We describe the first reported case of extensive calcification seen in association with serous cystadenofibroma of the ovary, illustrating that calcification in the female genital tract may be extensive in nature, presenting in a fashion that is not entirely typical of dystrophic or metastatic calcification. This case demonstrates that extensive calcification within the pelvis should be interpreted with caution, as it may not represent disseminated malignancy.

Introduction NICE guideline on induction of labour (IOL) at/ or beyond 41 weeks gestation is based on the evidence that IOL is associated with reduced perinatal morbidity/mortality and does not result in increased Caesarean deliveries. This recommendation however does not take into account the ethnic variation in gestational length. Aim To assess outcome of postdate pregnancy among a group of Asian women who underwent planned induction of labour. Materials and Methods Retrospective review of case notes of consecutive 300 Asian women with uncomplicated post dates pregnancy who were planned for IOL. Results 207 (69.4%) women went into spontaneous labour while waiting for IOL. 71% had spontaneous vaginal delivery, 23% instrumental deliveries and 6% emergency Caesarean section. 93 (30.6%) women had IOL with vaginal Prostin, in 46.6% cases and artifi cial rupture of membranes followed by Syntocinon infusion in 13.4% cases. 81% had spontaneous vaginal delivery, 2% forceps delivery and 17% emergency Caesarean section. Average gestational length in he induction group was 40+12 weeks and 40+8 weeks in spontaneous labour group. Discussion Recent evidence suggesting that Asian women, who may have gestational length 1 week shorter than the Caucasian, should be considered for early IOL. An early induction policy may help to reduce the risk of increased Caesarean delivery in this group of women. As NICE guideline on IOL does not take into account that gestational length can vary between ethnic groups, there is need for research to determine an induction policy in this group

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Background Obesity related hospital admissions increased 700% in last decade. Assessment of availability of suitable bariatric equipment across clinical areas is essential to optimise care environment for this vulnerable group to appropriate levels of ‘Safety &Quality’. Aim To assess availability of suitable equipment through gap analysis against CMACE/RCOG recommendations, before move of reconfigured maternity services (merger of two hospitals) to new unit. Method Evaluation of above in all settings(primary and secondary care clinics, scan suites, in-patient &day assessment wards, delivery suite and theatres) through a structured proforma. Results Pre move assessment identified gaps in availability of some bariatric equipment in all key areas. Safe weight threshold of examination couches &theatre tables were below recommended>250kg. Since move to new centre this availability was ensured in all clinics, wards &theatres as gap analysis &action implemented resulted in procurement of suitable equipment for all settings. Currently stand on scales and BP cuffs of varying sizes are available but Sit on scales, extra wide (EW) wheel chairs &toilet seats/commodes were lacking. It was noted that BMI charts/wheels had maximum limit of only 186kg/BMI 65. Conclusions/Recommendations CMACE/RCOG guidance has provided an opportunity for maternity services to take a lead role to ensure that bariatric policies for obese pregnant women are included in generic trust bariatric policies. Work is in progress to add a chapter on this within our trust bariatric policy. Disparity in equipment models noted in this review is currently being addressed through a phased electively planned procurement programme.

Collodion is a rare(1:200 000) congenital condition linked to gene mutation mostly and sometimes can be autosomal recessive. Babies appear to have an extra layer tight shiny skin (sausage skin appearance) predisposed to abnormal desquamation and dehydration. Clinical presentation and severity varies, ranging from harlequin ichthyosis, the most severe and fatal form, to less severe ones. Management requires multidisciplinary expertise of dermatologist, paediatrician, ophthalmologist, geneticist, physiotherapist. We present a case of collodion baby born at 37 weeks gestation, diagnosed at birth and managed successfully by ELHT multidisciplinary team. This case is interesting as we learnt since first baby that consanguinity confers higher risk status and six genes have been identified by Geneticists recently in association with collodion which makes pre natal diagnosis, and screening of other family members potentially possible now. Mother is currently in second pregnancy with us and referred for genetic counselling but declined prenatal testing.