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Australian & New Zealand Journal of Obstetrics & Gynaecology

Ryan Paul, Carissa Murugesh, Lynne Chepulis, Jade Tamatea, Louise Wolmarans
Babies born to mothers with gestational diabetes mellitus (GDM) are at a greater risk of developing respiratory complications and hypoglycaemia than those born to mothers without diabetes. However, there is currently insufficient evidence as to whether these risks are altered by antenatal corticosteroids after 37 weeks gestation. This retrospective study suggests that antenatal corticosteroids probably reduce respiratory admissions to the newborn intensive care unit with a mild increase in neonatal hypoglycaemia in women with GDM who deliver via caesarean section after 37 weeks gestation...
February 18, 2019: Australian & New Zealand Journal of Obstetrics & Gynaecology
Michael Yu, Erin Wilson, Sarah Janssens
Deeply impacted fetal head at caesarean section at full dilation is a rare obstetric emergency, and exposure for trainees can be limited. We aimed to pilot and evaluate a hospital-based training program incorporating mastery learning principles for trainees performing caesarean section at full dilation. We demonstrated improvements in knowledge, skills and self-confidence, and feel that this educational package shows promise as an important component of obstetric training, and warrants further exploration in the future...
February 18, 2019: Australian & New Zealand Journal of Obstetrics & Gynaecology
Michelle R Wise, Lynn Sadler, Brett Shorten, Kelly van der Westhuizen, Allison Shorten
BACKGROUND: Systematic approaches to information giving and decision support for women with previous caesarean sections are needed. AIM: To evaluate decision support within a 'real-world' shared decision-making model. METHODS: A pragmatic comparative effectiveness randomised trial in the Positive Birth After Caesarean Clinic. Women with one previous caesarean and singleton pregnancy <25 weeks were randomly allocated to standard Positive Birth After Caesarean care, or standard Positive Birth After Caesarean care plus a decision aid booklet...
February 18, 2019: Australian & New Zealand Journal of Obstetrics & Gynaecology
Farnaz Dave, Stephen Cole, Megan Rees
Obstructive sleep apnoea (OSA) during pregnancy has been associated with gestational diabetes mellitus, hypertension and low birth weight. Multiple pregnancy is associated with similar adverse perinatal outcomes. Multiple pregnancy rates have risen with increased access to assisted conception; simultaneously, advancing maternal age and weight are also driving a rise in the incidence of OSA in pregnancy. The intersection of OSA and multiple pregnancy would be presumed to have significant maternal and fetal morbidity; however, specific data are sparse...
February 17, 2019: Australian & New Zealand Journal of Obstetrics & Gynaecology
Nathalie V Kizirian, Kirsten I Black, Loretta Musgrave, Charlotte Hespe, Adrienne Gordon
BACKGROUND: Preconception care (PCC) defines health interventions prior to conception aimed at improving pregnancy and infant outcomes. AIM: To explore the understanding and provision of PCC by general practitioners (GPs) within the Sydney Local Health District. MATERIALS AND METHODS: A questionnaire developed with GPs assessed structure and content of PCC provided, attitudes toward PCC and perceived barriers and facilitators. RESULTS: One hundred and ten GPs completed the survey: 84% reported that GPs should be the main providers of PCC; however, only 53% were aware of PCC guidelines...
February 17, 2019: Australian & New Zealand Journal of Obstetrics & Gynaecology
Reem Zeki, Zhuoyang Li, Alex Y Wang, Caroline S E Homer, Jeremy J N Oats, Drew Marshall, Elizabeth A Sullivan
BACKGROUND: Obstetric anal sphincter injuries (OASIs) are associated with maternal morbidity; however, it is uncertain whether gestational diabetes (GDM) is an independent risk factor when considering birthweight mode of birth and episiotomy. AIMS: To compare rates of OASIs between women with GDM and women without GDM by mode of birth and birthweight. To investigate the association between episiotomy, mode of birth and the risk of OASIs. METHODS: A population-based cohort study of women who gave birth vaginally in NSW, from 2007 to 2013...
February 17, 2019: Australian & New Zealand Journal of Obstetrics & Gynaecology
Lynn C Sadler, Vicki L Masson, Sue Belgrave, Hillary F Bennett, Jutta van den Boom, Suzanne Miller, Malcolm R Battin
BACKGROUND: In 25% of affected babies, neonatal encephalopathy results from acute peripartum events, but rigorous review of these cases for quality improvement is seldom reported. New Zealand has maintained a national database of all babies diagnosed with Sarnat moderate and severe neonatal encephalopathy since 2010 under the Perinatal and Maternal Mortality Review Committee. AIMS: To determine the rate of contributory factors, potentially avoidable mortality or morbidity, and to identify key areas for improvements to maternity and neonatal care among cases of neonatal encephalopathy following an acute peripartum event...
