Australian & New Zealand Journal of Obstetrics & Gynaecology

BACKGROUND: Cushing's syndrome (CS) encompasses various causes of hypercortisolism including adrenocorticotropic hormone (ACTH) secreting pituitary adenoma with or without bilateral adrenal hyperplasia, an adrenal adenoma or carcinoma, ectopic ACTH or corticotrophin-releasing hormone (CRH) secretion by a neoplasm or exogenous corticosteroid therapy. The diagnosis of CS in pregnancy presents a challenge due to overlapping clinical features of pregnancy (weight gain, striae, acne). If untreated, CS in pregnancy is associated with increased risk of maternal and fetal complications...

BACKGROUND: Sexual violence remains a persistent and devastating issue in eastern Democratic Republic of Congo (DRC). AIM: To elucidate the sociodemographic, sexual, and obstetrical characteristics associated with the experiences of victims of sexual violence (VSV) among women in the region. MATERIALS AND METHODS: A cross-sectional study was conducted involving 625 women from eastern DRC. Participants provided self-reported data, collected through interviews conducted by trained female interviewers in secure environments...

AIMS: To explore the incidence and complexity of women presenting for maternity care who require concurrent cancer care, and to report the birth outcomes of these women. MATERIALS AND METHODS: A retrospective audit of women attending a 'high risk' maternal medicine clinic at an Australian tertiary maternity hospital between 1 October 2021 and 30 April 2023 was conducted. The inclusion criteria were a diagnosis of cancer and a concurrent pregnancy, or a diagnosis of cancer prior to the current pregnancy...

Across Pacific Island countries, women and men are disproportionately affected by several risk factors for infertility, including sexually transmissible infections, complications from unsafe abortions, postpartum sepsis, obesity, diabetes, tobacco smoking and excessive alcohol consumption. Despite this, little is known about community awareness of infertility, behavioural risk factors, the lived experiences of infertile couples or the contexts in which they access fertility care. In this opinion piece we discuss the current evidence and gaps in evidence regarding infertility in Pacific Island countries and the importance of locally tailored approaches to preventing infertility and the provision of fertility care...

BACKGROUND: The IMPROVE (IMproving Perinatal Mortality Review and Outcomes Via Education) eLearning, developed by the Stillbirth Centre of Research Excellence in partnership with the Perinatal Society of Australia and New Zealand was launched in December 2019. Based on the successful face-to-face program, the eLearning aims to increase availability and accessibility of high-quality online education to healthcare professionals providing care for families around the time of perinatal death, to improve the delivery of respectful and supportive clinical care and increase best practice investigation of perinatal deaths...

BACKGROUND: Current international guidelines recommend 28 days of enoxaparin as venous thromboembolism (VTE) prophylaxis after surgery for gynaecologic cancer. Direct oral anticoagulants (DOACs) have been investigated as an alternative to enoxaparin for post-operative VTE prophylaxis. High-quality evidence to demonstrate safety and efficacy is lacking. AIMS: We aim to investigate the current practice regarding VTE prophylaxis among gynaecological oncologists in Australia and New Zealand following laparotomy for gynaecological malignancy, in particular the use of DOACs for VTE prophylaxis...

Adverse outcomes associated with pregnancy, including severe acute maternal morbidity (SAMM) and mortality, are internationally regarded as important indicators of quality of maternity services. Varied definitions and processes are barriers for SAMM recording, reporting and review. Identifying and documenting these cases of SAMM is a critical first step. Case reviews allow exploration of factors contributing to SAMM. Translation of the lessons learnt into practice improvement strategies and dissemination of this knowledge is essential for continual quality improvement...

BACKGROUND: New Zealand's recently released Women's Health Strategy aims to provide accessible, equitable care which prioritises prevention, early intervention and areas of unmet need. An example of such care is the management of common sexual and reproductive health (SRH) issues by appropriately trained primary care practitioners in the community. AIMS: The aim was to identify primary care SRH program initiatives currently operating in New Zealand, how they are accessed and funded, whether they have been co-designed using mātauranga (knowledge) Māori principles and whether any have undergone formal evaluation...

BACKGROUND: Pregnancy in kidney transplant recipients has become increasingly common. However, pregnancy carries higher risks to these patients compared to the general population. AIMS: To describe pregnancy outcomes in kidney transplant recipients. MATERIALS AND METHODS: We conducted a single-centre retrospective cohort study of kidney transplant recipients who delivered after 20 weeks gestation at a quaternary hospital in Victoria, Australia, between 2000 and 2022 inclusive...

BACKGROUND: Australia's caesarean rate is higher than Organisation for Economic Co-operation and Development (OECD) average, and is rising. Vaginal birth after caesarean (VBAC) is safe for selected women. Midwifery continuity of care (CoC) is associated with higher rates of vaginal birth compared to other models; however, impacts on VBAC attempts and success are unknown. AIMS: The primary aim was to determine if there is a difference in achieving VBAC between CoC and non-CoC (NCoC) models...

No abstract text is available yet for this article.

BACKGROUND: Medication use in pregnancy is common; however, it is unknown if clinical practice guideline (CPG) prescribing recommendations referred to in Australia at the state, national and international level are consistent. AIMS: This systematic review aimed to: (1) identify sources of CPGs that inform prescribing during pregnancy in Australia; (2) assess CPG quality; and (3) evaluate variation within CPG recommendations for medication use in three common conditions in pregnancy: prophylactic antibiotics following premature rupture of membranes (PROM) at term, antidepressants in pregnancy and metformin in gestational diabetes mellitus (GDM)...

BACKGROUND: The methodology of surgically extracted sperm cells in fertility treatments remains debated, mainly due to the lack of data evaluating its predictive value on treatment outcomes. AIM: To gain insight into the effectiveness of testicular fine-needle aspiration (TEFNA) in a cohort of infertile men with absolute non-obstructive azoospermia and to examine whether the number of retrieved sperm cells affects the fertilisation rate. MATERIALS AND METHODS: A total of 89 infertile men, aged 26-47, meticulously diagnosed with non-obstructive azoospermia, participated in the study...

No abstract text is available yet for this article.

No abstract text is available yet for this article.

No abstract text is available yet for this article.

No abstract text is available yet for this article.

BACKGROUND: In the most severe stage of endometriosis, Stage IV, intestinal involvement is common. The true prevalence of endometriotic disease of the appendix in this population is not well described. A macroscopically normal looking appendix may harbour endometriosis. AIMS: Our study aims to assess the role of routinely performing appendicectomy in Stage IV endometriosis surgery, and the histopathological prevalence of true appendiceal endometriosis in this population...

Antenatal cannabis consumption is common and associated with adverse perinatal outcomes, including low birthweight, pre-term birth and increased rates of admission to neonatal intensive care. Cannabinoid hyperemesis syndrome (CHS) comprises severe, cyclical episodes of vomiting, intractable nausea and abdominal pain observed in chronic cannabis users. CHS, particularly during pregnancy, poses a diagnostic dilemma with a tendency to be ineffectively managed secondary to reduced clinician awareness and a scarcity of available therapies...

BACKGROUND: Menstrual cycle tracking apps are increasingly used by those trying to conceive as well as those diagnosed and treated for infertility. However, the small amount of existing research about the use of these apps does not include the perspectives of healthcare providers. AIMS: This study explores how healthcare providers describe the role of menstrual apps in fertility and infertility health care, and how this compares with patients' views. MATERIALS AND METHODS: Responses were collected from an online survey (n = 37 providers and n = 89 patients) and online focus groups (n = 4 providers and n = 6 patients) and analysed using reflexive thematic analysis...