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

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Clinical Questions 2017-18

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Library Guide

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BMJ Best Practice

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Royal Marsden Manual

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