RCOG: Recent Episodes
Royal College of Obstetricians and Gynaecologists
In this episode, Hannah and Naomi turn the tables and put the RCOG's Vice President for Education and Academia, Melanie Tipples, and Executive Director for Education, Carly Edwards, in the hot seat to answer the difficult questions they are asked time and time again by trainees. Together, they demystify who is responsible for key aspects of training — including curricula, study budgets, simulation, hysterectomy training, course costs and workforce planning — offering an honest insight into how decisions are made and what the future of surgical education could look like.
G or shared across the wider surgical community, and how organisations such as ASiT and the RCOG can work together to improve surgical education and support the next generation of surgeons. This episode is essential listening for trainees, trainers, education leads, and anyone with an interest in the future of surgical training.
G professionals, trainees, trainers, and education leads interested in innovative ways to improve surgical learning and support the future workforce.
G professionals, trainees, and anyone who has ever questioned whether they are 'good enough' — offering reassurance, perspective, and practical tools to thrive in surgery with confidence.
In this energising and insightful episode, hosts Hannah Pierce and Naomi Harvey are joined by Dr Tracy-Louise Appleyard OBE — the podcast’s first OBE recipient — to explore how military medicine can transform the way we lead, train and make decisions in healthcare. A Consultant Obstetrician and Gynaecologist at North Bristol NHS Trust and Defence Consultant Adviser in Obstetrics and Gynaecology for the Royal Army Medical Services, Dr Appleyard brings decades of experience from both the NHS and military environments. She shares how service life shaped her ability to make clear decisions under pressure, understand consequence, and lead teams through uncertainty.The conversation explores why decisiveness matters, how human factors can make healthcare safer, and what it takes to create psychologically safe teams in high-pressure environments. Dr Appleyard also shares memorable lessons on protecting your “life units”, setting boundaries, and recognising when stress is about perception rather than reality.
In this inspiring episode, hosts Hannah Pierce and Naomi Harvey are joined by Dr Amy Keightley to discuss how innovation, leadership, and ambition can transform surgical opportunities beyond tertiary centres. Working at Great Western Hospital, Dr Keightley shares her journey into gynaecological oncology, her experience in a unit-led gynae-oncology role, and how she established a CMR robotic surgery service within a district general hospital. She explores the challenges of introducing advanced technology in a non-tertiary setting and why access to complex surgery should not be limited by geography.
In this reflective and energising episode of Knot to be Missed: the RCOG Surgical Skills Podcast, hosts Hannah Pierce and Naomi Harvey are joined by Dr Simon Frazer, paediatrician and founder of Doctors Training, to explore what makes training meaningful, sustainable and human.Simon shares his journey from clinical paediatrics into medical education, including the importance of finding the 'extra thing' that brings joy and longevity to a medical career. The conversation explores how doctors can move beyond tick-box supervision towards real mentoring, why trainers need time and support to train well, and how simple conversations — often over coffee — can transform feedback, confidence and progression.Together, they discuss the pressures facing trainees and trainers, the need to invest in educators, how to handle difficult conversations constructively, and why professional sustainability starts with boundaries, reflection and self-care.
In this episode, hosts Hannah Pierce and Naomi Harvey are joined by Dr Sarah Maling to explore how innovative thinking can unlock new surgical training opportunities. Dr Maling shares how she helped create access to high-volume surgical training outside traditional NHS settings, ensuring trainees could continue to gain hands-on operative experience safely and effectively. Her work offers valuable lessons for all specialties facing reduced theatre exposure and increasing pressure on training opportunities. Together, they discuss what happens when clinical demand shifts away from traditional training environments, and how educators can respond with practical, collaborative solutions that protect both patient care and trainee development.
