320 results found
Regan L, 2019, Abortion law in the British Isles: progress needs to become the rule not the exception, BJOG: An International Journal of Obstetrics & Gynaecology, Vol: 126, Pages: 840-840, ISSN: 1470-0328
Jayasena CN, Radia UK, Figueiredo M, et al., 2019, Reduced testicular steroidogenesis and increased semen oxidative stress in male partners as novel markers of recurrent miscarriage, Clinical Chemistry, Vol: 65, Pages: 161-169, ISSN: 1530-8561
BACKGROUND: Recurrent pregnancy loss, (RPL) affecting 1%–2% of couples, is defined as ≥3 consecutive pregnancy losses before 20-week' gestation. Women with RPL are routinely screened for etiological factors, but routine screening of male partners is not currently recommended. Recently it has been suggested that sperm quality is reduced in male partners of women with RPL, but the reasons underlying this lower quality are unclear. We hypothesized that these men may have underlying impairments of reproductive endocrine and metabolic function that cause reductions in sperm quality.METHODS: After ethical approval, reproductive parameters were compared between healthy controls and male partners of women with RPL. Semen reactive oxygen species (ROS) were measured with a validated inhouse chemiluminescent assay. DNA fragmentation was measured with the validated Halosperm method.RESULTS: Total sperm motility, progressive sperm motility, and normal morphology were all reduced in the RPL group vs controls. Mean ±SE morning serum testosterone (nmol/L) was 15% lower in RPL than in controls (controls, 19.0 ± 1.0; RPL, 16.0 ± 0.8; P < 0.05). Mean ±SE serum estradiol (pmol/L) was 16% lower in RPL than in controls (controls, 103.1 ± 5.7; RPL, 86.5 ± 3.4; P < 0.01). Serum luteinizing hormone and follicle-stimulating hormone were similar between groups. Mean ±SE ROS (RLU/sec/106 sperm) were 4-fold higher in RPL than in controls (controls, 2.0 ± 0.6; RPL, 9.1 ± 4.1; P < 0.01). Mean ±SE sperm DNA fragmentation (%) was 2-fold higher in RPL than in controls (controls, 7.3 ± 1.0; RPL, 16.4 ± 1.5; P < 0.0001).CONCLUSIONS: Our data suggest that male partners of women with RPL have impaired reproductive endocrine function, increased levels of semen ROS, and sperm DNA fragmentation. Routine reproductive assessment of the male partners may be beneficial in RPL.
Finch E-L, Taheri M, Gedroyc W, et al., 2018, The treatment effect and re-intervention rate following MRI-guided focused ultrasound treatment of uterine fibroids since 2011 at St Mary's Hospital, RCOG National Trainee Conference, Publisher: Wiley, Pages: 13-14, ISSN: 1470-0328
Goddard A, Burn W, Regan L, et al., 2018, Open letter to Simon Stevens to ensure that tobacco dependence treatment is provided for every smoker cared for by the NHS, as part of the long term plan, BMJ, Vol: 363, ISSN: 0959-8138
Lord J, Regan L, Kasliwal A, et al., 2018, Early medical abortion: best practice now lawful in Scotland and Wales but not available to women in England, BMJ SEXUAL & REPRODUCTIVE HEALTH, Vol: 44, Pages: 155-158, ISSN: 2515-1991
Gillespie A, Taheri M, Sullivan M, et al., 2018, The impact of fibroids on the rate of first trimester miscarriage in the recurrent miscarriage population, RCOG Congress 2018, Publisher: WILEY, Pages: 41-41, ISSN: 1470-0328
DiMarco A, Christakis I, Constantinides V, et al., 2018, Undiagnosed Primary Hyperparathyroidism and Recurrent Miscarriage: The First Prospective Pilot Study., World Journal of Surgery, Vol: 42, Pages: 639-645, ISSN: 1432-2323
BACKGROUND: Primary hyperparathyroidism (pHPT) in pregnancy is reported to be associated with significant maternal and foetal complications and an up to threefold increase in the risk of miscarriage. However, the true incidence of pHPT in pregnancy, complete and miscarried, is unknown and there are no data on the prevalence of undiagnosed pHPT in recurrent miscarriage (RM) (≥3 consecutive miscarriages under 24-week gestation). This is the first prospective study aiming to establish the prevalence of undiagnosed pHPT in RM. METHODS: Following UK National ethics committee approval, women who had experienced 3 or more consecutive miscarriages were recruited from a nationwide RM clinic. Serum corrected calcium, phosphate, PTH and vitamin D were evaluated. Patients with raised serum calcium and/or PTH were recalled for confirmatory tests. Power calculations suggested that a minimum of 272 patients were required to demonstrate a clinically significant incidence of pHPT. RESULTS: Three hundred women were recruited, median age 35 years (range 19-42). Eleven patients had incomplete data, leaving 289 patients suitable for analysis; 50/289 patients (17%) with abnormal tests were recalled. The prevalence of vitamin D deficiency (<25 nmol/l) and insufficiency (25-75 nmol/l) was 8.7 and 67.8%, respectively. One patient was diagnosed with pHPT (0.34%) and underwent successful parathyroidectomy. CONCLUSIONS: The prevalence of undiagnosed pHPT (0.34%) in RM in this study appears to be many times greater than the 0.05% expected in this age group. The findings of this pilot study merit follow-up with a larger-scale study. Routine serum calcium estimation is not currently undertaken in RM and should be considered.
