Clinical Questions 2017 -18

Below are the clinical questions received by meeting the staff at WMUH Queen Mary Maternity Unit and attending haematology/O&G MDT meetings. Apr 2017- Mar 2018. Please contact us for more details.  Last updated 07/04/18.
Intrapartum care of partial mole pregnancy
oligohydramnios and spontaneous   pneumothorax
Conception following Busulfan and Cyclophosphamide Chemotherapy
In patients who recover following acute kidney injury, are they more likely to develop chronic renal failure?
Effects of mental health in pregnancy on offspring
Substance misuse in pregnancy
Recurrent thrombotic thrombocytopenic purpura (TTP) in pregnancy
placental mesenchymal dysplasia
Valsalva manouver vs spontaneous pushing in second stage labour
Lithotomy vs. other positions for second stage labour in women who have an epidural
Spontaneous rupture of membranes and rate of spontaneous onset of labour
Hysteroscopy and miscarriage/surgical management of miscarriage/ ERPC and hysteroscopy
Fetomaternal haemorrhage (rare causes) or association with amniotic fluid embolism
Routine ultrasound scanning at 34 or 36 weeks (third trimester) in low risk pregnancies
PROM at term and rates of infection per 24 hours
Amniotic Fluid Embolism
Hysterosalpingography (accuracy for confirming tubal ligation)
Role of GPs in antenatal care (frequency of visits and at what stage of gestation)
Management of submucosal fibroids in postmenopausal women
Effect of music in maternity waiting areas
Prevention of venous thromboembolism in women who have first trimester miscarriage or termination
 Effect of Schistosomiasis (bilharzia) in Pregnancy
 Pulmonary Leiomyomatous Hamartoma
 Motor neuron disease and pregnancy
 Riluzole in pregnancy
 Timing of Propess removal
Outpatient use of Propess for labour induction
Induction at 40 weeks in women with IVF pregnancies
Stelara (Ustekinumab) in pregnancy
Artificial rupture of membranes in a non-labour ward setting
Recurrence of Peripartum Cardiomyopathy in Future Pregnancies
Facial injuries associated with forceps delivery
Pulmonary hypertension in pregnancy
What percentage of histology from bilateral tubal ligation shows incomplete transection?
Lactate of ≥4 mmol/l as a trigger for sepsis.  What is the evidence for this? Normal lactate for woman in labour/post c-section
Facial arteriovenous malformation in pregnancy (modes of delivery, anaesthetic issues, exacerbation caused by pregnancy)
External Cephalic Version and maternalfetal haemorrhage/anti-D/Kleihaur test
VTE and first trimester abortion/miscarriage. Prothrombotic state following first trimester abortion/miscarriage
Vaginal cleansing prior to emergency caesarean sections
Intraoperative glove changing and caesarean section postoperative infections
Cell salvage at vaginal birth
Management of Chronic histiocytic intervillositis (particulalry in subsequent pregnancies)
Neurofibromatosis in pregnancy (complications to include preeclampsia and intrauterine growth retardation)
Pregnancy outcome for kidney donors or women with a solitary kidney
Renal outcomes in people with a solitary kidney (excluding donor kidneys)
Povidone iodine for the Prevention of Puerperal Sepsis
Massive obstetric haemorrhage
Stelara (Ustekinumab) in pregnancy
Celox in pregnancy/postpartum haemorrhage
Multiple Sclerosis and High-Dose Vitamin D
Association between PAPP-A and fetal growth restriction
Are growth scans required for woman with a low PAPP-A?
Is there evidence of deterioration of retinitis pigmentosa following vaginal birth?
Coronary artery dissection in pregnancy/postpartum period
Peripartum cardiomyopathy without symptoms of heart failure and rapid recovery
Preoperative diagnosis of leiomyosarcoma
Severe pain following laparoscopic clip sterilisation
Postplacental intrauterine device insertion at caesarean section
Effect of uterine scar dehiscence on mode of delivery/risk of uterine rupture
Klippel-Trenaunay syndrome (KTS) in pregnancy
Low sodium (Hyponatremia) and pre eclampsia
Ultrasound of uterine scars for predicting future or current pregnancy outcome
Intravenous iron and postpartum anemia
Validated quality of life tools in the postnatal period (particularly any which assess the impact of postnatal anaemia)
Post ECV monitoring – how long and when?
Frequency of post ECV re-version
Evidence of the efficay of moxibustion and acupunture in turning a breech presentation to cephalic
Spontaneous Resolution of Chiari Malformation with Syringomyelia
Evidence on the benefits of administering intravenous magnesium sulphate for gestations between 24-24 weeks
Impact of iron deficiency anaemia on pregnancy and neonatal outcomes
Paracetamol masking  fever in maternal sepsis
Plasminogen Activator Inhibitor 1 4G Mutation and Pregnancy Loss
Paternal stress in response to traumatic delivery
Gaucher’s disease and pregnancy
Mode of birth and genital warts
Disclaimer: Results of database and or Internet searches are subject to the limitations of both the database(s) searched and the search request. It is the responsibility of the requestor to determine the accuracy, validity and interpretation of the results. we make no representations and give no warranties with respect to the accuracy or completeness of the information. By giving you this information we are not giving any form of advice or recommendation and we do not intend you to rely upon it when making (or refraining from making) any decision.
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