Pub Date : 2025-04-01DOI: 10.1016/j.ogrm.2025.01.002
Bidisha Chatterjee, Helen Bolton
Post coital bleeding (PCB) and intermenstrual bleeding (IMB) are common gynaecological complaints that can result from a wide range of benign, infective, hormonal, structural, psychological and malignant conditions. Though a majority of these cases are benign in nature, persistent and unexplained bleeding warrants detailed assessments to rule out any sinister pathology. It can be a source of great distress in women and a comprehensive evaluation not only facilitates diagnosis and management but also can significantly improve the quality of life of the patients.
{"title":"Aetiology and management of postcoital and intermenstrual bleeding: a review of literature","authors":"Bidisha Chatterjee, Helen Bolton","doi":"10.1016/j.ogrm.2025.01.002","DOIUrl":"10.1016/j.ogrm.2025.01.002","url":null,"abstract":"<div><div>Post coital bleeding (PCB) and intermenstrual bleeding (IMB) are common gynaecological complaints that can result from a wide range of benign, infective, hormonal, structural, psychological and malignant conditions. Though a majority of these cases are benign in nature, persistent and unexplained bleeding warrants detailed assessments to rule out any sinister pathology. It can be a source of great distress in women and a comprehensive evaluation not only facilitates diagnosis and management but also can significantly improve the quality of life of the patients.</div></div>","PeriodicalId":53410,"journal":{"name":"Obstetrics, Gynaecology and Reproductive Medicine","volume":"35 4","pages":"Pages 98-100"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143791458","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}
Pub Date : 2025-03-26DOI: 10.1016/j.ogrm.2025.03.004
Hannah Pierce, Naomi Harvey
The surgical landscape of obstetrics and gynaecology (O&G) in the UK has shifted dramatically over the past decade, influenced by advances in minimally invasive techniques, outpatient procedures, and non-surgical options. While these innovations improve outcomes and patient satisfaction, they have also reduced training opportunities for essential open and vaginal procedures, creating challenges for skill development in the next generation of surgeons. The rise in complex obstetric procedures, such as Caesarean births and morbidly adherent placenta cases, further widens the gap between surgical demands and resident preparedness. Simulation training and regional collaboration offer potential solutions, yet resource constraints and disparities in access hinder their widespread adoption. Additionally, O&G educators face increasing pressures due to lack of time and funding for training. Addressing these challenges through systemic reforms and investment in simulation technology and educator support is essential to prepare O&G surgeons for the evolving complexities of modern surgical practice.
{"title":"The current landscape of obstetrics and gynaecology surgical training in the UK","authors":"Hannah Pierce, Naomi Harvey","doi":"10.1016/j.ogrm.2025.03.004","DOIUrl":"10.1016/j.ogrm.2025.03.004","url":null,"abstract":"<div><div>The surgical landscape of obstetrics and gynaecology (O&G) in the UK has shifted dramatically over the past decade, influenced by advances in minimally invasive techniques, outpatient procedures, and non-surgical options. While these innovations improve outcomes and patient satisfaction, they have also reduced training opportunities for essential open and vaginal procedures, creating challenges for skill development in the next generation of surgeons. The rise in complex obstetric procedures, such as Caesarean births and morbidly adherent placenta cases, further widens the gap between surgical demands and resident preparedness. Simulation training and regional collaboration offer potential solutions, yet resource constraints and disparities in access hinder their widespread adoption. Additionally, O&G educators face increasing pressures due to lack of time and funding for training. Addressing these challenges through systemic reforms and investment in simulation technology and educator support is essential to prepare O&G surgeons for the evolving complexities of modern surgical practice.</div></div>","PeriodicalId":53410,"journal":{"name":"Obstetrics, Gynaecology and Reproductive Medicine","volume":"35 6","pages":"Pages 167-169"},"PeriodicalIF":0.0,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144139228","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}
Pub Date : 2025-03-26DOI: 10.1016/j.ogrm.2025.03.003
Megan Wright, Alec McEwan
Abdominal pain in pregnancy is a common presentation to obstetric triage, although the wide range of differentials present a diagnostic challenge. Thorough history and examination are vital in forming differential diagnoses. Investigations should then be tailored to the clinical picture, allowing timely diagnosis and management of the underlying cause. Here we discuss the history, examination, investigation and management of abdominal pain in pregnancy though three case vignettes. Good supportive management is the mainstay of care for the majority of cases, though surgical intervention and early delivery are occasionally necessary. Consideration is given to obstetric, gynaecological, medical and surgical causes of abdominal pain in pregnancy.
