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BJOG Podcasts
BJOG is a journal at the forefront of both medicine, and technology. The editorial team, led by Professor Philip Steer, is always looking for ways to improve the journal, and from 2007 have brought you podcasts from BJOG. These are free to download and listen to. Please send your feedback to: bjog@rcog.org.uk
BJOG Audio Podcast: Termination of pregnancy and the risk of subsequent preterm birth – what is the evidence?
A meta-analysis published in October's BJOG suggests that even one termination of pregnancy can increase the risk of future preterm birth.
In this podcast, four international experts discuss the strengths and weaknesses of the analysis, which is based on a variety of observational studies. They speculate about possible mechanisms by which some traditional termination methods might damage the cervix and uterus, and suggest improvements in technique to minimise risk. They call for further studies on how termination of pregnancy affects future pregnancies, and research to establish the safest techniques.
Click here to listen to the podcast. (mp3, 21.8 mb, 31 min 3 secs)
Interviewees:
- Vincenzo Berghella (BJOG Editor): Professor, Department of Obstetrics and Gynecology, Thomas Jefferson University, Jefferson Medical College, Philadelphia, PA, USA
- John Thorp (BJOG Editor): McAllister Distinguished Professor OBG, Schools of Medicine, Public Health, University of North Carolina, NC, USA
- Laura MacIsaac: Professor of Obstetrics and Gynecology and Public Health at Columbia University, New York, USA
- Prakesh Shah (an author of the meta-analysis): Consultant Neonatal Intensivist and Clinical Epidemiologist, Associate Professor, University of Toronto, Toronto, Canada
Article up for discussion
Shah P, Zao J on behalf of Knowledge Synthesis Group of Determinants of preterm/LBW births. Induced termination of pregnancy and low birthweight and preterm birth: a systematic review and meta-analyses BJOG 2009; 116:1425–1442. DOI: 10.1111/j.1471-0528.2009.02278.x.
BJOG Audio Podcast: Maternity Audit in the developing world
Can audit reduce maternal mortality in the developing world? Listen to our podcast for the answers. Idea developed by Andrew Weeks. Interview by Wendy Barnaby. Click here to listen (mp3, 17.5mb, 24 mins 50 secs)
Articles up for discussion: C Ronsmans et al. Estimation of population-based incidence of pregnancy-related illness and mortality in two districts in West Java, Indonesia.
F Richard et al. The difficulty of questioning clinical practice: experience of facility-based case reviews in Ouagadougou, Barkina Faso
EJ Kongnyuy & N van den Broek. Audit for maternal and newborn health services in resource poor countries (Commentary)
Podcast content: three interviews
Clinical audit has only been introduced into developing countries relatively recently. In this podcast the benefits and difficulties of introducing audit to different cultures are discussed. Our expert panel also tackles the question of whether introduction of audit will result in an improvement in quality of care.
The experts:
Professor James Drife: British expert in audit who has worked for many years on the UK Confidential Enquiry into Maternal Deaths. Well known for his witty provocative writings in the BMJ and TOG.
Dr Nynke van den Broek: (Director RCOG International Office). Recently worked on strengthening maternal and perinatal death audit in Kenya and Malawi.
Professor Robert Pattinson: World renowned for his work in South Africa on audit and quality improvement. Was recently instrumental in setting up the South African Confidential Enquiry into Maternal deaths.
BJOG Video Podcast: Telemedicine for termination of pregnancy
Click here to watch the video (Flash file, 25 minutes, 21 seconds)
Discussants include author Rebecca Gomperts (Women on Web), Marge Berer (Editor of ‘Reproductive Health Matters’), Mariana Romero (an expert on reproductive health in South America) and Martin Lupton, (an obstetrician and ethicist who works in London).
Key issues:
- The high rates of ‘unsafe abortion’ around the world, especially in South America.
- The sale of counterfeit misoprostol over the internet: how women are attempting to obtain misoprostol without medical support after learning of its effectiveness for terminating pregnancy.
- Whether ‘Women on web’ provides an alternative to non-medically trained providers performing unsafe surgical terminations.
- How the women are assessed medically and guided through the process.
- Whether provision of medical termination in countries where access is restricted is morally and legally acceptable.
