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OBGYN.net Editorial Advisor
Obstetrics, Pregnancy & Birth
Ultrasound

C.R. Welch MD MRCOG - UK
Index of Articles by Dr. Welch

Personal
Name: Christopher Ross Welch

Date of Birth: 22nd AUGUST 1958

Family: Married with three children

Education:
Secondary

Tiffin Boy's School 9/69 -7/76
Kingston Upon Thames, Surrey.
12 `O' level passes

1. `A/O' level pass
2. 3 `A' level passes
3. Prizes at `O' and `A' level

MEDICAL
(Pre-clinical)
King's College 10/76 -7/81
The Strand, London

(Clinical)
King's College Hospital Medical School
Denmark Hill, London

Qualifications:
M.B.,B.S. 7/81
Family Planning Certificate 4/84
Diploma in Anaesthetics 5/85
M.R.C.O.G 1/89
MD (Fetal Medicine) King’s College London 6/95

Membership of Organsations:
General Medical Council 
Medical Protection Society 
British Medical Association

International Fetal Medicine and Surgery Society-President
Northern Fetal Society
Obstetric Anaesthetists' Association
Blair Bell Research Society
British Medical Ultrasound Society

Present Post:
Consultant Obstetrician and Gynaecologist
Special interest in Fetomaternal Medicine
Arrowe Parke Hospital, Upton Wirral L49 5PE (from 1/10/94)

Previous Appointments:
House Surgeon 8/81-1/82
ORPINGTON HOSPITAL, Kent.
(General Surgery/Urology/Ophthalmic Surgery)
Mr R.M.T.Walker Brash and Mr M.G.Glasspool

House Physician 2/82-7/82
ORPINGTON HOSPITAL, Kent. (General Medicine/Cardiology/Rheumatology)
Dr C.F.P.Wharton and Dr E.A.Kauffman

SHO Gynaecology 1/83-7/83
ROYAL DEVON & EXETER HOSPITAL, Exeter.
Mr N.H.N.Gardner and Mr S.M.Wood

SHO Obstetrics 8/83-2/84
ROYAL DEVON & EXETER HOSPITAL, Exeter.
Mr N.H.N.Gardner and Mr S.M.Wood

SHO Anaesthetics 4/84-4/85
ROYAL DEVON & EXETER HOSPITAL, Exeter.
Dr B.Perriss

SHO Obstetrics 7/85-1/86
QUEEN MARY'S UNIVERSITY HOSPITAL, Roehampton
(Academic department of Obstetrics and Gynaecology of Charing Cross and Westminster Medical Schools)
Professor P.Curzen Mr R.M.Ballard and Mr R.W.Worth

SHO Gynaecology 2/86-4/86
HAMMERSMITH HOSPITAL, London
Department of Gynaecological Oncology
Mr W.P.Soutter (Reader in Oncology) and Dr H.Lambert (Medical Oncologist)

Registrar in Obstetrics/Gynaecology 5/86-7/88
ST HELIER HOSPITAL, Carshalton
Mr N.A.McWhinney, Miss D.Moncrieff, Mr L.D.Ross and Mr P.Gough

CMO 12/90-8/91
Family Planning/Well Woman Clinic
Community Health
Richmond Twickenham & Roehampton Health Authority
Research Fellow/Honorary Registrar 10/89-9/91

FETAL MEDICINE UNIT
Royal Postgraduate Medical School
Institute of Obstetrics and Gynaecology
QUEEN CHARLOTTE'S AND CHELSEA HOSPITALS
Goldhawk Rd
London W6 0XG

Senior Registrar Obstetrics/Gynaecology 10/91-11/93
Mersey Regional Health Authority
(Liverpool Maternity/Countess Of Chester rotation)
Mr S.A.Walkinshaw

Lecturer in Fetal Medicine12/93-10/94
Department of Fetal Medicine, Birmingham University
Birmingham Maternity Hospital
Professor M.Whittle

CLINICAL EXPERIENCE:

Obstetrics:

I have gained experience in routine antenatal care, whilst working in busy district general hospitals and experience with high risk Obstetrics whilst working in Teaching centres and Regional referral centres.

