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SummaryBetween 1981 and 1982 the Royal College of Obstetricians and Gynaecologists undertook a national survey of late abortion practice in England and Wales. The study was based on a confidential enquiry, specifically authorized by the Chief Medical Officers of the DHSS and the Welsh Office, which used the notification system as the means of identifying cases. All abortions notified as carried out at 20 weeks gestational age or more were selected during the year, together with varying proportions of cases from other gestational groups. Data on avoidable and unavoidable causes of delay were obtained by questionnaire from notifying doctors, and a comparison was made of the subjectively attributed delay with any that was found through objective measures derived from both questionnaire and notification data. This paper presents results on delay associated specifically with abortions carried out at a gestational age of 20 weeks or more to residents of the United Kingdom only.

AbstractThree recent studies reported that early depletion of the primordial follicle pool is likely to be an independent risk factor for Down's syndrome pregnancies. The size of the primordial follicle pool at birth is determined by oogenesis and by the rate of follicle atresia during the intra uterine period. Since intra uterine growth retardation was reported to be associated with a significantly reduced primordial follicle pool at birth, we investigated the possibility of a relation between low birth weight for gestational age and the risk of a Down's syndrome pregnancy. In a case control study, 95 women with a history of a Down's syndrome pregnancy and 85 controls provided information on their own birth weight and length of gestation. Birth weight standard deviation scores, indicating the difference in birth weight from a reference group, were significantly lower in Down's syndrome mothers than in controls. These findings illustrate that the risk of a Down's syndrome pregnancy is related to a low birth weight corrected for gestational age, possibly by a causal relation between intra uterine growth retardation and the size of the primordial follicle pool

AIMS/HYPOTHESIS: Gestational diabetes mellitus (GDM) is associated with increased risks to mother and child, but globally agreed diagnostic criteria remain elusive. Identification of women with GDM is important, as treatment reduces adverse outcomes such as perinatal death, shoulder dystocia and neonatal hypoglycaemia. Recently, the UK's National Institute for Health and Care Excellence (NICE) recommended new diagnostic thresholds for GDM which are different from the International Association of the Diabetes and Pregnancy Study Groups (IADPSG) criteria endorsed by the WHO. The study aim was to assess neonatal and obstetric outcomes among women who would test positive for the IADPSG criteria but negative for the NICE 2015 criteria. METHODS: Data from 25,543 consecutive singleton live births (2004-2008) were obtained retrospectively from hospital records. Women were screened with a random plasma glucose (RPG; 12-16 weeks) and a 50 g glucose challenge test (GCT; 26-28 weeks). If RPG >7.0 mmol/l, GCT >7.7 mmol/l or symptoms were present, a 75 g OGTT was offered (n = 3,848). RESULTS: In this study, GDM prevalence was 4.13% (NICE 2015) and 4.62% (IADPSG). Women who 'fell through the net', testing NICE-negative but IADPSG-positive (n = 387), had a higher risk of having a large-for-gestational-age (LGA) infant (birthweight >90th percentile for gestational age; adjusted OR [95% CI] 3.12 [2.44, 3.98]), Caesarean delivery (1.44 [1.15, 1.81]) and polyhydramnios (6.90 [3.94, 12.08]) compared with women with negative screening results and no OGTT (n = 21,695). LGA risk was highest among women with fasting plasma glucose 5.1-5.5 mmol/l (n = 167): the mean birthweight was 350 g above that of the reference population and 37.7% of infants were LGA. CONCLUSIONS/INTERPRETATION: The IADPSG criteria identify women at substantial risk of complications who would not be identified by the NICE 2015 criteria. ; CLM receives salary funding from the European Union Seventh Framework Programme (FP7/2007–2013; grant agreement number 266408) and from the Wellcome Trust Translational Medicine and Therapeutics Programme, which is funded by the Wellcome Trust in association with GlaxoSmithKline. ; This is the final version. It was first published by Springer at http://link.springer.com/article/10.1007%2Fs00125-015-3647-z.

Origins and foundations : two features of the modern constitution -- The paradox of democratic founding : canonical statements and contemporary perspectives -- The people and the lawgiver : Rousseau on the possibility of democratic founding -- Building a homeland : founding and identity in Hanna Arendt's Jewish writings -- Revolution and constitution : the legitimacy of beginning in question -- Law and democracy in founding moments : deliberative constitution-making -- "The act by which a people is a people

A rapid increase in the prevalence of gestational diabetes mellitus (GDM) has been associated with various factors such as urbanization, lifestyle changes, adverse hyperglycemic intrauterine environment, and the resulting epigenetic changes. Despite this, the burden of GDM has not been well-assessed in Southeast Asia. We comprehensively reviewed published Southeast Asian studies to identify the current research trend in GDM in this region. Joanna Briggs Institute's methodology was used to guide the scoping review. The synthesis of literature findings demonstrates almost comparable clinical evidence in terms of risk factors and complications, challenges presented in diagnosing GDM, and its disease management, given the similarities of the underlying population characteristics in Southeast Asia. Evidence suggests that a large proportion of GDM risk in women may be preventable by lifestyle modifications. However, the GDM burden across countries is expected to rise, given the heterogeneity in screening approaches and diagnostic criteria, mainly influenced by economic status. There is an urgent need for concerted efforts by government and nongovernmental sectors to implement national programs to prevent, manage, and monitor the disease.