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3 results

The DRCOG Revision Guide
  • Examination Preparation and Practice Questions
  • 3rd edition
  • Susan Ward
  • Published online:
    16 June 2021
    Print publication:
    13 May 2021
  • Following the format change to single best answer questions (SBAs) for the Diploma of the Royal College of Obstetricians and Gynaecologists, this excellent resource is fully aligned with the new syllabus and exam style. Topics covered include basic clinical and surgical skills, all stages of pregnancy from antenatal care to postpartum problems, and general gynaecological and fertility concerns. Containing 310 single best answer (SBA) style questions, detailed explanations ensure candidates understand the reasoning and evidence-based decision-making behind each answer. With a recommended reading source also provided readers can explore and revise topics in further detail to reinforce their learning. A further 130 questions are included in two mock exam papers, helping candidates to strengthen their time management skills. Written by an author with many years' experience working on the DRCOG, candidates can be sure of the exact question format and how best to prepare for the actual exam.

  • Pregnancy Outcomes of Wives of Chemical and Non-Chemical Weapons Exposed Veterans in Ahvaz, Iran: A Retrospective Cohort Study

  • Leila Karimi, Andrew C. Miller, Alberto A. Castro Bigalli, Somaye Makvandi, Hossein Amini, Amir Vahedian-Azimi
  • Journal:
    Prehospital and Disaster Medicine / Volume 35 / Issue 5 / October 2020
    Published online by Cambridge University Press:
    25 June 2020, pp. 477-481
    Print publication:
    October 2020
  • Background:

    Sulphur mustard (HD) is a lipophilic caustic alkylating vesicant (blister agent) that has mutagenic and carcinogenic effects. Among the studied perturbations are long-term genitourinary (GU) and fertility effects. Approximately 50,000 Iranian soldiers and civilians were exposed to HD during the Iraq-Iran war (1980-1989). This study questioned the wives of Iraq-Iran war veterans to determine the effects of male HD-exposure on pregnancy complications, adverse pregnancy outcomes, and secondary infertility.

    Methods:

    A retrospective, survey-based cohort study was conducted of wives of Iranian military veterans that survived HD-associated injuries while serving in Ahvaz, Iran during the Iraq-Iran war (1980-1989), as compared to non-exposed veterans serving concomitantly. Patients were identified from a database of injured veterans maintained by the Foundation of Martyrs and Veterans Affairs (Iran) via a systematic random sampling method utilizing a random number table. Using a validated questionnaire, collected data included: demographics; type and severity of chemical injury; spouse’s obstetric history (pregnancy number, duration, complications, and outcomes before and after spouse’s chemical injury); and secondary infertility.

    Results:

    An increase in spontaneous abortion (P = .03), congenital anomalies (P < .0001), and secondary infertility (P = .003) were observed. These findings were greatest amongst those with HD injuries affecting >50% body surface area. No difference in stillbirth, premature birth, or low birth weight was observed.

    Conclusion:

    Exposure to HD in combat may have long-lasting fertility effects on soldiers and their spouses, including spontaneous abortion, congenital anomalies, and secondary infertility. Further investigation is needed into the long-term effects of HD exposure as well as methods to better protect soldiers.

  • Chapter 18 - Mechanical ventilation

  • from Section 3 - Special critical care tools and techniques
  • Edited by Marc van de Velde, Helen Scholefield, Lauren A. Plante
  • Book:
    Maternal Critical Care
    Published online:
    05 July 2013
    Print publication:
    04 July 2013, pp 187-199

  • Summary

    This chapter reviews the major physiological adaptations during pregnancy and also highlights changes in the reference ranges of common laboratory values encountered in pregnancy. Pregnancy induces a myriad of changes involving the cardiovascular system, respiratory system, gastrointestinal and hepatobiliary systems and genitourinary system. Pregnancy is associated with an overall increase in the serum concentrations of total cortisol, free cortisol, aldosterone, deoxycorticosterone, corticosteroid binding globulin, and adrenocorticotropic hormone. Pituitary enlargement occurs in pregnancy by estrogen mediated proliferation of prolactin-producing cells. During the first trimester of pregnancy, total thyroxine and total tri iodothyronine concentrations begin to increase and peak at mid-gestation, primarily as a result of increased production of thyroid-binding globulin. The immunological adaptations of pregnancy, particularly at the maternal-fetal interface, comprise complex mechanisms that enable the fetus to grow while preventing the mother from rejecting the fetus.