I am competent to manage normal, high risk and complicated labour and delivery within which ultrasound, fetal scalp blood sampling and intrauterine pressure monitoring play a part. I am competent in all forms of operative delivery, including: Caesarean section; rotational forceps, outlet forceps and vacuum extraction.

At the district general hospitals, I gained a broad based experience, under many consultants, seeing a wide variety of approaches to the management of uncomplicated pregnancy, together with some more specialised care. In particular, at Exeter, there was a relatively high incidence of severe Gestational Proteinuric Hypertension. I have also seen a variety of schemes of antenatal care.

During my appointment as a Gynaecological SHO at the Hammersmith Hospital, all SHOs spent six weeks on call on the labour ward where a high proportion of the labours were high risk and/or in utero transfers.

At St Helier further experience was gained in general Obstetrics, as one of three registrars, in a unit delivering 3,700 babies per annum. Also my interest in antenatal diagnosis developed, with teaching and practise in ultrasound (see later).

My obstetric experience has further extended during my Senior Registrar post (vide supra). I have gained experience in a Medical disorders in pregnancy antenatal clinic, jointly managing medical problems such as Diabetes, cardiac disease, thyroid disease and renal disease with a Consultant Physician. I have seen how many antenatal problems can be successfully managed in an Obstetric Daycare and fetal assessment unit and have learnt how infrequently patient's need admission.

Gynaecology:

I am competent with most gynaecological surgery, including minimal access techniques. I am competent with the CO2 and saline hysteroscope and have had some experience of the microcolpohysteroscope. I can perform simple and complicated abdominal hysterectomy and major vaginal surgery unsupervised. I am competent with acute gynaecological emergencies.

In Exeter I gained a broad experience in general Gynaecology and basic gynaecological surgery. At the Hammersmith the main commitment was to the Gynaecological Oncology unit where experience was gained in assisting oncological surgery as well as managing adjuvant chemotherapy.

At St Helier regular Joint Oncological Clinics were held with an oncologist from the Marsden Hospital. Colposcopy was first learnt whilst administering `daycase' anaesthesia for my previous Gynaecological Consultant in Exeter, where video cameras enabled one to one teaching. Further colposcopy experience was gained whilst working at the Hammersmith Hospital. At St Helier hospital I attended a weekly teaching colposcopy clinic providing practical experience. Similarly a weekly basic Subfertility clinic was held where experience in Hysterosalpingography, Post Coital tests and Cervical Mucus Hostility tests as well as the biochemical investigation of fertility problems was gained. As a Senior Registrar I have continued to maintain an interest in routine gynaecology. I have gained experience in the outpatient management of many minor gynaecological problems in a Minor procedures clinic. I was first taught outpatient gas hysteroscopy as an SHO in Exeter and would be keen to develop further the outpatient or "Office Gynaecology" field particularly utilising my expertise in ultrasound.

Ultrasound/Fetal Medicine:

My main clinical interest, Fetal Medicine, began whilst helping as a student at King's College Hospital with research into fetal breathing and trunk movements in early labour. During the St Helier post this interest rapidly expanded into competence with most routine scanning in obstetrics and gynaecology.

I have attended the beginner's and advanced courses in Ultrasound at King’s College Hospital which extended my knowledge of prenatal diagnosis as well as antenatal fetal wellbeing assessment (biophysical profiles).

During the two years at Queen Charlotte’s, I was scanning one session a week on ‘routine’, level 2 patients, and up to six sessions a week on patients referred with suspected fetal abnormalities. All this time was supervised by and as a part of the Fetal Medicine team (Prof. C.H. Rodeck/U.Nicolini/Prof. N.M. Fisk/Mrs J. Vaughan). At Liverpool I benefitted from having both Mr. S. Walkinshaw and Dr. D. Pilling to continue my training. I took an increasing part in the clinical service provision and in teaching both ultrasound and invasive techniques to other postgraduates. I am now competent to scan to "level 3/4".

