Obstetrics and Gynaecology
Antenatal care, obstetric emergencies and gynaecological disease.
- Antenatal Care and Screening The NHS appointment schedule and booking bloods, how the combined, quadruple and NIPT tests fit together, and what the 20-week anomaly scan does and does not look for.
- Hyperemesis Gravidarum The triad that separates it from ordinary morning sickness, PUQE scoring, the antiemetic ladder, and why the fluid must be saline rather than dextrose.
- Miscarriage and Intrauterine Death The six types of miscarriage and the ultrasound thresholds that confirm them, choosing between expectant, medical and surgical management, and the stillbirth pathway.
- Ectopic Pregnancy Why the pregnancy test is the test that saves lives, reading serial hCG in a pregnancy of unknown location, and the thresholds separating expectant, methotrexate and surgical care.
- Gestational Diabetes Risk-factor screening and the OGTT thresholds, the diet-metformin-insulin ladder with its numerical targets, and why postnatal glucose testing matters more than the pregnancy itself.
- Hypertension in Pregnancy Why the 20-week line separates chronic from gestational hypertension, which drugs are safe and which are teratogenic, and the monitoring that catches progression to pre-eclampsia.
- Pre-eclampsia and Eclampsia The two-stage placental model that explains why aspirin must start before 16 weeks, the NICE diagnostic criteria, the magnesium sulfate regimen, and HELLP syndrome.
- Antepartum Haemorrhage Grading blood loss after 24 weeks, the bedside features that separate abruption from praevia from vasa praevia, and why no one examines digitally until the placental site is known.
- Placenta Praevia Why 90% of low-lying placentas at 20 weeks resolve, how transvaginal scanning settles the diagnosis, and the accreta risk that rises with every previous caesarean.
- Placental Abruption The woody tender uterus and shock out of proportion to visible loss, why a normal scan proves nothing, and managing the coagulopathy that follows.
- Vasa Praevia Why bleeding at rupture of membranes with a well mother and a dying fetus means fetal vessels, and how antenatal Doppler turns 60% mortality into 97% survival.
- Polyhydramnios and Oligohydramnios Amniotic fluid as a real-time report on fetal kidneys and swallowing, the deepest-pocket thresholds, and the causes worth chasing at each end of the range.
- Multiple Pregnancy Why chorionicity matters more than zygosity, reading the lambda and T signs, twin-to-twin transfusion syndrome, and the timing and mode of birth for each type.
- Blood Group Incompatibility in Pregnancy Sensitising events and anti-D doses, why anti-K behaves differently from anti-D, the Kleihauer test, and MCA Doppler surveillance for fetal anaemia.
- Obesity in Pregnancy What changes when BMI is 30 or above: 5 mg folic acid, aspirin, the VTE score, growth scans instead of a tape measure, and planning anaesthesia before labour.
- Jaundice in Pregnancy Which liver tests change physiologically, the bile acid thresholds that now set the timing of birth in obstetric cholestasis, and spotting acute fatty liver early.
- Venous Thromboembolism in Pregnancy Virchow's triad in pregnancy and why the left leg, the RCOG risk score, why D-dimer is useless here, and choosing between a V/Q scan and CTPA.
- Chorioamnionitis The ascending route and the criteria that make the diagnosis, why epidural fever and steroids confound the bloods, and why the answer is antibiotics plus delivery.
- Normal Labour and Delivery The three stages and what counts as delay in each, the cardinal movements and why the head has to rotate, monitoring and analgesia, and active third-stage management.
- Complications of Labour The three Ps and how to manage delay, plus the drills for cord prolapse, shoulder dystocia, uterine rupture and inversion, and the caesarean urgency categories.
- Preterm Labour Predicting preterm birth with cervical length and fetal fibronectin, progesterone and cerclage for prevention, and what steroids, magnesium and tocolysis each achieve.
- Postpartum Haemorrhage The four Ts behind the bleeding, why blood loss is always underestimated by eye, and the mechanical-medical-surgical escalation ladder that stops it.
- Prescribing in Pregnancy and Breastfeeding Why timing decides teratogenic risk, the named drugs to avoid and their safer swaps, and how codeine's metabolism can turn breast milk toxic.
- Abnormal Uterine Bleeding The PALM-COEIN framework for sorting structural from systemic causes, when to biopsy rather than just scan, and why postmenopausal bleeding is cancer until proven otherwise.
- Fibroids Why location - submucosal, intramural or subserosal - decides symptoms, the fertility-sparing treatment ladder, and red degeneration in pregnancy.
- Endometriosis Why symptom severity and disease extent barely correlate, why a normal scan never excludes it, and the hormonal-to-laparoscopic treatment ladder.
- Adenomyosis Why the uterus feels boggy rather than lumpy, telling it apart from fibroids on exam and imaging, and why only hysterectomy is truly curative.
- Polycystic Ovary Syndrome The Rotterdam criteria that make the diagnosis, the insulin-LH-androgen cycle driving it, and why letrozole now leads ovulation induction over clomifene.
- Ovarian Cysts Functional versus pathological cysts, how the IOTA rules and Risk of Malignancy Index decide who gets an oncology referral, and torsion as an acute abdomen mimic.
- Ovarian Torsion Why a normal Doppler never excludes torsion, the recent shift towards detorsion over oophorectomy even for a dusky ovary, and why laparoscopy shouldn't wait for imaging.
- Pelvic Inflammatory Disease Why a negative chlamydia/gonorrhoea swab never rules it out, the empirical antibiotic regimen, and Fitz-Hugh-Curtis perihepatitis as a right-upper-quadrant mimic.
- Menopause and Perimenopause Why FSH is rarely needed to diagnose it, matching the HRT regimen to whether the uterus is still there, and the named absolute contraindications.
- Vaginal Prolapse Naming the compartment, the POP-Q staging system, the pessary-first conservative ladder, and why vaginal mesh use is now tightly restricted.
- Bacterial Vaginosis Why it isn't an STI despite the sexual-activity link, Amsel's criteria and clue cells on the wet mount, and why partners aren't routinely treated.
- Lichen Sclerosus The ivory-white, cigarette-paper vulval skin change, why a potent (not mild) topical steroid is first-line, and the 4-5% lifetime SCC risk behind lifelong follow-up.
- Cervical Ectropion Why it's a normal oestrogen-driven finding rather than a disease, and why postcoital bleeding still needs cancer and infection excluded before it's blamed on ectropion.
- Cervical Screening Why HPV testing now comes first and cytology only runs as a reflex test, the 12/24-month HPV-positive pathway, and why vaccination doesn't replace screening.
- Cervical Cancer How E6/E7 oncoproteins drive HPV-caused disease, FIGO staging from IA to IVB, and matching trachelectomy versus radical hysterectomy to the fertility wish.
- Endometrial Cancer Type 1 versus type 2 disease, why 'unopposed oestrogen' unifies nearly every risk factor, and the 4 mm ultrasound cut-off that fails in women on tamoxifen.
- Ovarian Cancer Why vague bloating and early satiety mean most present late, the CA-125-then-RMI pathway, and why complete surgical debulking drives survival more than almost anything else.
- Vulval Cancer The two distinct routes to disease - HPV-driven usual-type VIN versus lichen sclerosus-driven differentiated VIN - and why groin node status outweighs local stage for prognosis.