Imperial College London

Professor Tom Bourne

Faculty of MedicineDepartment of Metabolism, Digestion and Reproduction

Chair in Gynaecology
 
 
 
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Contact

 

+44 (0)20 3313 5131t.bourne Website

 
 
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Location

 

Early pregnancy and acute gynaecologyInstitute of Reproductive and Developmental BiologyHammersmith Campus

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Summary

 

Publications

Publication Type
Year
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518 results found

Heremans R, Van Den Bosch T, Valentin L, Wynants L, Pascual MA, Fruscio R, Testa AC, Buonomo F, Guerriero S, Epstein E, Bourne T, Timmerman D, Leone FPGet al., 2022, Ultrasound features of endometrial pathology in women without abnormal uterine bleeding: results from the International Endometrial Tumor Analysis study (IETA3), ULTRASOUND IN OBSTETRICS & GYNECOLOGY, Vol: 60, Pages: 243-255, ISSN: 0960-7692

Journal article

Mullins E, Perry A, Banerjee J, Townson J, Grozeva D, Milton R, Kirby N, Playle R, Bourne T, Lees C, PAN-COVID Investigatorset al., 2022, Pregnancy and neonatal outcomes of COVID-19: The PAN-COVID study., European Journal of Obstetrics Gynecology and Reproductive Biology, Vol: 276, Pages: 161-167, ISSN: 0301-2115

OBJECTIVE: To assess perinatal outcomes for pregnancies affected by suspected or confirmed SARS-CoV-2 infection. METHODS: Prospective, web-based registry. Pregnant women were invited to participate if they had suspected or confirmed SARS-CoV-2 infection between 1st January 2020 and 31st March 2021 to assess the impact of infection on maternal and perinatal outcomes including miscarriage, stillbirth, fetal growth restriction, pre-term birth and transmission to the infant. RESULTS: Between April 2020 and March 2021, the study recruited 8239 participants who had suspected or confirmed SARs-CoV-2 infection episodes in pregnancy between January 2020 and March 2021. Maternal death affected 14/8197 (0.2%) participants, 176/8187 (2.2%) of participants required ventilatory support. Pre-eclampsia affected 389/8189 (4.8%) participants, eclampsia was reported in 40/ 8024 (0.5%) of all participants. Stillbirth affected 35/8187 (0.4 %) participants. In participants delivering within 2 weeks of delivery 21/2686 (0.8 %) were affected by stillbirth compared with 8/4596 (0.2 %) delivering ≥ 2 weeks after infection (95 % CI 0.3-1.0). SGA affected 744/7696 (9.3 %) of livebirths, FGR affected 360/8175 (4.4 %) of all pregnancies. Pre-term birth occurred in 922/8066 (11.5%), the majority of these were indicated pre-term births, 220/7987 (2.8%) participants experienced spontaneous pre-term births. Early neonatal deaths affected 11/8050 livebirths. Of all neonates, 80/7993 (1.0%) tested positive for SARS-CoV-2. CONCLUSIONS: Infection was associated with indicated pre-term birth, most commonly for fetal compromise. The overall proportions of women affected by SGA and FGR were not higher than expected, however there was the proportion affected by stillbirth in participants delivering within 2 weeks of infection was significantly higher than those delivering ≥ 2 weeks after infection. We suggest that clinicians' thresh

Journal article

Harmsen MJ, van den Bosch T, De Leeuw RA, Dueholm M, Exacoustos C, Valentin L, Hehenkamp WJK, Groenman F, De Bruyn C, Rasmussen C, Lazzeri L, Jokubkiene L, Jurkovic D, Naftalin J, Tellum T, Bourne T, Timmerman D, Huirne JAFet al., 2022, Consensus on revised definitions of Morphological Uterus Sonographic Assessment (MUSA) features of adenomyosis: results of modified Delphi procedure, ULTRASOUND IN OBSTETRICS & GYNECOLOGY, Vol: 60, Pages: 118-131, ISSN: 0960-7692

Journal article

Kyriacou C, Bourne T, 2022, Comparing ultraviolet with chlorine dioxide wipe system for vaginal ultrasound probe cleaning: critical analysis of the term 'cleaning' Reply, ULTRASOUND IN OBSTETRICS & GYNECOLOGY, Vol: 60, Pages: 147-148, ISSN: 0960-7692

Journal article

Bortoletto P, Lucas ES, Melo P, Gallos ID, Devall AJ, Bourne T, Quenby S, Bennett PR, Coomarasamy A, Brosens JJet al., 2022, Miscarriage syndrome: Linking early pregnancy loss to obstetric and age-related disorders, EBIOMEDICINE, Vol: 81, ISSN: 2352-3964