{"title":"Abdominal pain in pregnancy","authors":"Megan Wright, Alec McEwan","doi":"10.1016/j.ogrm.2025.03.003","DOIUrl":"10.1016/j.ogrm.2025.03.003","url":null,"abstract":"<div><div>Abdominal pain in pregnancy is a common presentation to obstetric triage, although the wide range of differentials present a diagnostic challenge. Thorough history and examination are vital in forming differential diagnoses. Investigations should then be tailored to the clinical picture, allowing timely diagnosis and management of the underlying cause. Here we discuss the history, examination, investigation and management of abdominal pain in pregnancy though three case vignettes. Good supportive management is the mainstay of care for the majority of cases, though surgical intervention and early delivery are occasionally necessary. Consideration is given to obstetric, gynaecological, medical and surgical causes of abdominal pain in pregnancy.</div></div>","PeriodicalId":53410,"journal":{"name":"Obstetrics, Gynaecology and Reproductive Medicine","volume":"35 6","pages":"Pages 161-166"},"PeriodicalIF":0.0,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144139227","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}
Pub Date : 2025-03-01DOI: 10.1016/j.ogrm.2024.12.004
Hebatallah Awad, Sami Shawer
Menopause is a natural physiological process experienced by women, characterized by a hypoestrogenic state. This hormonal deficiency can arise from various factors such as aging, premature ovarian failure, or surgical oophorectomies. Historically, the focus has been primarily on the vasomotor and psychological manifestations of hypoestrogenism in menopausal women, likely due to the prevalence of these symptoms. However, it is important to recognize that genitourinary syndrome of menopause (GSM) significantly impacts a substantial portion of women during this stage of life. These symptoms are often overlooked or underreported due to feelings of embarrassment." This paper provides comprehensive overview of GSM, including its pathophysiology, epidemiology, clinical presentation, and impact on the quality of life. Furthermore, it will discuss current management strategies to provide healthcare professionals with a thorough understanding of GSM to improve patient outcomes through timely diagnosis and appropriate management.
{"title":"Genitourinary syndrome of menopause: overview and management","authors":"Hebatallah Awad, Sami Shawer","doi":"10.1016/j.ogrm.2024.12.004","DOIUrl":"10.1016/j.ogrm.2024.12.004","url":null,"abstract":"<div><div>Menopause is a natural physiological process experienced by women, characterized by a hypoestrogenic state. This hormonal deficiency can arise from various factors such as aging, premature ovarian failure, or surgical oophorectomies. Historically, the focus has been primarily on the vasomotor and psychological manifestations of hypoestrogenism in menopausal women, likely due to the prevalence of these symptoms. However, it is important to recognize that genitourinary syndrome of menopause (GSM) significantly impacts a substantial portion of women during this stage of life. These symptoms are often overlooked or underreported due to feelings of embarrassment.\" This paper provides comprehensive overview of GSM, including its pathophysiology, epidemiology, clinical presentation, and impact on the quality of life. Furthermore, it will discuss current management strategies to provide healthcare professionals with a thorough understanding of GSM to improve patient outcomes through timely diagnosis and appropriate management.</div></div>","PeriodicalId":53410,"journal":{"name":"Obstetrics, Gynaecology and Reproductive Medicine","volume":"35 3","pages":"Pages 82-85"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143534525","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}
Pub Date : 2025-03-01DOI: 10.1016/j.ogrm.2024.12.003
Anna K Richmond, Louise Dewick, Eamonn J Breslin
Fetuses are physiologically adapted to cope with labour. However, some fetuses are at risk of hypoxic injury. Whether fetuses are monitored using intermittent auscultation (IA) or continuous cardiotocography (CTG), knowledge of the fetal physiological responses to labour and the various mechanisms of hypoxia is vital to provision of appropriate interventions. Hypoxia in labour can be caused by umbilical cord compression and/or utero-placental insufficiency, sometimes potentiated through infection and inflammation. Recognition of intrapartum risks such as meconium stained liquor, bleeding or maternal pyrexia aid in determining the individual risk of fetal hypoxia but a holistic view needs to be maintained. Detection is only the first step, then requiring appropriate escalation, communication and timely action which are reinforced by initiatives including the Avoiding Brain injury in Childbirth (ABC) programme and the Each Baby Counts (EBC) project. This paper aims to provide an overview of intrapartum fetal monitoring founded in physiological interpretation and insights into new recommendations by the ABC programme.
