Victoria Louise Bills

National Health Service | NHS · Department of Obstetrics and Gynaecology

There is a significant glycocalyx present at the maternal-fetal interface of the human placenta, with increasing evidence to suggest it has an important role in placental function. Glycocalyx is adversely affected by traditional tissue processing and fixation techniques. Using transmission electron microscopy, we present methodologies for reliably...

Introduction Glycocalyx is a gel-like mesh which lines the luminal surface of vascular endothelium and has an important role in vessel function and permeability. Disruption of glycocalyx has been implicated in the endothelial dysfunction in pre-eclampsia. There is increasing evidence for a significant glycocalyx present at the maternal-fetal interf...

Since its discovery in 1997, the presence of cell-free fetal DNA in the maternal bloodstream has been put to clinical use to detect variety of fetal conditions, in the antenatal period. The use of fetal DNA can offer a highly accurate screen for the presence of Down syndrome (trisomy 21). This has numerous advantages over standard first trimester c...

Background Pre-eclampsia remains a dominant cause of maternal and fetal mortality in developed countries. In a previous prospective study we identified a fall in the VEGF-A isoform VEGF-A165b in the plasma of patients in the first trimester to be a predictor of later pre-eclampsia. VEGF-A165b has been shown to have potent cytoprotective properties...

Key content A practical template for a structured approach when planning a voluntary, obstetric teaching programme in low and middle‐income countries. How to establish common, obtainable learning objectives that meet the needs of both participants and recipients. Examples of teaching programmes and practical educational resources. Discussion of cul...

Red cell alloimmunisation involves the transplacental movement of maternally derived red cell antibodies into the fetal circulation, causing red cell haemolysis, fetal anaemia and ultimately fetal death. Current standard UK practice is to prevent sensitisation to the D antigen by administering anti-D at about 28weeks' gestation to all RhD negative...

It is widely accepted that the pathophysiological foundations of pre-eclampsia are laid down in the first trimester, with inadequate invasion of placental trophoblasts into maternal spiral arteries of the uterus, resulting in defective arterial remodelling. The angiogenic VEGF family of glycoproteins are expressed in first trimester trophoblasts an...

Pre-eclampsia is diagnosed by hypertension and proteinuria, probably caused by endothelial dysfunction, resulting in symptoms including oedema, inflammation and altered metabolism. Vascular endothelial growth factor A (VEGF-A) is detected at higher concentrations in plasma from patients with pre-eclampsia than in plasma from normotensive pregnant p...

In pre‐eclampsia VEGF‐A, a potent endothelial activator is upregulated as measured by radio and competitive‐enzyme immunoassays, and PlGF is reduced. However, the biological activity of VEGF in pre‐eclamptic plasma is not clear. To determine if circulating VEGF levels in pre‐eclampsia are biologically active, plasma from pre‐eclamptic (n=17) and no...

Pre-eclampsia is a pregnancy-related condition characterized by hypertension, proteinuria and endothelial dysfunction. VEGF(165)b, formed by alternative splicing of VEGF (vascular endothelial growth factor) pre-mRNA, inhibits VEGF(165)-mediated vasodilation and angiogenesis, but has not been quantified in pregnancy. ELISAs were used to measure mean...

The aim of this study was to determine the compliance rates for women being offered routine antenatal anti-D prophylaxis in two obstetric units in the UK. Haemolytic disease of the newborn (HDN) is a potentially serious condition that can result in substantial morbidity and sometimes death. Current guidelines recommend that 500 IU anti-D immunoglob...

A 73-year-old man presented with a huge intra-abdominal mass. Initially a gastrointestinal stromal tumour (GIST) was diagnosed, but his tumour was subsequently classified as a spindle cell sarcoma. Difficulties in the classification of rare intra-abdominal tumours are discussed.