Ballot opens (and probably closes) on Monday:  Read on for your best chance of securing a place in 2013. What an amazing achievement for our 5 Virgin London Marathon runners in 2012. Our grateful thanks goes to Catherine Mooney: 05:47:13 Carmen Norman: 04:52:14 Fola Olafare: 04:27:07 Tracy Rowson: 06:15:25 and Alexis Scorer: 04:26:01 and if you are looking for inspiration, those numbers next to their names is the time they ran it in. Huge congratulations to them all. If you would like to read about what motivated them or to sponsor them just click on those links. Your sponsorship will be put to very good use, delivering the EPT services. Hopefully, we’ll be adding their accounts to the Fundraisers’ Diary over the coming weeks. Reading about others achievements is often a real inspiration.

we want all our potential supporters to be ahead of the game. Mad though it might seem, if you or a friend are thinking about running the London Marathon in 2013 you have to think fast. You have three chances of a place. The first is by entering the public ballot, the second is through your own running club if you belong to one and the last is a Gold Bond charity place. So, first things first. If you think you would like to run in 2013 please make sure you enter the online Public Ballot. That way, we stand the chance of increasing our places in the race; and if you are then lucky enough to get a Ballot place, it will take the fundraising pressure off you.

The Ballot opens this year on MONDAY APRIL 30^th at www.virginlondonmarathon.com  Last year; it reached its upper entry limit within 24 hours, so to stand the best chance you should log on in the early hours of April 30. If not immediately successful, please keep trying throughout that day and even into May 1st, the longer you leave it into May 1^st though, the less chance of being awarded a ballot place.

After May the 1^st our Gold Bond places don’t become available until June. However, you can express your interest in one, by registering with our team managers CRunCH who will contact you toward the end of summer 2012 to offer places.

If a marathon is not for you, then there are still lots of ways you can help and support us, some of the them won’t actually cost you a penny. Use Everyclick as your search engine and we get a penny a click, eBay your extra stuff and nominate the EPT to benefit from a percentage of your sale, look us up on their select a charity list, shop through our partners Spend and Raise or Give As You Live or even, collect stamps for us. You can read more about that here. We also have a moderate amount of merchandise which you can check out here. Of course if you do fancy something sporty check out our events diary by visiting it here or clicking the events button on our website to the right of the screen.

More information and the abstract, published in the Journal of Clinical Gastroenterology and Hepatology which was published on 27th February 2012 can be found by searching for “IBS” AND “ectopic” within the online journal of Clinical Gastroenterology and Hepatology.

We want your thoughts about our homepage and how we can invite and encourage people to support the charity financially. We want to drive forward and continue to create a steady stream of income and whilst we already invite support on our Forums, Candle Tribute Website and when we reply by email , we’d like to ask people who use this Information Website, to support us too. We want to feel even more confident that we can assure the helpline, forums, email  and buddy services and information websites for people in the future, especially in the current financial climate.

So what are your thoughts?

What might inspire you when visiting a website like ours, to stop and make a donation or contribution?

Equally what would turn you off?

How could our homepage or other frequently visited website pages be altered to inspire donations?

And do you have any other ideas, however funky or blue sky that you want to tell us about that might just tip the balance for us in the income stakes?

Please let us know as soon as you can your thoughts and ideas, by emailing us we really do want to hear them.

Kind regards

The Ectopic Pregnancy Trust

If we have been able to help you then please consider helping us.

The Ectopic Pregnancy Trust

Registered charity: 1070811

2nd Floor, Golden Jubilee Wing

King’s College Hospital

Denmark Hill

London

SE5 9RS

Back in December just before Christmas I read an article about a half marathon event taking place in our home town of Colchester on March 11th. It was the nudge I needed and I promptly paid my entrance fee and bought a new pair of trainers.

My 19 year old son Jay (he’s on the left in the picture) who is a personal trainer said that he’d do the run with me for moral support. My wife Nicky had suffered 2 ectopic pregnancies in 2010 resulting in both of her fallopian tubes being removed. In times of crisis you look for support to try to make sense of what’s happened and through some web research we found the the EPT site. They were and continue to be real source of both education and support to us. I knew that I wanted to do something for them to raise some funds. Let’s be frank about it, unless either you or someone you know has been through this the EPT are not one of the “headline” charities that are on everyone’s radar. So, I’d encourage everybody who has been touched by ectopic pregnancy to think about what they can do however small to raise much needed funds. My training has gone well and today as I write this I’ve just come back from my longest run so far a 10 miler. Bit sore to say the least but I now know if I can do 10, I can definitely do 13.5.

Running does not come easy to me as although I always keep in shape with the gym etc running is a challenge as a couple of years ago I sustained permanent nerve damage to my left leg as a result of poor treatment following an ankle break. However, compared to what Nicky went through my

13.5 miles will be a walk in the park, even if it doesn’t feel that way on the day. The fundraising has been great and we’re over £500 already with a few weeks still to go. I’ll let you all know how I get on and I’d like to take this opportunity to thank Jill and the team for their considerable support to our charity event- it’s good to know that what we’re doing really will make a difference.