Journal article

Kyriacou C, Robinson E, Barcroft J, Parker N, Tuomey M, Stalder C, Gould D, Al-Memar M, Bourne Tet al., 2022, Comparing time effectiveness and convenience of ultraviolet vaginal ultrasound probe disinfection with chlorine dioxide multistep wipe system: prospective survey study., Ultrasound in Obstetrics and Gynecology, Vol: 60, Pages: 132-138, ISSN: 0960-7692

OBJECTIVES: To compare efficiency, ease of use, and user satisfaction of two methods of transvaginal ultrasound probe high-level disinfection: Ultraviolet (UV-C) (Germitec Hypernova Chronos) and a chlorine dioxide multi-step wipe system (Tristel Trio). METHODS: This was a prospective survey study. UV-C units were introduced into a busy Early Pregnancy Assessment Unit and compared with a multi-wipe system. Healthcare professionals (HCP's) measured time taken to complete a cycle of disinfection before each patient with the system allocated to that room using a stopwatch and recorded their responses using a quick response (QR) code-linked survey. Additional necessary tasks that could be completed before seeing the next patient as probe disinfection was ongoing were also documented. Using another QR code-linked survey, data on ease of use, satisfaction of the system used, and preference was collected. A section for free-text comments was then completed. RESULTS: Disinfection using UV-C (n=331) was 60% faster than the chlorine dioxide multi-wipe system (n=332) (101 vs 250 seconds, p<0.0001). A greater number of tasks during probe disinfection were completed when using UV-C, saving a further 74 seconds per patient (p<0.0001). HCP's using UV-C (n=71) reported greater ease of use (10 vs 3/10, p<0.0001) and satisfaction (10 vs 2/10, p<0.0001) than those using the multi-wipe system (n=43). HCP's reported that the chlorine dioxide system was time-consuming and environmentally unfriendly, whilst the UV-C system was efficient and easy to use. 98% HCP's preferred using the UV-C system. CONCLUSIONS: UV-C technology was more efficient and allowed more essential tasks to be completed during disinfection. For a four-hour ultrasound list of 15 patients, we calculated this would amount to 55 minutes 45 seconds extra time available. HCP's found UV-C preferable and easier to use. This article is protected by copyright. All rights reserved.

Journal article

Verberkt C, Jordans IPM, van den Bosch T, Timmerman D, Bourne T, de Leeuw RA, Huirne JAFet al., 2022, How to perform standardized sonographic examination of uterine niche in non-pregnant women., Ultrasound Obstet Gynecol

Journal article

Wynants L, Verbakel JYJ, Valentin L, De Cock B, Pascual MA, Leone FPG, Sladkevicius P, Heremans R, Alcazar JL, Votino A, Fruscio R, Epstein E, Bourne T, Calster BV, Timmerman D, Van den Bosch Tet al., 2022, The Risk of Endometrial Malignancy and Other Endometrial Pathology in Women with Abnormal Uterine Bleeding: An Ultrasound-Based Model Development Study by the IETA Group, GYNECOLOGIC AND OBSTETRIC INVESTIGATION, Vol: 87, Pages: 54-61, ISSN: 0378-7346

Journal article

Vanderstichele A, Busschaert P, Landolfo C, Olbrecht S, Coosemans A, Froyman W, Loverix L, Concin N, Braicu EI, Wimberger P, Van Nieuwenhuysen E, Han SN, Van Gorp T, Venken T, Heremans R, Neven P, Bourne T, Van Calster B, Timmerman D, Lambrechts D, Vergote Iet al., 2022, Nucleosome footprinting in plasma cell-free DNA for the pre-surgical diagnosis of ovarian cancer, NPJ GENOMIC MEDICINE, Vol: 7

Journal article

Jordans IPM, Verberkt C, De Leeuw RA, Bilardo CM, Van den Bosch T, Bourne T, Brolmann HAM, Dueholm M, Hehenkamp WJK, Jastrow N, Jurkovic D, Agten AK, Mashiach R, Naji O, Pajkrt E, Timmerman D, Vikhareva O, Van der Voet LF, Huirne JAFet al., 2022, Definition and sonographic reporting system for Cesarean scar pregnancy in early gestation: modified Delphi method, ULTRASOUND IN OBSTETRICS & GYNECOLOGY, Vol: 59, Pages: 437-449, ISSN: 0960-7692

