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Objectives To compare dinoprostone slow release pessary (propess) and gel (prostin) for induction of labour at term in nulliparous women. Method 100 case notes were reviewed with 50 women in both the propess and prostin groups, all were matched for age, BMI, parity, gestation and indications for induction. Results In the propess group, 62% of patients were induced with propess alone and the rest required additional doses of prostaglandin gel. 64% required artifi cial rupture of membranes and syntocinon augmentation. 52% of women in the propess group achieved a vaginal delivery. In the prostin group the majority of women needed 2 mg of prostin. 68% delivered vaginally. The Caesarean section rate for patients not in established labour was 8% in the propess group and 2% in the prostin group. In the propess group, the majority of patients took over 85 h from time of induction to delivery, compared to 13-24 h in the prostin group. Conclusion These preliminary data suggest that induction of labour with propess pessaries is a slower process, with a lower vaginal delivery rate and higher rate of failed inductions than using the traditional prostin gel. The longer time from induction to delivery and the price of propess compared to 2 mg prostin gel suggests this maybe a more expensive way to induce labour.group.bmj.com on August 21, 2015 -Published by http://fn.bmj.com/ Downloaded from

We have presented an unusual case of ectopic pregnancy with the negative urinary pregnancy test and a very low level of serum beta-hCG (11 IU/L). Ultrasound scan revealed right adnexal mass. Medical management and laparoscopic salpingectomy allowed for a favourable outcome.

Obesity is a big problem which is growing. Thus clinicians and surgeons are likely to treat obese patients more frequently. Obesity can affect medical practice in a number of ways. In order to protect ourselves from potential litigation, we need to focus on risk management efforts on creating a safe environment for patients of all sizes. The aim of our study was to review the risk management strategies of obese women prior to surgery, perioperatively and following surgery. We then identified the strategies and have brought them forward in our article.

Electronic searches of literature published between 1980 and 2014 were undertaken using MEDLINE, Embase, CINHAL, and the Cochrane Database of Systemic reviews. Search items included: post coital bleeding, colposcopy, cervical cancer. Postcoital bleeding remains a cardinal warning sign of lower genital tract cancer and it is important to remember that it can also occur in the absence of cancer. In the vast majority of cases, there will be no sinister pathological abnormality. The common causes are usually benign conditions such as cervical ectopy and benign cervical polyps. Only a small number of women with PCB will have invasive disease of the lower genital tract.