During my year with Professor Whittle in Birmingham I was able to refine and extend further my scanning and invasive Fetal Medicine, whilst taking a full role as a part of the clinical service team, performing the full range of procedures unsupervised. I am fully competent with all forms of invasive fetal diagnosis and therapy (e.g. CVS, cordocentesis, fetal transfusion, fetal shunting and fetoscopic procedures)

Anaesthetics

This post was taken as an elective in the M.R.C.O.G. training and was supervised throughout by a specialist Obstetric Anaesthetist.

General anaesthetic experience was obtained and I achieved competence in elective and emergency anaesthesia. Special techniques, including regional analgesia, were performed for orthopaedic, daycase, ophthalmic and ENT surgery. Paediatric and neonatal anaesthesia was performed on both elective and emergency cases.

The last three months were spent as a part of the labour ward anaesthetic team, gaining competence in epidurals, spinals, and general anaesthesia for labour and Caesarean section. There was a two bedded `high dependency' unit on the labour ward where severe pre eclamptics and other obstetric emergencies were managed jointly with the Obstetricians.

House Officer Posts:

My first post was in a busy general surgical unit, with two special interests: Urology and Ophthalmic Surgery. The special interest of my main consultant was male urology and as such many of the operating lists featured urological major surgery. Alternate weeks a `daycase' list of check cystoscopies gave an ideal opportunity to acquire and practise this skill, which would be useful subsequently in gynaecology.

My house physician post was again busy with special interests in Cardiology and Rheumatology. The cardiology side brought exposure to a wide range of common cardiological abnormalities. When on call the house physician and SHO were responsible for the Intensive Therapy Unit giving early experience in management of the acutely ill patient.

Teaching:

Regular undergraduate teaching was carried out at Queen Mary's, Roehampton, where students from Charing Cross and Westminster Hospitals were in residence. Formal and informal teaching was given. Further undergraduate teaching was given at St Helier Hospital, where students from St George's Hospital were in residence. Formal lectures were timetabled as well as bedside teaching to students attached to the `firm'.

I have also participated actively in postgraduate sessions in all the hospitals with case presentations, monthly statistics, and topic teaching. At Queen Charlotte’s, I was an examiner in the mock Viva voce exams as a part of the Part 2 MRCOG course.

Further involvement in both undergraduate and postgraduate teaching has continued in Merseyside, as detailed above, including teaching on the local Part 1 MRCOG course, the Blackpool Midwives refresher Course and MLSO in service training.

Computing:

The need to develop computer skills for my research has blossomed into a high level of competence with both DOS based PCs and with Macintosh computers. This led to my organising and chairing a study day at the RPMS Institute of Obstetrics and Gynaecology on computing in research. I maintain a keen interest in PC development, but have personally moved over wholeheartedly to the Apple Macintosh platform. I have been involved in advising colleagues in choosing equipment for their personal use and helping them reach competence.

Management/Administration:

I have completed the Mersey RHA management training course and am conversant with the structure and function of both sides of the purchaser/provider split. I have worked in three NHS Trusts and feel that I understand the workings of this system.

Consultant Experience:

I took up post as a consultant just under four years ago. My remit was clearly obstetrically biased with a minimal gynaecological input.I have set up the Fetal Medicine and Surgery unit from scratch including negotiating and guiding purchase of equipment. In our first year we were very busy with over 400 referrals mostly from within our own unit (4500 deliveries per year) but also from other hospitals near and far. I have performed the full range of invasive procedures with over 300 procedures per year. I have started a referral service for rhesus disease and am the only centre for fetal shunting in the North West region of the UK. I have recently started fetoscopic procedures with Storz 1mm equipment. Our current projections suggest about a 10% rise in work load in the current year, having had over 600 referrals in year 3.

