Research Updates

Feb 2023 Update

A qualitative analysis of medical students’ attitudes to abortion education in UK medical schools (Horan, C. et al, 2022)

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“I readA qualitative analysis of medical students’ attitudes to abortion education in UK medical schools’ in preparation for my SFP interview and due to my interest in this area as a doctors for choice curriculum champion. This study follows on from a previous quantitative study (link available above) Sample: 19 students from five different UK medical schools in which abortion teaching was delivered.Sampling was based on the amount of curriculum time dedicated to abortion teaching. Selected schools dedicated different amounts of time to abortion teaching: from <1 hour of teaching to >8 hours of teaching time. Phenomenon of interest: This study aimed to explore medical students’ views on their undergraduate abortion education, and whether it prepared them to be a competent practitioner. Study design: Qualitative study using semi-structured interviews. Interviews were then transcribed and analysed thematically. Results: Four overarching and interrelated themes were identified 1)Value of compulsory comprehensive abortion teaching. 2)Preparation for competent practice. 3)Accommodating diverse views. 4)Sensitivity as a barrier or incentive. Students’ responses were not always experientially driven; some followed reflection on what they thought their teaching lacked. Conclusion: The students interviewed felt abortion education is an important aspect of their undergraduate curriculum which should be given more focus given how common abortion is (many students were surprised by the figure that 1 in 3 women will have an abortion in the UK). Conversely to the quantitative study findings (interviewed abortion education providers/those involved in medical curriculum design rather than students), students believed that perceived sensitivity of abortion increases the importance of effective abortion teaching that prepares them to provide care when they qualify.” Victoria Leigh – University of Leeds Ambassador

The impact of the COVID-19 pandemic on ectopic pregnancy presentation and treatment: A retrospective cohort study (Aiob, A. et al, 2023)

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This study sought to investigate the effect of COVID19 on ectopic pregnancy incidence, presentation and management, and how this changed with the introduction of the COVID19 vaccination. Most saliently, Aoib et al., demonstrated that women diagnosed with an ectopic pregnancy during the pandemic were more likely to have to undergo an emergency laparoscopy as compared to antecedently. Women also presented later and their management was associated with a higher level of blood loss. Importantly, the subsequent introduction of the COVID-19 vaccination has not been associated with any change in these trends. The authors hypothesise these findings to be largely due delays in seeking timely healthcare due to fears of infection by the virus. The associated reluctance meant women were more likely to present at a later gestational date, symptomatic and in need of urgent surgery. The importance of this study is two-fold. Firstly, it highlights a need to stress the importance of early evaluation in pregnancy despite existing challenging situations, such the pandemic. Moreover, it shows the importance of educating women in the post-COVID era about the early warning signs of an ectopic pregnancy to encourage earlier self-recognition of symptoms, thereby preventing later, symptomatic presentation with a high risk of urgent intervention. Additionally, the authors note the crucial role social media played in the dissemination of information throughout the pandemic, and suggest this as a possible tool for education on this topic.” Natalia Niezgoda – University of Edinburgh ambassador

Jan 2023 Update

Preterm and term pre-eclampsia: relative burdens of maternal and perinatal complications (Von Dadelszen, P. et al, 2022)

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“Von Dadelszen, P. et al. (2022) “Preterm and term pre-eclampsia: relative burdens of maternal and perinatal complications,” BJOG: An International Journal of Obstetrics &amp; Gynaecology, 129(13). This research article used a prospective observational cohort study of tea English maternity units to determine the relative burdens of maternal and perinatal complications for pre-term and term pre-eclampsia. Women with singleton pregnancies who developed pre-eclampsia were looked at and results were obtained by comparing the health records of those with pre-eclampsia at term, and pre-eclampsia preterm. The key outcomes that were measured were severe maternal hypertension, maternal mortality or major morbidity, perinatal mortality of major neonatal morbidity, neonatal unit admission and birthweight in <3rd percentile. The study found that in women with singleton pregnancies, although there was a greater risk of adverse events in preterm pre-eclampsia compared to term pre-eclampsia, the absolute risk of maternal complications in term preeclampsia was found to be equivalent to that of preterm pre-eclampsia which is often overlooked. Thus this article highlights the importance of decreasing the risk of term pre-eclampsia through regular antenatal checks and the use of low-dose aspirin for those with risk factors as required.” – Stephanie Soosaipillai – Anglia Ruskin Ambassador

Time trends in contraceptive prescribing in UK primary care 2000-2018: a repeated cross-sectional study (Pasvol TJ et al., 2022)

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“This piece of research outlines trends in contraceptive prescribing in the UK over an 18 year time period. Over this period of time, combined contraceptive pill prescribing decreased and progesterone-only contraceptive pill and long-acting reversible contraceptive prescriptions increased. There was also a disparity in 2018 between deprivation and the type of contraceptive prescribed, with women from deprived areas more likely to be prescribed long-acting reversible contraceptives and women from less deprived areas prescribed combined contraceptive pills. This is compared to 2009, where LARC prescribing increased regardless of age and social deprivation. This is thought to be due to the pay-for-performance financial incentive offered at the time, which was later withdrawn in 2014. This piece of work is important because it demonstrates that social deprivation impacts prescribing and clinician’s working in these areas should be aware of this. It also suggests that the withdrawal of the pay-for-performance incentive has unfavourably impacted the LARC uptake in adolescent groups and there is the need for the reintroduction for this initiative or the introduction of a new initiative to support this vulnerable group.” Lauren Franklin – Keele University Ambassador