The review found an extensive range of surgical treatment techniques, but reported results were rarely statistically significant. It is difficult to be categorical about the effectiveness of a surgical treatment method; nonetheless, each technique has its own advantages and drawbacks.

All retrieved papers were reviewed. Sudden hearing loss is a rare occurrence during pregnancy, leading to a dearth of literature due to limited clinical experience. Audiological investigation findings for such patients remain equivocal. Recovery can be spontaneous during the postpartum period. In patients who require medical treatment, a dextran 40 infusion can be employed. There remains scope for further research, in the form of larger studies, to ascertain the best management option for this clinical problem.

Aims To investigate maternal and perinatal outcomes for women with singleton pregnancies with polyhydramnios in Tayside. Methods All women diagnosed with polyhydramnios (AFI ≥ 25 cm/deepest pool ≥ 8 cm) between 01/01/13–31/10/13 were included. All women had an ultrasound scan (USS) assessment of fetal anatomy and a random blood sugar assessment as part of routine ante-natal care. Data for obstetric outcomes were collected from the local maternity database (Torex Protos Evolution, v3.5.19). Results 59/3270(1.8%) were diagnosed with polyhydramnios. Median gestation at diagnosis was 34+2weeks (range = 23+4–40+1 weeks). 14/59(23.7%) were associated with diabetes; 5/59(8.5%) had pre-existing diabetes and 9/59(15.3%) had gestational diabetes. 5/59(7%) had perinatal aetiology; 1 case of rhesus isoimmunisation diagnosed at the ante-natal booking visit and 4 congenital abnormalities. 2 congenital abnormalities were diagnosed ante-natally (1 exomphalos, 1 oro-facial cleft). 1 tracheo-oesophageal fistula and 1 case of arthrogryposis multiplex congenita were diagnosed following delivery. 40/59(68%) had idiopathic polyhydramnios. 14/40(35%) resolved on USS. Median gestation at delivery was 39+1weeks (range = 32+6–41+4weeks). Median birth weight was 3480g (range = 1375–4400g). 3/40(7.5%) had pre-term birth. 18/40(45%) had induction of labour (IOL). The median gestation for IOL was 39+1weeks (range=37+1–40+3weeks). 20/40(50%) required caesarean section. 13/20 had planned CS and 7/20 had emergency CS. 4/40(10%) had major post-partum haemorrhage (PPH). 2/40(5%) neonates required NICU admission. Conclusions Idiopathic polyhydramnios is associated with a high rate of obstetric interventions. A diagnosis of polyhydramnios was associated with high rates for induction of labour, operative delivery and major PPH, and also adverse perinatal outcome. This information will be useful to counsel women with polyhydramnios and plan management.

Aims To determine the frequency of intra-partum fetal monitoring with segment analysis (STAN), 2 years after its introduction to Ninewells Hospital, Dundee. Furthermore to assess whether the increased use of STAN was associated with improved obstetric outcomes. Methods In 2007 the use of STAN was audited prospectively over 6 months. The findings were presented at local audit meetings and recommendations were made to increase the use of STAN. For the second phase of the audit, data was collected prospectively between 1 October 2009 and 31 December 2009. Results STAN use increased from 253/1510 (17%) to 268/638 (42%) (p<0.0001). The number of women who had at least one ST event was similar (144/253 (57%) vs 149/268 (56%) (p=NS)). The number of women who had at least one attempt at fetal blood sampling (FBS) fell from 40/253 (16%) to 12/268 (4%) (p<0.0001). Similar numbers of women required operative delivery for suspected fetal distress (47/253 (19%) vs 44/268 (16%) (p=NS)). In the first phase of the audit 3/253 (1%) were delivered because of ST events that were associated with normal cardiotocography. In the second phase no women were delivered for this reason. In both phases of the audit there were similar numbers of infants with severe metabolic acidosis (5/253 (2%) vs 4/268 (1.5%) (p=NS)). Conclusions The rate of STAN use increased significantly and this was associated with a significant reduction in FBS. Both phases of the audit have shown that more than half of women will have at least one ST event. Completion of the audit cycle has shown a greater adherence to STAN guidelines, although this has not influenced neonatal morbidity.