We have, along with most of the other units in the country, standardised on the King’s Fetal database for data collection and analysis.

I have also been responsible for updating most of the labour ward protocols and guidelines for the management of high risk patients and obstetric emergencies. I have also commenced CTG tutorials on the labour ward.

Since arrival I have been responsible for the obstetric care of most of the high risk obstetric patients and have started a Medical disorders clinic jointly with a consultant physician. This clinic contains the diabetic pregnancies (pre-existing and gestational) and provides a "triage" system for other medical conditions which complicate pregnancy, advising and organising appropriate medical care before returning them to their own obstetric consultant.

I have taken a full part in the management structure of the directorate over the year and have instituted updating clinics for local GPs both in Gynaecology and Obstetrics, enabling them to spend time with consultants on a one to one basis.

I have a small gynaecological work load with a "one stop" gynaecology clinic once a week utilising vaginal ultrasound, endometrial sampling and hysteroscopy in the clinic setting. I teach local GPs in this clinic. I have one operative session which alternates between a majors list and a daycase list, minimising my use of inpatient beds.

RESEARCH:

I have been actively involved in several areas of research both laboratory based and clinical. Most of my ideas have stemmed from clinical problems and I would like to continue being involved in clinically based research:

Research to date:

My first exposure to research was as a student assistant in the Department of Obstetrics and Gynaecology at King's. My first study, as a registrar, involved investigating vaginal granulation tissue after abdominal hysterectomy and the role of suture technique and material.

During my time at the Fetal Medicine Unit, Queen Charlotte's Hospitals, I carried out a research project, the aim of which was to predict fetal haematocrit in utero, non invasively, with Doppler ultrasound. It has also, however, led to an almost unique interest in fetal haemorheology (parameters such as fetal blood viscosity, plasma viscosity, fibrinogen and plasma proteins), and its effects on the dynamics of blood flow in fetal vessels and the consequential changes in the doppler waveform.

The project has resulted in the description of reference ranges of these various parameters in fetuses from 18 weeks onwards and their alterations in disease. In particular the affect of fetal intravascular transfusion on fetal haemorheology, which has resulted in alterations to our technique of fetal transfusion and less fetal risk. This work forms the substance of an M.D. thesis, which has been awarded by the University of London.

Several papers have been published and others are in preparation for publication although the bulk of the findings have already been presented at international conferences and learned societies (vide infra).

Offshoots of the main project have involved developing and improving the standard spinal needle used for fetal blood sampling, to facilitate more accurate haematological assessment (e.g. in fetal alloimmune thrombocytopenia) and to collect the fetal ECG directly (from 18 weeks onwards). This has led to the commercial production of two new needles for use in fetal invasive procedures. The project has also brought a greater understanding of doppler ultrasound and why in current usage it lacks sensitivity as a clinical tool. I have started a collaborative study with Mathematicians and Fluid Dynamacists to develop a better understanding of what the Doppler Flow velocity waveform is showing us and how best to use it.

Research grants awarded:

 

Current research:

My main area of interest is in fetal haemorheology and its effect on blood flow and the doppler waveforms derived from that flow. Having studied this area in the normal fetus and during fetal transfusion, I next plan to submit grant applications to extend my research into the haemorheology of intrauterine growth retardation.

I have just commenced a collaborative project with the departments of Fetal and Infant Pathology and Clinical Engineering (Univ. of Liverpool). We are producing casts of the fetal aortic and ductal arches from which to make vascular models to study blood flow around their confluence and in the descending aorta in vitro.

An offshoot of my MD project was the development of a needle specifically for fetal sampling procedures. With a further modification to this needle, we have successfully monitored the fetal ECG, directly, at gestations as early as 18 weeks. The advantages of being able to monitor direct fetal ECG during fetal blood sampling or transfusion are obvious. Also through our recent collaboration with Dr. K. Walsh, Consultant Paediatric Cardiologist at Alder Hey Hospital, I have developed a proposal to investigate cardiac stress, by analysis of the fetal ECG during fetal transfusion.

