This review article outlines the prevalence of nausea and vomiting of pregnancy (NVP) and hyperemesis gravidarum (HG), definition of NVP and HG, aetiology, risk factors, complications of HG, recommended investigations, primary care management, hospital and ambulatory daycare, therapeutic management of HG supported by good clinical evidence, discharge planning, and importance of the multidisciplinary team to provide high quality care in patients with NVP and HG.
Uterine arteriovenous malformation (AVM) is an abnormal connection between arteries and veins within the uterus. Although AVM can be congenital or acquired, this article focuses on the diagnosis and management of acquired AVMs identified following early pregnancy complications. AVMs may develop as a result of damage to the uterine tissue following spontaneous miscarriage, pregnancy termination, dilatation and curettage, caesarean scar pregnancy, or gestational trophoblastic disease.1 The incorporation of necrotic villi in the venous sinuses of scar tissue is thought to cause acquired AVM.2
Uterine arteriovenous malformation (AVM) is an abnormal connection
between arteries and veins within the uterus. Although AVM can be
congenital or acquired, this article focuses on the diagnosis and
management of acquired AVMs identified following early pregnancy
complications. AVMs may develop as a result of damage to the uterine
tissue following spontaneous miscarriage, pregnancy termination,
dilatation and curettage, caesarean scar pregnancy, or gestational
trophoblastic disease.1 The incorporation of necrotic villi in the venous sinuses of scar tissue is thought to cause acquired AVM.2
The approach in prenatal diagnosis has been revolutionized by advances in prenatal molecular diagnostics. New algorithms in prenatal diagnosis are evolving and becoming increasingly complicated (Figure 1). The goal is to maximize the prenatal information for pregnant women and the families to make choices for the next generations.
Thalassaemia becomes a global health problem. Most women with thalassaemia trait can be picked up by universal prenatal screening for thalassaemia using mean corpuscular volume/haemoglobin, followed by haemoglobin pattern with or without DNA analysis.
The incidence of twins and high-order multiple pregnancies have been increasing over the past decades as a result of the widespread use of assisted reproductive techniques (ART). While multiple gestation rates have increased from 1.93% in 1980 to 3.15% in 2003 in the United States, the global coverage seems to be around 30 per 1,000 births in the past decade.1
The main causes of increased perinatal mortality and morbidity in multiple pregnancies as compared to singletons are preterm delivery and low or extremely low birth weight. Even in those infants that survived, the risk of cerebral palsy and other forms of neurological developmental defects was estimated to be around four times that of singleton pregnancies. The incidence of milder forms of neurological or developmental deficits such as educational difficulties or behavioural problems are even more common in these pregnancies.
Menstrual problems are the commonest gynaecological complaint in adolescent females.The most common menstrual problems seen in paediatric and adolescent gynaecology clinic include dysmenorrhoea, heavy menstrual bleeding, oligomenorrhoea and amenorrhoea.
Infertility is defined as failure to achieve pregnancy after one year of regular unprotected intercourse. It is a significant global problem with a prevalence of approximately 1 in 7 couples.1 Male factor is a common diagnostic category, and as a single factor it accounts for approximately 20% of the infertile couples.2, 3
Pregnancy is a proinflammatory state with activation of endothelial cells while operative delivery and genital tract injury can result in endothelial damage. Venous dilatation and compression of pelvic veins by the gravid uterus encourages venous formation in the lower limbs.
Group B Streptococcus (GBS) is the commonest cause of severe early-onset neonatal infection, which is associated with a high rate of morbidity and mortality (5–10%).1-3 About half of GBS meningitis will be complicated by neurodevelopment impairment. Because the early-onset disease develops shortly and rapidly after birth, there has been little improvement in the disease treatment, and the focus thus lies in disease prevention.
Dr Tan Toh Lick, Consultant Obstetrician and Gynaecologist at Thomson
Women’s Clinic, and Thomson Wellth Clinic Singapore, shares the complexities
of diagnosing polycystic ovarian syndrome in adolescent girls
Evacuation proctography, magnetic resonance imaging, and transperineal and endovaginal ultrasonography demonstrate similar diagnostic test accuracy for posterior pelvic floor disorders in women with obstructed defecation syndrome, a recent study has shown.
Results of a recent clinical trial showed that treatment with niraparib, a poly ADP ribose polymerase (PARP) inhibitor, improved progression-free survival (PFS) by more than 15 months in patients with recurrent ovarian cancer responding to platinum.