Journal article

Dawood Y, Buijtendijk MFJ, Shah H, Smit JA, Jacobs K, Hagoort J, Oostra R-J, Bourne T, van den Hoff MJB, de Bakker BSet al., 2022, Imaging fetal anatomy., Seminars in Cell and Developmental Biology, ISSN: 1084-9521

Due to advancements in ultrasound techniques, the focus of antenatal ultrasound screening is moving towards the first trimester of pregnancy. The early first trimester however remains in part, a 'black box', due to the size of the developing embryo and the limitations of contemporary scanning techniques. Therefore there is a need for images of early anatomical developmental to improve our understanding of this area. By using new imaging techniques, we can not only obtain better images to further our knowledge of early embryonic development, but clear images of embryonic and fetal development can also be used in training for e.g. sonographers and fetal surgeons, or to educate parents expecting a child with a fetal anomaly. The aim of this review is to provide an overview of the past, present and future techniques used to capture images of the developing human embryo and fetus and provide the reader newest insights in upcoming and promising imaging techniques. The reader is taken from the earliest drawings of da Vinci, along the advancements in the fields of in utero ultrasound and MR imaging techniques towards high-resolution ex utero imaging using Micro-CT and ultra-high field MRI. Finally, a future perspective is given about the use of artificial intelligence in ultrasound and new potential imaging techniques such as synchrotron radiation-based CT to increase our knowledge regarding human development.

Journal article

Farren J, Jalmbrant M, Falconieri N, Mitchell-Jones N, Bobdiwala S, Al-Memar M, Parker N, Van Calster B, Timmerman D, Bourne Tet al., 2022, Prognostic factors for post-traumatic stress, anxiety and depression in women after early pregnancy loss: a multi-centre prospective cohort study, BMJ Open, Vol: 12, ISSN: 2044-6055

Objectives: To investigate prognostic factors for anxiety, depression and post-traumatic stress symptoms one month after early pregnancy loss (EPL).Design: A prospective cohort study. Consecutive women were recruited, and demographic and clinical data collected. Surveys containing the hospital anxiety and depression scale (HADS) and posttraumatic stress diagnostic scale (PDS) were emailed one month after a loss. Univariable logistic regression was performed to link factors with caseness of anxiety, depression or post-traumatic stress (PTS) according to screening measures.Setting: Early pregnancy units of three central London hospitals.Participants: 737/1116 eligible women with an EPL were recruited. 492 responded to HADS and 487 to PDS.Primary and secondary outcome measures: Primary outcome is the area under the curve (AUC) to predict any psychological morbidity (defined as moderate/severe anxiety or depression, or meeting screening criteria for PTS) for each variable. Further outcomes are explained variation (R-squared) and p-value for any morbidity, and AUC, explained variation, and p-value for each morbidity separately. Results: Women who had a current or past diagnosis of a psychiatric condition were more likely to meet criteria for anxiety, depression or PTS (75% for current versus 55% for past versus 30% for no diagnosis; AUC 0.61; R-squared 8.4%; p<0.0001), as were those with previous pregnancy loss (48% versus 30%; AUC 0.59; R-squared 4.3%; p<0.0001). Most of the assessed factors did not demonstrate potential utility in predicting psychological distress, including gestational age, overnight admission, time taken for diagnosis, pre-existing children, and the diagnosis itself (miscarriage versus ectopic versus other) (AUCs≤0.54; R-squared≤0.9%). Conclusions: Women with a history of mental health problems, or those with previous losses, may be at higher risk of psychological illness one month after pregnancy loss. However, prognostic ability was po

Journal article

Salvesen K, Ter Haar G, Miloro P, Sinkovskaya E, Lees C, Bourne T, Maršál K, Dall'asta A, Bioeffects and Safety Committee and the Board of the International Society of Ultrasound in Obstetrics and Gynecology ISUOGet al., 2022, ISUOG Safety Committee updated recommendation on use of respirators by practitioners undertaking obstetric and gynecological ultrasound in context of SARS-CoV-2 Omicron variant of concern, Ultrasound in Obstetrics and Gynecology, Vol: 59, Pages: 411-411, ISSN: 0960-7692

Journal article

Verbakel JY, Heremans R, Wynants L, Epstein E, De Cock B, Pascual MA, Leone FPG, Sladkevicius P, Alcazar JL, Van Pachterbeke C, Jokubkiene L, Fruscio R, Bourne T, Van Calster B, Timmerman D, Van den Bosch Tet al., 2022, Risk assessment for endometrial cancer in women with abnormal vaginal bleeding: Results from the prospective IETA-1 cohort study, INTERNATIONAL JOURNAL OF GYNECOLOGY & OBSTETRICS, ISSN: 0020-7292

