Recent Posts by Louise Hudman

Rhesus D prophylaxis in pregnancy

This guideline is very relevant to us. Nothing has really changed, but it reiterates best practice. It applies to non-sensitised women (ie who don’t have anti-D antibodies on their booking bloods): When would we need to give it? Most of the time (eg terminations / evacuation of products etc), anti-D will be given in secondary…
Read more

RCOG | Breast cancer and pregnancy

A lot of this is aimed at specialists. There are some useful bits about preconception counselling in a woman who’s had breast cancer and also advice about breast feeding. The most useful things are: New presentation of breast lump – ensure you refer women as you would if they weren’t pregnant. Women can have treatment…
Read more

Nice | Ovarian cancer

This is well worth a read – it changes our way of investigating women with abdominal symptoms quite a lot. Using our current system, most women are diagnosed at a late stage, so we need to do something different. The basis of this guideline is: 1) Identify women Women over 50 who have had symptoms…
Read more

Nice | Tuberculosis

This is quite a complex, meaty guideline, with lots of flow-charts. Remember to consider if a newly registering patient should be screened and remember BCG in neonates at risk, but otherwise I would suggest referring to the guideline if a specific situation arises. However, the main new things here are: At registration of a new…
Read more

Sign | Management of testicular germ cell tumours

Most of this is not new for us, or is for secondary care. Worthwhile noting is: 2 week wait refer if epididymo-orchitis/orchitis is suspected but is not resolving in 2 to 3 weeks. Patients have an increased risk of cardiovascular disease, because of chemo and radiotherapy, so ensure that they are given appropriate lifestyle advice.…
Read more

Inflammatory Bowel Disease

This is a guideline which seems to be aimed predominantly at specialists. From our point of view there are a few useful bits: Patient Information. It lists some useful sources of information for patients. Faecal calcoprotein can be used in the assessment. (There is a good editorial on this in the BMJ. It has a…
Read more

Alzheimer’s drugs

Some new alzheimers drugs Donepazine, galantamine and rivastigmine can now be used in mild, as well as in moderate disease. Memantine can be used if someone is intolerant to or has contraindications to the other drugs and can also be used in severe disease. Initiation is still by specialists but follow-up can be done by…
Read more

Vulval Skin Disorders

This is a good guideline to have a quick read through as it is a good summary of vulval skin disorders. There is a really useful patient hand out on vulval skin care on page 17. Ask the obvious questions and also about sexual problems, cervical cytology history, immune deficiency, any pads or tampons or…
Read more

Reduced Fetal Movements

A lot of this is what we already do. However there is a good flow chart at page 14. New things for me were: In a pregnancy with 2 or more episodes of reduced fetal movements (RFM), there is a worse outcome, so warn the mother to get checked each time. If a woman hasn’t…
Read more

Recent Comments by Louise Hudman