BJOG : an international journal of obstetrics and gynaecology
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To assess the performance of ultrasonography in a multimodal ovarian cancer screening strategy. ⋯ A variety of ultrasound criteria can achieve high sensitivity, specificity and positive predictive value for index cancers in postmenopausal women with an elevated CA125. Use of ovarian morphology to interpret ultrasound may increase sensitivity and use of complex ovarian morphology may increase the positive predictive value.
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To investigate whether the 10-item Edinburgh Postnatal Depression Scale (EPDS) administered antenatally is accurate in predicting postpartum depressive symptoms, and whether a two-item EPDS has similar predictive accuracy. ⋯ The EPDS was not sufficiently accurate in predicting risk of postpartum depressive symptoms. Nevertheless, when using the ≥5 cut-off value, it may be adequate for initial screening, followed by further assessments and possibly antenatal intervention when positive. Furthermore, when negative, women may be reassured that postpartum depressive symptoms are unlikely. A two-item version showed poor predictive accuracy.
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Umbilical cord prolapse is an acute obstetrical emergency requiring rapid identification and intervention. Its management has undergone significant changes over the past century. This study aims to document the changes in incidence, morbidity, and perinatal mortality over a 69-year period. ⋯ There has been a large reduction in the incidence of cord prolapse over a period of 69 years. A reduction in grand multiparity and use of caesarean section as the gold standard for delivery are likely to have accounted for the changes seen. Neurological impairment remains unusual.
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Randomized Controlled Trial
Transdermal clonidine in the treatment of severe hyperemesis. A pilot randomised control trial: CLONEMESI.
To study the efficacy of transdermal clonidine in the treatment of severe refractory hyperemesis gravidarum (HG), the most severe illness of pregnancy. ⋯ This preliminary RCT demonstrates the efficacy of transdermal clonidine in the treatment of severe HG, leading to a significant reduction of symptoms and reducing the need for other supportive measures and medications.