The advanced hysteroscopy special skills module has been developed by the Royal College of Obstetricians and Gynaecologists (RCOG) in association with the British Society of Gynaecologic Endoscopists (BSGE). It is mainly aimed at senior specialist registrars in obstetrics and gynaecology in their final two years of training, but it can also be undertaken by non-training posts in the same field. By completion of the module, ideally within a year, trainees are expected to have reached independent competence in performing both diagnostic, as well as operative hysteroscopy. A survey was done on trainees attending the mandatory course at the RCOG (intermediate/advanced hysteroscopic surgery course in 2006), which is part of the requirement for obtaining the Advanced hysteroscopy special skills module. Feedback was obtained from 44 trainees who were either already registered for the special skills module in advanced hysteroscopy or were planning on registering. Overall, 50% of candidates found the oneyear target difficult to achieve. The majority attended at least one hysteroscopy outpatient clinic per week (85%) and/or one hysteroscopy theatre list per week (87%). This suggested the adequate attendance of hysteroscopy sessions; however, the problem was with operative hysteroscopy, which comprised 0-20% of training for the majority of trainees (59%). The conclusion was that the one-year target for obtaining the special skills module was difficult to achieve, with the most evident cause being the inability to acquire the expected operative hysteroscopy standard within the intended time.

Introduction Interventions, including commencement of antiretroviral therapy (ARV), have decreased the rate of MTCT to less than 1%. This study looks at women who commenced ARV therapy during pregnancy as this group may be at high risk of MTCT. Methods A retrospective cohort study of HIV-positive women commencing ARV during pregnancy at a London teaching hospital from January 2004–December 2013. Results Complete data sets were obtained from 55 HIV-positive pregnant women, (total 59 pregnancies). Median age at diagnosis of HIV was 30.5 (18.2–44.9). 98% contracted HIV through heterosexual contact and one case resulted from MTCT. 26/55 were diagnosed during pregnancy with median gestational age at diagnosis of 16.3 weeks (5.3–37.6). Median gestational age at ARV commencement was 22.8 weeks. Diagnosis during pregnancy was associated with a later start of ARVs (23.4 vs 19.9 weeks, p = 0.02). Viral load at delivery was available in 56 pregnancies from which only 14.3% (8/56) were detectable. 60% (29/48) babies were delivered by Caesarean section (10 emergency and 19 elective). Spontaneous vaginal delivery was achieved in 31% (15/48). Median gestational age at birth was 38 weeks with 21% (10/48) <37 weeks gestation. Average birth weight was 3076g (1100–4096). Conclusion Antiretroviral therapy commenced during pregnancy, together with a dedicated multidisciplinary team approach, was associated with an extremely low MTCT (1/59). In this small series, no particular drug regimen was associated with prematurity, however this will require further investigation with a larger cohort size.