Objective To explore the risk of adverse maternal and perinatal outcomes in women with antepartum bleeding of unknown origin (ABUO).Design Cohort study based on data extracted from the Aberdeen Maternity and Neonatal Databank. Exposure was antepartum haemorrhage occurring after the first trimester not attributable to placenta praevia or placental abruption.Setting Aberdeen Maternity Hospital, Aberdeen, Scotland, UK.Population All primigravidae delivering between 1976 and 2010.Methods Data were analysed using univariate and multivariate statistical methods.Main outcome measures Pre-eclampsia, induced labour, mode of delivery, preterm delivery, postpartum haemorrhage, admission to neonatal unit, perinatal death.Results Between 1976 and 2010, there were 7517 women with ABUO and 68 423 women without ABUO in the cohort. Women with ABUO were more likely to be non-smokers, belong to a lower social class, and have a higher body mass index. ABUO was a significant risk factor for induced labour (adjusted odds ratio, aOR, 1.23; 95% CI 1.16-1.31), preterm delivery at <37 weeks of gestation (aOR 2.30; 95% CI 2.11-2.50), and postpartum haemorrhage (aOR 1.15; 95% CI 1.06-1.25). There was no significant association detected with pre-eclampsia (aOR 0.93; 95% CI 0.83-1.05). Whereas there was an increased risk of low birthweight (aOR 0.90; 95% CI 0.79-1.03) and stillbirth (aOR 0.92; 95% CI 0.66-1.30) with ABUO on univariate analysis, once adjusted for confounding factors this risk was non-significant.Conclusion Pregnancies complicated by ABUO are at a greater risk of preterm delivery and induced labour. There was no increase seen in perinatal mortality after adjusting for preterm birth.

The differentiation between mono- and dichorionic placentation in twin pregnancies is of clinical importance because of the significant difference in perinatal morbidity and mortality between the two, and the increased surveillance indicated in monochorionic gestations. Application of ultrasonography has enabled very precise prenatal determination of chorionicity. While this is best performed in the first trimester when accuracy approaches 100%, even in the third trimester, using a composite cascade of available sonographic features, accuracy has been reported to approach 97%. While two clearly separate placentae or discordant fetal gender conform to dichorionicity, in most twin pregnancies other features need to be assessed to determine chorionicity. The presence of the 'lambda' or the 'T' sign in the presence of a single placenta, best determined in the first trimester, is the most reliable indicator of chorionicity, with measurements of the inter-twin membrane thickness and counting of the membrane layers being less reliable. In this article, we review the sonographic features that help in the accurate depiction of chorionicity.

Introduction: Cancer is the second leading cause of death globally. Adverse effects of chemotherapy affect physiological and psychological aspects of human life. Self-care practice to manage side effects can improve the quality of life. Aims: The study investigates the relationship between knowledge on the adverse effects of chemotherapy and self-care ability to manage chemotherapy survivors' side effects. Subjects and methods: This was a single centre, Cross-sectional, descriptive study. A face-to-face interview guided by a structured questionnaire was conducted among 100 cancer patients admitted at the daycare centre to receive repeated chemotherapy cycles. Information gathered included knowledge on chemotherapy and its adverse effects and self-care ability to manage them. Results: Results indicated 58% had an above-average level of experience on chemotherapy and side effects,16.42 ± 3.56 Vs 8.52 ± 3.37.To overcome hair loss, 77% of patients preferred to use a wig/scarf to cover the head. To reduce nausea and vomiting symptoms, 48% chose to consume less food. Knowledge on side effects of chemotherapy moderate positively related to self-care practices with (r = 0.55,p = 0.001 level), which shows a significant raise on knowledge level will improve their self-care practices. Knowledge of the adverse effects of chemotherapy was not associated with the demographic variables of study participants. Conclusion: Study concluded that it was essential to enhance awareness and overcome adverse chemotherapy effects via counselling services using current modalities for better self-care practices.

No abstract

In this pilot sample, 400 mg of mifepristone was effective in inducing cervical changes and labor. Although there were no adverse effects using oral misoprostol in combination with mifepristone, labor was more difficult to induce in the women who did not respond to mifepristone alone, and these women had a higher operative delivery rate.