Maternal height and labour outcome.

The aim of this study was to assess if maternal height has an effect on duration of labour, mode of delivery and birth weight. This was a retrospective analysis of casenotes of 1000 white primigravidae in a district general hospital. Spearman's rank correlation coefficient, logistic regression analysis, and Pearson's correlation coefficient was used to determine the relation between height and duration of labour, height and mode of delivery and birth weight, respectively. Odds ratio was used to quantify the association. There was no significant association between height and duration of labour. There was a statistically significant positive correlation between height and birth weight and a negative association between height and incidence of caesarean sections. A cut-off height of 160 cm is proposed as a screening tool to predict a need for caesarean section.

Management of uterine fibroids.

Until recently the management of uterine fibroids has been exclusively surgical in the form of either hysterectomy or myomectomy. The development of minimally invasive techniques and the introduction of LHRH agonists has allowed more conservative management to maintain or restore fertility.

The effect of hysterectomy on urinary symptoms and residual bladder volume.

This was a prospective, clinical study to evaluate the effect of abdominal and vaginal hysterectomy for benign indications on urinary symptoms and residual bladder volume. One hundred and seven women undergoing hysterectomy for benign conditions were included in the study that took place in a district general hospital between April 1998 and January 2000. Urinary symptoms such as stress incontinence of urine, urgency, frequency, nocturia, sensation of incomplete voiding and voiding difficulties were considered. A questionnaire was filled out and the residual bladder volume measured with a 'Bard' bladder scanner on three occasions-before the operation, postoperative days 3 or 4 and at the 6-week postoperative visit. Statistical analysis involved using a generalised estimating equation and significance assessed at the 5% level. Each woman acted as her own control. There was no evidence of changes in nocturia and voiding difficulties after surgery. All other symptoms and residual bladder volumes decreased significantly postoperatively. The type of hysterectomy did not have an effect.

Obstetric outcome in women over the age of 40 years.

This is a retrospective review of 109 deliveries during a 5-year period in women aged 40 years or over and the results were compared with other studies in literature. The incidence was 1%. There was no increase in complications of pregnancy though there was an increased caesarean section rate and perinatal mortality rate. It is imperative that all mature pregnant women are managed as a high risk group but we should be mindful of the need to justify intervention in the same way as in the younger age group.

Assessment of women's satisfaction with medical termination of pregnancy.

This was a prospective study involving 205 women seeking medical abortion with gestational age

The influence of religious beliefs on general practitioners' attitudes towards termination of pregnancy--a pilot study.

We set out to examine the attitudes of general practitioners in the West Norfolk area towards requests for abortion for various reasons and explore the factors that may influence their views, particularly their religious beliefs. This cross-sectional survey was conducted using a questionnaire, targeting 140 general practitioners. A response rate of 51.4% was achieved. All respondents were older than 30, and were mostly males (84.6%), married (93.8%) with children (90.9%). Most were either Church of England Christians (C of E) (48.5%) or had no stated religion (35.3%). The former were significantly less likely to agree with abortion than the latter for social reasons (P = 0.02) or in the case of teenage pregnancy (P = 0.006). A total of 73.8% of respondents followed-up patients after termination. Other associations were indicated, but were not statistically significant. Larger studies are needed to verify these associations for general practitioners in general.

Vaginal pressure as an index of intra-abdominal pressure during urodynamic evaluation.

Vaginal pressure was measured using balloon catheters in 20 patients and open-ended fluid-filled catheters in another 21. The results showed excellent correlation between vaginal, vesical and rectal pressures in response to changes in abdominal pressure.

Vaginal sacrospinous fixation: experience in a district general hospital.

This is an observational retrospective study, which included 77 patients who underwent sacrospinous fixation (SSF) over a period of 3 years in a district general hospital. Casenotes were reviewed and all patients were invited to attend a further review appointment (14-49 months). The object was to determine short- and long-term success of SSF,particularly in elderly (28% were > or = 70 years), obese (24.7%) and medically compromised (64.9%) patients. Fifty-two patients (67.5%) had previous gynaecological procedures, while the remaining 25 (32.5%) had no previous surgery. Intra- and postoperative complications were 3.9% and 32.5%, respectively. There was considerable relief of patients' symptoms at both short- and long-term followup, while the rate of recurrence of vault prolapse was 10.3%. Our experience suggests that SSF appears to be a safe and effective procedure, especially for those who may constitute surgical or anaesthetic risks. It has a reasonable success rate, good postoperative recovery and acceptable long-term results.

The place of Zoladex in deferred surgery for uterine fibroids. Zoladex Myoma Study Group.

Two hundred and forty-seven patients with uterine fibroids were randomized to surgery alone or 3 months' Zoladex (Zeneca, Macclesfield, Ches., UK) followed by surgery. Zoladex significantly reduced uterine and fibroid volumes (p = 0.0001). There was a significantly (p = 0.002) greater mean rise in haemoglobin from entry to preoperation in the Zoladex group (1 g/dl) compared with the surgery-alone group (0.3 g/dl) as well as a tendency towards easier surgery, and reduced operative blood loss. Zoladex-treated patients had a significantly (p = 0.016) shorter hospital stay and pelvic pain and abdominal pressure symptoms were significantly (p < 0.0001) reduced in this group. Zoladex was well tolerated.