A5073126414- Ectopic Pregnancy Diagnosis and Management
- Assisted Reproductive Technology and Twin Pregnancy
- Pregnancy and preeclampsia studies
- Prenatal Screening and Diagnostics
- Gestational Trophoblastic Disease Studies
- Pregnancy-related medical research
- Appendicitis Diagnosis and Management
- Maternal and fetal healthcare
- Pregnancy and Medication Impact
- Birth, Development, and Health
- Cancer Risks and Factors
- Reproductive System and Pregnancy
- Endometriosis Research and Treatment
- Reproductive Health and Contraception
- Abdominal Trauma and Injuries
- Pelvic floor disorders treatments
- Trauma, Hemostasis, Coagulopathy, Resuscitation
- Maternal and Perinatal Health Interventions
- Gestational Diabetes Research and Management
- Anesthesia and Pain Management
- Ovarian cancer diagnosis and treatment
- Intestinal and Peritoneal Adhesions
- Vascular Procedures and Complications
- Gynecological conditions and treatments
- Hernia repair and management
University College London
2019-2025
University College Hospital
2019-2025
Imperial College London
2011-2024
University College London Hospitals NHS Foundation Trust
2020-2022
Chelsea and Westminster Hospital
2010-2021
Chelsea and Westminster Hospital NHS Foundation Trust
2010-2021
Queen Charlotte's and Chelsea Hospital
2012-2020
St Mary's Hospital
2020
St. Mary's Hospital
2020
Middlesex Hospital
2019
Bleeding in early pregnancy is strongly associated with loss. Progesterone essential for the maintenance of pregnancy. Several small trials have suggested that progesterone therapy may improve outcomes women who bleeding pregnancy.We conducted a multicenter, randomized, double-blind, placebo-controlled trial to evaluate progesterone, as compared placebo, vaginal Women were randomly assigned receive suppositories containing either 400 mg or matching placebo twice daily, from time at which...
Abstract Objectives There is significant variation in cut‐off values for mean gestational sac diameter (MSD) and embryo crown–rump length (CRL) used to define miscarriage, suggested the literature ranging from 13 25 mm MSD 3 8 CRL. We aimed false‐positive rate (FPR) diagnosis of miscarriage associated with different CRL measurements or without a yolk large study population patients attending early pregnancy clinics. also that, on basis single measurement, can definitively diagnose so exclude...
BackgroundThe anti-progesterone drug mifepristone and the prostaglandin misoprostol can be used to treat missed miscarriage. However, it is unclear whether a combination of more effective than administering alone. We investigated treatment with plus would result in higher rate completion miscarriage compared alone.MethodsMifeMiso was multicentre, double-blind, placebo-controlled, randomised trial 28 UK hospitals. Women were eligible for enrolment if they aged 16 years older, diagnosed by...
Previous studies have examined ultrasound findings in histopathologically confirmed cases of hydatidiform mole. The aim this study was to assess the first-trimester ultrasonographic all women suspected having mole on and those subsequently diagnosed with after histological examination removed products conception surgical evacuation uterus. obtain a true sensitivity positive predictive value for diagnosis mole.A retrospective analysis performed sonographically histologically proven presenting...
Measurement of embryonic or foetal size using the greatest length embryo crown rump can be used to accurately determine gestational age a normal first trimester pregnancy within three five days. Transvaginal ultrasound scan measure an and gestation sac earlier than transabdominal ultrasound. The original Robinson curve for dating pregnancies is still valid in most cases. Ultrasound now recommended all women with spontaneous pregnancies, even those certain menstrual dates. First growth not...
Objectives To validate recent guidance changes by establishing the performance of cut-off values for embryo crown-rump length and mean gestational sac diameter to diagnose miscarriage with high levels certainty. Secondary aims were examine influence age on interpretation values, determine optimal intervals between scans findings repeat that definitively pregnancy failure. ) Design Prospective multicentre observational trial. Setting Seven hospital based early assessment units in United...
To estimate the incidence of caesarean scar pregnancy (CSP) and to describe management outcomes associated with this condition.A national cohort study using UK Early Pregnancy Surveillance Service (UKEPSS).86 participating Units.All women diagnosed in units CSP between November 2013 January 2015.Cohort identified through UKEPSS monthly mailing system.Incidence, clinical complications.102 cases were reported, an estimated 1.5 per 10 000 (95% CI 1.1-1.9) maternities. Full outcome data...