In this episode, hosts Hannah Pierce and Naomi Harvey speak with Dr Rebecca McKay, consultant obstetrician and gynaecologist and the associate dean for abortion training, about the future of surgical abortion training in the UK. They explore how abortion care has evolved, what this means for current and future trainees, and the dual need for emergency skills and a elective sustainable consultant workforce. Dr McKay shares her vision for improving access to training—particularly in collaboration with the independent sector—and outlines practical solutions to current barriers. An insightful listen for anyone interested in shaping inclusive, competent, and future-ready abortion care services.
Every surgeon remembers their first truly unwell patient — the adrenaline, the uncertainty, the weight of getting it right. Miss Christine Ang joins us to talk about how CCrISP and emergency simulation give trainees the closest thing to experience before the real crisis hits. Christine shares what she’s learned from directing the course, the barriers trainees face in the current system, and why simulation isn’t a 'nice extra' — it’s essential preparation for the realities of modern practice. Whether you’re early in training or decades into your career, this episode will change the way you think about emergency care.
G workforce and delve into the content of the paper. We'd like to give a content warning for this episode, which discusses themes of work-related trauma and post-traumatic stress symptoms throughout. If this topic is triggering for you, you may wish to listen to one of our other podcasts instead.
In this episode, Laura Hipple and Kirsty Dundas discuss the value of peer support in our specialty. Kirsty shares insight into the peer support initiative in place at NHS Lothian in Scotland, which is offered to staff affected by adverse events in obstetrics and gynaecology. Kirsty explains what peer support is and what it isn’t, provides an overview of how it was set up in NHS Lothian, and reflects on why peer support initiatives are invaluable to supporting staff. We'd like to give a content warning for this episode, as it touches on the themes of trauma and adverse events. If these topics are triggering for you, you may wish to listen to one of our other podcasts.
he RCOG is committed to working towards racial equity in the UK, through listening to our membership, raising awareness and sharing examples of good practice that can overcome differential attainment and workplace discrimination. In this episode, Laura Hipple and Farah Siddiqui celebrate the launch of the RCOG’s Race equity in the workforce resource. Farah summarises the College’s work in this area over the last three years that led to the development of an eLearning package, including gaining member insights from across the UK. This free resource, hosted on RCOG Learning, is designed to empower every member of staff, at every level, to be a part of meaningful change, not just in conversation, but also through action. Farah explains what is included in the six modules and highlights how everyone can play their part in cultivating psychologically safe environments that benefit both staff and patients.
In this episode, Susie Crowe talks to co-founder of Psych Safety, Tom Geraghty, about what psychological safety is and why it is important in healthcare. Susie and Tom discuss how we can cultivate psychologically safe teams in obstetrics and gynaecology by modelling psychological safety, encouraging all members of the team to ask questions, flattening the hierarchy and providing people with the space and time to reflect, communicate and contribute in their own individual way.
In this episode, Ganga Verma speaks to Katharine Backhouse and Ellie Carlisle about their involvement in establishing wellbeing initiatives in Wessex. They outline the rationale for setting up trainee open discussion groups and running a wellbeing-themed teaching day, to equip doctors with the tools they need to care for themselves and empower them to prioritise their own wellbeing.Katharine and Ellie share insight into the benefits these have had on the workforce, reflect on the challenges as well as the successes, and provide tips for other deaneries who may be considering introducing similar initiatives in their regions.
Incivility and poor workplace behaviours can hinder psychological safety and impact team morale, effective communication, and overall team performance. These permissive environments can lead to defensive practice, high stress, burnout, and sickness. In this episode, Laura Hipple, Ganga Verma, and Susie Crowe discuss the importance of promoting positive workplace behaviours in our specialty, for both staff and patient safety, and explain the impact that poor workplace behaviours can have on the workforce. Ganga and Susie share more about their role as RCOG Workplace Behaviour Advisors and offer insight into the breadth of the RCOG’s ‘Supporting our Doctors’ portfolio, including signposting to key resources that can support you throughout your career.
