This was a prospective observational study in a tertiary referral obstetric unit in Dublin to ascertain the delivery outcome in the first 1000 nulliparous women in 2000. The initial diagnosis of labour was confirmed in the first 1000 consecutive nulliparous women in spontaneous labour with cephalic presentation at term. All patients underwent active management of labour. Active management included strict criteria for the diagnosis of labour, early amniotomy, 2-hourly vaginal examinations, oxytocin augmentation where progress of labour was slow and the presence of a companion (personal nurse) in labour. Epidural analgesia was freely available. Mode of delivery, duration of labour, analgesia usage and maternal and perinatal complications were the main outcome measures. All patients presented with painful uterine contractions, 75% with show in addition, and 36% had spontaneous rupture of membranes on admission. Eighty per cent presented with a cervical dilatation of 12 hours) was 4.3%. Postpartum haemorrhage occurred in 3.8% of mothers and 1.6% of babies were admitted to the special care baby unit. Our study suggests that active management of labour is associated with a low incidence of prolonged labour and a low caesarean section rate.

The aim of the study was to document the role of laboratory investigations for unexpected stillbirths at term. It was a retrospective casenote review of 75 unexpected stillbirths at term from 1995 to 1999, at the National Maternity Hospital, Dublin, Republic of Ireland. Investigations performed included blood tests, chromosomal analysis, autopsy and placental histology. Perinatal autopsy was the most informative investigation with positive findings in 49% of cases. There were positive placental findings in 37% of cases. Six of the 26 cases showed abnormal karyotyping. Of the blood tests performed, the Kleihauer-Betke test was most informative, revealing a feto-maternal haemorrhage in 8% of cases and anticardiolipin antibodies were positive in 4% of cases. FBC, TORCH and glycosylated Hb were negative in all 75 patients. Despite thorough investigations 32 of cases (43%) remained unexplained.

The hallmark of ovarian cancer treatment, over decades, is accurate diagnosis, precise surgical staging, and optimal cytoreduction, followed by chemotherapy in the majority of cases. However, it is distressing to see the development of disease recurrence, resistance, and poor prognosis. Ovarian cancer cells express gene signatures, which pose significant challenges for cancer drug development. The aim of this review is to discuss the recent developments in terms of screening, surgical management, newer chemotherapeutic agents and molecular targeted therapies to improve the overall prognosis of ovarian cancer.

Androgenic alopecia is a patterned hair loss occurring due to systemic androgens and genetic factors. It is the most common cause of hair loss in both genders. The appearance of this condition is the cause of significant stress and psychological problems, making appropriate management important. A 68-year-old postmenopausal female presented with complaints of increased hair loss from scalp, excessive hair growth at undesired sites and hirsutism not corrected with medications. On thorough investigations, CT scan whole abdomen and endocrinological workup, a clinical diagnosis of alopecia and hirsutism due to hyperandrogenemia secondary to ovarian tumor made. Abdominal hysterectomy with B/L salpingo-oophorectomy was done. Histopathological examination revealed an encapsulated tumor in right ovary-sex cord stromal tumor consistent with Leydig cell tumor in right ovary, no evidence of malignancy. Left ovary was normal. Patient showed significant regression of clinical signs and symptoms on follow up after 1 month. All women with severe hirsutism or androgenic alopecia needs further work up to locate the source of androgen over production.

No abstract