A5073475634- Ectopic Pregnancy Diagnosis and Management
- Gestational Trophoblastic Disease Studies
- Maternal and fetal healthcare
- Pregnancy and preeclampsia studies
- Pregnancy-related medical research
- Prenatal Screening and Diagnostics
- Assisted Reproductive Technology and Twin Pregnancy
- Reproductive System and Pregnancy
- Ultrasound in Clinical Applications
- Grief, Bereavement, and Mental Health
- Reproductive tract infections research
- Gynecological conditions and treatments
- Preterm Birth and Chorioamnionitis
- Homicide, Infanticide, and Child Abuse
- Family Support in Illness
- Appendicitis Diagnosis and Management
- Neonatal and fetal brain pathology
- Maternal and Perinatal Health Interventions
- Reproductive Health and Contraception
- Cancer Risks and Factors
- Neonatal Respiratory Health Research
- Ovarian cancer diagnosis and treatment
- Statistical Methods in Epidemiology
- Advanced Causal Inference Techniques
- Surgical Simulation and Training
Queen Charlotte's and Chelsea Hospital
2015-2024
Imperial College London
2015-2024
Tommy's
2016-2024
Miscarriage Association
2017-2023
Imperial College Healthcare NHS Trust
2012-2020
St Mary's Hospital
2020
St. Mary's Hospital
2020
University Medical Center Utrecht
2018
Charles University
2018
Oregon Health & Science University
2018
To characterise vaginal bacterial composition in early pregnancy and investigate its relationship with first second trimester miscarriages.Nested case-control study.Queen Charlotte's Chelsea Hospital, Imperial College Healthcare NHS Trust, London.161 pregnancies: 64 resulting miscarriage, 14 miscarriage 83 term pregnancies.Prospective profiling comparison of bacteria using 16S rRNA gene-based metataxonomics from 5 weeks' gestation pregnancies ending or uncomplicated deliveries matched for...
ABSTRACT Objectives A uniform rationalized management protocol for pregnancies of unknown location (PUL) is lacking. We developed a two‐step triage to select PUL at high risk ectopic pregnancy (EP), based on serum progesterone level presentation (step 1) and the human chorionic gonadotropin (hCG) ratio, defined as ratio hCG 48 h 2). Methods This was cohort study 2753 (301 EP), involving secondary analysis prospectively consecutively collected data from two London‐based university teaching...
To investigate and compare post-traumatic stress (PTS), depression anxiety in women their partners over a 9-month period following miscarriage or ectopic pregnancy.This was prospective cohort study. Consecutive were approached the early pregnancy units of three hospitals central London. At 1, 3 9 months after loss, recruits e-mailed links to surveys containing Hospital Anxiety Depression Scale Post-traumatic Stress Diagnostic Scale. The proportion participants meeting screening criteria for...
Risk models often perform poorly at external validation in terms of discrimination or calibration. Updating methods are needed to improve performance multinomial logistic regression for risk prediction. We consider simple and more refined updating approaches extend previously proposed dichotomous outcomes. These include model recalibration (adjustment intercept and/or slope), revision (re-estimation individual coefficients), extension (revision with additional markers). suggest a closed...
Objectives To assess if there is any association between hyperemesis gravidarum (HG), psychological morbidity and infant bonding to quantify psychosocial consequences of HG. Design Two-point prospective case–control, multicentre survey study with antenatal postnatal data collection. Setting Three London hospitals. Participants Pregnant women at ≤12 completed weeks gestation recruited consecutively over 2 years. Women HG were the time admission; controls from a low risk clinic. 106 case group...
The M6 risk-prediction model was published as part of a two-step protocol using an initial progesterone level ≤ 2 nmol/L to identify probable failing pregnancies (Step 1) followed by the 2). has been shown have good triage performance for stratifying women with pregnancy unknown location (PUL) being at low or high risk harboring ectopic (EP). This study validated in clinical practice evaluating number protocol-related adverse events and how effectively patients were triaged.This prospective...
What are the adverse outcomes associated with using M4 model in everyday clinical practice for women pregnancy of unknown location (PUL)? There were 17/835 (2.0%) events and no serious performance practice. The has previously been shown to stratify classified as a PUL at low or high risk complications good level test performance. triage is better than single measurements serum progesterone hCG ratio (serum 48 h/hCG presentation). A prospective multi-centre cohort study 1022 carried out...