Articles discussed:
Using telemedicine for termination of pregnancy with mifepristone and misoprostol in settings where there is no access to safe services
RJ Gomperts, K Jelinska, S Davies, K Gemzell-Danielsson, G Kleiverda DOI: 10.1111/j.1471-0528.2008.01787.x (pages 1171-1178)
This paper is accompanied by commentaries including an Editor’s Commentary (Julia Hussein), a legal perspective (Bertie Leigh) and a developing world perspective (TKS Ravindran and MR Nair)
Termination of pregnancy by telemedicine: an ethicist's viewpoint
M Lupton DOI: 10.1111/j.1471-0528.2008.01790.x (pages 1071-1073)
First BJOG Video: The changing landscape of IVF: how to reduce multiple pregnancy without reducing pregnancy rates.
The video is a discussion on the paper Khalaf et al, published in February’s BJOG.
Click here to watch the video (Flash file, 18 minutes 14 seconds)
The Chair: Phil Steer, Editor-in Chief of BJOG.
Discussants: Yacoub Khalaf, Tony Rutherford, Bill Ledger and Tarek El-Toukhy
Location: Council Chamber, RCOG, London
What steps can be taken in IVF practice to reduce multiple pregnancies? How can multiple pregnancy rates be reduced without reducing pregnancy rates? These key questions are addressed.
Best practice for introducing selective single blastocyst transfer (SBT) is discussed. Also described in the video are the strategies being used to reduce multiple pregnancies resulting from IVF in Belgium and Sweden, highlighting the political and financial perspectives.
After watching the video, for further details please read the paper discussed:
Selective single blastocyst transfer reduces the multiple pregnancy rate and increases pregnancy rates: a pre- and postintervention study
Y Khalaf, T El-Toukhy, A Coomarasamy, A Kamal, V Bolton, P Braude 2008;115:385–390 (doi:10.1111/j.1471-0528.2007.01584.x)
BJOG Audio Podcast: ECG-ST analysis in labour: lessons learnt
STAN is a recently introduced method of fetal monitoring during labour. How is it different from monitors previously used? STAN not only measures fetal heart rate but also measures the ECG waveform, in particular the ST segment of the heart signal.
When continuous electronic fetal monitoring was first introduced in the 1960s, hopes were high that intrapartum fetal mortality and morbidity could be dramatically reduced, or even abolished. In the event, problems with user interpretation of the fetal heart rate patterns, and delay in delivering the compromised baby, have meant that the potential benefits of the technology have been difficult to realise in practice. Are we seeing a similar story with STAN?
In this third BJOG podcast, Mr Austin Ugwumadu, Mr Aris Papageorghiou and Professor Arulkumaran are interviewed. Hear about the advantages, limitations and pitfalls of the STAN monitoring system, and their hopes for the future. Click here to listen (mp3 file: 11.9mb. 16 minutes 57 seconds)
Articles discussed in the podcast are listed below (BJOG September 07): Fetal electrocardiogram: ST waveform analysis in intrapartum surveillance Limitations of ST-analysis in clinical practice: three cases of intrapartum metabolic acidosis. Review of the first 1502 cases of ECG-ST waveform analysis during labour in a teaching hospital
BJOG Audio Podcast: Monitoring Obstetricians' Performance with Statistical Process Control Charts
Hear from Steven Lane, Helen Scholefield, Zarko Alfirevic and Andrew Weeks. Interviewing journalist: Wendy Barnaby Click here to listen (mp3 file: 17.2MB, 24 minutes 26 seconds).
Articles discussed in the podcast are listed below: Monitoring obstetricians' performance with statistical process control charts (Lane et al)
BJOG Audio Podcast: Screening for cervical pre-cancer: Have we dismissed ablative treatment too soon in colposcopy practice?
Hear from Dr Pierre Martin-Hirsch. Interviewing journalist: Wendy Barnaby. Click here to listen (mp3 file:13.5 MB, 33 minutes 5 seconds).
Articles discussed in the podcast are listed below (BJOG January 2007): Precancerous changes in the cervix and risk of subsequent preterm birth. (Bruinsma et al)
Do women with high-grade cervical intraepithelial neoplasia prefer a see and treat option in colopscopy? (Balasubramani et al)
Have we dismissed ablative treatment too soon in colposcopy practice? (Paraskevaidis et al)
