Nice | Obesity; consider early referral

This updated guideline from NICE looks at obesity. The big changes from the 2006 guideline have been well publicised in the news and mainly advise that referral for bariatric surgery be considered at a lower BMI to previously, especially where the patient has new onset Type 2 Diabetes Mellitus (T2DM). Most of the rest of the guideline isn't…
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Nice | Obesity in adults and children

  The big changes from the 2006 guideline have been well publicised in the news and mainly advise that referral for bariatric surgery be considered at a lower BMI to previously, especially where the patient has new onset Type 2 Diabetes Mellitus (T2DM). Most of the rest of the guideline isn't significantly different, but I…
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FSRH | Emergency contraception in obese women

There is a new statement from the FSRH reassuring us that the use of oral emergency contraception (EC) in obese women is OK. Levonorgestrel is available in Europe with the brand name 'Norlevo' and it has the warning that it is not effective in women over 80kg, and is less effective in women over 75kg. However, the…
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Shoulder dystocia

Most of this guideline is aimed at secondary care. From our point of view: Elective Caesarean may be offered to diabetic women with an estimate birth weight of over 4.5kg (though it is acknowledged that estimation of birth weight is inaccurate). Previous shoulder dystocia – ask for this at booking. If there has been shoulder…
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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…
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