Journal article

Bourne T, Kyriacou C, Shah H, Ceusters J, Preisler J, Metzger U, Landolfo C, Lees C, Timmerman Det al., 2022, The experiences and wellbeing of healthcare professionals working in the field of ultrasound in Obstetrics and Gynecology as the SARS-CoV-2 pandemic was evolving: a cross-sectional survey study, BMJ Open, Vol: 12, Pages: 1-12, ISSN: 2044-6055

Objectives: Assess experience of healthcare professionals (HCPs) working with ultrasound in Obstetrics and Gynecology during the evolving SARS-CoV-2 pandemic given the new and unprecedented challenges involving viral exposure, personal protective equipment (PPE) and wellbeing.Design: Prospective cross-sectional survey study.Setting: Online international survey. Single-best, open box and Hospital and Anxiety Depression Scale (HADS) questions.Participants: The survey was sent to 35,509 HCPs in 124 countries and was open from 7th-21st May 2020. 2237/3237 (69.1%) HCPs from 115 countries who consented to participate completed the survey. 1058 (47.3%) completed the HADS. Primary outcome measures: Overall prevalence of SARS-CoV-2, depression and anxiety amongst HCPs in relation to country and PPE availability.Analyses: Univariate analyses were used to investigate associations without generating erroneous causal conclusions.Results: Confirmed/suspected SARS-CoV-2 prevalence was 13.0%. PPE provision concerns were raised by 74.1% of participants; highest amongst trainees/resident physicians (83.9%), and amongst HCPs in Spain (89.7%). Most participants worked in self-perceived high-risk areas for SARS-CoV-2 (67.5-87.0%), with proportionately more trainees interacting with suspected/confirmed infected patients (57.1% versus 24.2-40.6%) and sonographers seeing more patients who did not wear a mask (33.3% versus 13.9-7.9%). The most frequent PPE combination used were gloves and a surgical mask (22.3%). UK and US respondents reported spending less time self-isolating (8.8 days) and lower satisfaction with their national pandemic response (37.0-43.0%). 19.8% and 8.8% of respondents met the criteria for moderate to severe anxiety and depression respectively. Conclusions: Reported SARS-CoV-2 HCP prevalence is consistent with literature findings. Most respondents used gloves and a surgical mask, with a greater SARS-CoV-2 prevalence compared with those using ‘full’ PPE. HCP

Journal article

Grewal K, Lee Y, Smith A, Brosens J, Bourne T, Al-Memar M, Kundu S, MacIntyre D, Bennett Pet al., 2022, Chromosomally normal miscarriage is associated with vaginal dysbiosis and local inflammation, BMC Medicine, Vol: 20, ISSN: 1741-7015

BackgroundEmerging evidence supports an association between vaginal microbiota composition and risk of miscarriage, however the underlying mechanisms are poorly understood. We aim to investigate the vaginal microbial composition and the local immune response in chromosomally normal and abnormal miscarriages and compare this to uncomplicated pregnancies delivering at term.Methods We used 16S rRNA gene based metataxonomics to interrogate the vaginal microbiota in a cohort of 167 women, 93 miscarriages (54 euploid and 39 aneuploid using molecular cytogenetics) and 74 women who delivered at term and correlate this with the aneuploidy status of the miscarriages. We also measured the concentrations of IL-2, IL-4, IL-6, IL-8, TNF-α, IFN-γ, IL-1β, IL-18 and IL-10 in cervical vaginal fluid.Results We show that euploid miscarriage is associated with a significantly higher prevalence of Lactobacillus spp. deplete vaginal microbial communities compared to aneuploid miscarriage (P=0.01). Integration of matched cervicovaginal fluid immune-profiles showed that Lactobacillus spp. depleted vaginal microbiota associated with pro-inflammatory cytokine levels most strongly in euploid miscarriage compared to viable term pregnancy (IL-1β; P<0.001, IL-8; P=0.01, IL-6; P<0.001). ConclusionOur data suggest the vaginal microbiota plays an important aetiological role in euploid miscarriage and may represent a target to modify risk of pregnancy loss.