In this special episode, Hannah Pierce and Naomi Harvey are joined by Mr Fevzi Shakir, Consultant Gynaecologist and Chair of the Local Organising Committee for the BSGE Annual Scientific Meeting 2026, to explore his journey into advanced endoscopic surgery, the principles that shape high-quality surgical training, and the future direction of skills development in obstetrics and gynaecology.The conversation reflects on the impact of the RCOG Surgical Skills Project, the role of national organisations in supporting trainees and educators, and what makes ASMs such an important opportunity for trainees to develop their surgical skills, highlighting how networking, community, and informal learning play a vital role alongside technical excellence. With insights for trainees, trainers, and early-career consultants alike, this episode offers practical advice, inspiration, and opportunities for further surgical skill development.
Surgical training has long relied on observation, opportunity, and the occasional raised eyebrow. In this episode, we explore a novel approach: an interactive, AI-enabled simulation that allows trainees to talk through decisions, explore anatomy in 3D, and receive immediate feedback — all outside the operating theatre. We’re joined by Dr Sophie Bracke, an Obstetrics and Gynaecology registrar with a passion for leadership, innovation, and education, to discuss the development of this project and what it could mean for confidence, competence, and the future of surgical training.
In this episode, Hannah and Naomi speak with Hans Nagar, Consultant Gynaecological Oncologist at Belfast City Hospital, and Courtney McMullan, Subspecialty Trainee in Gynaecological Oncology, to explore the growing role of dual (buddy) operating in modern surgical practice.Drawing on their recently published paper on buddy operating in gynae-oncology, Hans and Courtney discuss how working as paired surgeons can improve patient outcomes, enhance safety, and strengthen the learning environment for both trainees and consultants. They reflect on its impact on operative performance, professional development, reducing burnout, and fostering a more open and collaborative theatre culture. Listen to hear how buddy operating is shaping the future of surgical training and team-based practice.
G operating. They discuss the introduction of a standardized protocol to enhance safety during challenging caesarean sections, focusing on reducing maternal morbidity and mortality. Key surgical strategies include improved pelvic access in cases of adhesions, safer bladder mobilization, and targeted control of postpartum hemorrhage through detailed anatomical guidance. They emphasise early risk identification, team preparedness, simulation-based training, and continuous surgical outcome evaluation to foster a culture of safety and excellence in obstetric care.
This episode comes with a twist: Professor Ranee Thakar steps in as guest-host to interview Surgical Skills Fellows Hannah Pierce and Naomi Harvey. Together they explore the highs, hurdles, and heartfelt moments of the RCOG Surgical Skills Project — from early-phase challenges to nationwide insights and what lies ahead in Phase 3. Expect thoughtful reflections, honest conversations, and just enough humour to keep the stitches neat.
G can adopt similar models to prepare for the next generation of surgical innovation. Listen for insights on how to build skills in robotics, access training opportunities, and sustain learning throughout their careers.
G at UCLA and a global leader in minimally invasive gynaecologic surgery. Together, they delve into the development and impact of the EMIGS platform—a validated surgical training and assessment program now required for board certification in the U.S. Professor Munro shares insights from the landmark validation study, discusses how simulation can accelerate skill acquisition, and reflects on the evolving role of structured training in improving surgical outcomes. A must-listen for anyone interested in the future of competency-based surgical education.
How do you teach the teachers? In this episode, Hannah Pierce and Naomi Harvey chat with Mr Tom Ind about what makes a great surgical trainer. From feedback tips and adult learning theory to simulation and psychological safety, they uncover the secrets to training the next generation of surgeons. Whether you’re just starting out or refining your skills, this conversation is full of practical takeaways.