I have been using a flexible 0.5mm fibre optic device, as a ‘microfetoscope’ passed down a standard 20 gauge needle for ultrasound directed fetal viewing or in the future perhaps fetal procedures. We anticipate that it would have no more risk than those of amniocentesis. I have signed agreements with the company, that make the fibre, to pursue development of the technology, and am awaiting the first 'scope designed to my specifications.

PUBLICATIONS:

Hornbuckle J, Thornton JG, Kelly M, Welch CR, Oldham J for the GRIT Study Group. Patient randomisation on the Web, Netlines. BMJ 1997; 314: p1604

The GRIT Study Group. When do obstetricians recommend delivery for a high-risk preterm growth-retarded fetus? Growth Restriction Intervention Trial. Eur J Obstet Gynecol Reprod Biol 1996;67(2):121-6.

Nwosu EC, Welch CR, Manasse P, Gazvani K, Walkinshaw SA. Clinical estimation of fetal weight in labour by mothers and midwives. J Obstet Gynaecol 1996 16:483-7

Welch CR, Talbert DG, Warwick RM, Letsky EA, Rodeck CH,. Needle modifications for invasive fetal procedures. Obstet Gynecol 1995 85: 113-117

Bromilow IM, Downing I, Walkinshaw SA, Welch CR, Duguid JKM. A case of unexplained mild Rh(D) haemolytic disease in utero. Transfusion Medicine 1995 5:31-35

Walkinshaw SA, Welch CR, Walsh K, Mccormack J. In utero pacing for fetal congenital heart block. Fet Diagn Ther 1994 9:183-5

Welch CR, D’Mello M, Whittle MJ. Antenatal serum screening for trisomy in donor egg in-vitro fertillisation. Lancet 1994 343: 549-50

Fisk NM, Bennett PR, Warwick RM, Letsky EA, Welch CR, Vaughan J, Moore G. Clinical utility of fetal Rh typing in alloimmunised pregnancies using the polymerase chain reaction on amniocytes or chorion villi. Am J Obstet Gynecol 1994 171 :50-4

Welch CR, Rampling MW, Anwar MA, Talbert DG, Rodeck CH. Changes in hemo-rheology with fetal intravascular transfusion. Am J Obstet Gynecol. 1994 170 :726-32

Welch CR, Rampling MW, Anwar MA, Talbert DG, Rodeck CH. Gestational reference ranges for fetal haemorheological parameters. Clin Haemorh 1994 14 : 93-103

Nwosu EC, Welch CR, Walkinshaw SA. Measurement of amniotic fluid volume using Maximum Pool Depth. Contemp Rev Obstet Gynaecol 1993 6: 25-30

Nwosu EC, Welch CR, Manasse PR, Walkinshaw SA. Longitudinal assessment of amniotic fluid index. Brit J Obstet Gynaecol 1993 100: 816-819

Nwosu EC, Welch CR, Manasse PR, Walkinshaw SA. Longitudinal assessment of amniotic fluid volume using maximum pool depth. Brit J Obstet Gynaecol 1993 100: 774

Welch CR, Makepeace PA , Walkinshaw S. Modern management of pregnancies complicated by Rhesus (D) antibodies. Brit J Hosp Med 1993 49: 813-816

Fisk NM, Welch CR, Ronderos-Dumit D, Vaughan JI, Nicolini U, Rodeck CH. Relief of presumed compression in oligohydramnios: amnioinfusion does not effect umbilical artery doppler waveforms. Fetal Diagn Ther 1992 7: 180-5

Welch CR. The future Obstetrician/Gynaecologist . Brit J Obstet Gynaecol 1991 98: 840-1(letter)

Vaughan J, Warwick RM, Welch CR, Letsky EA. Anti-Kell in Pregnancy. Brit J Obstet Gynaecol 1991 98: 944-945 (letter)

Welch CR, Nicolini U. Biochemical assessment of the fetus. Contemp Rev Obstet Gynaecol 1991 3:189-192