Journal article

Kasaven LS, Saso S, Ben Nagi J, Joash K, Yazbek J, Smith JR, Bourne T, Jones BPet al., 2022, TOGadvisor: the role of online feedback in obstetrics and gynaecology, OBSTETRICIAN & GYNAECOLOGIST, Vol: 24, Pages: 7-11, ISSN: 1467-2561

Journal article

Naji O, Souter V, Mullins E, Gaughran J, Diab Y, Edward Fitzgerald J, Bourne T, Morris Eet al., 2022, The blind spot: value‐based health care in obstetrics and gynaecology, The Obstetrician & Gynaecologist, Vol: 24, Pages: 67-72, ISSN: 1467-2561

Key contentContinuing financial constraints on the UK’s National Health Service means the need for clinicians to provide high-quality care in a cost-effective way has never been greater.While the medical education system equips doctors with skills to provide safe clinical care, it should also provide an understanding of healthcare costs and cost-effectiveness analysis.Value-based care is becoming a key paradigm in women’s health services, where clinicians must employ strategies for delivering value, rationalising costs and capitalising on the use of emerging technologies.The calculation of value of an intervention for providers and service users may differ; care must be taken to ensure this concept is adapted for, and not imposed on healthcare systems.Engaging trainees in systems transformation and embedding the concepts of ‘do no financial harm’ are essential to ensure sustainable healthcare services.Learning ObjectivesTo understand the principles of value-based health care.To highlight the importance of adopting ‘cost-conscious’ care within daily clinical practice.To learn the differences between ‘cost’, ‘charge’, ‘price’ and ‘reimbursement.To encourage developing value-based competencies for future medical workforce through utilising out of programme placements and digital resources.Ethical IssuesThe ethical obligation of clinicians to consider cost may encompass justice and equity. However, the impact of practicing value-based health care is yet to be evaluated.

Journal article

Phylactou M, Abbara A, Al-Memar M, Daniels E, Patel B, Eng PC, Nadir R, Izzi-Engbeaya C, Clarke S, Mills E, Hunjan T, Pacuszka E, Yang L, Bech P, Tan T, Comninos A, Kelsey T, Kyriacou C, Fourie H, Bourne T, Dhillo Wet al., 2022, Changes in circulating kisspeptin levels during each trimester in women with antenatal complications, Journal of Clinical Endocrinology and Metabolism, Vol: 107, Pages: e71-e83, ISSN: 0021-972X

ContextAntenatal complications such as hypertensive disorders of pregnancy (HDP), fetal growth restriction (FGR), gestational diabetes (GDM), and preterm birth (PTB) are associated with placental dysfunction. Kisspeptin has emerged as a putative marker of placental function, but limited data exist describing circulating kisspeptin levels across all three trimesters in women with antenatal complications.ObjectiveTo assess whether kisspeptin levels are altered in women with antenatal complications.DesignWomen with antenatal complications (n=105) and those with uncomplicated pregnancies (n=265) underwent serial ultrasound scans and blood-sampling at least once during each trimester (March 2014 to March 2017).SettingEarly Pregnancy Assessment Unit at Hammersmith Hospital, UK.ParticipantsWomen with antenatal complications: HDP (n=32), FGR (n=17), GDM (n=35) and PTB (n=11), and 10 women with multiple complications, provided 373 blood samples, and a further 265 controls provided 930 samples.Main outcomeDifferences in circulating kisspeptin levels.ResultsThird trimester kisspeptin levels were higher than controls in HDP but lower in FGR. The odds of HDP adjusted for gestational age, maternal age, ethnicity, BMI, smoking and parity were increased by 30% (95%CI 16-47%; p<0.0001), and of FGR were reduced by 28% (95%CI 4-46%; p=0.025), for every 1 nmol/L increase in plasma kisspeptin. Multiple of gestation-specific median values of kisspeptin were higher in pregnancies affected by PTB (p=0.014), and lower in those affected by GDM (p=0.020), but not significantly on multivariable analysis.ConclusionWe delineate changes in circulating kisspeptin levels at different trimesters and evaluate the potential of kisspeptin as a biomarker for antenatal complications.