To validate externally five approaches to predict ectopic pregnancy (EP) in pregnancies of unknown location (PUL): the M6P and M6NP risk models, two-step triage strategy (2ST, which incorporates M6P), M4 model, beta human chorionic gonadotropin ratio cut-offs (BhCG-RC).Secondary analysis a prospective cohort study.Eight UK early assessment units.Women presenting with PUL BhCG >25 IU/l.Women were managed using 2ST protocol: classified as low EP if progesterone ≤2 nmol/l; remaining cases...
Clinical models to predict first trimester viability are traditionally based on multivariable logistic regression (LR) which is not directly interpretable for non-statistical experts like physicians. Furthermore, LR requires complete datasets and pre-established variables specifications. In this study, we leveraged the internal non-linearity, feature selection missing values handling mechanisms of machine learning algorithms, along with a post-hoc interpretability strategy, as potential...
To assess prospectively the association between pelvic pain, vaginal bleeding, and nausea vomiting occurring in first trimester of pregnancy incidence later adverse outcomes.
To investigate prognostic factors for anxiety, depression and post-traumatic stress (PTS) symptoms 1 month after early pregnancy loss (EPL). A prospective cohort study. Consecutive women were recruited, demographic clinical data collected. Surveys containing the Hospital Anxiety Depression Scale (HADS) Post-traumatic Stress Diagnostic (PDS) emailed a loss. Univariable logistic regression was performed to link with caseness of or PTS according screening measures. Early units three central...
Human chorionic gonadotropin (hCG) is a glycoprotein hormone that essential for the maintenance of pregnancy. Glycosylation hCG known to be its biological activity. “Hyperglycosylated” variants secreted during early pregnancy have been proposed involved in initial implantation embryo and as potential diagnostic marker gestational diseases. However, what constitutes “hyperglycosylation” not yet fully understood. In this study, we perform comparative N-glycomic analysis expressed same...
ABSTRACT Objective To assess whether sonographic diagnosis of intrauterine hematoma (IUH) in the first trimester pregnancy is associated with first‐trimester miscarriage and antenatal, delivery neonatal complications. Methods This was a prospective observational cohort study women an singleton between 5 14 weeks' gestation recruited at Queen Charlotte's Chelsea Hospital, London, UK, March 2014 2016. Participants underwent serial ultrasound examinations trimester, presence, location, size...
ABSTRACT Objectives Ectopic pregnancy (EP) is a major high‐risk outcome following of unknown location (PUL) classification. Biochemical markers are used to triage PUL as high vs low risk guide appropriate follow‐up. The M6 model currently the best risk‐prediction model. We aimed update and evaluate whether performance can be improved by including clinical factors. Methods This prospective cohort study recruited consecutive between January 2015 2017 at eight units (Phase 1), with two centers...
Abstract Introduction There is no global agreement on how to best determine pregnancy of unknown location viability and using biomarkers. Measurements progesterone β human chorionic gonadotropin (βhCG) are still used in clinical practice exclude the possibility a viable intrauterine (VIUP). We evaluate predictive value progesterone, βhCG, βhCG ratio cut‐off levels VIUP women with location. Material methods This was secondary analysis prospective multicenter study data consecutive between...
The objective was to validate a virtual reality simulation ultrasound model as tool for training in the use of transvaginal ultrasonography gynaecology and early pregnancy.Three separate groups consisting novice intermediate level residents well expert examiners were recruited study. All asked answer questionnaire regarding demographic data experience. They subsequently completed two modules: basic pregnancy, followed by corresponding assessments using high-fidelity simulator (Scantrainer;...
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Serum biomarkers (namely human chorionic gonadotrophin (hCG) and progesterone) are used to determine the management of women with a PUL (pregnancy unknown location). This study assessed value endometrial thickness (ET) measurement, an ultrasound based marker, at initial transvaginal scan in risk-stratifying as either low-risk or high-risk clinical complications. was prospective, observational study. Consecutive five UK hospitals from April 2015 July 2016 were included managed according M6...
<h3>ABSTRACT</h3> Since the introduction of European Working Time Directive, specialist registrars arguably contribute less to clinical service. The purpose this study was broadly quantify service contribution across a range specialties and their value an NHS organisation. A questionnaire-based survey activities in large trust undertaken. Simple costing analyses clinical activity were performed. Responses from 66 24 showed average 51% overall autonomy. Trainees attended 2.7 outpatient...