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After 14 weeks
88%' 94.7 %
14. 3% of MC placentas have two placental masses (bipartite), so these are
not necessarily dichorionic.
15. The prospective risk of unexplained stillbirth after 32 weeks in MCDA
twins is 1/23 (4.35%)
16. reported incidence of vasa previa varies between one in 2000 and one in
6000 pregnancies in IVF it is 1 in 300
17. Sensitivity and specificity of different ultrasound modalities in
diagnosing placenta accreta are : grey scale 95% , 76%, Doppler 92%' 68%'
2
and 10%
66>Approximately 5% of women experience severe premenstrual
symptoms .
67>Up to 10% of women will have some form of surgery during their
lifetime for the presence of an ovarian mass.
68>The overall incidence of a symptomatic ovarian cyst in a premenopausal
female being malignant is approximately 1:1000 increasing to 3:1000 at the
age of 50.
69>Although up to 20% of borderline ovarian tumours appear as simple
cysts on ultrasonography the majority of such tumours will
have suspicious ultrasonographic finding.
70>ca 125 is only raised in 50% of early stage disease.
71>RMI I sensitivity 78% specificity 87% in premenopausal women for
RMI of 200
72>Using IOTA rules the reported sensitivity was 95%, specificity
91%, positive likelihood ratio of 10.37 and negative likelihood ratio of
0.06.
73>The recurrence rates after laparoscopic needle aspiration of simple cysts
range from 53% to as high as 83%.
74>Chemical peritonitis due to spillage of dermoid cyst contents has been
reported in different series to occur in less than 0.2% of cases
75>Serum CA125 is well established, being raised in over 80% of ovarian
cancer cases
76> In post menopausal women if a cut-off of 30u/ml is used, the test has a
sensitivity of 80% and specificity of 75%.
77> Ultrasound is also well established, achieving a sensitivity of 90% and
specificity of 73% when using a morphology index.
78>Using a cut off point of RMI of 250 in post menopausal women and
sensitivity of 70% and specificity of 90% can be achieved.
79> 12-17% percent of women undergoing excision of VIN have clinically
unrecognised invasion diagnosed on histology.
80>Survival from cervical cancer is stage dependent, with an overall 5-year
survival of approximately 60%. Other prognostic indicators are the tumour
type, tumour bulk, age and performance status of the individual patient.
81>. Cure rates of exenteration in cervical cancer is 30–50% have been
reported but the operation has a mortality of approximately 2–4%.
82>The need for chemotherapy following a complete mole is 15% and 0.5
% after a partial mole .
83>the development of postpartum GTN requiring chemotherapy occurs at
a rate of 1/50 000 births.
6
113.In women with placenta praevia and five or more prior caesarean
deliveries, the incidence of placenta accreta is up to 67%.. .
114.observational studies, have shown similar rates of VBAC success with
two previous caesarean births (VBAC success rates of 62–75%) and single
prior caesarean birth(72-75%).
114.The rates of hysterectomy (56/10 000 0.5% compared with 19/10 000)
0.2% and transfusion (1.99% compared with 1.21%) were increased in
women undergoing VBAC after two previous caesarean births compared
with one previous caesarean birth.
115.The rates of hysterectomy (56/10 000 compared with 19/10 000) and
transfusion (1.99% compared with 1.21%) were increased in women
undergoing VBAC after two previous caesarean births compared with one
8
117.Most uterine ruptures (more than 90%) occur during labour (the peak
incidence being at 4–5 cm cervical dilatation), with around 18% occurring in
the second stage of labour and 8% being identified post vaginal delivery.
118.The risk of uterine rupture in an unscarred uterus is extremely rare at 2
per 10 000 (0.02%) and in ERCS the risk is 2 per 10 000 (0.02%) also.
119.It is important to note that scar dehiscence may be asymptomatic in
up to 48% of women.
120.classic triad of a complete uterine rupture (pain, vaginal bleeding, fetal
heart rate abnormalities) may present in less than 10% of cases.
121.In the NICHD
study,18 prostaglandin induction compared with nonprostaglandin induct
ion (e.g. amniotomy or intracervical Foley catheter) was associated wit
h a higher uterine rupture risk (87 per 10 000 [0.87%] versus 29 per 10 000
[0.29%]) and a higher risk of perinatal death due to uterine rupture (11.2 per
10 000 [0.11%] versus 4.5 per 10 000
122.At least 80% of women tested will have VZV IgG and can be reassured.
123. The incidence of pneumonia complicating varicella in pregnancy has
been quoted at 1014%.
124. Pooled data from nine cohort studies detected 13 cases of FVS
following 1423 cases of maternal chickenpox occurring before 20 weeks of
gestation: an incidence of 0.91%The risk appears to be lower in the first
trimester (0.55%)
125.If maternal infection occurs 1–4 weeks before delivery, up to 50% of
babies are infected and approximately 23% develop clinical varicella.