Journal article

Kyriacou C, Cooper N, Robinson E, Parker N, Barcroft J, Kundu S, Letchworth P, Sur S, Gould D, Stalder C, Bourne Tet al., 2021, Ultrasound characteristics, serum biochemistry and outcomes for ectopic pregnancies presenting during the SARS-CoV-2 pandemic: retrospective analysis, Ultrasound in Obstetrics and Gynecology, Vol: 58, Pages: 909-915, ISSN: 0960-7692

OBJECTIVES: To describe and then compare the characteristics of ectopic pregnancies (EP) in the year prior to and then during the SARS-CoV-2 pandemic. METHODS: This was a retrospective analysis from 1st January 2019 to 31st December 2020 of women diagnosed with an EP (n=275) at a London dual center early pregnancy assessment service. Women were identified via the AstraiaTM ultrasound reporting system using coded and non-coded outcomes of 'EP' or 'pregnancy outside the uterine cavity'. Data relating to predefined outcomes were collected using AstraiaTM and CernerTM electronic reporting systems. Main outcome measures included clinical, ultrasound and biochemical features of EP, in addition to reported complications and management. Statistical analysis was carried out using GraphPad Prism v8.2.1. RESULTS: Similar numbers and proportions of EP were seen in 2019 (n=141, 1%) and 2020 (n=134, 1%). Both cohorts were comparable in age, ethnicity, weight and method of conception. Gestational age at first ultrasound and at diagnosis was similar, with no difference in EP location, size or morphology. Human chorionic gonadotrophin (hCG) levels at time of EP diagnosis were higher in 2020 than 2019 (1005 IU/L vs 665 IU/L, p=0.03). The type of final EP management was similar, but more failed first line management during the pandemic (16% vs 6%, p=0.01). Rates of blood visualized on ultrasound within the pelvis (hemoperitoneum) (23% vs 27%, p=0.58) and of rupture confirmed surgically (9% vs 3%, p=0.07) were both similar. CONCLUSIONS: No difference was observed in the location, size, morphology and gestational age of ectopic pregnancies. Complication rates and management were also unchanged. HCG levels were higher, and a greater proportion of conservative management measures failed during the pandemic. Our findings suggest women continued to access appropriate care for EP during the SARS-CoV-2 pandemic, with no evidence of diagnostic delay or increase in adverse outcomes in our popul

Journal article

Bobdiwala S, Kyriacou C, Christodoulou E, Farren J, Mitchell-Jones N, Al-Memar M, Ayim F, Chohan B, Kirk E, Abughazza O, Guruwadahyarhalli B, Guha S, Vathanan V, Gould D, Stalder C, Timmerman D, Van Calster B, Bourne Tet al., 2021, Evaluating cut-off levels for progesterone, beta human chorionic gonadotropin and beta human chorionic gonadotropin ratio to exclude pregnancy viability in women with a pregnancy of unknown location: A prospective multicenter cohort study, Acta Obstetricia et Gynecologica Scandinavica, Vol: 101, Pages: 46-55, ISSN: 0001-6349

IntroductionThere is no global agreement on how to best determine pregnancy of unknown location viability and location using biomarkers. Measurements of progesterone and β human chorionic gonadotropin (βhCG) are still used in clinical practice to exclude the possibility of a viable intrauterine pregnancy (VIUP). We evaluate the predictive value of progesterone, βhCG, and βhCG ratio cut-off levels to exclude a VIUP in women with a pregnancy of unknown location.Material and methodsThis was a secondary analysis of prospective multicenter study data of consecutive women with a pregnancy of unknown location between January 2015 and 2017 collected from dedicated early pregnancy assessment units of eight hospitals. Single progesterone and serial βhCG measurements were taken. Women were followed up until final pregnancy outcome between 11 and 14 weeks of gestation was confirmed using transvaginal ultrasonography: (1) VIUP, (2) non-viable intrauterine pregnancy or failed pregnancy of unknown location, and (3) ectopic pregnancy or persisting pregnancy of unknown location. The predictive value of cut-off levels for ruling out VIUP were evaluated across a range of values likely to be encountered clinically for progesterone, βhCG, and βhCG ratio.ResultsData from 2507 of 3272 (76.6%) women were suitable for analysis. All had data for βhCG levels, 2248 (89.7%) had progesterone levels, and 1809 (72.2%) had βhCG ratio. The likelihood of viability falls with the progesterone level. Although the median progesterone level associated with viability was 59 nmol/L, VIUP were identified with levels as low as 5 nmol/L. No single βhCG cut-off reliably ruled out the presence of viability with certainty, even when the level was more than 3000 IU/L, there were 39/358 (11%) women who had a VIUP. The probability of viability decreases with the βhCG ratio. Although the median βhCG ratio associated with viability was 2.26, VIUP were identi

Journal article

Vaulet T, Al-Memar M, Fourie H, Bobdiwala S, Saso S, Pipi M, Stalder C, Bennett P, Timmerman D, Bourne T, De Moor Bet al., 2021, Gradient boosted trees with individual explanations: An alternative to logistic regression for viability prediction in the first trimester of pregnancy, COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE, Vol: 213, ISSN: 0169-2607

