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Background Antenatal detection of the small for gestational (SGA) fetus has become an important indicator of quality of antenatal care in the UK. This has been driven by a desire to reduce stillbirth in this at risk group. Methods We conducted a postal survey of 187 NHS consultant units within the UK to determine what the current practice for the detection and subsequent management of the suspected SGA fetus was following the guidance from the Royal College of Obstetricians and Gynaecologists (RCOG) in 2013. Results The survey was performed in 3 rounds between 2016 and 2017 with a response rate of 65%. 85% of units assessed risk factors for SGA at booking. 81% of units used a customized symphysis fundal height (SFH) chart to screen for SGA with 95% of them using a cut off of

The aim of this study was to compare the diagnostic accuracy of routine versus selective small for gestational age babies screening policy using data from two European Maternity Units. Methods for the antenatal detection of small for gestational age babies (SGA) differ between countries. This was a retrospective cohort study from Liverpool Women’s Hospital, UK, that uses selective third trimester sonography and from the University Hospital Centre Zagreb, Croatia, that uses routine third trimester sonography for SGA detection. Screen positive cases were defined as pregnancies with estimated fetal weight (EFW)

This prospective study assessed von Willebrand factor (VWF) expression in the endometrium using immunohistochemical staining in women with menorrhagia with or without von Willebrand disease (VWD) compared with a control group of women with normal menstrual loss. Endometrial VWF expression is significantly lower in women with VWD, which may play a local underlying role in pathogenesis of menorrhagia in these women.

An 18-year-old primigravida presented following recurrent failed attempts at pregnancy termination for intra-uterine fetal death. Clinical examination aroused suspicion of non-communicating uterine horn with bicornuate uterus. Examination under anaesthesia and laparotomy revealed a partial vaginal septum, complete septate uterus with septum deviated to one side and fetus lying in the non-communicating right blind hemicavity (Robert's uterus). Hysterotomy and ipsilateral tubal ligation were performed.

Background. Distant metastasis in carcinoma of uterine cervix is a rare manifestation and bone metastasis is uncommon. Case. A 60-year-old woman treated by radical radiotherapy for moderately differentiated cervical carcinoma FIGO stage IIIB presented 4 months later with swelling over right side of the scalp. Fine needle aspiration cytology from swelling showed poorly differentiated metastatic carcinoma. X-ray of the skull was suggestive of osteolytic metastasis of calvaria. Conclusion. Bone metastasis in cervical carcinoma is a late manifestation of advanced malignancy and heralds poor prognosis. Scalp metastasis is a very rarely reported phenomenon.

A 23-year-old woman, Gravida 3, Para 2 presented following termination of a 10 weeks pregnancy by an unauthorised local practitioner 2 days earlier with complains of severe pain in lower abdomen, recurrent vomiting and inability to pass stools or flatus for 24 h. She was hypothermic, pale and dehydrated with a pulse rate of 100/min and blood pressure of 90/70 mmHg. The respiratory and cardiovascular system examination were normal. The abdomen was distended, tense and tender with guarding and rigidity all over. Shifting dullness was present and bowel sounds were sluggish. On speculum examination, blood clots were seen in the vagina and the cervical os was not visualised. On vaginal palpation the os was open, with tissue fragments felt in the vagina which could not be removed. There was severe lower abdominal tenderness and both fornices appeared full. The exact size of the uterus could not be made out as the patient was very tender. An erect abdominal X-ray revealed the presence of gas under the diaphragm and ultrasound of the abdomen was suggestive of multiple organised fluid pockets with dilated bowel loops. A provisional diagnosis of septic abortion with uterine and gut perforation with peritonitis was made, and the patient was prepared for exploratory laparotomy. At operation fecal peritonitis was present with about 2 l of dirty foul smelling fluid. The uterus was normal in shape and size with multiple loops of ileum seen entering it via a fundal perforation (Fig. 1). The loops could not be extracted even after giving pressure through the vagina. Bowel exploration revealed a terminal gangrenous ileum within 5 cm of the ilieo–caecal junction. A single 1 cm 1 cm perforation was found in the ileum proximal to the gangrenous area. Total abdominal hysterectomy with right hemicolectomy with excision of the gangrenous bowel (Fig. 2) with ileo-transverse anastomosis with peritoneal lavage was done. Two drains were left in the peritoneal cavity—one in the pelvis and the other in Morrison’s pouch. Intraoperatively, she received 6 units of whole blood and 4 units of plasma. On postoperative day 7, her condition deteriorated suddenly, and fecal matter started discharging from the abdominal wound. A repeat laparotomy confirmed an ilieo–colic anastomotic leak. Closure of the colon segment with terminal ileostomy was done. She had a stormy postoperative course complicated by septicaemia and chest infection requiring ventilatory support for 10 days. She was discharged in satisfactory condition on postoperative day 27 and closure of the ileostomy was successfully accomplished 3 months later.