Barry Whitlow

• Colchester Hospital University NHS Foundation Trust

Pelvic organ prolapse shows an increasing prevalence (3-50 %). The gold standard treatment for apical prolapse is sacrocolpopexy, which can be performed via minimal access (conventional laparoscopy or robotic surgery) or open sacrocolpopexy. The objective is to appraise the effectiveness and safety of robotic surgery compared with laparoscopic sacr...

This paper reports the findings from a case study research about in-depth analysis of ‘decoupling point’ as a reference model to address a particular management dilemma. Managers from a health service organisation contacted the researchers to investigate possible causes of a managerial dilemma where managers and clinical professionals were not able...

Background Thrombin activatable fibrinolysis (TAFI) is a glycoprotein that inhibits fibrinolysis. Pro-TAFI is cleaved by Factor IIa – Thrombomodulin complex, producing actived TAFI (TAFI:Ac).Pregnancy is a hypercoaguable state associated with increased levels of pro-coagulant factors; enhanced thrombin generation and impaired fibrinolysis.TAFI may...

This study seeks to identify areas of poor utilisation of theatre time and estimate the cost of late starts. Retrospective study of elective gynaecological operations from September to November 2008 in a district general hospital was conducted. Primary outcome measures were time to send, time for anaesthesia and procedure time. Secondary outcome me...

Ectopic pregnancy has been increasing in frequency over the past years. The first step in the diagnosis of ectopic pregnancy is the demonstration of pregnancy by performing a sensitive qualitative urine test; hence, a negative urine pregnancy test will generally exclude ectopic pregnancy from the differential diagnosis. The following is a report of...

We describe a rare case of unilateral twin tubal ectopic pregnancy in a multiparous lady in the right fallopian tube that was confirmed on laparoscopy and managed by laparoscopic salpingectomy.

In this paper, we describe a presacral dermoid which was not seen at laparoscopy, despite being quite large and causing displacement of the rectum on magnetic resonance imaging (MRI). It later became symptomatic and was removed laparoscopically. Histology confirmed it to be a benign developmental cyst.

Without Abstract

Acute pancreatitis in pregnancy is often associated with severe morbidity. It is usually an antepartum problem occurring in late pregnancy. It rarely occurs in the postpartum period and when it does diagnosis can be difficult. We report a case of 'unexplained' ascites following ventouse delivery, diagnosed 6 weeks later as acute pancreatitis. Altho...

We describe a case of postpartum haemorrhage due to retained products of conception that failed to resolve after two attempts of evacuation of retained products of conception. A subsequent histology and MRI scan confirmed retained products of conception despite repeated attempts at treatment. We introduce transcervical endometrial resection as an e...

To evaluate whether the traction force indicator in a ventouse device gave an accurate estimation of the force applied. The study was carried out at the Derby City Hospital. An estimate of measurement errors was made by analyzing the standard deviation of the residuals for 30 Kiwi OmniCup devices (Clinical Innovations, Abingdon, Oxfordshire, Englan...

Pre-sacral or sacral plexus nerve blocks are reported in the anaesthetic literature as effective in controlling pelvic pain, but are rarely performed as they are technically difficult. The pre-sacral space, however, is easily assessable at laparoscopy, and it seemed that infiltration of local anaesthetic solution into this space might offer good pa...

To ascertain and compare psychological morbidity following first- and second-trimester termination for fetal anomaly. This was a cohort study of 30 women aged 20-40 years in a north London teaching hospital, 14 of whom had had a first-trimester termination and 16 a second-trimester termination for fetal anomaly. The main outcome measures were quest...

Background To determine fetal biometrical reference ranges for the fetal kidney from 10+° to 14+6 weeks' gestation.MethodsA prospective cross-sectional study in a University Department of Obstetrics and Gynaecology, London. Four hundred and thirty-eight women from an unselected population underwent a detailed assessment of fetal anatomy at 10–14 we...