Episode 11: Knot to be missed: the RCOG Surgical Skills Podcast - mind the gap by Royal College of Obstetricians and Gynaecologists
Episode 10: Knot to be missed: the RCOG Surgical Skills Podcast - incivility in surgery by Royal College of Obstetricians and Gynaecologists
Episode 9: Knot to be Missed: RCOG surgical skills podcast: serving up the future of training by Royal College of Obstetricians and Gynaecologists
In this episode of Knot to be Missed: the RCOG Surgical Skills Podcast, hosts Hannah Pierce and Naomi Harvey are joined by Miss Nahid Gul, a leading consultant in gynaecological pelvic laparoscopic and robotic surgery. Together, they explore Miss Gul’s inspiring career journey—from her early days in obstetrics and gynaecology to her pioneering work in minimally invasive and robotic surgery. With insights into training, mentorship, and the evolving future of surgical practice in the UK, this conversation offers a compelling look at innovation, leadership, and the transformative potential of technology in women's health.
Episode 7: Knot to be missed: the RCOG surgical skills podcast - laparoscopic simulation training by Royal College of Obstetricians and Gynaecologists
Long gynaecology waiting lists, workforce shortages and the increasing complexity of surgeries have limited residents' exposure to surgical skills practice and training. We need to reprioritise surgical training through earlier focus on endoscopic training. by increasing adaptability in training and through investment in innovative technologies that support residents in accessing training opportunities. Simulation training has become a vital tool for surgical skills acquisition, providing a safe, controlled environment where doctors can practice procedures without risking patient safety. We will examine how we can embed simulation training into the RCOG curriculum and will establish a Simulation Working Group to ensure equal access to training. In this episode, we discuss the third focus of the Surgical Skills project- Re-prioritising surgical training - and what we will be working on in the next phase of the project.
In our first episode the surgical skills fellows (Hannah Pierce & Naomi Harvey) talk to RCOG president, Ranee Thakar, and RCOG Vice-president for education, Ian Scudamore, on how the surgical skills project came to be and their own personal experiences of surgical skills training. The following bitesize episodes will do a deeper dive into each of the five chapters of the surgical skills interim report. Highlighting the key findings and generating conversation on some of the potential solutions to be taken forward in the next phase of the project
Knot to be missed: the RCOG surgical skills podcast - investing in the educators by Royal College of Obstetricians and Gynaecologists
In this episode, we discuss the fourth focus of the Surgical Skills project- Lifelong learning - and what we will be working on in the next phase of the project. New consultants and specialists often face the challenge of continuing their surgical skills acquisition in an environment where surgical opportunities may belimited by clinical responsibilities, rota pressures and increasing patient demands. Protected time and support are required for ongoing surgical skills maintenance and development. The next phase of the project will explore the role of fellowships.
Knot to be missed: the RCOG surgical skills podcast - simulation and virtual learning by Royal College of Obstetricians and Gynaecologists
Our future workforce faces significant challenges in meeting the demands of an evolving healthcare landscape and the increasing complexity of patient needs. We must be strategic in supporting our workforce to match changing trends bу developing strong progressive career support for each resident doctor and ensuring we proactively develop a workforce capable of managing increased surgical complexity. In this episode, we discuss the first focus of the Surgical Skills project- Workforce of the future- and what we will be working on in the next phase of the project.