If you’d like to support Robbie by sponsoring him, visit his fundraising page

The EPT is appealing to you because 11,000 women are admitted to hospital every year as an emergency. Many thousands more are cared for in emergency clinics.

If you could support us with a regular gift of a few pounds each month, so that we can continue to support those who already use our services and those who will find us over the coming months of the New Year, we can assure our service in 2012.

If our ‘friends’ felt they could donate £5 a month – this would generate sufficient income to provide our helpline for a year.

If our Facebook friends felt they could support us with £5 a month, The EPT would have more than 2/3 of the income we need to provide all of our services for a year.

If we have helped you, then please consider helping us to ensure our services are there for the thousands of families who will need us in 2012 and the hundreds of thousands who’ve  found us and used us over the last 13 years and continue to do so.

Wising you gentle New Year

Recent research suggests that given inter-observer variability in ultrasound measurements

and the greater variation in early embryonic growth than has hitherto been assumed, a more

conservative approach to the diagnosis of early pregnancy loss is warranted.

The studies from Imperial College London, Queen Mary, University of London and the

Katholieke Universiteit Leuven, Belgium published in the November 2011 issue of

Ultrasound in Obstetrics and Gynaecology concluded that current definitions used to

diagnose miscarriage could lead to an incorrect diagnosis and they call for clearer evidence-

based guidance on detecting miscarriage through ultrasound scans.

Having carefully considered these papers, we recommend adoption of the following interim

guidance with immediate effect:

1. Ultrasound diagnosis of miscarriage should only be considered with a mean

gestation sac diameter >/= 25mm (with no obvious yolk sac), or with a fetal pole with

crown rump length >/=7mm (the latter without evidence of fetal heart activity)

2. A transvaginal ultrasound scan should be performed in all cases

3. Where there is any doubt about the diagnosis and/or a woman requests a repeat

scan, this should be performed at an interval of at least one week from the initial scan

before medical or surgical measures are undertaken for uterine evacuation. No

growth in gestation sac size or CRL is strongly suggestive of a non-viable pregnancy

in the absence of embryonic structures.

These revised values for ‘mean gestation sac diameter’ and ‘crown rump length’ do not imply

that previously used values were wrong, nor that diagnosis of miscarriage in the past has

been unsafe, This interim guidance suggests a more cautious approach is warranted,

pending more definitive data becoming available. It extends the criteria included in the

RCOG Green Top Guideline No 25, which recommended a conservative approach with

mean gestation sac diameter <20mm or fetal CRL <6mm.

Christoph Lees MRCOG on behalf of the RCOG Ultrasound Advisory Group

Kim Hinshaw FRCOG Lead author, Green Top Guideline No. 25

Philip Owen FRCOG Chair, RCOG Guidelines Committee

David Richmond FRCOG RCOG Vice President (Standards)

19th October 2011

Notes

The Ultrasound Advisory Group has representation from the Society and College of Radiographers,

International Society of Ultrasound in Obstetrics and Gynecology, British Maternal-Fetal Medicine

Society, British Medical Ultrasound Society and Royal College of Radiologists. This guidance is

endorsed by BMUS, and by the Council of the Society and College of Radiographers.

It was a detailed and varied programme which involved not only a look at where we are at now but actively invited volunteers to engage with us in creating our forthcoming publication.

The afternoon focused on person centered listening and how to ask open ended questions as part of the counselling skills module of our training programme.

The day passed very quickly and for those who could stay on a little, ended after a very pleasant meal at the Watermill Inn. If you have considered volunteering but just not got around to filling out a volunteer interest form, then we want you to know we always have space for one more volunteer. You can download the VIF form here and we’d love to have you on board.

Here are some images of the day.

A systematic review of the evidence in the literature (not including new the new data from Imperial college) concludes that the evidence base that has been used to derive the current miscarriage guidelines is based on insufficient data, poor quality studies and so cannot be relied upon in all cases. This view is supported by an opinion paper by Professor Tom Bourne that highlights the problem further and again illustrates that the cut-off values for gestation sac and embryo size may lead to a viable pregnancy being wrongly diagnosed as a miscarriage.

Three papers are also published by the London-Leuven research group based at Imperial College London and the Katholieke University in Leuven, Belgium. These represent the largest study published on the ultrasound based diagnosis of early miscarriage and include over a one thousand women.

The findings of these papers can be summarized into four important points:

1. The current UK guideline used to define miscarriage states an empty gestation sac with mean sac diameter (MSD) of over 20 mm can be classified as miscarriage. The study shows this is associated with a 0.5% risk of misclassifying a viable pregnancy as a miscarriage. The confidence intervals show that at worst the false positive rate at this cut-off could be as high as 3.0%.