Welch CR, Rampling MW, Rodeck CH. The effect of donor blood haematocrit on fetal blood rheology after in utero transfusion. Brit J Obstet Gynaecol 1991 98:1305

Morey AL, Nicolini U, Welch CR, Economides D, Chamberlain P, Cohen BJ. Parvovirus B19 infection and transient fetal hydrops. Lancet 1991 337:496

Welch CR, Rodeck CH. The effect of intravascular transfusion for rhesus haemolytic disease on umbilical artery doppler flow velocity waveforms. Brit J Obstet Gynaecol 1990 97:865-866

Manyonda IT, Welch CR, McWhinney NA, Ross LD. The influence of suture material on vaginal vault granulations following abdominal hysterectomy. Brit J Obstet Gynaecol 1990 97:608-612 (This was presented at the 1990 Royal Society of Medicine Registrar's Conference and was the prizewinning presentation.)

Clarke CF, Welch CR, Piggott JL. Neonatal Occulogyric Crisis associated with maternal intrapartum Prochloperazine administration. J Obstet Gynaecol 1989 9:301-2

PAPERS CURRENTLY SUBMITTED:

Welch CR, Hocking M, Franklyn JA, Whittle MJ. Fetal Thyroid Stimulating Hormone: the best indicator of long term outcome ? Fetal Diagn Ther 1997 12

PAPERS IN PREPARATION:

Welch CR on behalf of the Northern Fetal Society. Cysts of the Fetal choroid Plexus, the final word ?

Welch CR, Talbert DG, Rampling MW, Anwar MA, Rodeck CH. Helical blood flow observed in fetal arterial doppler spectra.

Welch CR, Rampling MW, Anwar MA, Talbert DG, Rodeck CH. A comparison of in utero and neonatal haemorheological parameters

Welch CR, Rampling MW, Fisk NM . Fetal haemorheological parameters in twin to twin transfusion syndrome.

Welch CR, Rampling MW, Anwar MA, Talbert DG, Rodeck CH. Fetal haemorheological parameters in aneuploidy

ABSTRACTS/PRESENTATIONS:

Welch CR. Reversal of hydrops after in utero shunting in microcystic CCAML. International Fetal Medicine and Surgery Society, Anchorage, Al. USA June 1997

Welch CR on behalf of the Northern Fetal Society. Cysts of the Fetal choroid Plexus, the final word ? British Maternal and Fetal Medicine Society, Warwick UK, April 1996

Welch CR, Nwosu EC, Walkinshaw SA, Royston P. Conditional Fetal Growth

International Fetal Medicine and Surgery Society, Newport R.I. , USA May 1995

Welch CR, Walkinsha SA, Walsh K, McCormack J. In utero pacing for fetal congenital heart block. International Fetal Medicine and Surgery Society, Whistler, Canada. May 1993

Fisk NM, Warwick R, Welch CR, Moore G, Letsky E, Vaughan JI, Bennet PR. Fetal Rhesus genotyping in alloimmunised pregnancies using the Polymerase Chain reaction on amniocytes or Chorionic Villi. International Fetal Medicine and Surgery Society, Whistler, Canada May 1993

Walkinshaw SA, Nwosu EC, Welch CR. Comparison of birthweight charts with ultrasound estimated fetal weight charts in preterm infants. International Society of Ultrasound in Obstetrics and Gynaecology. Bonn, Germany. July 1992

Nwosu EC, Welch CR, Walkinshaw SA. Comparison of birthweight charts with ultrasound estimated fetal weight charts in preterm infants. 26th British Congress of Obstetrics and Gynaecology, Manchester, July 1992.

Nwosu EC, Welch CR, Walkinshaw SA. Longitudinal assessment of amniotic fluid index 26th British Congress of Obstetrics and Gynaecology, Manchester, July 1992.