Regan L, Glasier A, 2017, The British 1967 Abortion Act-still fit for purpose?, LANCET, Vol: 390, Pages: 1936-1937, ISSN: 0140-6736
Solanky N, Leon L, Maurer C, et al., 2017, A new biological and clinical resource for research into pregnancy complications: The Baby Biobank, 27th Mammalian Genetics and Development Workshop of the Genetics-Society, Publisher: CAMBRIDGE UNIV PRESS, ISSN: 0016-6723
Regan L, 2017, INTEGRATING HUMAN RIGHTS AND WOMEN'S HEALTH. COMPETENCIES FOR PRACTICE, 23rd Congress of the World Association of Sexual Health, Publisher: WILEY, Pages: E221-E222, ISSN: 1743-6095
Sarodey G, Regan L, Rai R, 2017, Audit on psychological assessment of couple in a tertiary care recurrent miscarriage unit in the United Kingdom, RCOG World Congress 2017, Publisher: WILEY, Pages: 11-11, ISSN: 1470-0328
Hopkinson NS, Dacre J, Regan L, et al., 2017, The need for a new Tobacco Control Plan: an issue of justice, British Medical Journal, Vol: 356, ISSN: 1468-5833
jayasena C, abbara A, comninos A, et al., 2016, Novel circulating placental markers prokineticin-1, soluble fms-like tyrosine kinase-1, soluble endoglin and placental growth factor and risk of late miscarriage, Human Reproduction, Vol: 31, Pages: 2681-2688, ISSN: 0268-1161
STUDY QUESTION Are novel circulating placental markers prokineticin-1 (PK-1), soluble fms-like tyrosine kinase-1 (sFlt-1), soluble endoglin (sEng) and placental growth factor (PlGF) associated with late miscarriage in asymptomatic first trimester pregnant women?SUMMARY ANSWER Increased serum sFlt-1 or PlGF, but not sEng or PK-1, were significantly associated with reduced miscarriage risk after adjustment for age, BMI, gestational age, smoking and blood pressure.WHAT IS KNOWN ALREADY Abnormal placental development is observed in two-thirds of miscarriages. Identifying women at high risk of late miscarriage could help diagnose potentially treatable causes of miscarriage such as infection, thrombosis or immunological disease. Recently, the circulating placental markers PK-1, sFlt-1, sEng and PlGF have been identified; however, it is not known if circulating levels of these markers are associated with late miscarriage.STUDY DESIGN, SIZE, DURATION A single-centre observational cohort study with prospectively collected data was carried out at a tertiary care centre 2010–2012, in 993 asymptomatic pregnant women. Plasma PK-1, and serum sEng, sFlt-1 and PlGF were measured once in each patient during the antenatal booking visit, and pregnancy outcome was monitored prospectively. Less than 1% of patients were lost to follow-up. Multiples of median (MOM) levels were calculated to adjust for gestational age.PARTICIPANTS/MATERIALS, SETTING, METHODS Nine-hundred and ninety-three asymptomatic pregnant women attending antenatal clinic for a routine booking antenatal appointment were recruited to the study, of whom 12 were lost to follow-up and excluded from analysis. Of the cohort, 50 of the remaining 981 women suffered late miscarriage.MAIN RESULTS AND THE ROLE OF CHANCE Gestation-adjusted sEng, sFlt-1 and PlGF levels were 11% (P < 0.01), 36% (P < 0.001) and 30% (P < 0.001), respectively, lower in women who later suffered miscarriage compared with unaffected pregnanc
Leon LJ, Solanky N, Stalman SE, et al., 2016, A new biological and clinical resource for research into pregnancy complications: The Baby Bio Bank, Placenta, Vol: 46, Pages: 31-37, ISSN: 1532-3102
