The proposed toolkit enables clinicians to predict the risk of postpartum hemorrhage. As a result, preventative measures for postpartum hemorrhage could be undertaken. Further external validation of the current toolkit is required.

As survival of babies born following high-risk pregnancies continues to increase globally, understanding the long-term impacts of suboptimal intrauterine environments on future health becomes increasingly important. The intrauterine environment is a key influence on later metabolic health, particularly the tendency to later-life obesity and dyslipidaemia. Recent evidence shows that female reproductive function is also highly sensitive to the influence of the early life environment. Various suboptimal intrauterine environments are linked to adverse reproductive and metabolic outcomes, including maternal obesity, low-protein diets and chronic fetal hypoxia. Learning objectivesTo know that the prevalence of high-risk intrauterine environments is increasing in maternity populations because of, for example, increasing rates of maternal obesity. To be aware of the later-life health implications for the fetus when caring for women with high-risk pregnancies. To understand that children who are survivors of high-risk pregnancies are at increased risk of adverse metabolic health outcomes and more work is required to determine optimal follow-up.

Introduction: Endometriosis is defined as 'the presence of endometrial glands and stroma outside the uterine cavity'. Appendiceal cancers are rare tumours of the gastrointestinal tract. There are some reported cases of these two disease processes occurring simultaneously within separate lesions. However, there are no reported cases of the two diseases occurring within the same entity. We report the unique case of an appendiceal cancer (combined mucinous cyst adenoma and carcinoid tumour) with coexistant histological features of an endometrioma. Case report: A 36 year old nulliparous woman was referred to clinic with primary infertility, with an unremarkable past medical history. After routine infertility investigations, diagnostic laparoscopy was carried out and endometriosis was diagnosed. A suspicious lesion was also seen on the appendix. A right hemicolectomy and appendectomy was performed. Histological results showed mucinous cystadenoma with well differentiated carcinoid tumour and coexistent features of an endometrioma. Discussion: An association between endometriosis and cancer has been well documented in literature. Existence with appendiceal cancers is rare. Carcinoids and cyst adenomas are both common types of appendiceal cancers, found incidentally or mimicking acute appendicitis. Occurrence in the same lesion is rare and unique to be found with features of an endometrioma. Conclusion: This case illustrates the broad spectrum of appendiceal and endometrial disease. We hope to highlight the interesting asymptomatic presentation of this patient and therefore the importance of requesting routine histopathological analysis after appendicectomy.

No abstract

No abstract