{"title":"Intrapartum fetal monitoring","authors":"Anna K Richmond, Louise Dewick, Eamonn J Breslin","doi":"10.1016/j.ogrm.2024.12.003","DOIUrl":"10.1016/j.ogrm.2024.12.003","url":null,"abstract":"<div><div>Fetuses are physiologically adapted to cope with labour. However, some fetuses are at risk of hypoxic injury. Whether fetuses are monitored using intermittent auscultation (IA) or continuous cardiotocography (CTG), knowledge of the fetal physiological responses to labour and the various mechanisms of hypoxia is vital to provision of appropriate interventions. Hypoxia in labour can be caused by umbilical cord compression and/or utero-placental insufficiency, sometimes potentiated through infection and inflammation. Recognition of intrapartum risks such as meconium stained liquor, bleeding or maternal pyrexia aid in determining the individual risk of fetal hypoxia but a holistic view needs to be maintained. Detection is only the first step, then requiring appropriate escalation, communication and timely action which are reinforced by initiatives including the Avoiding Brain injury in Childbirth (ABC) programme and the Each Baby Counts (EBC) project. This paper aims to provide an overview of intrapartum fetal monitoring founded in physiological interpretation and insights into new recommendations by the ABC programme.</div></div>","PeriodicalId":53410,"journal":{"name":"Obstetrics, Gynaecology and Reproductive Medicine","volume":"35 3","pages":"Pages 73-81"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143534522","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}
Pub Date : 2025-03-01DOI: 10.1016/j.ogrm.2024.12.001
Beth Bateson, David Brown, Richard Kennedy
Sexually transmitted infections (STIs) directly impact sexual and reproductive health, with a particular burden in women. They can lead to significant adverse complications and outcomes during pregnancy, and infertility. Antenatal care guidance focuses on a holistic approach, ensuring risk assessments are carried out at every appointment. Except for performing hepatitis B/HIV/syphilis serology at booking appointments, STIs are often overlooked. There are no explicit recommendations on when to perform STI screening tests during pregnancy. Given the current burden (and potential impact) of STIs, it is imperative these are considered during antenatal appointments and screened for appropriately. Early detection and treatment are necessary to secure good outcomes for the pregnant person and fetus. Partner notification is essential to halt transmission and prevent reinfection. Management should be via a multidisciplinary, cross-specialty approach. In this article we review various (non-HIV) STIs in pregnancy - focusing on presentation, diagnosis, management, and possible complications of each.
{"title":"Non-HIV sexually transmitted infections in pregnancy","authors":"Beth Bateson, David Brown, Richard Kennedy","doi":"10.1016/j.ogrm.2024.12.001","DOIUrl":"10.1016/j.ogrm.2024.12.001","url":null,"abstract":"<div><div>Sexually transmitted infections (STIs) directly impact sexual and reproductive health, with a particular burden in women. They can lead to significant adverse complications and outcomes during pregnancy, and infertility. Antenatal care guidance focuses on a holistic approach, ensuring risk assessments are carried out at every appointment. Except for performing hepatitis B/HIV/syphilis serology at booking appointments, STIs are often overlooked. There are no explicit recommendations on when to perform STI screening tests during pregnancy. Given the current burden (and potential impact) of STIs, it is imperative these are considered during antenatal appointments and screened for appropriately. Early detection and treatment are necessary to secure good outcomes for the pregnant person and fetus. Partner notification is essential to halt transmission and prevent reinfection. Management should be via a multidisciplinary, cross-specialty approach. In this article we review various (non-HIV) STIs in pregnancy - focusing on presentation, diagnosis, management, and possible complications of each.</div></div>","PeriodicalId":53410,"journal":{"name":"Obstetrics, Gynaecology and Reproductive Medicine","volume":"35 3","pages":"Pages 57-62"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143534527","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}
Pub Date : 2025-03-01DOI: 10.1016/j.ogrm.2024.12.002
Kate McCrossan, Holly Vickers
Urodynamic investigations provide a valuable tool to aid diagnosis and management of lower urinary tract symptoms by evaluating bladder function during the filling, storage and voiding phases. As well as covering basic urinary tract anatomy and physiology, this article provides a comprehensive overview of urodynamic principles, from a gynaecological perspective. It discusses an overview of the various different tests including cystometry, uroflowmetry and pressure flow studies including understanding abdominal pressure, bladder pressure and detrusor pressure significance. It provides case studies that include useful tips for interpreting urodynamic studies, including two single best answer questions, in order to aid professionals preparing for the MRCOG exam or those participating in urogynaecology clinics.
{"title":"A basic understanding of urodynamics","authors":"Kate McCrossan, Holly Vickers","doi":"10.1016/j.ogrm.2024.12.002","DOIUrl":"10.1016/j.ogrm.2024.12.002","url":null,"abstract":"<div><div>Urodynamic investigations provide a valuable tool to aid diagnosis and management of lower urinary tract symptoms by evaluating bladder function during the filling, storage and voiding phases. As well as covering basic urinary tract anatomy and physiology, this article provides a comprehensive overview of urodynamic principles, from a gynaecological perspective. It discusses an overview of the various different tests including cystometry, uroflowmetry and pressure flow studies including understanding abdominal pressure, bladder pressure and detrusor pressure significance. It provides case studies that include useful tips for interpreting urodynamic studies, including two single best answer questions, in order to aid professionals preparing for the MRCOG exam or those participating in urogynaecology clinics.</div></div>","PeriodicalId":53410,"journal":{"name":"Obstetrics, Gynaecology and Reproductive Medicine","volume":"35 3","pages":"Pages 63-72"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143534528","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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