When we talk about cervical cancer, we are normally referring to squamous cell carcinoma. Cervical cancer is a bit complicated. There are normal physiological changes that occur to the cervix, as well as pre-cancerous changes, and cervical cancer itself, which can alter the appearance and histology of the cervix. Normal physiological changes
IUS – intrauterine device – aka Mirena Coil This is a progesterone only contraceptive, and releases levonorgestrel directly into the uterine cavity. It is licensed for use as: Contraceptive Treatment for menorrhagia
Emergency contraception These below methods do not cause abortion. Instead, they prevent ovulation, fertilisation, and/or implantation. Those who believe life begins at fertilisation may argue that abortion can occur with these methods, and may have objections. However, the method does not cause any alteration to an embryo after implantation.
Implant – aka Implanon Lasts 3 years 12% will have heavier bleeding, particularly in the first 6-12 months. This can be alleviated with: Tranexamic acid – 1g/6-8h for up to 4 days – an antifibrinolytic, can reduce menorrhagia by 50%
When discussing contraception with a patient, in may be useful to understand a little about the patient’s religious background. Obviously, it is not the medical professional’s position to advise on any religious aspects, but only to advise on the medical basis of contraceptive methods, and their use and efficacy, thus that the patient may make their own informed decision. It can be a difficult decision for patients, when their Religious beliefs and personal views on contraception are at odds.
Resistance to insulin is a normal physiological response in pregnancy, thought to be induced by maternal hormones. However, in some women, this is severe enough to result in gestational diabetes. In these women, there is reduced ability of the pancreas to produce enough insulin to overcome the insulin resistance. Gestation diabetes is defined as - Any hyperglycaemia with first onset or presentation during pregnancy
Much of the follow-up of pregnant women is carried out in the community, by midwifes at primary health care centres. The risk of death from pregnancy in the UK is roughly 1 in 20 000. Antenatal care is as much about educating women about pregnancy, childbirth and child care, as it is about providing for actual medical needs, particularly in the case of a first pregnancy. The exact measures will differ between NHS trusts, but below is a general outline of the type of care provided in pregnancy.
C-section is major surgery, with real risks, and the decision to perform such an operation should not be taken lightly! Epidemiology Incidence in increasing, mainly due to the increased diagnoses of fetal distress, as diagnosed by CTG monitoring. Also increasing used for non-longitudinal lies (e.g. breech, transverse) WHO recommends not >15% of deliveries should be via c-section
Definition Implantation of conceptious outside uterine cavity When Women in reproductive age present with pelvic pain and positive pregnancy test à Ectopic pregnancy until proven otherwise Incidence 20:1000 pregnancies Increasing from 11:1000 pregnancies
What is a ‘normal delivery’? Normal time of delivery is between 38 and 41 weeks since the LMP (which is between 36 and 39 weeks gestation) Approx 70% of all babies are born at this gestation, and 80% within 1 month of the predicted date
The menstrual cycle is on average, 28 days long. It can be between 20-45 days. It varies from person to person, and month to month. A few quick facts: Both oestrogen and progesterone are produced from cholesterol LH and FSH are known as the gonadotropins