February 12, 2019: Australian & New Zealand Journal of Obstetrics & Gynaecology
David C Hsieh, Lisa G Smithers, Mairead Black, John W Lynch, Gustaff Dekker, Chris Wilkinson, Michael J Stark, Ben W Mol
BACKGROUND: Vaginal instrumental delivery is a common obstetrical intervention, but its effect on children's later development is not well known. AIMS: To determine if vaginal instrumental delivery is associated with adverse neurodevelopment as measured by school achievement. MATERIAL AND METHODS: We performed a whole-of-population study involving linkage of routinely collected perinatal data with school assessments among children born in South Australia from 1999 to 2008...
February 7, 2019: Australian & New Zealand Journal of Obstetrics & Gynaecology
Georgina Davis, Jessica Jellins
BACKGROUND: Female genital mutilation (FGM) and its impact on women's health are becoming relevant in Australia due to increases in numbers of refugees and migrants from affected countries. Notwithstanding the psychological trauma from FGM, there is a broad range of sequelae relevant to obstetrics and gynaecology, particularly related to maternal morbidity from labour and delivery. AIMS: To assess the prevalence of FGM in our unit and document its effect on maternal and neonatal outcomes...
February 7, 2019: Australian & New Zealand Journal of Obstetrics & Gynaecology
Tracey J Taylor, Ann E Quinton, Bradley S de Vries, Jonathon A Hyett
BACKGROUND: First-trimester miscarriage is common, with women increasingly offered an ultrasound scan early in the first trimester to assess the status of their pregnancy. Ultrasound is uniquely situated to significantly impact the clinical management of these women. AIMS: This study aims to determine whether there were any differences in the early ultrasound appearances of pregnancies that continued to be viable or resulted in miscarriage before 12 weeks gestation...
February 6, 2019: Australian & New Zealand Journal of Obstetrics & Gynaecology
Hilary Bowman-Smart, Julian Savulescu, Cara Mand, Christopher Gyngell, Mark D Pertile, Sharon Lewis, Martin B Delatycki
BACKGROUND: Non-invasive prenatal testing (NIPT) has been available in Australia on a user-pays basis since 2012. Since its introduction, it has grown in popularity as a screening method for fetal aneuploidy and may become publicly funded. AIMS: To assess the motivations and experiences of women who have undergone NIPT in a user-pays system in Australia. MATERIALS AND METHODS: One thousand women who had undergone NIPT through the Victorian Clinical Genetics Services in Melbourne, Australia were contacted and asked to complete a mixed-methods survey...
February 6, 2019: Australian & New Zealand Journal of Obstetrics & Gynaecology
Anh Duy Nguyen, Cathy Zhenao Liu, Christoph Lehner, Akwasi Atakora Amoako, Renuka Sekar
BACKGROUND: Recent data suggest that quantitative measurements of fetal fibronectin can be used accurately to predict increased risk of preterm birth. AIM: The purpose of this study was to demonstrate that the quantification of fetal fibronectin improves diagnostic accuracy in women who present with symptoms suggestive of threatened preterm labour (TPL) using a quantitative fetal fibronectin (qfFN) bedside analyser. STUDY DESIGN: This was a retrospective cohort study of pregnant women who presented between 22+6 and 32+6  weeks gestation with symptoms of TPL who had qfFN measured using the Rapid fFN Q10 system...
February 6, 2019: Australian & New Zealand Journal of Obstetrics & Gynaecology
Rhonda Farrell
Ovarian cancer is the leading cause of death due to gynaecological malignancy with a five-year relative survival of only 20-30% for Australian women with stage 3 and 4 disease. Most cases present with spread of cancer cells outside the pelvis to the peritoneal surfaces of the abdomen and associated viscera. Efforts to improve survival from advanced disease have therefore led to more extensive cytoreductive surgery, including the use of peritonectomy surgery, which is usually combined with hyperthermic intraperitoneal chemotherapy (HIPEC)...