About 20% of pregnancies are affected by some form of complication. Research has shown that anomalies in implantation, development, and growth of the fetus; ineffective nutrient exchange between mother and fetus due to placental dysfunction; and maternal problems such as hypertension or infection during pregnancy can all lead to adverse pregnancy outcomes. However, the molecular aetiology of such events remains poorly understood. Fetal growth restriction (FGR), recurrent miscarriage (RM), preterm birth (PTB), and pre-eclampsia (PE) are the most common pregnancy complications encountered in the UK and these outcomes can result in an array of morbidities in both mother and baby, and in the most severe cases in mortality. We need to know more about normal pregnancy and where the important triggers are for failure. This prompted us to collect a large set of biological samples with matching clinical data from over 2500 normal and abnormal pregnancies, for use in research into these conditions. This paper outlines the nature of these sample sets and their availability to academia and industry, with the intention that their widespread use in research will make significant contributions to the improvement of maternal and fetal health worldwide (http://www.ucl.ac.uk/tapb/sample-and-data-collections-at-ucl/biobanks-ucl/baby-biobank).
Karmarkar R, Fernando R, Regan L, et al., 2016, Urethral sphincter volume and urodynamic diagnoses, Neurourology and Urodynamics, Vol: 35, Pages: S213-S214, ISSN: 1520-6777
Karmarkar R, Fernando R, Regan L, et al., 2016, Is the urethra more mobile in women with stress urinary incontinence?, Neurourology and Urodynamics, Vol: 35, Pages: S368-S369, ISSN: 1520-6777
Schreiber K, Breen K, Sciascia S, et al., 2016, Proposed trial: HYPATIA - a prospective randomised controlled trial of hydroxychoroquine vs. placebo during pregnancy in women with antiphospholipid antibodies, Journal of Thrombosis and Haemostasis, Vol: 14, Pages: 163-163, ISSN: 1538-7933
Coomarasamy A, Williams H, Truchanowicz E, et al., 2016, PROMISE: first-trimester progesterone therapy in women with a history of unexplained recurrent miscarriages - a randomised, double-blind, placebo-controlled, international multicentre trial and economic evaluation, Health Technology Assessment, Vol: 20, Pages: 1-94, ISSN: 1366-5278
Coomarasamy A, Williams H, Truchanowicz E, et al., 2015, A Randomized Trial of Progesterone in Women with Recurrent Miscarriages, New England Journal of Medicine, Vol: 373, Pages: 2141-2148, ISSN: 1533-4406
Donaldson B, Jain P, Holder BS, et al., 2015, What determines uptake of pertussis vaccine in pregnancy? A cross sectional survey in an ethnically diverse population of pregnant women in London, Vaccine, Vol: 33, Pages: 5822-5828, ISSN: 1873-2518
Demetriou C, Abu-amero S, White S, et al., 2015, Investigation of the Annexin A5 M2 haplotype in 500 white European couples who have experienced recurrent spontaneous abortion, Reproductive Biomedicine Online, Vol: 31, Pages: 681-688, ISSN: 1472-6491
Annexin A5 is a placental anti-coagulant protein that contains four nucleotide substitutions (M2 haplotype) in its promoter. This haplotype is a risk factor for recurrent spontaneous abortion (RSA). The influence of the M2 haplotype in the gestational timing of spontaneous abortions, paternal risk and relationships with known risk factors were investigated. European couples (n = 500) who had experienced three or more consecutive spontaneous abortions, and two fertile control groups, were selected for this study. The allele frequency of M2 was significantly higher among patients who had experienced early RSA than among controls (P = 0.002). No difference was found between controls and patients who had undergone late spontaneous abortions. No difference was found between patients who had experienced RSA who had a live birth or no live births, or between patients who were positive or negative for known risk factors. Male and female partners in each group had similar allele frequencies of M2. The M2 haplotype is a risk factor for early spontaneous abortions, before the 12th week of gestation, and confers about the same relative risk to carriers of both sexes. Having one or more M2 allele(s) in combination with other risk factors further increases the RSA risk.