2. For an MSD cutoff of 16 mm as used in the USA, the false positive rate for miscarriage is 4.4% and may be as high as 8.4%.

3. Current guidance that an absence of MSD growth may be a sign of miscarriage. The published studies show that this is not the case and that there may be little or absent growth over several days and still a pregnancy can be viable. So an absence of growth in either an embryo or gestation sac is not a definitive sign of miscarriage.

4. There is variation in how different clinicians will measure any given gestation sac or embryo. This is important as it may mean that an MSD measurement of 20 mm may in fact be 16 mm – leading to a higher risk of the pregnancy being misdiagnosed as a miscarriage.

5. The number of pregnancies this may have been affected by this or might be relevant to in the future is not accurately known.

It is very important to put these papers in context for both clinicians and patients. What these papers DO NOT say is that the diagnosis of miscarriage for the vast majority of women who have had or will have a miscarriage is likely to be incorrect. These papers relate to the specific situation where a women undergoes an ultrasound scan and a gestations sac is visualized, but no embryo with a heartbeat is seen. Furthermore they apply to relatively small gestation sacs of under 25 mm. The papers do not suggest there is any problem when a diagnosis of miscarriage is made in the presence of either gestations sacs with an MSD of greater than 25 mm or embryos that are more than 7 mm in size.

However these data are important and show that current criteria for the use of ultrasound to diagnose miscarriage cannot exclude the possibility of misdiagnosis. The authors suggest that the guidance be changed on the basis of this new information in order to avoid the possibility of error.

Accuracy of first-trimester ultrasound in the diagnosis of early embryonic demise: a systematic review. Jeve Y, Rana R, Bhide A, Thangaratinam S. Ultrasound Obstet Gynecol 2011. http://doi.wiley.com/10.1002/uog.10108

Limitations of current definitions of miscarriage using mean gestational sac diameter and crown–rump length measurements: a multicenter observational study. Abdallah Y, Daemen A, Kirk E, Pexsters A, Naji O, Stalder C, Gould D, Ahmed S, Guha S, Syed S, Bottomley C, Timmerman, Bourne T. Ultrasound Obstet Gynecol 2011: http://doi.wiley.com/10.1002/uog.10109

Gestational sac and embryonic growth are not useful as criteria to define miscarriage: a multicenter observational study. Abdallah Y, Daemen A, Guha S, Syed S, Naji O, Pexsters A, Kirk E, Stalder C, Gould D, Ahmed S, Bottomley C, Timmerman D, Bourne T. Ultrasound Obstet Gynecol 2011: http://doi.wiley.com/10.1002/uog.10075

Clinical implications of intra- and interobserver reproducibility of transvaginal sonographic measurements of gestational sac and crown–rump length at 6–9 weeks’ gestation. Pexsters A, Luts J, van Schoubroeck D, Bottomley C, van Calster B, van Huffel S, Abdallah Y, D’Hooghe T, Lees C, Timmerman D, Bourne T. Ultrasound Obstet Gynecol 2011: http://doi.wiley.com/10.1002/uog.8884

For decades experts have been prevented from fully understanding the bacteria as they have been unable to manipulate the genome of chlamydia trachomatis (C. trachomatis).

Now researchers in Southampton have made a significant breakthrough in accessing the chlamydial genome and believe it could pave the way for more effective treatment of the disease.

The research was carried out at the Molecular Microbiology Group at the University of Southampton in conjunction with the department of virology at the Ben-Gurion University of the Negev in Israel.

Professor Ian Clarke, from the University of Southampton, said: “We, together with our colleagues in Israel, discovered that by treating the chlamydia with calcium ions we were able to introduce a piece of foreign DNA.

“This will open up the field of chlamydia research and will enable a better understanding of chlamydial genetics. It could lead to the development of new approaches to chlamydial vaccines and therapeutic interventions.”

Their paper detailing the breakthrough in the study of chlamydia is published in the Public Library of Science journal PLoS Pathogens and carried as a news story in the UK.

The Event will this year be hosted by Les Dennis and promises to be a great night of laughs and music and a time to remember. It will begin with an invitation to light a candle in memory of the babies which have been lost. The concert will then deliver a great line up of talent including Stefan Booth, Belle Humble, Tupele Dorgu (Coronation Street and Waterloo Road) and Lisa Scott Lee (Steps).

The Baby Loss Awareness Campaign  promotes the campaign which highlights the all to common occurrence of baby loss and is a collaboration between 4 sister charities and 1 not for profit organisation: the Miscarriage Association, The Ectopic Pregnancy Trust, SANDS, ARC and Babyloss.com.

The evening is designed to raise your spirits whilst also raising awareness.

Visit the Baby Loss Awareness Campaign website for information about what might be going on in your area

Tickets cost £12  Book your ticket.