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. In January 2007 BJOG podcasts were launched. These are free to download and listen to. Please send your feedback to: email@example.com
If you are based in the UK, for viewing/listening to a BJOG podcast you may claim 1 CPD credit under reflective learning (you will need to complete a reflective learning form which is provided in the CPD ePortfolio).
March 2012: Developments in Gynaecological Oncology
Click here to watch the video (11 minutes and 18 seconds)
This video podcast discusses three papers from the BJOG 2012 themed issue on Gynaecological Oncology. Chaired by Dr Vanessa Harry (BJOG Trainee Editor), Dr Raj Naik (BJOG scientific editor) and Dr Sean Kehoe (BJOG editorial board member) highlight developments in gynaecological oncology which these papers showcase. Dr Raj Naik starts by talking about a paper he co-authored on systematic (complete) para-aortic lymphadenectomy which describes a novel surgical classification with technical and anatomical considerations. Dr Harry then goes on to discuss another surgical paper with Dr Naik on upper abdominal cytoreduction and thoracoscopy for advanced epithelial cancer. Both of these papers discussed include impressive surgical photographs which are available as supporting information files online, and several are included in this video.
A third paper from the themed issue entitled “Ports and complications for intraperitoneal chemotherapy delivery” is analysed by Dr Harry and Dr Kehoe. Their discussion includes the background to intraperitoneal (IP) chemotherapy, the problems associated with its use, and the impact these have when considering future trials to look at IP therapy in advanced ovarian cancer.
- How would a classification that standardises para-aortic lymphadenectomy help develop clinical trials?
- Is there a role for para-aortic lymph node dissection in endometrial cancer and/or cervical cancer?
- Novel surgical techniques
- Current developments in research on IP chemotherapy
A transcript of this podcast is available to download.
January 2011: Recurrent miscarriage and heart attack: common pathways?
Click here to watch the video (15 minutes and 56 seconds)
The study used routinely collected data sources to link the experience of miscarriage in women to the incidence of cardiovascular disease in her parents. The authors found that there was a relationship between the number of miscarriages experienced by the women and the likelihood that her parents would have experienced heart disease. Interestingly, they found that there was no association with cerebrovascular disease or venous thromboembolism.
- What are the implications of this study?
- Can epigenetic phenomena explain the associations found?
- Is there a common mechanism underlying both heart disease and miscarriage?
- What significance does this study hold in practical terms?
This discussion features answers to the above and further questions from a panel of experts and provides an accessible means for the viewer to learn more about the significance of the study. The viewers may consider the role this study could play in spurring future research on investigating the underlying mechanisms/genetic predispositions that link recurrent miscarriage and cardiovascular disease.
Dimitrios Siassakos: BJOG Journal Club Editor and Trainee Scientific Editor
Professor and Head of the Obstetrics and Gynaecology at the University of Cambridge, UK
Consultant Obstetric Physician at the Institute for Women’s Health London, UK
Professor of Obstetrics and honorary consultant at the University of Warwick/Birmingham Heartlands Hospital, UK
Study: Smith G, Wood A, Pell J, Hattie J. Recurrent miscarriage is associated with a family history of ischaemic heart disease: a retrospective cohort study BJOG 2011 doi: 10.1111/j.1471-0528.2010.02890.x
Other papers highlighted in the discussion
Smith GCS, Pell JP, Walsh D. Spontaneous loss of early pregnancy and risk of ischaemic heart disease in later life: retrospective cohort study. BMJ 2003;326:423–4. doi: 10.1136/bmj.326.7386.423
Kharazmi E, Dossus L, Rohrmann S, Kaaks R. Pregnancy loss and risk of cardiovascular disease:a prospective population-based cohort study(EPIC-Heidelberg). Heart. 2011;97:49-54. doi:10.1136/hrt.2010.202226
Kaandorp SP, Goddijn M, van der Post JAM, Hutten BA, Verhoeve HR, Hamulyák K, Mol BW, Folkeringa N, Nahuis M, Papatsonis DN, Büller HR, van der Veen F, Middeldorp S. Aspirin plus heparin or aspirin alone in women with recurrent miscarriage. N Engl J Med. 2010;362(17):1586-96. doi: 10.1056/NEJMoa1000641
Clark P, Walker ID, Langhorne P, Crichton L, Thomson A, Greaves M, Whyte S, Greer IA; Scottish Pregnancy Intervention Study (SPIN) collaborators. SPIN (Scottish Pregnancy Intervention) study: a multicenter, randomized controlled trial of low-molecular-weight heparin and low-dose aspirin in women with recurrent miscarriage. Blood. 2010;115(21):4162-7. doi: 10.1182/blood-2010-01-267252
Bhattacharya S, Townend J, Bhattacharya S. Recurrent miscarriage: Are three miscarriages one too many? Analysis of a Scottish population-based database of 151,021 pregnancies. Eur J Obstet Gynecol Reprod Biol. 2010;150(1):24-7 doi: 10.1016/j.ejogrb.2010.02.015
Smith GC, Wood AM, White IR, Pell JP, Hattie J. Birth weight and the risk of cardiovascular disease in the maternal grandparents. Am J Epidemiol. 2010;171(6):736-44. doi: 10.1093/aje/kwp448
March 2010: Should HPV testing be used in the management of low grade abnormalities of the cervix?
Click here to watch the video (Flash file 157MB, 32 minutes, 21 seconds)
Invasive squamous cell cervical cancers are preceded by a long phase of preinvasive disease, collectively referred to as cervical intraepithelial neoplasia (CIN). CIN may be categorized into grades 1, 2 and 3 depending upon the proportion of the thickness of the epithelium showing mature and differentiated cells. While treatments for high grade abnormalities are well established, the best approach for women with low grade abnormalities - the majority of whom will not develop cervical cancer - is not so clear cut. What role does HPV testing play? When is immediate colposcopy preferable to cytological surveillance and immediate LLETZ over biopsy and recall?
Discussion Chair and BJOG Trainee Editor: Vanessa Harry, Subspecialty Fellow in Gynaecological Oncology St Bartholomew's Hospital, London, UK
Author: Maggie Cruickshank, Senior Lecturer at the University of Aberdeen, UK
Invited experts: Patrick Walker, Consultant Gynaecologist at the Royal Free Hospital, London, UK
Amanda Herbert, Consultant in Cytopathology at Guy’s and St Thomas’ Hospital, London, UK
Study: Cotton S, Sharp L, Little J, Cruickshank M, Seth R, Smart L, Duncan I, Harrild K, Neal K,
Waugh N, The TOMBOLA (Trial Of Management of Borderline and Other Low-grade Abnormal
smears) Group* The role of human papillomavirus testing in the management of women with low-grade abnormalities: multicentre randomised controlled trial BJOG 2010; 10.1111/j.1471-0528.2010.02519.x
Commentary: Arbyn M, Martin-Hirsch P, Wentzensen N Human papillomavirus-based triage of women showing a cervical cytology result of borderline or mild dyskaryosis BJOG 2010; 10.1111/j.1471-0528.2010.02521.x.
September 2009: 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 audio podcast. (mp3, 21.8 mb, 31 min 3 secs)
- 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.
January 2009: 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 to the audio podcast (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.
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.
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.
August 2008: 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).
- 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.
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, February 2008: 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)
October 2007: 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
May 2007: 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)
January 2007: 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)