Maternal GBS colonization rate was higher than previously reported, and varied with different risk populations. EOGBSD reduced after universal screening.
It is difficult to prenatally identify 5p deletion (−) syndrome. Here, we report five cases of 5p‐ syndrome diagnosed by invasive prenatal diagnosis. Of them, three had a small cerebellum in the second trimester. In one case, a prominent renal pelvis and an absent nasal bone were also found in the first trimester. However, there were no abnormal ultrasound findings in the other two cases. Two cases had noninvasive prenatal testing and one showed a ‘5p‐ syndrome positive result’ because of reduced amount of cell‐free DNA in 5p. Two had combined first‐trimester screening performed where one had a high‐risk result for trisomy 18 and a low pregnancy‐associated plasma protein‐A level. Two cases of 5p‐ syndrome resulted from a parental balanced translocation. Prenatal diagnosis will only be made on invasive prenatal diagnosis for abnormal ultrasound findings with small cerebellum, abnormal prenatal screening or a parental reciprocal translocation involving 5p.
The use of a crew resource management simulation-based training programme is a valuable teaching tool for frontline health care staff. Concepts of crew resource management were relevant to clinical practice. It is a highly rated training programme and our results support its broader application in Hong Kong.
IntroductionCurrent evidence suggests annual training in the management of shoulder dystocia is adequate. The aim of this trial is to test our hypothesis that skills start to decline at 6 months after training and further decline at 12 months.MethodsIn this randomised, single-blinded study, 13 obstetricians and 51 midwives were randomly assigned to attend a 1-hour mixed lecture and simulation session on shoulder dystocia management. Training was conducted on group 2 at month ‘0’ and on group 1 at month ‘6’. Their knowledge scores (primary outcome) were assessed before (pre-training), immediately after the training (at-training) and retested at month ‘12’ (post-training).ResultsTwo-way repeated-measures analysis of variance showed a statistically significant interaction between the testing time frame (pre-training, at-training and post-training) on the score (p<0.001), but no significant interaction between the groups on the score (p=0.458).Compared to pre-training, the score increased after the simulation training (at-training) in both group 1 (8.69 vs 14.34, p<0.001) and group 2 (9.53 vs 14.66, p< 0.001), but decreased at 6 months post- training in group 1 (14.34 vs 11.71, p<0.001) and at 12 months post-training in group 2 (14.66 vs 11.96, p< 0.001). However the score was better than before the training. There was no significant difference in the post –training score (11.71vs 11.96, p=0.684) between both groups.ConclusionsOur study demonstrated that simulation training results in short-term and long-term improvement in shoulder dystocia management however knowledge degrades over time. Ongoing training is suggested at a minimum of 12 months’ interval for all members of the obstetrics team including midwives and doctors.
Bulleted Statements:
What's already known about this topic?
The incidence of discordant fetal sex was estimated to be 1 in 1500–2000. Comprehensive evaluation is required to investigate the underlying cause.
What does this study add?
Chimera is one of the possible causes of genotype–phenotype sex discordance. It could be detected prenatally with the combination of noninvasive prenatal screening and ultrasound.
Genetic counseling to prospective parents on chimera can be complex where early support and information from experienced professionals are important.
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