126.In uncomplicated malaria, fatality rates are low: approximately 0.1%
for P. falciparum. In severe malaria, particularly in pregnancy, fatality
rates are high (15–20% in nonpregnant women compared with 50% in
pregnancy).
127.The reported prevalence of congenital malaria varies from 8% to 33%.
128.warfarin embryopathy (hypoplasia of nasal bridge, congenital heart
defects, ventriculomegaly, agenesis of
the corpus callosum, stippled epiphyses) in approximately 5% of fetuses
exposed between 6 and 12 weeks of gestation.
129.The sensitivity of serial compression ultrasonography with Doppler
imaging was 94.1% and the negative predictive value was 99.5%
130.lower risk of LMWH compared with unfractionated heparin for heparin-
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80% for the under 50s age group; however,the survival rate may be lower in
very young women.
147.overall survival for ovarian cancer is 35%.
148.The overall 5-year survival for cervical cancer is approximately 60%
148. Overall 5 year survival of GTN is 93%.( stage I =97%'
stageII=86%,stageIII=83% stage IV=61%)
152.Fewer than 10% ofwomendiagnosedwith breast cancer subsequently
become pregnant.
153.Amenorrhoeais reported in 20–70% of premenopausal
womenwithbreastcancer,69 but the rate ranges from less than 5% in women
under 30 years of age to 50% in women aged 36–40 years
154.is now well established that HPV is found in over 95% of cervical
cancers.
155.The two most common high-risk HPV viruses for development of
cervical cancer are HPV-16 and HPV-18, which account for approximately
70% of squamous cell cancers.
156.PHVP has been reported to follow 11.6% of hysterectomies performed
for prolapse and 1.8% for other benign diseases.6 A large study from
Austria estimated the frequency of PHVP requiring surgical repair to be
between 6% and 8%.
157. After ASC At 24 months’ follow-up, the vaginal vault was well
supported in 99.2%, with 89.2% showing stage 0 vaginal vault prolapse and
10% showing stage I prolapse that did not require revision surgery
158. A systematic review of observational studies reported long-term
success rates of 78–100%.
159.Mesh erosion was observed in 2–11%, Serious complications such as
bowel injury, sacral myelitis and severe bleeding have an estimated
incidence of 2% (range 0–8%).
160.in SSF One concern is the high incidence (8–30%) of postoperative
anterior compartment prolapse and SUI.
161.use of TVM in treatment of PHVP objective success rates of 87–95%
with short-term follow-up (6–18 months). Mesh erosion occurred in 4.6–
10.7% and reoperation rates were 0.4–6.0%.
162.Lichen sclerosus accounts for at least 25% of the women seen in
dedicated vulval clinics, with estimates of incidence quoted as one in 300 to
one in 1000 of all patients referred to dermatology departments.
163.On excision, 19–22% of cases of VIN have unrecognised invasion
detected.
164. In case of VIN Rported risk of progression to cancer varies widely,but
appears to be in the order of 40–60%.
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184. Creatinine value falls from 62 to 44 um/lit, while urea falls from 4.3 to
3.2 mm/lit as GFR increases as early as 6 weeks of pregnancy
185.risk of meconium passage increases linearly with a 19.7% increase for
each 10 micromoles/litre increase in total bile acid concentration.
186. Transabdominal cerclage has incidence (3.4% versus 0%) of serious
operative complications (bleeding requiring transfusion, injury to
bladder/bowel/uterine artery, anaesthetic .
187. complications with cervical cerclage including bladder
damage, cervical trauma, membrane rupture and bleeding are reported but
are raresia problems)
188.The incidence of intra-amniotic infection in ultrasound-indicated
cerclage is about 1–2%.
189.The rate of ectopic pregnancy is 11 per 1000 pregnancies, with a
maternal mortality of 0.2 per 1000 estimated ectopic pregnancies
190.Inform women having a salpingotomy that up to 1 in 5 women may
need further treatment. This treatment may include methotrexate and/or a
salpingectomy.
191.The mortality rate in vasa Previa is around 60% although significantly
improved survival rates of up to 97% have been reported where the
diagnosis is made antenatally.
192. TVS HAS sensitivity 88%' specificity 98.8%, positive predictive
value 93.3%, negative predictive value 97.6% and false negative rate
2.33%).for diagnosis of placenta Previa.
193. Sensitivity of MRI in diagnosis of placenta accreta is 80% and
specificity is 65%.
194.As gestation advances vasa praevia can resolve in up to 15% of cases.
195. Incidence of velamentus cord insertion in general population is 1% and
bi lobed placenta and succenturate lobe is 1.7%p
196.APH complicates 3-5% of pregnancies.
197. 20% of all preterm deliveries are in association with APH.
198.70% cases of placental abruption occur in low risk pregnancies.
199.Obstetric haemorrhage remains a major cause of maternal mortality in
the UK and is now the third leading cause of direct maternal deaths,
accounting for approximately 10% of direct deaths.
200. antenatal use of iron, with or without folic acid, showed a 50%
reduction in the risk of anaemia in the third trimester or at delivery.