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Australian & New Zealand Journal of Obstetrics & Gynaecology

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https://www.readbyqxmd.com/read/29787638/incidence-trends-and-severity-of-primary-postpartum-haemorrhage-in-australia-a-population-based-study-using-victorian-perinatal-data-collection-data-for-764-244-births
#1
Margaret Flood, Susan J McDonald, Wendy Pollock, Fiona Cullinane, Mary-Ann Davey
BACKGROUND: Increasing incidence and severity of postpartum haemorrhage, together with postpartum haemorrhage-associated morbidities, have been reported in many high-resource countries. In-depth analysis of such factors in Victorian births since 2002 was lacking. AIMS: Our aim was to determine the incidence and trends for primary postpartum haemorrhage (World Health Organization and International Classification of Diseases 10th revision, Australian Modification definitions) for all confinements in Victoria, Australia, for the years 2003-2013 and the incidence and trends for severe postpartum haemorrhage (≥1500 mL) for 2009-2013...
May 22, 2018: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/29787622/mother-to-child-transmission-of-hiv-in-australia-and-other-high-income-countries-trends-in-perinatal-exposure-demography-and-uptake-of-prevention-strategies
#2
REVIEW
Kelly O'Donovan, Theophilus I Emeto
Virtual elimination of mother-to-child transmission (MTCT) of human immunodeficiency virus (HIV) is a global target. A review of the literature was conducted using medical databases and health department websites to examine the current trends related to perinatal HIV exposure and MTCT in Australia in comparison with other high-income countries (HICs). The review discusses the uptake of prevention strategies and barriers that impede MTCT prevention. The literature suggests an increase in the numbers of HIV-exposed deliveries, but a marked decline in the rates of MTCT within HICs...
May 22, 2018: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/29781191/clinical-approach-to-vulvovaginal-cysts-and-abscesses-a-review
#3
REVIEW
Jessica De Bortoli, Prathima Chowdary, Payam Nikpoor, Emma Readman
Vulvovaginal cysts are a common problem for women, causing significant pain, discomfort and impact on quality of life. For clinicians, classifying and differentiating these cysts from each other and selecting appropriate management can be challenging, yet there is no integrated classification system and little literature that broadly summarises a clinical approach. We aimed to create a useful tool for clinicians by providing a detailed summary of various vulvovaginal cysts and abscesses with a clear novel classification system and hierarchy for diagnosis and management, to aid clinicians in this process...
May 21, 2018: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/29763509/surgical-approach-to-hysterectomy-and-barriers-to-using-minimally-invasive-methods
#4
Monika Janda, Nigel R Armfield, Gayle Kerr, Suzanne Kurz, Graeme Jackson, Jason Currie, Katie Page, Edward Weaver, Anusch Yazdani, Andreas Obermair
Minimally invasive approaches to hysterectomy have been shown to be safe, effective and have recovery advantages over open hysterectomy, yet in Australia 36% of hysterectomies are still conducted by open surgery. In 2006, a survey of Australian gynaecological specialists found the main impediment to increasing laparoscopic hysterectomy to be a lack of surgical skills training opportunities. We resurveyed specialists to explore contemporary factors influencing surgeons' approaches to hysterectomy; 258 (estimated ~19%) provided analysable responses...
May 15, 2018: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/29744859/prescription-opioid-use-in-pregnancy
#5
REVIEW
Julie Blandthorn, Laura Leung, Yuan Loke, D Martyn Lloyd-Jones, Robin Thurman, Ellen Bowman, Yvonne Bonomo
Prescription medications, including opioid analgesics, are increasingly prescribed in Australia and internationally. More women are presenting in pregnancy with prescription opioid use which can potentially cause harm to the mother and fetus. This article outlines the different types of prescription opioids, defines how prescription opioid use disorder presents clinically and suggests a rational clinical approach to assess and manage patients in the context of pregnancy and their infants.
May 10, 2018: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/29718540/obesity-gestational-diabetes-and-macrosomia-are-associated-with-increasing-rates-of-early-term-induction-of-labour-at-the-canberra-hospital
#6
Jonathan T McGuane, Lori Grlj, Michael J Peek
BACKGROUND: Early-term delivery is an important cause of short-term neonatal morbidity and associated high healthcare costs, with possible additional long-term developmental ramifications. As a form of 'iatrogenic' delivery, induction of labour (IOL) is a potentially modifiable contributor to this burden. AIMS: To determine patterns of, and primary indication for, early-term IOL, as well as temporal trends in this primary indication and differences from other modes of delivery with respect to maternal factors and maternal/neonatal outcomes...
May 2, 2018: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/29700827/why-we-miss-fetal-growth-restriction-identification-of-risk-factors-for-severely-growth-restricted-fetuses-remaining-undelivered-by-40-weeks-gestation
#7
Prerna Diksha, Michael Permezel, Natasha Pritchard
BACKGROUND: Severe fetal growth restriction (FGR) is a leading cause of adverse perinatal morbidity and mortality; however, in Victoria, 35% of severely growth-restricted infants are undelivered by 40 weeks gestation. AIMS: We aimed to identify factors associated with failure to deliver severely growth-restricted fetuses by 40 weeks gestation. METHODS: We conducted a retrospective case-control study of term singletons born <3rd centile for gestation at a single tertiary centre (2010-2017)...
