Acupuncture is an ancient form of medicine involving sensory stimulation via needle insertion. In the UK, Western medical acupuncture (WMA), an adaptation of traditional Chinese approach, is used in varying circumstances, including in obstetrics and gynaecology. Outcome studies have demonstrated that acupuncture can be effective in pain management, fertility and obstetrics (during pregnancy, intrapartum and postpartum). Acupuncture is safe and has a very low risk of adverse incidents if carried out by trained and accredited practitioners. Learning objectivesTo understand that there is a different but complementary option available when treatment success is not achieved with Western medicine and that women may opt for acupuncture over more recognised treatment options. To be aware that studies have shown that acupuncture can be a beneficial treatment, but most studies are non-randomised. Ethical issuesWomen should be given information about all suitable treatments, including acupuncture, to make an informed choice.

The way in which gynaecology services are provided in the UK has drastically changed within a short space of time due to the global COVID-19 pandemic. Gynaecologists are not considered front-line staff in the treatment of the novel coronavirus unlike our intensive care or accident and emergency colleagues. However, the impact this is having on those with chronic problems is significant, and the morbidity associated with missed malignancies could be problematic. This article summarises the strategies developed at King’s College Hospital to remodel services to best provide optimum treatment to patients in this new era.

Stress urinary incontinence is common in pregnancy and its severity can be reduced with pelvic floor muscle training. Overactive bladder syndrome prevalence increases with gestation and treatment can be conservative or medical. Pelvic organ prolapse is multifactorial. Pelvic floor exercises and pessaries are important treatments and previous surgical management can affect the mode of delivery. Recurrent urinary tract infections can be treated with antibiotic prophylaxis or with non-antibiotic prophylaxis such as methanamine hippurate, D-Mannose and hygiene behaviour. Urinary retention can occur at any point during pregnancy, causing bladder distension, voiding dysfunction and subsequent lifelong catheterisation. Learning objectivesTo be aware of the pathophysiology and management of different types of urinary tract dysfunction in pregnancy and the postpartum period. To understand the potential causes and management of pelvic organ prolapse in pregnancy and the postpartum period. To understand the different potential management options in recurrent lower urinary tract infections.