Welch CR, Rampling MW, Anwar MA, Talbert DG, Rodeck CH. Normal fetal haemorheology International Fetal Medicine and Surgery Society, Evian, France May 1992

Welch CR, Rampling MW, Anwar MA, Talbert DG, Rodeck CH. Fetal haemorheology and intravascular transfusion for alloimmune anaemia. International Fetal Medicine and Surgery Society, Evian, France May 1992

Nwosu EC, Welch CR, Walkinshaw SA. Longitudinal assessment of amniotic fluid index. British Medical Ultrasound Society, Bournemouth, December 1991.

Welch CR, Rodeck CH, Rampling MW. The effect of donor blood haematocrit on fetal blood rheology after in utero transfusion.

Welch CR, Rampling MW, Anwar A, Bignal S, Rivers R. Gestational age related changes in haemorheology determined from blood of the newborn premature infant and from in utero fetal blood sampling. 7th European Conference on Clinical Haemorheology, Southampton, UK July 1991.

Welch CR, Rampling MW, Anwar A, Bignal S, Rivers R. The six ages of man (a comparative study). 7th European Conference on Clinical Haemorheology, Southampton, UK July 1991.

Welch CR, Talbert DG, Rodeck CH, Nicolini U, Maclachlan N, Warwick RM, Letsky EA.

Needle modifications for invasive fetal procedures. International Fetal Medicine and Surgery Society Phoenix, Arizona June 1991

Welch CR, Rodeck CH, Rampling MW. The effect of donor blood haematocrit on fetal blood rheology after in utero transfusion. Blair Bell Research Society January 1991

Welch CR, Rodeck CH, Rampling MW. Rheological Changes in Human Fetal Blood after Intravascular Transfusion. First Scientific Meeting of the Royal College of Obstetricians and Gynaecologists Singapore 1990

Manyonda IT, Welch CR, McWhinney NA, Ross LD. The influence of suture material on vaginal vault granulations following abdominal hysterectomy. Royal Society of Medicine Registrar's Conference 1990 (prizewinning presentation) .

COURSES AND SYMPOSIA: ORGANISED / LECTURES:

Organised:

I recently organised the inaugural meeting of the International Fetal Growth Group, a group involved in collaborative studies into longitudinal fetal growth assessment.

I organised the first meeting of a group of Fetal Medicine practitioners which has now become known as the Northern Fetal Society. This society meets twice a year to discuss topics of interest and to coordinate multicenter population based research into aspects of Fetal Medicine and Ultrasound. I am the coordinator for the NFS Choroid Plexus cyst study and the randomised trial of rhesus management (OD450 vs ultrasound).

The Personal Computer as a Research Tool: A symposium at the RPMS Institute of Obstetrics and Gynaecology

Lectures:

Theoretical & Practical course on Doppler Blood Flow Measurement in Pregnancy

Institute Of Obstetrics and Gynaecology

Interpretation of fetal heart traces

Midwives Refresher Course, Blackpool 1992.

Clinical/Viva examiner in mock MRCOG exams as a part of the MRCOG course run at Hammersmith and Queen Charlotte's Hospitals

POSTGRADUATE STUDY DAYS AND COURSES ATTENDED:

• Imaging techniques in Obstetrics and Gynaecology
• Anaesthetist's role in Obstetrics and Gynaecology
• RCOG Modern Management of Labour course
• I.V.F. Study day
• Operative Gynaecological Problems
• Anaesthesia and Analgesia in Obstetrics and Gynaecology
• Prostaglandin Study day
• Beginner's course in Obstetric Ultrasound (King's College Hosp)
• Advanced course in Obstetric Ultrasound (King's College Hosp)
• Ultrasound in Obstetrics and Gynaecology
• Fetal Physiology
• RCOG/RCR Theoretical course in Obstetric Ultrasound
• Manpower and Achieving a Balance
• International Symposium on Perinatal Asphyxia
• Controversies in Fetal Medicine
• Senior Registrar’s Management Training Course
• British Maternal and Fetal Medicine Society
• Senior Staff conference RCOG