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Please cite this paper as: Andersson S, Rymer J, Joyce D, Momoh C, Gayle C. Sexual quality of life in women who have undergone female genital mutilation: a case-control study. BJOG 2012;119:1606-1611. Objective To investigate the sexual quality of life of women who have undergone female genital mutilation (FGM) and compare them with a similar group who has not undergone FGM. Design Case-control study. Setting A large central London teaching hospital. Population A total of 73 women who had undergone FGM and 37 control women, who had not undergone FGM but were from a similar cultural background where FGM is practiced. Methods The women completed a questionnaire containing the Sexual Quality of Life-Female (SQOL-F) questionnaire. Main outcome measures SQOL-F score. Results Women who have undergone FGM of any type have a significantly lower ( P < 0.001) overall SQOL-F score than control women (mean = 62.44, SD = 27.93 versus mean = 88.84, SD = 13.73). Women who were sexually active and had undergone FGM type III differed the most from sexually active controls ( P < 0.05) in their SQOL-F score. Women who were sexually inactive but who had undergone FGM reported significantly lower overall SQOL-F scores ( P = 0.015) than sexually inactive controls, but were not differentiated by type of FGM. Conclusion FGM significantly reduces women's sexual quality of life, based on the results of the SQOL-F questionnaire. [ABSTRACT FROM AUTHOR]

Please cite this paper as: Memmo A, Dias T, Mahsud-Dornan S, Papageorghiou A, Bhide A, Thilaganathan B. Prediction of selective fetal growth restriction and twin-to-twin transfusion syndrome in monochorionic twins. BJOG 2012;119:417-421. Objective To study the correlation of discrepancy between crown-rump length (CRL) and nuchal translucency (NT) in monochorionic twins at 11-14 weeks of gestation and subsequent development of twin-to-twin transfusion syndrome (TTTS) and selective fetal growth restriction (sFGR). Design Retrospective cohort study. Setting Tertiary-care Fetal Medicine Unit, London. Sample Monochorionic twin pregnancies with known outcome. Methods Inter-twin discrepancy was calculated as a percentage of the larger CRL and smaller NT and compared among those developing TTTS, those with sFGR and those with normal outcome. Receiver operating characteristic (ROC) curves were constructed to evaluate the performance of inter-twin discrepancy in prediction of sFGR and TTTS. Main outcome measures Development of TTTS and sFGR. Results A total of 242 monochorionic twin pregnancies were studied (102 TTTS, 36 sFGR and 104 controls). The median CRL discrepancy in the sFGR group (11.9%) was significantly higher ( P < 0.001) than in the TTTS group (3.8%) and control group (3.5%). Median inter-twin NT discrepancies were not significantly different ( P = 0.869) between sFGR and both TTTS and control groups (15.6%, 16.7% and 14.8%, respectively). Discrepancy in CRL performs well as a screening test for sFGR (area under ROC curve = 0.89), but not for TTTS (area under ROC curve = 0.58). Conclusions First-trimester CRL discrepancy in monochorionic twins is a marker for subsequent development of sFGR rather than TTTS. Inter-twin NT discrepancy does not appear to be significantly different in these two groups from those with normal outcome. [ABSTRACT FROM AUTHOR]