To analyze the value of second trimester ultrasound examination among those women whose fetuses were indicated to be at low risk of chromosomal anomalies on the basis of both first trimester nuchal translucency measurement and second trimester biochemical screening. A retrospective study of 5500 pregnancies carried out at the fetal medicine unit, R...

Background The aim of this study was to determine whether the position of the fetal neck has a significant effect on nuchal translucency measurement (NT).MethodA prospective cross-sectional study was carried out. One hundred and ninety-six women from an unselected population underwent transabdominal sonography. The nuchal translucency was measured...

Background To determine fetal biometrical reference ranges from 10 to 14 weeks' gestation.MethodsA prospective cross-sectional study in a University Department of Obstetrics and Gynaecology, London. Four hundred and seventy women from an unselected population underwent a detailed assessment of fetal anatomy at 10+°−14+6 weeks' of gestation (confirm...

Objective To determine the value of early pregnancy sonography in detecting fetal abnormalities in an unselected obstetric population. Design Prospective cross-sectional study. All women initially underwent transabdominal sonography and when the anatomical survey was considered to be incomplete, transvaginal sonography was also performed (20.1 %)....

The risks of a first occurrence and a recurrence of neural tube defects have been shown to be reduced by periconceptional folic acid supplementation—that is by taking folic acid from 3 months before conception to 3 months after conception.1 2 The Expert Advisory Group in the United Kingdom recommended in 1992 that women who were trying to conceive...

To determine the feasibility of correctly identifying fetal gender from 11 to 14 weeks' gestation. A prospective cross-sectional study in a university Department of Obstetrics and Gynaecology, London. A total of 524 women from an unselected population underwent a detailed assessment of fetal anatomy at 11-14 weeks of gestation (confirmed by crown-r...

To assess the sonographic screening for anencephaly in the first trimester in a low-risk obstetric population. Since 1994, 5388 women attended our clinic for a first-trimester scan (11-14 weeks of gestation) and screening for structural and chromosomal abnormalities. The patients underwent transabdominal scanning, and transvaginal scanning if neces...

To determine the significance of certain soft ultrasonographic markers for chromosomal abnormalities in the first trimester. This was a prospective cross-sectional study. University Department of Obstetrics and Gynaecology, London, UK. A total of 5385 women from an unselected population underwent a detailed assessment of fetal anatomy at 11-14 week...

Letters p 748Ultrasound scanning has been an integral part of antenatal care in industrialised countries for some time,1 but until recently detection of fetal abnormalities by this method has been possible only in the second trimester. High resolution scanning during the first trimester is now possible and is routine in some units. Not only chromos...

To determine the influence of the position of the fetal neck on nuchal translucency measurement. A prospective cross-sectional study. One hundred and ninety-six. Nuchal translucency was measured in the mid-sagittal plane, with the fetal neck in the flexed, neutral and extended positions. Measurements were made to the nearest 0.1 mm. Statistical ana...

The objective of this study was to determine the optimal gestational age for examining fetal anatomy and nuchal translucency in the first trimester. In a prospective cross-sectional study, 1288 women from an unselected population underwent a detailed assessment of fetal anatomy at 10–14 weeks of gestation (confirmed by crown-rump length) with the u...

To investigate the role of first trimester sonography in detecting chromosomal abnormalities in an unselected obstetric population. 2281 women (mean maternal age 30 years [range 16-47]; mean gestational age 12(+3) weeks [range 11-14]) underwent transabdominal scanning to assess fetal structure and, if anatomical survey was considered to be incomple...

Whilst ultrasound screening for fetal anomalies in the second trimester is an established practice in the United Kingdom, the feasibility of such screening in early pregnancy (11-14 weeks) with modern high-resolution ultrasound machines has not been fully evaluated. In this prospective review of over 5400 fetuses, transabdominal sonography (TAS) an...

V A H Pearson and colleagues report that 81% of the teenagers in their study had heard of emergency contraception. In the department of genitourinary medicine at St. Georges Hospital we recently conducted a study of patients knowledge of emergency contraception. Of 100 consecutive women interviewed (age range 15-48) 85 had heard of emergency contra...