Assessments- A Trainee’s Perspective - Hannah Pierce by Royal College of Obstetricians and Gynaecologists
The Global Judgement Process - Dr Alastair Campbell FRCOG by Royal College of Obstetricians and Gynaecologists
Assessments In The O&G Curriculum - Dr Alastair Campbell FRCOG by Royal College of Obstetricians and Gynaecologists
The Global Judgement Process - Dr Fiona Clarke FRCOG by Royal College of Obstetricians and Gynaecologists
This information is for you if you have pelvic organ prolapse and want to know more about it.Links to further information are available on the RCOG website: https://www.rcog.org.uk/for-the-public/browse-our-patient-information/pelvic-organ-prolapse/
This information is for you if you want to know more about nausea and vomiting of pregnancy or about hyperemesis gravidarum, which is the most severe form of the condition.Links to further information are available on the RCOG website:https://www.rcog.org.uk/for-the-public/browse-our-patient-information/pregnancy-sickness-nausea-and-vomiting-of-pregnancy-and-hyperemesis-gravidarum/
This information is for you if you are pregnant and are thinking of travelling by air.Links to further information are available on the RCOG website: https://www.rcog.org.uk/for-the-public/browse-our-patient-information/air-travel-and-pregnancy/
This information is for you if you have been diagnosed with intrahepatic cholestasis of pregnancy (ICP), also known as obstetric cholestasis.Links to further information are available on the RCOG website: https://www.rcog.org.uk/for-the-public/browse-our-patient-information/intrahepatic-cholestasis-of-pregnancy/
This information is for you if you want to know about having a cervical stitch, which is also called cervical cerclage.Links to further information are available on the RCOG website: https://www.rcog.org.uk/for-the-public/browse-our-patient-information/cervical-stitch/
This information is for you if you are pregnant or planning a pregnancy and want information about COVID-19 infection.Links to further information are available on the RCOG website: https://www.rcog.org.uk/for-the-public/browse-our-patient-information/covid-19-and-pregnancy/
The O&G Curriculum 2024- Our Journey - Alec McEwan FRCOG by Royal College of Obstetricians and Gynaecologists
Redeveloping The O&G Curriculum - Alec McEwan FRCOG by Royal College of Obstetricians and Gynaecologists
Changes To Special Interest Training In Curriculum 2024 - Judith Moore FRCOG by Royal College of Obstetricians and Gynaecologists
This information is for you if you have been told you may have endometriosis.Links to further information are available on the RCOG website: https://www.rcog.org.uk/for-the-public/browse-our-patient-information/endometriosis/
This information is for you if you want to know more about eating healthily in pregnancy.
It also gives you advice about using vitamin supplements before you get pregnant and during pregnancy.
This information is for you if you wish to know more about diabetes that develops in pregnancy or if you have been offered testing for gestational diabetes.It may also be helpful if you are a partner, relative or friend of someone who is in this situation.
A multiple pregnancy means you are having more than one baby at the same time. This is most commonly twins, but may includes triplets, or, rarely, more.This information is for you if you are having a multiple pregnancy. It may also be helpful for your partner, family or friends.
The RCOG podcast discusses living with fibroids. This condition affects 2 in 3 women, and, for some people they can really impact their lives. Dr Karen Joash discusses diagnosis, treatment and impact with Gochi Nwulu about living with this painful condition
MP3 Audio Version of Green-top Guideline No. 75, Cervical Cerclage, published February 2022
The purpose of this guideline is to review the literature and provide evidence-based guidance on the use of cerclage in women at risk of preterm birth and second trimester loss.
- Key recommendations (0:35)
- Background and scope (03:03)
- Identification and assessment of evidence (05:35)
- Definitions (07:30)
- History-indicated cerclage (11:14)
- Ultrasound-indicated cerclage (16:54) 6.1. When should an ultrasound-indicated cerclage be offered? (16:58) 6.1.1 Women with a singleton pregnancy and a history of spontaneous second trimester loss or preterm birth (19:45) 6.2. Who should be offered serial sonographic surveillance with a view to ultrasound-indicated cerclage? (24:19)
