Early GDM – what happens post partum?

29th November 2024, A/Prof Chee L Khoo

We have written a bit on the paradigm change in our diagnosis and management of GDM over the last couple of years. We have looked at the TOBOGM study at length about early GDM (eGDM). This is GDM diagnosed before 24-week gestation. The TOBOGM study demonstrated that it is important to diagnosed early GDM as early treatment significantly improve neonatal and maternal outcomes.…

The role of US in postmenopausal bleeding

13th October 2024, NIA Diagnostic Imaging

transvaginal US

Menopause is characterised by complete absence of menstrual cycle due to no ovarian follicles left in reserve and it is clinically diagnosed when a woman has amenorrhea for at least 1 year (Sung, 2023).
Any post-menopausal women with vaginal bleeding should be appropriately managed through comprehensive clinical examinations and diagnostic studies; these include diagnostic imaging and, in some cases, endometrial biopsies (Sung, 2023).…

HbA1c in early pregnancy – is it a good screening test for GDM?

25th July 2024, A/Prof Chee L Khoo

The current gold standard for screening for gestational diabetes mellitus (GDM) for women with no risk factors for hyperglycaemia is an oral glucose tolerance test (OGTT) at 24-28 weeks’ gestation. Women with risk factors are recommended to have an OGTT in the first trimester. Unfortunately, many women are nauseous during the first trimester and performing an OGTT during that time can be very unpalatable.…

Intravenous iron for iron deficiency – can you give too much?

13th July 2024, A/Prof Chee L Khoo

Iron infusion

Iron deficiency can occur in a number of scenarios. It can arise from blood loss (gastrointestinal, gynaecological), inadequate dietary sources or limited absorption in inflammatory conditions (e.g CKD, heart failure or diabetes). Oral iron supplements not only can have annoying GI side effects but absorption is poor under the best of conditions.…

Transvaginal vs Transperineal US in Obstetric Imaging

Transperineal US

13th July 2024, NIA Diagnostic Imaging

Preterm birth/labour (PTL) is the most common cause of neonatal mortality and morbidity. Preterm birth is defined as delivery prior to 37 weeks of gestation (1). In Australia, the preterm birth rate ranges from 8.3% in 2011 and 8.2% in 2021 with the highest in recent years at 8.7% in 2018 (2). Transvaginal ultrasound (TVUS) is considered as the gold standard in the measurement of cervical length (CL) and is routinely used as part of preterm labour’s risk assessment (4).…

DEXA – The key to diagnosing osteoporosis

6th June 2024, NIA Diagnostic Imaging

DEXA (Dual-Energy X-ray Absorptiometry), is a non-invasive, quick and simple medical imaging modality used to measure bone mineral density (BMD). It is highly effective in diagnosing osteoporosis or osteopenia, hence enabling managing clinicians to assess the extent of bone loss for their patients. It is considered the “gold standard” by the World Health Organisation (WHO) and is the most accurate and inexpensive test to diagnose osteoporosis.…

Breast Imaging at Spectrum Medical Imaging

31st May 2024, Spectrum Medical Imaging

When you have to further investigate any breast conditions including breast lesions, the imaging modalities can be many. You want to refer a patient to a radiology service which can offer a whole array of imaging modalities. Spectrum Medical Imaging is the first practice for breast screening in NSW to offer personalised risk assessment and screening recommendations.…

Omega-3 supplements in pregnancy for leaner kids?

11th May 2024, A/Prof Chee L Khoo

Omega-3 supplements?

I recall reading somewhere that increasing fish intake during pregnancy results in leaner offsprings. It all makes sense as we know that ω-3 fatty acid (ω-3 FA) is beneficial for adults (also read somewhere). It must be good for babies then. Is there data on those claims? Well, sort of. We shall look into them.…

Uterine artery doppler – when would you order one?

13th February 2024, NIA Diagnostic Imaging

Uterine Artery

Commonly, uterine artery doppler ultrasound is conducted to measure the blood flow in the uterine arteries. This specific ultrasound allows for qualitative information to be gathered on the presence/absence of flow, the direction of flow, the quality of flow, to determine if the flow is laminar or turbulent and to distinguish waveform shape (low resistance, high resistance, early diastolic notch) (Naguib et al.,2012).…

Salpingectomy to prevent ovarian cancer?

27th January 2024, A/Prof Chee L Khoo

Ovaries

The World Health Organisation classifies epithelial ovarian carcinomas into several morphological categories according to cell type: serous carcinomas (SC), mucinous carcinomas, endometrioid carcinomas, and clear-cell carcinomas, transitional-cell Brenner tumours, mixed, and undifferentiated type [1]. SC account for 75-80% of epithelial carcinomas and are subdivided into high-grade SC (HGSC) and low-grade SC (LGSC). Like any other cancers, early diagnosis would be important to improve the prognosis but often when diagnosed, ovarian cancer is in its advanced stages.…

Cervical screening – hands up who’s not here?

25th November 2023, A/Prof Chee L Khoo

Cervical screening for cervical cancer for the prevention of cervical cancer has to be one of the most successful campaigns in primary care. For most, instead of having an intimate check every two years, doing it every 5 years is such a relief. For others, it is still having to endure an insertion of a vaginal speculum.…