Schreiber K, Sciascia S, Breen K, et al., 2015, Proposed trial: hypatia - a prospective randomised controlled trial of hydroxychoroquine versus placebo during pregnancy in women with antiphospholipid antibodies, XXV Congress of the International Society on Thrombosis and Haemostasis, Publisher: Wiley, Pages: 281-281, ISSN: 1538-7836
Regan L, 2015, Domestic violence, BJOG-AN INTERNATIONAL JOURNAL OF OBSTETRICS AND GYNAECOLOGY, Vol: 122, Pages: 384-385, ISSN: 1470-0328
Regan L, 2015, Human rights and women's health in the 21st century, BJOG-AN INTERNATIONAL JOURNAL OF OBSTETRICS AND GYNAECOLOGY, Vol: 122, Pages: 377-378, ISSN: 1470-0328
Moore GE, Ishida M, Demetriou C, et al., 2015, The role and interaction of imprinted genes in human fetal growth, PHILOSOPHICAL TRANSACTIONS OF THE ROYAL SOCIETY B-BIOLOGICAL SCIENCES, Vol: 370, ISSN: 0962-8436
Aghajanova L, Mahadevan S, Altmaee S, et al., 2015, No evidence for mutations in NLRP7, NLRP2 or KHDC3L in women with unexplained recurrent pregnancy loss or infertility, HUMAN REPRODUCTION, Vol: 30, Pages: 232-238, ISSN: 0268-1161
Jayasena CN, Abbara A, Izzi-Engbeaya C, et al., 2014, Reduced Levels of Plasma Kisspeptin During the Antenatal Booking Visit Are Associated With Increased Risk of Miscarriage, JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM, Vol: 99, Pages: E2652-E2660, ISSN: 0021-972X
Rolls AE, Riga CV, Bicknell CD, et al., 2014, Robot-Assisted Uterine Artery Embolization: A First-in-Woman Safety Evaluation of the Magellan System, JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY, Vol: 25, Pages: 1841-1848, ISSN: 1051-0443
Quinn SD, Vedelago J, Gedroyc W, et al., 2014, Safety and five-year re-intervention following magnetic resonance-guided focused ultrasound (MRgFUS) for uterine fibroids., Eur J Obstet Gynecol Reprod Biol, Vol: 182, Pages: 247-251
OBJECTIVE: To examine the safety and re-intervention rates following magnetic resonance-guided focused ultrasound (MRgFUS) for uterine fibroids at 5 years. To assess how the non-perfused volume (NPV), fibroid signal intensity and use of gonadotrophin-releasing hormone analogues (GnRHa) affect the re-intervention rates. STUDY DESIGN: Cohort study of women undergoing MRgFUS for treatment of their uterine fibroids between 2003 and 2010. RESULTS: Of 280 women undergoing MRgFUS the rate of minor complications was 3.9% and there were 3 serious complications (1.1%) including one skin burn, a fibroid expulsion and one case of persistent neuropathy. The NPVs achieved following MRgFUS have increased as the experience with this treatment has grown. In a 5-year follow-up study of 162 women, the overall re-intervention rate was 58.64%, but in those treatments with greater than 50% NPV the re-intervention rate was 50%. CONCLUSION: MRgFUS treatment of uterine fibroids is a safe treatment for uterine fibroids. The re-intervention rate at 5 years is high, but the improvements in NPVs achieved may further improve the long term results.
Gargasole C, Quinn S, Cartwright R, et al., 2014, THE IMPACT OF BULKY FIBROIDS ON LUTS: DOES EITHER THE SIZE OR THE POSITION MAKE A DIFFERENCE?, 44th Annual Meeting of the International-Continence-Society (ICS), Publisher: WILEY-BLACKWELL, Pages: 921-921, ISSN: 0733-2467
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