Self reflection RANZCOG tool                 
Educational acitivy CPD points
 
Step by step process for entering points
 
2024

 June            Ultrasound assessment of lower uterine segment thickness 
I found the take-home message from this paper was that if the myometrial thickness, which is something I had never used before, is less than two millimeters, the  successful outcome of a trial of Labor in a patient who has previously had a cesarean section is virtually zero for vaginal birth.  

 July               Risk of endometrial cancer in relation to endometrial thickness
Should we use 3 mm or not as a cut off  the following is a link to an AJOG letter regarding the above 
Risk of endometrial cancer in asymptomatic postmenopausal women in relation to ultrasonographic endometrial thickness (ajog.org)  also this letter about the same topic    Risk of endometrial cancer in asymptomatic postmenopausal women in relation to ultrasonographic endometrial thickness: a dutiful reply - American Journal of Obstetrics & Gynecology (ajog.org)

 August             Caesarean section and anal incontinence in women after obstetric anal sphincter injury
Due to low evidence quality, we are unable to determine whether planned caesarean is protective against AI after OASI. Higher quality evidence is required to guide personalised decision-making for asymptomatic women and to determine the effect of subsequent birth mode on long-term AI outcomes.

 September     A Position Modification Device for the Prevention of Supine Sleep During Pregnancy
We found no evidence to suggest that the adoption of a pillow designed to discourage supine sleep was effective in late pregnancy, with women spending an average of 1 h per night supine. Alternative devices should be investigated, incorporating lessons learnt from this study to inform trials of supine sleep minimisation in pregnancy.

 October        Mirena and Breast Cancer risk with the Expert response to this paper found here
Should we believe or refute the current body of evidence for the potential association between breast cancer and mirena use?

 November   Microbiome in Endometriosis
How fascinating and novel and supports the nutritional component of lifestyle changes in controlling endometriosis.

 December  vNotes Complication rates
This never goes away but now there is compelling real life evidence that the technique has great merit with no greater complication than alternative strategies.

2025

 January        Post Partum PreEclampsia Outcomes
Very good reminder that complications intrapartum can be a pointer for the development of post partum Pre Eclampsia

 February     RANZCOG ASM Abstracts
A great selection of what is interesting our colleagues and our own minds 

 March          Why most Published Research Findings are False 
This is a fascinating paper that eloquently if not a little complicated in manner the issues of bias - selection and internal being the major issues involved.

 April               Big baby trial to induce or not
Our take home message from this paper and after listening to the Mercy Hospital Webinair is that it is safe to NOT induce non diabetic singleton pregnancies at 39 to 40 weeks with babies over the 90th centile.
If considering IOL then perhaps only when greater than the 95th centile. However, our internal biases have a huge influence upon decison making 

May                 Vaginal Lactobacillus Crispatus in high risk HPV
A potentially promising treatment of high risk HPV carriers. This paper is linked to others in the citation and shows that no harm is done taking either oral or vaginal preperations of L Crispatus. However, trying to find a product that has good quality control is not easy.....
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June                Maternal Opthalmic Artery Doppler and Pre Eclampsia
This is a fascinating article showing that the performance of the opthalmic artery is independent of other markers for pre eclampsia and a presentation in the upcoming world fetal medicine foundation congress in Prague in June / July this year.
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July.                         Mans searching for meaning; Victor Frankel

Between stimulus and response lies a space.
In that space is our power to choose our response.
In our response lies our growth and freedom.
 
In an era of cultural change, responses are best served cold and tasteful rather than reactive and bitter.

This is a book (the link takes you to a free download PDF of the book but you buy it on audible) that we should all read. I will never complain again about my life when we compare what we have now but forgetting the reason for why we live and what we live for can soon produce the complaining whingeing man in me!!
I have linked this to a podcast on spotify (free) from a mental health series that discusses the work of Victor Frankel and in particular logotherapy. The podcast is run by a psychiatrist and is specifically focussing on how us clinicians can improve the quality of care for patients and resilience for physicians. Essential reading for all trainees perhaps? 
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August.               Maternal and Neonatal Outcomes:  Public vs Private Outcomes
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This contempraneous paper answers less questions as it asks.  We discussed this at our recent Bali conference. The outcomes of the debate were varied. What do you think?

September.    Patient Physician Alliance

This is a fascinating arena. This is also perhaps linked to the August paper where a strong trusting relationship improves outcomes for patients particuarly in respect to psycho/pharmacotherapy.
Psychodynamic Psychomarmacy
I have also included a link for the spotify discussion between psychiatrists on how this effect can improve outcomes for patient by up to 50%

October.          Techniques for closure at Caesarean Section

This paper published in the AJOG  is a great example of human factors. The paper is littered with internal biases, assumptions and extrapolations. I was surprised that these issues were not clearly outined in the paper to avoid any errors in interpretation of the content. What do you think now that I have set the scene!!

November   Augment to reduce episiotomy complications

Well this paper appears to be  suggesting that prophylactic antibiotics reduce wound complications but the conclusion is self contradictory.  So many confounding variables that were not accounted for such as salt baths......reminds me of the findings that people who live in bungalows are less fit than those who live in two storey houses!!