April 27, 2018: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/29700811/timing-of-elective-pre-labour-caesarean-section-a-decision-analysis
#8
Freke A Wilmink, Clarabelle T Pham, Nicole Edge, Chantal W P M Hukkelhoven, Eric A P Steegers, Ben W Mol
BACKGROUND: Since caesarean sections (CSs) before 39+0  weeks gestation are associated with higher rates of neonatal respiratory morbidity, it is recommended to delay elective CSs until 39+0  weeks. However, this bears the risk of earlier spontaneous labour resulting in unplanned CSs, which has workforce and resource implications, specifically in smaller obstetric units. AIM: To assess, in a policy of elective CSs from 39+0  weeks onward, the number of unplanned CSs to prevent one neonate with respiratory complications, as compared to early elective CS...
April 26, 2018: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/29681134/an-audit-of-pregnancy-outcomes-in-solid-organ-transplant-recipients-at-a-metropolitan-hospital
#9
Yunjing E Fang, Roshini Nayyar, Hayley Diplock
BACKGROUND: Pregnancies in patients with solid organ transplants have higher rates of complications and caesarean sections (CS). AIM: To perform an audit of the pregnancy outcomes in transplant recipients, to determine the rate of CS in our cohort, the appropriate skin incision for CS in these patients and to formulate recommendations for preoperative planning. MATERIALS AND METHODS: This is a retrospective cohort study. All patients who had a solid organ transplant were identified from the obstetrics database...
April 22, 2018: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/29681079/abortion-law-reform-why-ethical-intractability-and-maternal-morbidity-are-grounds-for-decriminalisation
#10
Andrew McGee, Melanie Jansen, Sally Sheldon
In this paper, we present two grounds for arguing that abortion should be decriminalised. First, we consider the implications of the fact that the long-standing ethical debate concerning the morality of abortion has to date proven intractable. We maintain that because the philosophical literature has failed to demonstrate conclusively that views either for or against abortion's moral acceptability are false, the matter remains at a stalemate in terms of rational debate, contributing to the ongoing absence of political and popular consensus about the issue in our society...
April 22, 2018: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/29672838/efficacy-feasibility-and-patient-acceptability-of-ultrasound-guided-manual-vacuum-aspiration-for-treating-early-pregnancy-loss
#11
Jacqueline Pui Wah Chung, Cathy Hoi Sze Chung, Jennifer Sze Man Mak, Tin Chiu Li, Grace Wing Shan Kong
BACKGROUND: Ultrasound-guided manual vacuum aspiration (USG-MVA) is an effective but underutilised alternative to medical or surgical evacuation of the uterus following first trimester miscarriage. AIMS: To evaluate the efficacy, feasibility and patient acceptability of USG-MVA for treating early pregnancy loss. MATERIAL AND METHODS: We invited patients with early pregnancy losses to participate in this prospective cohort study. We reviewed the medical records of the participants and their visual analogue pain score during MVA...
April 19, 2018: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/29672829/timing-of-diagnosis-of-gestational-diabetes-and-pregnancy-outcomes-a-retrospective-cohort
#12
Alexis Shub, Tess Chee, Alexandra Templeton, Deborah Boyce, Catharine McNamara, Christine Houlihan, Leonid Churilov, Elizabeth A McCarthy
BACKGROUND: Recent guidelines suggest screening high-risk women in early pregnancy for gestational diabetes (GDM); however, there is little evidence to support this. AIMS: To compare pregnancy outcomes associated with diabetes for women with risk factors for GDM according to gestation of diagnosis. Early GDM was defined as a positive test before 20 weeks gestation, late GDM as a positive test at 20 or more weeks and no GDM when both tests were negative. MATERIALS AND METHODS: Retrospective analysis in an Australian tertiary hospital of women who underwent a glucose tolerance test in pregnancy prior to 20 weeks gestation, and a repeat test after 20 weeks gestation if the initial test was negative...
April 19, 2018: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/29672825/estimating-success-of-vaginal-birth-after-caesarean-section-in-a-regional-australian-population-validation-of-a-prediction-model
#13
Samantha S Mooney, Richard Hiscock, Inkeri D'Arcy Clarke, Simon Craig
BACKGROUND: Following a primary caesarean section (CS), women must decide between attempted vaginal birth after caesarean (VBAC) and elective repeat caesarean section (ERCS) in subsequent pregnancies. Both options carry potential morbidity and mortality for mother and child, with the most feared being uterine rupture and its consequences. In attempts to reduce morbidity, several predictive nomograms have been developed to assist in delivery mode decisions. AIM: To assess the validity of the predictive nomogram developed by Grobman et al...
