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PCOS diagnosis – an end to the dog breakfast?

11th October, 2018, Dr Chee L Khoo

The original diagnostic criteria for polycystic ovary syndrome (PCOS) put forward after the first international conference on PCOS in 1990 was oligo-anovulation and hyperandrogenism or hyperandrogenaemia in the absence of all other endocrinopathies. This was based on expert consensus rather than clinical research data. The Rotterdam criteria 2003 added ultrasound as a third diagnostic marker and to allow for a diagnosis of PCOS if two of the three criteria were met.…

Prenatal programming – can it affect offspring mental outcomes?

11th October 2018, Dr Chee L Khoo

Epigenetics is the modification of the DNA that changes a gene’s expression without altering the nucleotide sequence. DNA methylation and histone modifications are the most commonly studied epigenetic mechanisms by which cell structure and function can be altered during embryogenesis. The in-utero environment can lead to prenatal programming by which genes are activated or deactivated.…

3D Mammogram – is there a role in clinical practice?

30th September, 2018, Dr Chee L Khoo

There is no question that screening mammograms have led to a decline in late stage breast cancers. There have been a gradual decrease in breast cancer mortality, at least partly, due to the introduction of screening mammograms over the last 25 years. But screening mammograms are not perfect. In women with dense breast tissue, the sensitivity of mammogram decreases.…

Ondansetron – is it safe in pregnancy?

15th September, 2018, Dr Chee L Khoo

Nausea and vomiting affects up to 80% of pregnancies but severe nausea and vomiting in early pregnancy or hyperemesis gravidarum (HG) can affect up to 1% of pregnancy. As GPs, we are often the first port of call for these women. We know how debilitating it is to those women. There is also an significant economic impact not just because of many of these women ended up in hospital on more than one occasion before 20 weeks of gestation but many (and often their partners) can’t go to work during this period.…

Non-invasive prenatal screening – A package deal

Increasingly, women are now requesting non invasive prenatal screening. Spectrum Medical Imaging now offers a comprehensive non-invasive prenatal screening at Liverpool.

For patient convenience, they provide pre-test discussion, a viability/dating scan, GeneStyle NIPS and 13 week structural scan. NIPS results are available within 5 days. Genetic counselling for NIPS if required post test.

Click here for more details.…

Metformin in pregnancy – where are we now?

April 2018, Dr Chee L Khoo

Another day, another study published on the good or bad about metformin use in pregnancy. There is a lot of confusion and unknowns about the benefit or safety of metformin to the mother-to-be or to the long-term outcome of the baby. When there is a lot of conflicting data coming our way, we need to sit back and look at the overall picture of hyperglycaemia in pregnancy and its management before we can make sense of these studies.…

Metformin during pregnancy – Goldilocks principle strikes again!

March 15, 2018 Dr Chee L Khoo

Hyperglycaemia during pregnancy has significant metabolic consequences for the mother, the pregnancy as well as for the offspring’s future health. It is tempting to assume that keeping the glucose lower during pregnancy must be beneficial for both parties. Metformin has been used in women with PCOS, GDM and obesity during pregnancy in an attempt to improve pregnancy and foetal outcomes but this practice is not based on solid scientific evidence.…

Non-invasive prenatal testing – what GPs need to know

February 2018, Dr Chee L Khoo

You would have no doubt come across a few patients enquiring about non-invasive prenatal testing. Obviously, this come on top of the “optional” nuchal translucency (NT) with or without maternal serum analysis which has been around for some years. What does non-invasive prenatal tests (NIPT) exclude and what does it not exclude?

So, what does NIPT test for?…

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