- Can cervical cerclage be recommended in any other groups of women considered at increased risk of preterm birth (29:50) 7.1. Multiple pregnancy (30:00) 7.2. Cervical surgery, trauma and uterine abnormalities (35:57) 7.3. Women with raised BMI (43:43)
- Transabdominal cerclage (45:09) 8.1. When should a transabdominal cerclage be considered? (45:14) 8.2. Should a transabdominal cerclage be performed laparoscopically? (50:06) 8.3. How should women who experience delayed miscarriage or fetal death be cared for? (53:08)
- Emergency cerclage (55:19) 9.1. When should a rescue cerclage be discussed and considered? (55.22) 9.2. What are the contraindications to cerclage insertion? (1:00:39) 9.3. What information should be given to women before cerclage insertion? (1:01:28)
- Pre-operative management (1:08:00) 10.1. What investigations should be performed before insertion of cervical cerclage? (1:08:04) 10.2. Should amniocentesis to detect infection be performed before rescue or ultrasound-indicated cerclage? (1:10:53) 10.2.1. Is amnioreduction before emergency cerclage recommended? (1:14:23) 10.2.2. Should a latency period be observed between presentation and insertion of a rescue or ultrasound-indicated cerclage? (1:15:20) 10.2.3. Should routine genital tract screening for infection be carried out before cerclage insertion? (1:16:17)
- Operative issues (1:17:35) 11.1. Should perioperative tocolysis be used for insertion of cerclage? (1:17:39) 11.2. Should perioperative antibiotics be given? (1:19:11) 11.3. What method of anaesthesia should be employed for the insertion of cerclage? (1:20:31) 11.4. Can cerclage be performed as a day-case procedure? (1:21:53) 11.5. Which technique and material should be used? (1:22:58)
- Adjuvant management (1:28:53) 12.1. Bed rest (1:28:56) 12.2. Sexual intercourse (1:30:36) 12.3. Is there a role for post-cerclage serial sonographic surveillance of cervical length? (1:31:15) 12.4. Is fetal fibronectin testing useful following insertion of a cervical cerclage? (1:35:07) 12.5. Should women receive supplement progesterone following cerclage? (1:37:38) 12.6. Should women be offered Arabin pessary or progesterone instead of cerclage? (1:40:44)
- When should the cerclage be removed? (1:44:39) 13.1. Should the cerclage be removed following PPROM? (1:47:30)
- Recommendations for future research (1:50:28)
- Suggested audit topics (1:51:25) Closing statement (1:52:05)
The aim of this guideline is to provide evidence-based recommendations on the use of antenatal corticosteroids in women at risk of preterm birth or undergoing caesarean birth at term.
1: Key Recommendations (00:50) 2: Background and Scope (03:46 ) 3: Identification and Assessment of Evidence (06:27) 4: The Benefits of Antenatal Corticosteroids (07:30) 4.1: What are the benefits of corticosteroids in preterm labour and birth (07:35) 4.2 What are the benefits of corticosteroids in planned caesarean birth at term (10:04) Table 1: Risks and benefits of antenatal corticosteroids to be discussed and offered (16:46) 5: At what gestation should antenatal corticosteroids be discussed and offered (27:03) 6: In what particular circumstances would antenatal corticosteroids be discussed with and offered to women? (34:43) 6.1: Multiple pregnancy (34:54) 6.2 Women with diabetes mellitus (39:03) 6.3 Pregnancies complicated by fetal growth restriction, pre-eclampsia or antepartum haemorrhage (43:11) 6.4. Preterm, prelabour rupture of membranes (PPROM) (51:17) 7: What is the optimum dose and route of administration for a course of antenatal corticosteroids? (55:46) Betamethasone (58:44 ) Dexamethasone (1:01:00) 8: How long after administration is a course of antenatal corticosteroids most effective? (1:05:40) 9: What are the risks associated with the administration of antenatal corticosteroids? (1:17:50) 9.1: What are the risks to the woman? (1:19:00) 9.2: What are the risks to the baby? (1:20:53) 10 - What are the contraindications to the use of antenatal corticosteroids? (1:31:44 ) 11 - In what circumstances should an antenatal course of corticosteroids be repeated? (1:33:31) 12. Recommendations for future research (1:37:21) 13. Auditable topics (1:38:37) Closing Statement (1:39:52)
This guideline sets a series of evidence-based standards to ensure a high level and consistency of practice in the provision and performance of amniocentesis and chorionic villus sampling (CVS).