April 19, 2018: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/29667703/diagnosis-and-management-practices-for-gestational-diabetes-mellitus-in-australia-cross-sectional-survey-of-the-multidisciplinary-team
#14
Nina Meloncelli, Adrian Barnett, Fiona Pelly, Susan de Jersey
BACKGROUND: Gestational diabetes mellitus (GDM) is one of the most common pregnancy disorders; however, if well managed, women with GDM experience similar pregnancy outcomes to those without. Currently, there is limited evidence on actual management practices across Australia or how multidisciplinary teams interact to optimise care. AIMS: To examine the current screening, diagnostic, task and role perceptions and management practices, as reported by members of the GDM multidisciplinary team...
April 18, 2018: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/29658986/natural-fertility-infertility-and-the-role-of-medically-assisted-reproduction-the-knowledge-amongst-women-of-reproductive-age-in-north-queensland
#15
Nicole K Cheung, Anne Coffey, Cindy Woods, Caroline de Costa
BACKGROUND: The demand for medically assisted reproduction continues to increase, with more women encountering challenges with fertility. Due to misconceptions and gaps in knowledge, women are often unaware of the risks related to delayed childbearing. Lack of understanding of natural fertility, infertility and the role of medically assisted reproduction can lead to emotional suffering and changes in family plans. AIMS: To assess the understanding and knowledge that women of reproductive age in North Queensland have regarding natural fertility, infertility and the role of medically assisted reproduction...
April 16, 2018: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/29624638/medical-management-of-miscarriage-predictive-factors-of-success
#16
Vanessa Lusink, Clare Wong, Bradley de Vries, Joanne Ludlow
Medical management of miscarriage is an acceptable option available to women, and has advantages of providing timely treatment, while avoiding exposure to surgery and anaesthesia. This retrospective cohort study aimed to determine factors predictive of successful medical management, utilising a single dose protocol of 800 µg vaginal misoprostol. In this cohort, the success rate was 67% (199/296), and smaller mean gestational sac diameter independent of gestational age predicted success (P = 0.046). Success is not significantly related to parity, miscarriage type, pelvic pain or vaginal bleeding at the outset of treatment...
April 6, 2018: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/29603139/a-direct-to-patient-telemedicine-abortion-service-in-australia-retrospective-analysis-of-the-first-18-months
#17
Paul Hyland, Elizabeth G Raymond, Erica Chong
BACKGROUND: In 2015, the Tabbot Foundation launched a nationwide direct-to-patient telemedicine service to enable women to obtain medical abortion without visiting an abortion provider. AIMS: We aimed to describe results from the first 18 months of this service. MATERIALS AND METHODS: To have an abortion through the Foundation, a woman obtained screening tests locally and had a telephone consultation with a Foundation doctor. If she was eligible, mifepristone, misoprostol and other medications were sent to her by mail...
March 30, 2018: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/29602171/appendicectomy-during-pregnancy-and-the-risk-of-preterm-birth-a-population-data-linkage-study
#18
Ibinabo Ibiebele, Margaret Schnitzler, Tanya Nippita, Jane B Ford
BACKGROUND: Suspected appendicitis is a common non-obstetric indication for emergency abdominal surgery during pregnancy. AIMS: Assess the risk of preterm birth and other maternal and neonatal adverse birth outcomes following appendicectomy during pregnancy. MATERIALS AND METHODS: Population-based data linkage study of women with singleton births in New South Wales, Australia, 2002-2014. Pregnancies with appendicitis and appendicectomy were compared to pregnancies without appendicitis...
March 30, 2018: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/29577243/pain-after-vaginal-prolapse-repair-surgery-with-mesh-is-a-post-surgical-neuropathy-which-needs-to-be-treated-and-can-possibly-be-prevented-in-some-cases
#19
Thierry Vancaillie, Yasmin Tan, Jason Chow, Lauren Kite, Liz Howard
Post-surgical neuropathy leading to chronic pain is a recognised complication. It also can occur after surgery for pelvic organ prolapse repair involving mesh. Post-surgical neuropathy needs to be identified and properly treated to minimise the occurrence of chronic pain. A treatment algorithm is put forward for discussion .
March 25, 2018: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/29573269/improved-laparoscopic-skills-in-gynaecology-trainees-following-a-simulation-training-program-using-take-home-box-trainers
#20
Erin Wilson, Sarah Janssens, Lucas A McLindon, David G Hewett, Brian Jolly, Michael Beckmann
BACKGROUND: Lack of time and access to equipment are recognised barriers to simulation training. AIM: To investigate the effect of a take-home laparoscopic simulator training program on the laparoscopic skills of gynaecology trainees. METHOD: Participants (n = 17 in 2015, n = 16 in 2016) were supplied with a box trainer, associated equipment and instructions on self-directed training. A program was designed and implemented in 2015 comprising of ten weekly laparoscopic skills tasks and modified in 2016 to eight monthly tasks...
March 24, 2018: Australian & New Zealand Journal of Obstetrics & Gynaecology
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