include stratification of patients with BPS into subtypes such as peripheral or central disease and investigation of the urinary microbiome and bladder barrier replacement.
{"title":"Present status and advances in bladder pain syndrome: central sensitisation and the urinary microbiome","authors":"I. Offiah, Rosie Campbell, A. Dua, L. Bombieri, R. Freeman","doi":"10.1111/tog.12807","DOIUrl":"https://doi.org/10.1111/tog.12807","url":null,"abstract":"Bladder pain syndrome (BPS) presents as a spectrum of urological symptoms with poorly understood pathophysiology. Bladder mucosal injury secondary to low grade sub‐clinical infection is a possible trigger, leading to nociceptive upregulation and, subsequently, central sensitisation. Brain abnormalities associated with BPS suggest that neuropathological brain alterations exist, which may contribute to the perceived pain. Central sensitisation plays a role in the disease pathophysiology via an augmentation in the responsiveness of the central pain signalling neurons. The urinary microbiome is implicated as a trigger for the development and maintenance of BPS. Future directions to improve treatment strategies include stratification of patients with BPS into subtypes such as peripheral or central disease and investigation of the urinary microbiome and bladder barrier replacement.","PeriodicalId":51862,"journal":{"name":"Obstetrician & Gynaecologist","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2022-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47310638","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 TOG app (available for iOS and Android).
{"title":"CPD questions for volume 24 issue 2","authors":"","doi":"10.1111/tog.12806","DOIUrl":"https://doi.org/10.1111/tog.12806","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 TOG app (available for iOS and Android).","PeriodicalId":51862,"journal":{"name":"Obstetrician & Gynaecologist","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41901160","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}
Disclosure of interests: There are no conflicts of interest.
Contribution to authorship: TD and RT conceptualised the article. TD researched and wrote the article; RT wrote and edited the article. All authors approved the final version.
{"title":"Domestic violence: an invisible pandemic.","authors":"Teesta Dey, Ranee Thakar","doi":"10.1111/tog.12798","DOIUrl":"https://doi.org/10.1111/tog.12798","url":null,"abstract":"<p><strong>Disclosure of interests: </strong>There are no conflicts of interest.</p><p><strong>Contribution to authorship: </strong>TD and RT conceptualised the article. TD researched and wrote the article; RT wrote and edited the article. All authors approved the final version.</p>","PeriodicalId":51862,"journal":{"name":"Obstetrician & Gynaecologist","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9115482/pdf/TOG-24-90.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10252897","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Women’s health continues to make headline news both in the UK and globally. There is increasing data on the safety of COVID-19 vaccinations in pregnancy, with benefits not just for the pregnant woman but also her yet-to-be-born baby (with decreased infant admission for COVID-19 in the first 6 months of life for those born to vaccinated mothers). In my practice, the message seems to be getting through, but we must still listen to those who are worried by vaccination and explore their fears individually.
{"title":"Editorial","authors":"K. Harding","doi":"10.1111/tog.12802","DOIUrl":"https://doi.org/10.1111/tog.12802","url":null,"abstract":"Women’s health continues to make headline news both in the UK and globally. There is increasing data on the safety of COVID-19 vaccinations in pregnancy, with benefits not just for the pregnant woman but also her yet-to-be-born baby (with decreased infant admission for COVID-19 in the first 6 months of life for those born to vaccinated mothers). In my practice, the message seems to be getting through, but we must still listen to those who are worried by vaccination and explore their fears individually.","PeriodicalId":51862,"journal":{"name":"Obstetrician & Gynaecologist","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43682243","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}
I looked a bit shocked when the TOG Managing Editor informed me that it was 5 years since my last ‘Spotlight on . . . gynaecological cancer’ (TOG 2017;19:107). She was too kind to mention thiswas related tomyadvancing years, tenuous grip on time and blas e attitude to deadlines (although she will probably cut this in the edit [note fromManaging Editor –we’ve left this in!]). Looking back, it has been an eventful 5 years! While the British Gynaecological Cancer Society (BGCS) has been busy drafting guidelines for management of patients affected by the COVID-19 pandemic, our community has also been busy updating TOG on significant advances in the understanding and treatment of gynaecological cancers. Thank you to the excellent author teams for sharing their knowledge and insights, exploring topics I hope will be relevant to both gynaecological oncologists and those with other specialist interests.
