MRCOG Part 2

Haematological changes in pregnancy for the MRCOG exam. What haematological changes occur during pregnancy? What variables go up, go down or remain the same? Why? A key MRCOG mini-lecture by Professor Arri Coomarasamy.

The PRISM trial is the largest ever randomised trial in miscarriage prevention; it recruited more than 4000 women from 48 hospitals in the UK. It evaluated the effects of progesterone hormone in women with early pregnancy bleeding. Overall, there was a 3% increase in live birth rate with progesterone, compared with placebo, but the finding was associated with some statistical uncertainty (RR 1.03, 95% CI 1.00 to 1.07, p = 0.08). However, a clear benefit was found for women with the dual risk factors of early pregnancy bleeding and a history of (any number of) previous miscarriages (RR = 1.09, [...]

<p>An MRCOG lesson on hereditary gynaecological cancers (BRCA1, BRCA2, RAD51C, RAD51D, BRIP1, Lynch syndrome, Bowden syndrome and Peutz-Jeghers syndrome). An essential lesson for MRCOG.</p>

The Fetal Medicine Foundation webinar, organised by the legend Professor Kypros Nicolaides, was attended by over 7000 delegates from 154 countries. In this lecture, you can hear Professor Arri Coomarasamy discuss the role of progesterone hormone for the prevention miscarriages. What is evidence for effectiveness and safety? What does the totality of evidence, summarised in a meta-analysis show? Which progesterone, what dose, what regimen? This video has the answers! It also covers the two landmark trials on the subject, the PROMISE and PRISM trials, both of which were published in the New England Journal of Medicine. [...]

Contraception after pregnancy in 10 questions and answers: an Essential MRCOG lesson by ACE Courses (www.acecourses.co.uk). Find the answers to many questions around the use of contraception just after child birth, including: when does a women need emergency contraception after childbirth? which emergency contraceptives are safe after childbirth in breastfeeding women? what regular contraceptions are available to breastfeeding women? can combined oral contraceptives be used in breastfeeding women? When can you use copper IUD after childbirth? Can DMPA be used after childbirth?

<p>Bowel injury during gynaecological operation: an essential lesson of the MRCOG exam. What are the risk factors? What are the complications? How should you diagnose and manage a small and large bowel injury? When should you use primary repair, resection and repair or a stoma? What post-operative care is needed? Find out the answers to this this and other questions in this video. Visit www.acecourses.co.uk for MRCOG resources.</p><p>This video is based on the best-selling O&amp;G book: <a href="https://www.youtube.com/redirect?event=video_description&amp;redir_token=QUFFLUhqa1kzbmFNdWNpZHJPQ2V2UnZVSW8zcG9IRWQwQXxBQ3Jtc0tsWXVwZGxrU2NHVF9PTG5HeHp6WFo2cXpfbXVHV01rN0VwcjdOLS0xcGcxTWF6LXNlbXk5T2JDQnZUZGt5OGFxSjBDYXdTWFloMnpmR01qM2x0dHkwZ21RRmNsQ2U0U0laeHg2eGpFeG1zazl3a3JfSQ&amp;q=https%3A%2F%2Fwww.amazon.co.uk%2FGynecologic-Obstetric-Surgery-Challenges-Management%2Fdp%2F0470657618">https://www.amazon.co.uk/Gynecologic-...​.</a> All royalties from this book go to the Charity Ammalife to support healthcare providers in low-income countries.</p>

Bleeding at and after caesarean section kills mothers, particularly in low resource countries. This presentation addresses the epidemiology, diagnosis and management of PPH at CS. The presentation was made at the Jhpiego PPH CoP Virtual Annual Meeting on the 23rd July 2020. The presenters are Arri Coomarasamy and John Varallo, and the chair is Augustino Hellar.

An analysis, led by Arri Coomarasamy, Professor of Gynaecology at the University of Birmingham and the Director of the Tommy’s National Centre for Miscarriage Research, published in a series of 3 articles in the Lancet has shown that Black women are at a high risk of miscarriage. It is not yet known if this is due to differences in biology, social circumstances, lifestyle factors, or other reasons. Professor Coomarasamy and his team are calling for further research, and discuss what can be done to reduce the risk of miscarriage in Black women. Find out more at <a href="https://www.youtube.com/redirect?event=video_description&amp;redir_token=QUFFLUhqa0lUQ3M1cHZxTnI2UWlqV0ZMZXRBalVFU2NwUXxBQ3Jtc0ttekI1RmZwMDJsZUpOdnFQVk9LMmxGRWkxU1E0WlVEUlYxdTd0SmxHUU9lRzVIc1NuU2EwanlXaWxDMVNWekY4Yk5OVXM0VFZnNXlkXzFnZExudFFXM3ZrWnBOdDFZenNyalFZbjZTSU5zTEZwZXdLTQ&amp;q=https%3A%2F%2Fwww.thelancet.com%2Fseries%2Fmiscarriage">https://www.thelancet.com/series/misc...</a> [...]

In the UK, women need to have had 3 miscarriages before they are provided specialist care. Arri Coomarasamy, Professor of Gynaecology at the University of Birmingham and the Director of the Tommy’s National Centre for Miscarriage Research, argues this is simply wrong. A series of 3 articles published in the Lancet shows that this practice is based more on tradition than evidence. Professor Coomarasamy and his team call for ‘every woman to have appropriate care after every miscarriage’. Find out more at <a href="https://www.youtube.com/redirect?event=video_description&amp;redir_token=QUFFLUhqbXpsRFJEZDJfNDJhZ29qSThXUE5udGZfUlVxd3xBQ3Jtc0ttV0hRTldNbWxEclFjdzU5QXVWN2xXWndNT3FPcDFHTU1xdjc1cVJaTXNPMEowUlYtZ2RVWFBGV2RYd1p6bHBENmVJc0JnSVVLRGZ6ajhoaUt6SVVvdmZhRTF5QnloSVZqa0pQenJ6aGxYSjFkUUMtNA&amp;q=https%3A%2F%2Fwww.thelancet.com%2Fseries%2Fmiscarriage">https://www.thelancet.com/series/misc...</a>

Couples who have suffered a miscarriage would want to know if a future miscarriage can be prevented. Arri Coomarasamy, Professor of Gynaecology at the University of Birmingham and the Director of the Tommy’s National Centre for Miscarriage Research, explains that there is a profound misconception out there that all miscarriages are “nature’s way of dealing with a pregnancy that is not normal”, and therefore nothing could be done to prevent them. This is incorrect. The various steps that can be taken to reduce the risk of miscarriage are shared in a series of 3 articles published in the Lancet [...]