February 1, 2019: Australian & New Zealand Journal of Obstetrics & Gynaecology
Kathryn Graham, Felicity Park, Andrew McLennan, Marilena Pelosi, Paul Williams, Liona C Poon, Jon Hyett
BACKGROUND: The Fetal Medicine Foundation developed a multiple logistic regression algorithm for risk prediction of delivering a small for gestational age neonate. AIM: To validate this algorithm in an Australian population. METHODS: At the combined first trimester screen participants' medical histories, demographic data, mean arterial pressure, uterine artery pulsatility index and pregnancy-associated plasma protein-A were assessed. After delivery, risk of delivering a small for gestational age neonate at <37 or ≥37 weeks gestation was retrospectively calculated using the Fetal Medicine Foundation algorithm...
January 24, 2019: Australian & New Zealand Journal of Obstetrics & Gynaecology
Briony Hill, Melissa Hayden, Skye McPhie, Cate Bailey, Helen Skouteris
BACKGROUND: Prevention of excessive gestational weight gain during pregnancy is difficult; targeting women before pregnancy may be more effective. AIMS: In order to generate knowledge that may influence the development of effective interventions to promote healthy weight in reproductive-aged women, this study aimed to explore knowledge and belief formation regarding gestational weight gain for preconception and pregnant women. MATERIALS AND METHODS: Women ≥18 years (preconception n = 265; pregnant women at 16 weeks gestation n = 271) completed questionnaires assessing knowledge and beliefs about gestational weight gain...
January 24, 2019: Australian & New Zealand Journal of Obstetrics & Gynaecology
Skandarupan Jayaratnam, Maria Lucia de Fatima Godinho Soares, Belinda Jennings, Amitha Pradan Thapa, Cindy Woods
BACKGROUND: Assessment of severe maternal morbidity is increasingly being undertaken to understand the aetiology and factors which lead to adverse maternal outcomes. Their use in conjunction with maternal deaths may allow a comprehensive assessment of care provided, highlight areas for improvement within the health system and allow benchmarking of care against other institutions. Timor-Leste has one of the highest rates of maternal mortality in the Asia-Pacific region; however, there has been limited research into the level of severe obstetric morbidity in the country...
January 20, 2019: Australian & New Zealand Journal of Obstetrics & Gynaecology
Mawson Wang, Neil Athayde, Suja Padmanabhan, Ngai Wah Cheung
BACKGROUND: Diabetes in pregnancy may result in stillbirth or neonatal death. AIM: This audit examined stillbirths of mothers with pre-existing diabetes in pregnancy (DIP) and gestational diabetes (GDM) to determine maternal and diabetic characteristics implicated in these deaths. MATERIALS AND METHODS: A retrospective cohort study was conducted to identify stillbirths occurring in diabetic pregnancies at Westmead Hospital during 2006-2017...
January 20, 2019: Australian & New Zealand Journal of Obstetrics & Gynaecology
Keisuke Tanaka, Lars Eriksson, Rebecca Asher, Andreas Obermair
BACKGROUND: Adverse events (AEs) are unintended consequences of healthcare management that result in temporary or permanent disability, death or prolonged hospital stay. The incidence of AEs has been reported to be higher in surgical specialties compared to medical specialties but information on the incidence of AEs in gynaecology is sparse. AIMS: To collect evidence on the incidence, preventability and mortality of AEs in gynaecological hospital admissions by conducting a systematic review and meta-analysis...
January 20, 2019: Australian & New Zealand Journal of Obstetrics & Gynaecology
Hans Peter Dietz, Sascha Callaghan
No abstract text is available yet for this article.
January 20, 2019: Australian & New Zealand Journal of Obstetrics & Gynaecology
Anna Adcock, Fiona Cram, Beverley Lawton, Stacie Geller, Merilyn Hibma, Peter Sykes, E Jane MacDonald, Wendy Dallas-Katoa, Bronwyn Rendell, Tracey Cornell, Tania Mataki, Tania Rangiwhetu, Naieta Gifkins, Selah Hart
Human papillomavirus (HPV), the causative agent of cervical cancer, can be screened for using self-collected vaginal samples (self-testing). This may overcome barriers to screening for Māori women who suffer a greater burden of cervical disease than New Zealand European women. This study aimed to explore the potential acceptability of HPV self-testing for never/under-screened (self-reported no cervical screen in 4+ years, aged 25+) Māori women by Kaupapa Māori (by, with and for Māori) mixed methods, involving hui (focus groups/interviews) and survey...
January 7, 2019: Australian & New Zealand Journal of Obstetrics & Gynaecology
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