Journal article

Sprooten J, Vankerckhoven A, Vanmeerbeek I, Borras DM, Berckmans Y, Wouters R, Laureano RS, Baert T, Boon L, Landolfo C, Testa AC, Fischerova D, Van Holsbeke C, Bourne T, Chiappa V, Froyman W, Schols D, Agostinis P, Timmerman D, Tejpar S, Vergote I, Coosemans A, Garg ADet al., 2021, Peripherally-driven myeloid NFkB and IFN/ISG responses predict malignancy risk, survival, and immunotherapy regime in ovarian cancer, Journal for ImmunoTherapy of Cancer, Vol: 9, Pages: 1-18, ISSN: 2051-1426

Background Tumors can influence peripheral immune macroenvironment, thereby creating opportunities for non-invasive serum/plasma immunobiomarkers for immunostratification and immunotherapy designing. However, current approaches for immunobiomarkers’ detection are largely quantitative, which is unreliable for assessing functional peripheral immunodynamics of patients with cancer. Hence, we aimed to design a functional biomarker modality for capturing peripheral immune signaling in patients with cancer for reliable immunostratification.Methods We used a data-driven in silico framework, integrating existing tumor/blood bulk-RNAseq or single-cell (sc)RNAseq datasets of patients with cancer, to inform the design of an innovative serum-screening modality, that is, serum-functional immunodynamic status (sFIS) assay. Next, we pursued proof-of-concept analyses via multiparametric serum profiling of patients with ovarian cancer (OV) with sFIS assay combined with Luminex (cytokines/soluble immune checkpoints), CA125-antigen detection, and whole-blood immune cell counts. Here, sFIS assay’s ability to determine survival benefit or malignancy risk was validated in a discovery (n=32) and/or validation (n=699) patient cohorts. Lastly, we used an orthotopic murine metastatic OV model, with anti-OV therapy selection via in silico drug–target screening and murine serum screening via sFIS assay, to assess suitable in vivo immunotherapy options.Results In silico data-driven framework predicted that peripheral immunodynamics of patients with cancer might be best captured via analyzing myeloid nuclear factor kappa-light-chain enhancer of activated B cells (NFκB) signaling and interferon-stimulated genes' (ISG) responses. This helped in conceptualization of an ‘in sitro’ (in vitro+in situ) sFIS assay, where human myeloid cells were exposed to patients’ serum in vitro, to assess serum-induced (si)-NFκB or interferon (IFN)/ISG responses (as act

Journal article

Van Calster B, Bourne T, Froyman W, Timmerman D, Valentin Let al., 2021, Re: "Diagnostic Accuracies of the Ultrasound and Magnetic Resonance Imaging ADNEX Scoring Systems for Ovarian Adnexal Mass: Systematic Review and Meta-Analysis", ACADEMIC RADIOLOGY, Vol: 28, Pages: 1643-1644, ISSN: 1076-6332

Journal article

Timmerman D, Cibula D, Planchamp F, Bourne T, Landolfo C, Testa AC, du Bois A, Chiva L, Concin N, Fisherova D, Froyman W, Lemley B, Loft A, Mereu L, Morice P, Querleu D, Vergote I, Vandecaveye V, Scambia G, Fotopoulou Cet al., 2021, Response to: Correspondence on "ESGO/ISUOG/IOTA/ESGE Consensus Statement on pre-operative diagnosis of ovarian tumors" by Thomassin-Nagarra et al, INTERNATIONAL JOURNAL OF GYNECOLOGICAL CANCER, Vol: 31, Pages: 1396-1397, ISSN: 1048-891X

Journal article

Phylactou M, Abbara A, Al-Memar M, Kyriacou C, Pei Chia E, Nadir R, Izzie-Engbeaya C, Clarke S, Mills E, Daniels E, Huo L, Pacuszka E, Yang L, Patel B, Tan T, Bech P, Comninos A, Fourie H, Kelsey T, Bourne T, Dhillo Wet al., 2021, Performance of plasma kisspeptin as a biomarker for miscarriage improves with gestation during the first trimester, Fertility and Sterility, Vol: 116, Pages: 809-819, ISSN: 0015-0282

