Post pregnancy contraception

This is a new guideline from the FSRH on contraception after pregnancy. There is nothing particularly new about specific methods, but there are a few new interesting points (including a reminder that ...

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RCOG | Ovarian Hyperstimulation Syndrome

Ovarian Hyperstimulation Syndrome
This is a new guideline from the RCOG on managing ovarian hyperstimulation syndrome (OHS). Most patients will ultimately be managed in secondary care, but we need to be aware of it, as most women appa...

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RCOG | Chickenpox in pregnancy

This is a new guideline from RCOG on managing chickenpox in pregnancy. It doesn't change our management, but I'm doing a quick summary as I often forget what is classed as significant contact and when...

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Nice | Vision amniotic leak detector

This guideline advises that the ‘Vision Amniotic Leak Detector’ can be used. This sounds like a rather handy device. The idea is to allow us to reliably exclude amniotic fluid leak as a cause of ‘wetn...

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Ella-One and breast-feeding

This guideline notes that the advice for using this form of emergency contraception whilst breastfeeding has changed. Women should not breastfeed for 5 days after taking Ella-One. They should express ...

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Sepsis following pregnancy

This guideline from the RCOG covers management of post-natal sepsis (i.e. in the first 6/52 after delivery). Causes of sepsis following pregnancy In women presenting with infection postnatally, especi...

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Antepartum Haemorrhage

Most of this guideline is aimed at secondary care. From our point of view: Any bleeding, including spotting needs evaluation in secondary care, even if painless. Beware cervical lesions as a cause, e...

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Multiple pregnancy

Most of this is directed at secondary care. Things that may impact on us: Anaemia Do a FBC at 20 to 24/40, then again at the normal 28/40. This is because multiple pregnancies carry a higher risk of a...

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Caesarean Section

The technical bits of guidance on caesarian section are directed at secondary care. There are 3 elements that really affect us. The first is that all pregnant women should be given information about c...

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Obstetric cholestasis

This is a good overview of the condition. Remember – it is a diagnosis of exclusion. Features: Pruritus without a rash (except excoriation). It is often worse at night and affects palms and soles too...

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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): Wh...

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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: N...

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Maternal collapse

There is a good algorithm that you can print out on page 22. Remember that in BLS for a pregnant woman, you need a tilt to the left of 15°. This can be achieved by getting someone to put their knees u...

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