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Uterine fibroids affect between 20% and 50% of women in their reproductive years and may cause abnormal or excessive uterine bleeding, dysmenorrhoea, pelvic pain or pressure symptoms. They may also...

Fetal macrosomia represents a continuing challenge in obstetrics, as it has risk of shoulder dystocia leading to transient or permanent fetal, maternal injury and medicolegal liability. The overall incidence of macrosomia has been rising. Non-diabetic macrosomia is still an obstetric dilemma, as there is no clear consensus regarding its ante-partum prediction and management, as accurate diagnosis is only made retrospectively. The risk of shoulder dystocia rises from 1.4% for all vaginal deliveries to 9.2-24% for birth weights more than 4,500 g. Unfortunately, 50% of all cases of shoulder dystocia occur at birth weights of less than 4,000 g. Brachial plexus injury occurs in 1:1,000 births and permanent damage in 1:10,000 deliveries (12% of all) leading to litigation 1:45,000 deliveries. The prenatal diagnosis of macrosomia remains imprecise. Pre-pregnancy and ante-partum risk factors and ultrasound have poor predictive value. Induction of labour and prophylactic caesarean delivery has not been shown to alter the incidence of shoulder dystocia among nondiabetic patients. Caesarean section and induction of labour are associated with increased risk of operative morbidity and mortality with added cost implications.

Bartholin's abscess and cyst account for 2% of all gynaecological visits per annum. This article reviews the anatomy, epidemiology and pathophysiology of the Bartholin's gland. The management of Bartholin's abscess including antibiotic use in the early stage of the condition together with options for surgical intervention are discussed and in so doing the variation of clinical practice in other countries is considered. The use of the word catheter, carbon dioxide laser are compared with traditional surgical techniques of incision and drainage and marsupialisation. The outcomes of treatment particularly the high recurrence rate (2-25%) and the associated morbidity are reviewed. Finally the issue of cancerous pathology as an aetiology is highlighted in the postmenopausal age group.