ObjectiveTo compare the performance of kisspeptin and beta human chorionic gonadotropin (βhCG), both alone and in combination, as biomarkers for miscarriage throughout the first trimester.DesignProspective, nested case-control study.SettingTertiary Centre, Queen Charlotte Hospital, London, United Kingdom.Patient(s)Adult women who had miscarriages (n = 95, 173 samples) and women with healthy pregnancies (n = 265, 557 samples).Intervention(s)The participants underwent serial ultrasound scans and blood sampling for measurement of plasma kisspeptin and βhCG levels during the first trimester.Main Outcome Measure(s)The ability of plasma kisspeptin and βhCG levels to distinguish pregnancies complicated by miscarriage from healthy pregnancies unaffected by miscarriage.Result(s)Gestation-adjusted levels of circulating kisspeptin and βhCG were lower in samples from women with miscarriages than in women with healthy pregnancies by 79% and 70%, respectively. The area under the receiver-operating characteristic curve for identifying miscarriage during the first trimester was 0.874 (95% confidence interval [CI] 0.844–0.904) for kisspeptin, 0.859 (95% CI 0.820–0.899) for βhCG, and 0.916 (95% CI 0.886–0.946) for the sum of the two markers. The performance of kisspeptin in identifying miscarriage improved with increasing length of gestation, whereas that of βhCG worsened. A decision matrix incorporating kisspeptin, βhCG, and gestational age had 83% to 87% accuracy for the prediction of miscarriage.Conclusion(s)Plasma kisspeptin is a promising biomarker for miscarriage and provides additional value to βhCG alone, especially during later gestational weeks of the first trimester.

Journal article

Timmerman D, Planchamp F, Bourne T, Landolfo C, du Bois A, Chiva L, Cibula D, Concin N, Fischerova D, Froyman W, Madueno GG, Lemley B, Loft A, Mereu L, Morice P, Querleu D, Testa AC, Vergote I, Vandecaveye V, Scambia G, Fotopoulou Cet al., 2021, ESGO/ISUOG/IOTA/ESGE Consensus Statement on pre-operative diagnosis of ovarian tumors, International Journal of Gynecological Cancer, Vol: 31, Pages: 961-982, ISSN: 1048-891X

The European Society of Gynaecological Oncology (ESGO), the International Society of Ultrasound in Obstetrics and Gynecology (ISUOG), the International Ovarian Tumour Analysis (IOTA) group, and the European Society for Gynaecological Endoscopy (ESGE) jointly developed clinically relevant and evidence-based statements on the pre-operative diagnosis of ovarian tumors, including imaging techniques, biomarkers, and prediction models. ESGO/ISUOG/IOTA/ESGE nominated a multidisciplinary international group, including expert practising clinicians and researchers who have demonstrated leadership and expertise in the pre-operative diagnosis of ovarian tumors and management of patients with ovarian cancer (19 experts across Europe). A patient representative was also included in the group. To ensure that the statements were evidence-based, the current literature was reviewed and critically appraised. Preliminary statements were drafted based on the review of the relevant literature. During a conference call, the whole group discussed each preliminary statement and a first round of voting was carried out. Statements were removed when a consensus among group members was not obtained. The voters had the opportunity to provide comments/suggestions with their votes. The statements were then revised accordingly. Another round of voting was carried out according to the same rules to allow the whole group to evaluate the revised version of the statements. The group achieved consensus on 18 statements. This Consensus Statement presents these ESGO/ISUOG/IOTA/ESGE statements on the pre-operative diagnosis of ovarian tumors and the assessment of carcinomatosis, together with a summary of the evidence supporting each statement.

Journal article

Fourie H, Al-Memar M, Smith A, Ng S, Lee Y, Timmerman D, Bourne T, MacIntyre D, Bennett Pet al., 2021, The relationship between systemic oestradiol and vaginal microbiota composition in miscarriage and normal pregnancy, Publisher: OXFORD UNIV PRESS, Pages: 311-312, ISSN: 0268-1161

Conference paper

Grewal K, Lee Y, Smith A, Brosens J, Al-Memar M, Bourne T, Kundu S, MacInytre D, Bennett Pet al., 2021, Lactobacillus deplete vaginal microbial composition is associated with chromosomally normal miscarriage and local inflammation, Publisher: OXFORD UNIV PRESS, Pages: 56-56, ISSN: 0268-1161

Conference paper

Grewal K, Lee YS, Smith A, Brosens JJ, Bourne T, Al-Memar M, Kundu S, MacIntyre DA, Bennett Pet al., 2021, Euploid Miscarriage Is Associated with Lactobacillus spp. Deplete Vaginal Microbial Composition and Local Inflammation., Publisher: SPRINGER HEIDELBERG, Pages: 77A-77A, ISSN: 1933-7191

Conference paper

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