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Key recommendations (00:34)
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Aim (02:17)
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Background (02:52)
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Identification and assessment of evidence (05:36)
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How should care be organised in providing amniocentesis and CVS? (6:38)
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What are the additional risks associated with invasive testing? (09:44)
6.1 What is the additional risk of miscarriage associated with amniocentesis and CVS? (09:51)
6.2 What are the additional risks associated with invasive testing? (23:19)
- At what gestation should amniocentesis and CVS be carried out? (24:24)
7.1 At what gestation should amniocentesis be carried out? (24:32)
7.2 When should CVS be carried out? (27:24)
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What are the considerations when performing amniocentesis or CVS for multiple pregnancy? (29:30)
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What is the role of third trimester amniocentesis? (37:44)
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What are the risks of mother to child transmission of infection? (40:33)
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Recommendations for future research (47:24)
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Auditable topics (47:44)
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Useful links and support groups (48:57)
Disclosures of interest (50:33)
Funding (50:49)
References (51:30)
Scientific Impact Paper No. 63 Elective Egg Freezing For Non-Medical Reasons by Royal College of Obstetricians and Gynaecologists
Green-top Guideline No. 26 Assisted Vaginal Birth by Royal College of Obstetricians and Gynaecologists
00:00:28 Executive Summary
00:16:11 1. Purpose and Scope
00:17:02 2. Introduction and background epidemiology
00:21:57 3. Identification and assessment of evidence
00:23:44 4. Clinical issues 00:23:47 4.1. Can women at risk of collapse be identified early? 00:29:15 4.2. What are the causes of maternal collapse? 00:31:13 4.2.1. Haemorrhage 00:32:40 4.4.2. Thromboembolism 00:33:21 4.2.3. Amniotic fluid embolism 00:36:03 4.2.4. Cardiac Disease 00:38:43 4.2.5. Sepsis 00:39:34 4.2.6. Drug toxicity and overdose 00:42:01 4.2.7. Eclampsia 00:42:41 4.2.8. Intracranial haemorrhage 00:43:09 4.2.9. Anaphylaxis 00:46:03 4.2.10. Other causes
00:47:01 4.3. What are the physiological and anatomical changes in pregnancy that affect resuscitation? 00:48:45 4.3.1. Aortocaval compression 00:50:36 4.3.2. Respiratory changes 00:51:54 4.3.3. Intubation 00:52:33 4.3.2. Aspiration 00:53:51 4.3.5. Circulation
00:55:02 4.4. What is the optimal initial management of maternal collapse? 00:55:10 4.4.1. Resuscitation in maternal collapse 01:00:00 4.4.2 Relieving aorto-caval compression 01:03:58 4.4.3 Airway 01:07:11 4.4.4 Breathing 01:08:58 4.4.5 Circulation 01:15:25 4.4.6 Drugs 01:15:47 4.4.7 Other considerations
01:16:59 4.5 When, where and how should perimortem caesarean section (PMCS) be performed?
01:25:27 4.6 What does the ongoing management consist of? 01:26:47 4.6.1 Haemorrhage 01:29:31 4.6.2 Venous thromboembolism 01:30:36 4.6.3 Amniotic fluid embolism 01:34:28 4.6.4 Cardiac disease 01:35:44 4.6.5 Sepsis 01:39:48 4.6.6 Drug overdose and toxicity 01:40:27 4.6.6.1 Magnesium sulphate 01:41:23 4.6.6.2 Local anaesthetic agents 01:46:18 4.6.7 Eclampsia 01:46:58 4.6.8 Intracranial haemorrhage 01:47:54 4.6.9 Anaphylaxis
01:50:29 4.7 What are the outcomes for mother and baby?
01:57:28 4.8 Who should be on the team?