{"title":"Spotlight on … gynaecological cancer","authors":"J. Morrison","doi":"10.1111/tog.12795","DOIUrl":"https://doi.org/10.1111/tog.12795","url":null,"abstract":"I looked a bit shocked when the TOG Managing Editor informed me that it was 5 years since my last ‘Spotlight on . . . gynaecological cancer’ (TOG 2017;19:107). She was too kind to mention thiswas related tomyadvancing years, tenuous grip on time and blas e attitude to deadlines (although she will probably cut this in the edit [note fromManaging Editor –we’ve left this in!]). Looking back, it has been an eventful 5 years! While the British Gynaecological Cancer Society (BGCS) has been busy drafting guidelines for management of patients affected by the COVID-19 pandemic, our community has also been busy updating TOG on significant advances in the understanding and treatment of gynaecological cancers. Thank you to the excellent author teams for sharing their knowledge and insights, exploring topics I hope will be relevant to both gynaecological oncologists and those with other specialist interests.","PeriodicalId":51862,"journal":{"name":"Obstetrician & Gynaecologist","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44869121","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}
Paraneoplastic syndrome (PNS) is a clinical manifestation of both benign and malignant tumours. Symptoms are not attributable to direct organ involvement of the cancer nor as a therapeutic adverse effect; instead, they are a result of hormones, cytokines or growth factors released by the tumour, or an immunological response. Paraneoplastic syndromes can affect any body system, so can cause myriad potential symptoms. These clinical manifestations often pre‐date those of the underlying disease process. The incidence of PNS attributable to gynaecological tumours is increasing, resulting in considerable morbidity in those affected. There is an overall lack of awareness of PNS among clinicians; this, combined with wide‐ranging signs and symptoms, creates an opportunity for diagnostic difficulty and therapeutic delay.
{"title":"Paraneoplastic syndrome associated with gynaecological malignancy: a review of the evidence","authors":"A. Brown, S. McKenna, Deborah Forbes, I. Harley","doi":"10.1111/tog.12804","DOIUrl":"https://doi.org/10.1111/tog.12804","url":null,"abstract":"Paraneoplastic syndrome (PNS) is a clinical manifestation of both benign and malignant tumours. Symptoms are not attributable to direct organ involvement of the cancer nor as a therapeutic adverse effect; instead, they are a result of hormones, cytokines or growth factors released by the tumour, or an immunological response. Paraneoplastic syndromes can affect any body system, so can cause myriad potential symptoms. These clinical manifestations often pre‐date those of the underlying disease process. The incidence of PNS attributable to gynaecological tumours is increasing, resulting in considerable morbidity in those affected. There is an overall lack of awareness of PNS among clinicians; this, combined with wide‐ranging signs and symptoms, creates an opportunity for diagnostic difficulty and therapeutic delay.","PeriodicalId":51862,"journal":{"name":"Obstetrician & Gynaecologist","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2022-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41467449","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 haemoglobinopathies encompass a complex collection of red blood cell disorders that are responsible for considerable morbidity and mortality in women and their unborn children. Sickle cell disease and the thalassaemias are the commonest haemoglobinopathies encountered in UK clinical practice. A consistent standard of care will enable women with haemoglobinopathies to have a pregnancy that is as safe as possible, with good outcomes and minimal long‐term effects on their health and the health of their babies. The most effective way to deliver a consistent standard of care for these women is via the multidisciplinary team (MDT). The MDT should include a haematologist, cardiologist, maternal medicine obstetrician, specialist midwife, reproductive medicine specialist and a nurse specialist. The care of these women, within the MDT, should start with pre‐conception advice and continue through their antenatal care, intrapartum support and finally, provide postnatal considerations including contraception advice.
{"title":"The management of haemoglobinopathies in pregnancy and childbirth","authors":"Lucy A Jackson, Q. Hill, E. Ciantar","doi":"10.1111/tog.12805","DOIUrl":"https://doi.org/10.1111/tog.12805","url":null,"abstract":"The haemoglobinopathies encompass a complex collection of red blood cell disorders that are responsible for considerable morbidity and mortality in women and their unborn children. Sickle cell disease and the thalassaemias are the commonest haemoglobinopathies encountered in UK clinical practice. A consistent standard of care will enable women with haemoglobinopathies to have a pregnancy that is as safe as possible, with good outcomes and minimal long‐term effects on their health and the health of their babies. The most effective way to deliver a consistent standard of care for these women is via the multidisciplinary team (MDT). The MDT should include a haematologist, cardiologist, maternal medicine obstetrician, specialist midwife, reproductive medicine specialist and a nurse specialist. The care of these women, within the MDT, should start with pre‐conception advice and continue through their antenatal care, intrapartum support and finally, provide postnatal considerations including contraception advice.","PeriodicalId":51862,"journal":{"name":"Obstetrician & Gynaecologist","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2022-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47576909","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}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：