Australian & New Zealand Journal of Obstetrics & Gynaecology

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BACKGROUND: Current understanding of clinical practice and care for maternal kidney disease in pregnancy in Australia is hampered by limitations in available renal-specific datasets. AIMS: To capture the epidemiology, management, and outcomes of women with significant kidney disease in pregnancy and demonstrate feasibility of a national cohort study approach. MATERIALS AND METHODS: An Australian prospective study (2017-2018) using a new kidney disease-specific survey within the Australasian Maternity Outcomes Surveillance System (AMOSS)...

Sickle cell disease (SCD) is a hereditary haemoglobinopathy which causes multi-organ dysfunction. Pregnancies in SCD are high risk with significant maternal and fetal morbidity and mortality, including vaso-occlusive crises, thrombosis, anaemia, placental insufficiency, fetal growth restriction, preterm birth and medication effects. High level evidence on this topic is lacking. The Australian Sickle Cell Disease Working Group has reviewed international guidelines on this topic and provide an up-to-date and structured approach to the pre-conception, antenatal, birth and post-partum management of these women...

OBJECTIVE: This study aimed to evaluate the costs and consequences of a new midwife-navigator-facilitated care pathway for reduced fetal movements. MATERIALS AND METHODS: This study was conducted at a tertiary obstetric centre in Queensland, Australia and modelling occurred for this and smaller services. Two months of data from pre (n = 112 in 2019) and post (n = 141 in 2020) implementation of the care pathway were analysed with T-tests and logistic regression models to evaluate maternal and neonatal outcomes...

BACKGROUND: Pregnant women have historically been excluded from participation in medication trials, in part due to the perceived risks of drug exposure to mothers and fetuses. However, little is known about pregnant women's attitudes toward risk and participation in such trials. AIMS: To address this knowledge gap and to identify factors that influence trial participation. MATERIALS AND METHODS: Australian women over the age of 18, currently pregnant or within six months of delivery, were recruited to participate in an online survey (n = 623) and follow-up interviews (n = 11)...

BACKGROUND: Choice, a fundamental pillar of woman-centred maternity care, depends in part on the right to decline recommended care. While professional guidance for midwives and obstetricians emphasises informed consent and respect for women's autonomy, there is little guidance available to clinicians or women about how to navigate maternity care in the context of refusal. AIM: To describe the process and outcomes of co-designing resources to support partnership between the woman who declines recommended maternity care and the clinicians and health services who provide her care...

BACKGROUND: Obstetric ultrasound is an important tool, aiding in screening, diagnosis, and surveillance throughout pregnancy. AIMS: To explore obstetric doctors', midwives', and sonographers' experiences and views of obstetric ultrasound in Victoria, Australia. To investigate the increasing role of obstetric ultrasound for clinical management, and the adequacy of resources and training for appropriate use of ultrasound in clinical management. MATERIALS AND METHODS: This cross-sectional study forms part of a multi-national CROss-Country Ultrasound Study (CROCUS) exploring the views of consumers and health professionals from high-, middle- and low-income countries...

INTRODUCTION: Microsurgical testicular sperm extraction (microTESE) is crucial for treating non-obstructive azoospermia (NOA), offering both 'fresh' and 'frozen' options. This study evaluates the impact of fresh versus frozen microTESE on the progression to intra-cytoplasmic sperm injection (ICSI) cycles, focusing on sperm motility. MATERIALS AND METHODS: We conducted a retrospective analysis of microTESE procedures at a major medical centre from 2007 to 2021, excluding cases of obstructive azoospermia and cryptozoospermia...

BACKGROUND: Miscarriage is a common medical occurrence which can be associated with significant psychological distress. Patients and partners are frequently disappointed by aspects of their care, especially with regard to emotional support. Although most published studies investigated the experiences of patients and partners in emergency departments (EDs) of public hospitals, miscarriage is also frequently diagnosed in non-emergency settings, such as during sonography or antenatal appointments, and approximately 25% of Australian women receive maternity care in private hospitals...

Mitochondrial donation to reduce the risk of primary mitochondrial disease transmission from mother to child is now permitted under Australian law as part of a clinical trial. The energy demands of pregnancy have the potential to worsen mitochondrial disease symptoms and severity in affected women. We conducted a systematic literature review on mitochondrial disease in pregnancy; five cohort studies and 19 case reports were included. For many women with mitochondrial disease, pregnancy does not have a negative effect on health status...

AIMS: The aim was to explore Endometrial cancer (EC) survivors' experiences of being offered nutrition and well-being advice. METHODS: This qualitative study was conducted at two tertiary centres in Aotearoa New Zealand. Semi-structured conversations with people who had completed treatment for EC in the past 12 months were undertaken to explore how they were offered nutrition and well-being advice as part of standard follow-up care. Interviews were analysed using reflexive thematic analysis...

BACKGROUND: Women in leadership in obstetrics and gynaecology in Australia and Aotearoa New Zealand have historically been underrepresented, despite forming a significant portion of the workforce. This study extends prior research from 2017, examining shifts in gender representation, attitudes, and perceived leadership barriers within the specialty. AIMS: The study aims to evaluate changes in gender diversity among leadership positions in the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) and accredited training hospitals since 2017...

STUDY OBJECTIVE: To investigate the aetiology of vaginal bleeding and discharge in prepubescent girls, and the utility of vaginoscopy for making a diagnosis. DESIGN: Retrospective observational study over 14 years. SETTING: Two major tertiary referral paediatric hospitals in Sydney, Australia. PARTICIPANTS: All prepubescent girls (n = 104) who presented with vaginal bleeding and/or discharge and subsequently underwent a vaginoscopy...

Correspondence and Opinion provide a 'human voice,' serving as the captivating elements that grab readers' attention and stimulate contemplation. The extent of ChatGPT's involvement in writing raises controversy. We tested ChatGPT's capability to generate readable Correspondence or Opinion, producing an English Opinion from a Japanese abstract. We also tasked ChatGPT with creating Correspondence and Reply for an English→German translated Opinion. Opinion, Correspondence, and Reply output here were found to be readable and reasonable...

BACKGROUND: Infection of the amniotic cavity is an important driver and/or consequence of preterm prelabour rupture of membranes (PPROM). Prediction of infection is challenging, limiting guidance for interventions during the antenatal period. Infection typically triggers a host inflammatory response, and non-invasive indirect markers of the maternal or fetal inflammatory response have been reported in the context of PPROM and intra-amniotic infection. Some of these markers have also been tested in amniotic fluid (AF) samples...

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BACKGROUND: Effective analgesics with minimal side effects are imperative for patient and neonate wellbeing postpartum. Post-caesarean section ultrasound-guided transversus abdominis plane (TAP) blocks have proven safety and efficacy. Surgical TAP blocks appear effective and require little time and equipment. No previous examination of surgical TAP blocks in patients having undergone emergency caesarean section has been undertaken. AIMS: To investigate surgical TAP block and multimodal analgesic use during emergency caesarean section, the effect on surgical time, post-operative analgesia use, and admission length...

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INTRODUCTION: The public health response (PHR) to the COVID-19 pandemic significantly disrupted healthcare services worldwide. Our hospital, a major tertiary centre, is a unique two-state service across Queensland and New South Wales (NSW). OBJECTIVE: The primary objective is to describe changes in service demand and delivery in our hospital resulting from the COVID-19 PHR. The secondary objective is to investigate patient perceptions of this impact. MATERIALS AND METHODS: We performed a retrospective interrupted time series analysis and a population-based survey to examine patient perceptions of the impact of the COVID-19 PHR...

No abstract text is available yet for this article.