02:00:59 5 Clinical governance 02:01:03 5.1 Documentation 02:02:05 5.2 Incident reporting 02:03:57 5.3 Training 02:07:27 5.4 Debriefing
02:08:26 6 Recommendations for future research
02:09:01 7 Auditable topics
02:10:05 8 Useful links and support groups
02:12:04 Disclosures of interest
02:12:15 Funding
02:13:13 Appendix 1: Explanation of guidelines and evidence levels
02:14:35 Appendix 2: Causes of maternal collapse
02:17:04 Appendix 3: Physiological and physical changes in pregnancy
02:20:52 Appendix 4: Maternal collapse algorithm
02:21:23 Appendix 5: Recommended airway equipment
02:21:57 Appendix 6: Post collapse management
02:22:25 References
This information is for you if you have been diagnosed with molar pregnancy or another type of gestational trophoblastic disease (GTD). Molar pregnancy is one of a number of different conditions that are called gestational trophoblastic disease (GTD). These rare conditions happen when a pregnancy does not develop normally from the very beginning.
This information may also be helpful if you are a partner, relative or friend of someone in this situation.
An assisted vaginal birth is when a healthcare professional uses specially designed instruments to help you give birth to your baby. This information is for you if you wish to know more about assisted vaginal birth.
Perineal tears during childbirth - what you need to know during pregnancy by Royal College of Obstetricians and Gynaecologists
Care of a third- or fourth-degree tear that occurred during childbirth by Royal College of Obstetricians and Gynaecologists
This information is for you if you have been offered a myomectomy or hysterectomy using morcellation.
This guideline comprises recommendations relating to the diagnosis, assessment, care and timing of birth of women presenting with suspected PPROM from 24+0 to 36+6 weeks of gestation. It also addresses care in a subsequent pregnancy.
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Key recommendations (01:07)
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Background and scope (03:35)
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Identification and assessment of evidence (04:45)
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Diagnosis (05:27)
4.1 How is the diagnosis of PPROM made? (05:30)
- Assessment (10:54)
5.1 What is required antenatally to identify infection? (10:58)
5.2 Should neonatologists be included in the woman's care? (15:10)
- Management (16:58)
6.1 Should antibiotics be given? (17:00)
6.2 What is the role of antenatal corticosteroids? (20:09)
6.3 What is the role of magnesium sulfate for neuroprotection of the baby? (25:30)
6.4 Should tocolytic agents be used? (28:17)
6.5 Can women be monitored at home? (30:22)
6.6 Is there a role for amnioinfusion in PPROM? (35:35)
6.7 Should women with PPROM be offered emotional support? (37:34)
- Birth (39:02)
7.1 When is the appropriate time to deliver the baby? (39:05)
- Care in a subsequent pregnancy following PPROM (44:26)
8.1 Who should care for a the woman in a subsequent pregnancy? (44:32)
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Recommendations for future research (46:45)
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Auditable topics (47:49)
Disclosures of interest (49:18)
Funding (49:35)
Supporting information (50:13)
References (51:03)
When your waters break prematurely by Royal College of Obstetricians and Gynaecologists
Being overweight during pregnancy and after birth by Royal College of Obstetricians and Gynaecologists
Placenta praevia, placenta accreta and vasa praevia by Royal College of Obstetricians and Gynaecologists
Managing premenstrual syndrome (PMS) by Royal College of Obstetricians and Gynaecologists
Treatment for symptoms of the menopause by Royal College of Obstetricians and Gynaecologists
Group B Streptococcus (GBS) in Pregnancy and Newborn Babies by Royal College of Obstetricians and Gynaecologists
Breech baby at the end of pregnancy by Royal College of Obstetricians and Gynaecologists
Heavy bleeding after birth (post partum haemorrhage) by Royal College of Obstetricians and Gynaecologists
Multiple Pregnancy - having more than one baby by Royal College of Obstetricians and Gynaecologists
Bleeding and/or pain in early pregnancy by Royal College of Obstetricians and Gynaecologists
Birth Options After Previous Caesarean Section by Royal College of Obstetricians and Gynaecologists