MRCOG Part 3

Ureteric injury: one of the most dreaded complications for a gynaecologist! What are the risk factors for ureteric injury? How do you minimise the risk of injuring the ureter during gynaecological operations? How do you diagnose a ureteric injury? How do you manage a ureteric injury? When will you use uretero-ureterostomy (end-to-end anastomosis of the ureter) versus uretero-neo-cystostomy (ureteric implantation into the bladder)? What is psoas hitch? What Is Boari flap? Answers to these and numerous other questions in our longest MRCOG video to date!

How do you diagnose and manage bladder injuries in patients having gynaecological operations? What are the risk factors for bladder injury and how can you try to minimise the risk of it happening in the first place? Answers to these and other questions in this MRCOG video.

What are the peri-operative risks for a patient with HIV? How do you work-up a patient with HIV for a gynaecological operation? How do you reduce the risk of transmission of HIV to healthcare workers? Answers to these and other questions in this short MRCOG video.

Hypertension is common. I seem to get a patient with hypertension in almost every operating list that I do! How do we manage a patient with hypertension? What pre-operative assessment and peri-operative care do they need? When is it unsafe to operate on a patient with hypertension? Answers to these and other questions in this short MRCOG video.

How do you manage a patient with thyroid disease (hyperthyroidism, hypothyroidism or goitre) scheduled to have an operation on your operating list? If she develops 'thyroid storm' in the peri-operative period, are you ready to manage her? You can find the answers to these and other questions in this short MRCOG video.

How do you manage a patient with diabetes who needs to have an operation? What pre-operative assessments will you do? How will you deal with oral hypoglycaemic medicines or insulin on the day of the operation? How will you manage peri-operative hyperglycaemia or hypoglycaemia? The answers can be found in this short MRCOG video.

An MRCOG lesson on RCTs. A randomised trial is the best design for assessing the effectiveness of a treatment. In this video we look at the 6 methodological features that are important for the quality of an RCT: randomisation; concealment; blinding; ITT; good follow-up rate and comparability of care provided. In Part B, we will look at the statistics of RCTs!

An MRCOG lesson on RCTs: Part B. In part A (please watch that video also!), we learnt about the quality features of an RCT. In this video, we learn about the common statistics we use in the reporting of RCTs. These include: Risk, Relative risk (or Risk Ratio, RR); Absolute risk difference (ARD); and Number Needed to Treat (NNT). We also look at what a Confidence Interval (CI) means. The statistics are illustrated with a simple numerical example. Enjoy!

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>