Journal of obstetrics and gynaecology : the journal of the Institute of Obstetrics and Gynaecology
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Vulvovaginal atrophy (VVA) has an impact on the quality of life (QoL) of women. This post hoc analysis of the EVES study provides an overview of the QoL in postmenopausal Italian women in relation with VVA severity. We included 1066 women attending menopause/gynaecologic centres. ⋯ What are the implications of these findings for clinical practice and/or further research? The implications of our findings involve the need for a better management, not only of the physical aspects of VVA, but also of the non-physical dimensions. Clinicians should ask for the impact of VVA on QoL aspects, making postmenopausal women aware about the possible affected spheres. Medical personnel should conduct future campaigns in the Italian general population, not only in those asking for medical help, to make all women conscious about this silent disorder affecting physical and non-physical dimensions and in order to treat it at early stages.
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Patients of abnormally invasive placenta (AIP) undergoing caesarean delivery are at increased risk of haemorrhage. Conventional management includes piecemeal removal of placenta or placenta left in situ. However, they often require hysterectomy after delivery. ⋯ These patients should be diagnosed and referred to tertiary care centres with such facilities electively so as to provide optimal care to these patients. Cooperation between interventionist and obstetrician and adjoining availability of OT and catheter lab can further help in reducing the time to embolisation after delivery. A hybrid operating theatre with digital subtraction angiography (DSA) facilities would be ideal for the management of such patients.
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A survey was circulated to consultant gynaecologists across Wales, to evaluate the management of pre-operative urine dipstick results. Questions were based on NICE guideline 171, regarding the management of urinary incontinence in women. Six respondents never checked their patient's urine dipstick results. ⋯ What the implications are of these findings for clinical practice and/or further research? We propose removing the urine dipstick as a pre-operative screening test. Asymptomatic bacteriuria is common in women and routine screening for UTI pre-operatively will therefore inevitably lead to unnecessary intervention (i.e. cancellation). Further research is needed into the outcomes of gynaecological surgery in women symptomatic of UTI to be able to provide guidance on the use of pre-operative urinalysis and management of the test results.
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The importance of incorporating non-technical skills in surgical training cannot be understated, however, these remain non-core components of training. The aim of our study was to evaluate the effectiveness of a training course in improving residents' non-technical skills performance in the operating room. Twenty-eight eligible Obstetrics and Gynaecology residents were divided into conventional and experimental groups by using blocked randomisation. ⋯ What do the results of this study add? The results of our study enable a comparative analysis between learning curves of conventional training, with the experimental group demonstrating the effectiveness of a training course. This strongly supports implementation of non-technical training in postgraduate competency-based curricula. What are the implications of these findings for clinical practice and/or further research? This study shall be used as an evidence-based source to design curricula for teaching non-technical skills to residents.
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Comparative Study
Accuracy of the Manipal Cervical Scoring System for predicting successful induction of labour.
The Manipal Cervical Scoring System is an accurate and objective sonographic score that predicts the outcome of induced labour. The aim of the current study was to compare the performance of the Manipal Cervical Scoring System against the Bishop Score. A prospective study was conducted on 105 women underwent labour induction in Ain Shams University Hospital, Cairo, Egypt. ⋯ This helps to decrease the discomfort of repeated vaginal examination and increases the women satisfaction with labour process, especially in women at higher risk of infection. Thus evaluating cervical status using an ultrasound cervical scoring system can similarly increase women's satisfaction with labour process. Our goal in the upcoming trial is to perform RCT comparing ultrasound versus Bishop in women undergoing IOL using oral misopristol regarding measures of satisfaction during labour in the parturient women.