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Objective\ud To determine the characteristics and outcomes of pregnancy in women with Turner Syndrome\ud \ud Design\ud Retrospective 20-year cohort study (2000-2020)\ud \ud Setting\ud 16 tertiary referral maternity units in the UK\ud \ud Population or Sample\ud 81 women with Turner syndrome who became pregnant\ud \ud Methods\ud Retrospective chart analysis\ud \ud Main Outcome Measures\ud Mode of conception, pregnancy outcomes\ud \ud Results\ud We obtained data on 127 pregnancies in 81 women with a Turner phenotype. All non-spontaneous pregnancies (54/127 (42.5%)) were by egg donation. Only 9/31 (29%) of pregnancies in women with karyotype 45,X were spontaneous, compared with 53/66 (80.3%) with mosaic karyotype 45,X/46,XX (p

Background Mysodelle is a 200 mcg misoprostol, vaginal delivery system. It is a PGE1 analogue and accepted as a method of IOL by Scottish medicine consortium in 2014 (Medicines Health and Regulatory Authority; Wing et al., 2013 ). Aims The main objective of this project was to determine efficacy of Mysodelle with regards to time interval between insertions to delivery. We also studied the safety profile of Mysodelle with regards to operative delivery rates, foetal concerns and incidence of hyperstimulation. Methodology A protocol which outlined the criteria for suitability for the use of Mysodelle was developed. This method was used for IOL for primiparous women more than 38 weeks of gestations with unfavourable cervix and intact membranes with no foetal concerns on scan, i.e. suboptimal growth or reduced liquor. Mysodelle was left in situ for maximum duration of 24 hours and CTG was monitored every 4 hours. The data was collected prospectively over 1 year from January 2016. Results We reviewed 50 women for the study period of one year. All women were primiparous with singleton term gestations between 38 + 5 weeks to term +11 days. The indications for IOL included postdates, reduced foetal movement, big baby and advanced maternal age. Following the use of Mysodelle, 55% of the women progressed to active labour and did not require oxytocin on labour ward. In 20% of the women, Mysodelle was removed for suspicious CTG or tachysystole. Four women failed IOL with Mysodelle. 14% women had hyperstimulation response to Mysodelle and needed terbutaline. 46% women had spontaneous vaginal delivery and 24% needed instrumental delivery. Remaining 30% patients delivered by caesarean section. The median time from Mysodelle administration to vaginal delivery was 21 hours (95% confidence interval 18.8-26.8 hours). There were no neonatal adverse outcomes. Conclusions Results at AMH overall are in keeping with those from EXPEDITE study (Wing et al. 2013 ). It was found to be more efficacious in terms of insertion to delivery time, however, was associated with more tachysystole and hyperstimulation requiring terbutaline as previously highlighted in Cochrane review (Alfirevic and Weeks 2006 ; Hofmeyr et al. 2010 ). There was no increased risk of operative delivery or adverse neonatal outcome with the use of Mysodelle. A reduction in time to vaginal delivery and time to active labour associated with misoprostol vaginal delivery system may be an advantage for patients and the service (ISD Scotland 2013 ), but it needs to be seen if this benefit is offset due to increased requirements for foetal monitoring due to uterine tachysystole and hyperstimulation. MHRA have advised that Mysodelle can cause uterine tachysystole, that might not respond to tocolytic treatment. (MHRA medicine update 2018).