Tubal ectopic pregnancies can cause substantial morbidity or even death. Current treatment is with methotrexate surgery. Methotrexate fails in approximately 30% of women who subsequently require rescue Gefitinib, an epidermal growth factor receptor inhibitor, might improve the effects methotrexate. We assessed efficacy oral gefitinib methotrexate, versus alone, to treat tubal pregnancy.We performed a multicentre, randomised, double-blind, placebo-controlled trial across 50 UK hospitals....
To assess intra- and interobserver agreement of routinely performed measurements-crown-rump length (CRL) mean gestational sac diameter (MSD)-for assessing the likelihood miscarriage in first trimester pregnancy using transvaginal sonography.A cross-sectional study CRL measurements first-trimester pregnancies was conducted a fetal medicine referral center with predominantly Caucasian population. Gestational age ranged from 6 to 9 weeks. All patients underwent ultrasound examination...
BACKGROUNDThe objective of this study was to determine the optimal gestational age at which establish location and viability an early pregnancy using transvaginal ultrasonography (TVS).
To examine whether viable early pregnancies that subsequently end in miscarriage exhibit evidence of first-trimester growth restriction.Prospective cohort study.Early pregnancy unit (EPU) a teaching hospital.Women attending EPU between 5 and 10 weeks gestation.Women with spontaneously conceived intrauterine, singleton certain last menstrual period regular cycles were included. The deviation the observed expected crown-rump length (CRL) for gestation was calculated expressed as z score....
Abstract Objective . To compare the appearance and behavior of ectopic pregnancies (EPs) initially classified as unknown location (PULs) to those visualized on initial transvaginal ultrasound scan (TVS). Methods An observational study over a four‐year period women undergoing TVS prior diagnosis tubal EP. Demographic details, presenting symptoms, findings, serum hCG progesterone levels were recorded at time EP in PUL. Results 411 with underwent treatment. In 85.9% (353/411) was while...
STUDY QUESTIONCan we accurately define a group of pregnancies unknown location (PULs) as low risk in order to safely reduce follow-up for these and allocate resources at an increased being ectopic?
To explore how women, understand, interpret and use a validated individualised early pregnancy outcome prediction score tool. Qualitative interview study nested within larger quantitative randomised controlled trial (RCT) the Early Pregnancy Unit of London teaching hospital. Women with an ultrasound diagnosis intrauterine uncertain viability (PUV) were to receive or routine care. Those who received invited interview. Thematic analysis was conducted focus on women's experiences receiving...
First trimester growth restriction may predict miscarriage or adverse outcome later in the pregnancy, but determinants of early are not well described. Our objective was to examine factors influencing fetal and gestational sac size first trimester.Prospective observational study 1828 singleton pregnancies before 12 weeks gestation. Maternal characteristics (ethnicity, maternal age, obstetric history, abdominal pain vaginal bleeding), crown rump length (CRL) mean diameter (MSD) were recorded....
Abstract Objectives We studied changes in mean gestational sac diameter (MSD) and embryonic crown–rump length (CRL) intrauterine pregnancies of uncertain viability (IPUVs). aimed to establish cut‐off values for MSD CRL growth that could be definitively associated with either or miscarriage, the relationship between appearance structures sac. Methods One thousand sixty consecutive IPUVs were recruited prospectively from four London University hospitals: 462 no yolk embryo, 419 a but 179 an...
What is the performance of a simple scoring system to predict whether women will have an ongoing viable intrauterine pregnancy beyond first trimester? A using demographic and initial ultrasound variables accurately predicts viability trimester with area under curve (AUC) in receiver operating characteristic 0.924 [95% confidence interval (CI) 0.900–0.947] on independent test set. Individual factors, such as maternal age, vaginal bleeding gestational sac size, are strong predictors...
Background Progesterone is essential for a healthy pregnancy. Several small trials have suggested that progesterone therapy may rescue pregnancy in women with early bleeding, which symptom strongly associated miscarriage. Objectives (1) To assess the effects of vaginal micronised bleeding first 12 weeks (2) evaluate cost-effectiveness bleeding. Design A multicentre, double-blind, placebo-controlled, randomised trial Setting total 48 hospitals UK. Participants Women aged 16–39 years...
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...
Abstract Objectives The Robinson and Hadlock crown–rump length (CRL) curves are commonly used to estimate gestational age (GA) based on the CRL of an embryo or fetus. However, curve was derived from a small population using transabdominal sonography generated early transvaginal ultrasound equipment. aim this study use large pregnancies assess embryonic fetal size, so create new normal 5.5 weeks' gestation. We compared with curves. Methods A retrospective database in first‐trimester embryos...