Please cite this paper as: Saso S, Ghaem-Maghami S, Chatterjee J, Naji O, Farthing A, Mason P, McIndoe A, Hird V, Ungar L, Del Priore G, Smith J. Abdominal radical trachelectomy in West London. BJOG 2012;119:187-193. Objective Traditionally, the surgical management of invasive cervical carcinoma that has progressed beyond microinvasion has been a radical abdominal hysterectomy. However, this results in the loss of fertility, with significant consequences for the young patient. This report describes abdominal radical trachelectomy (ART) as a potential replacement for radical hysterectomy in patients with stage IA2-IIA cervical cancer who desire a fertility-sparing procedure without decreasing the curative rates. Design Observational, retrospective study. Setting Teaching hospital and regional cancer centre in London, UK. Population Patients undergoing ART. Methods Patients presenting during the period 2000-2009 with cervical cancer stage IA2-IIA were offered a trachelectomy, if they expressed a desire to preserve fertility. The type of trachelectomy (vaginal/abdominal) was chosen based on patient anatomy and neoplastic and magnetic resonance imaging characteristics. Each patient was counselled as to the experimental nature of the procedure. Main outcome measures Survival, recurrence and fertility issues among ART patients. Results A total of 30 patients underwent ART (open and laparoscopic) between 2001 and 2009. Three patients presented with a recurrence, two of which have died (median follow-up: 24 months). Only three patients required further surgical re-intervention because of operative complications. Ten patients attempted to conceive, resulting in three conceptions (30%) and two live children. Conclusions Abdominal radical trachelectomy provides a feasible, cost-effective and safe treatment option for young women who have been diagnosed with early-stage cervical cancer and wish to preserve their fertility. [ABSTRACT FROM AUTHOR]

Please cite this paper as: Oteng-Ntim E, Pheasant H, Khazaezadeh N, Mohidden A, Bewley S, Wong J, Oke B. Developing a community-based maternal obesity intervention: a qualitative study of service providers' views. BJOG 2010;117:1651-1655. The aim of this study was to explore healthcare professionals' views on the development of multicomponent interventions for obese pregnant women. A cohort of 22 healthcare professionals was interviewed. The interview transcripts were analysed thematically. Three key themes were highlighted by the interviews: (1) the lack of existing services for obese pregnant women in south-east London; (2) the barriers and challenges that need to be overcome (e.g. ethnic and cultural) when considering the creation of a new service for obese women who are pregnant; (3) the possible components of a new intervention. The findings of this study will inform the design of a programme to combat maternal obesity. [ABSTRACT FROM AUTHOR]

Please cite this paper as: Phadnis S, Atilade A, Young M, Evans H, Walker P. The volume perspective: a comparison of two excisional treatments for cervical intraepithelial neoplasia (laser versus LLETZ). BJOG 2010;117:615–619. Objective To compare two excisional treatments, laser cone biopsy and large loop excision of the transformation zone (LLETZ), in terms of the volume of tissue removed, and to determine the relation between the height and the total volume of the cone specimen. Design Retrospective cross-sectional study. Setting Large teaching hospital in London. Population A total of 1136 eligible excisional treatments (laser cone or large loop excision of the transformation zone, LLETZ). Methods Eligible excisional treatments (laser cone or LLETZ) performed between 1 January 2002 and 31 December 2007 in our colposcopy unit were identified using the Infoflex® database. The total volume of the cone biopsy was calculated mathematically using the data provided in the histopathology reports. Main outcome measures The volume of the cone biopsy was compared with the technique of excision and the histology grades. Results Three hundred and thirty-nine laser cone biopsies were performed, whereas 797 LLETZ biopsies were recorded, during the study period. There was no difference in the mean age in the two groups. However, there is a proportional increase in the volume of the cone as the height of the cone increases, and a significant number of the values are skewed, suggesting that the diameter of the base of the cone contributes significantly to the total volume. Laser cone biopsies (median volume 1.84 cm3, 95% CI 1.98–2.54 cm3) account for a larger volume of tissue excised compared with LLETZ (median volume 0.78 cm3, 95% CI 0.91–1.02 cm3) ( P < 0.0001). This relationship is not altered when the two procedures are stratified for grade of lesion, i.e. excision for low-grade cervical intraepithelial neoplasia (CIN) (laser median volume 1.55 cm3, 95% CI 1.46–2.06; LLETZ median volume 0.62 cm3, 95% CI 0.73–0.88 cm3) ( P < 0.0001) or high-grade CIN (laser median volume 1.84 cm3, 95% CI 2.11–2.53 cm3; LLETZ median volume 0.82 cm3, 95% CI 0.94–1.07 cm3) ( P < 0.0001). Conclusions The volume of cervical tissue removed during laser conisation is significantly more than that removed with LLETZ. The indication of the cone biopsy does influence the volume of tissue removed. [ABSTRACT FROM AUTHOR]