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Australian & New Zealand Journal of Obstetrics & Gynaecology

Keith Harrison, John Peek, Michael Chapman, Mark Bowman
BACKGROUND: Assisted reproductive technology (ART) clinics in Australia and New Zealand are accredited and licensed against a Code of Practice audited by certifying bodies accredited by the Joint Accreditation System for Australia and New Zealand (JAS-ANZ). The system is administered by the Reproductive Technology Accreditation Committee (RTAC) of the Fertility Society of Australia. AIMS: To review the incidence of variances and findings identified by certifying bodies in Australian and New Zealand ART clinics within the currency of a single version of the Code of Practice...
October 21, 2016: Australian & New Zealand Journal of Obstetrics & Gynaecology
Kelton Tremellen, Sam Everingham
BACKGROUND: Australian law allows for altruistic surrogacy but prohibits compensation of surrogates beyond their expenses, or the use of professional surrogacy agencies. These restrictions limit local access to surrogacy, driving Australians overseas where they can access commercial surrogacy. AIM: To assess the Australian public's views regarding the use of gestational surrogacy under various social and medical scenarios, together with their level of support for financial compensation of surrogates and the use of professional surrogacy agencies...
October 19, 2016: Australian & New Zealand Journal of Obstetrics & Gynaecology
Yu Sun Bin, Christine L Roberts, Michael C Nicholl, Natasha Nassar, Jane B Ford
BACKGROUND: Recent population-wide changes in perinatal risk factors may affect rates of breech presentation at birth, and have implications for the provision of breech services and training in breech management. AIMS: To investigate whether changes in maternal and pregnancy characteristics explain the observed trend in breech presentation at term. MATERIALS AND METHODS: All singleton term (≥37 week) births in New South Wales during 2002-2012 were identified through birth and associated hospital records...
October 17, 2016: Australian & New Zealand Journal of Obstetrics & Gynaecology
Deborah Bateson, Caroline Harvey, Lieu Trinh, Mary Stewart, Kirsten I Black
BACKGROUND: Copper intrauterine device (Cu-IUD) use in Australia is low despite being a highly effective, cost effective non-hormonal contraceptive with reported 12-month continuation rates of 85% compared to 59% for oral contraception. AIMS: To describe the characteristics of Cu-IUD users in the Australian context, their experiences of side effects, continuation rates and reasons for discontinuation. METHODS: Between August 2009 and January 2012 we undertook a prospective cohort study of consecutive women presenting for Cu-IUD insertion to three family planning clinics in Queensland and New South Wales...
October 5, 2016: Australian & New Zealand Journal of Obstetrics & Gynaecology
Sushena Krishnaswamy, Euan Wallace, Jim Buttery, Michelle Giles
Maternal immunisation is the most effective strategy to reduce infant morbidity and mortality from pertussis infection, and is now standard of care in many countries, including Australia. However, uptake cannot be guaranteed unless the barriers to implementing programs locally are understood. Education and resources for antenatal care providers, embedding vaccination within antenatal care, and provision of culturally appropriate information for pregnant women are integral to a successful antenatal vaccination program...
October 5, 2016: Australian & New Zealand Journal of Obstetrics & Gynaecology
Praveen H De Silva, Dushyant Maharaj, Fali Langdana
Perimortem caesarean section is a term many obstetricians are familiar with despite few encountering it first-hand. It is estimated the intervention will be needed every 53 000 maternities. Despite this rarity it is vital clinicians are trained in detecting and intervening where perimortem caesarean is required. In New Zealand eight perimortem caesareans were performed from 2006 to 2013. Here we discuss two perimortem caesarean sections performed in two New Zealand hospitals alongside current guidance and recommendations...
October 5, 2016: Australian & New Zealand Journal of Obstetrics & Gynaecology
Valentina Shaw, Alain C Vandal, Christin Coomarasamy, Alec J Ekeroma
INTRODUCTION: To evaluate the effectiveness of the levonorgestrel intrauterine system (LNG-IUS) in obese women with heavy menstrual bleeding in Counties Manukau Auckland area, New Zealand. METHODS: Prospective observational study in a tertiary teaching hospital. Twenty women with heavy menstrual bleeding (HMB) who agreed to treatment with the LNG-IUS and had a body mass index (BMI) of >30 kg/m(2) were recruited between May and December 2014. The women completed two validated tools (Menstrual Impact Questionnaire and the Pictorial Bleeding Assessment Chart) at recruitment, 6 and 12 months follow-up...
October 3, 2016: Australian & New Zealand Journal of Obstetrics & Gynaecology
Bradley de Vries, Bianca Bryce, Tatiana Zandanova, Jason Ting, Patrick Kelly, Hala Phipps, Jon A Hyett
BACKGROUND: There is global concern about rising caesarean section rates. Identification of risk factors could lead to preventative measures. AIMS: To describe the association between neonatal head circumference and (i) caesarean section for failure to progress, (ii) intrapartum caesarean section overall. MATERIALS AND METHODS: This was a retrospective cohort study of 11 687 singleton live births with cephalic presentation, attempted vaginal birth and at least 37 completed weeks gestation from January 2005 to June 2009...
September 15, 2016: Australian & New Zealand Journal of Obstetrics & Gynaecology
Eva L Pijpers, Sanne Kreijkamp-Kaspers, Treasure M McGuire, Laura Deckx, Wendy Brodribb, Mieke L van Driel
BACKGROUND: For many medicines, safe use during pregnancy is not established and adherence is often poor due to safety concerns. Therefore, it is important to identify consumers' medicines information needs during pregnancy. MATERIALS AND METHODS: A retrospective, mixed methods analysis was conducted on eight years of pregnancy-related calls to an Australian national medicines call centre. The call profile of pregnancy and non-pregnancy-related questions were compared...
September 14, 2016: Australian & New Zealand Journal of Obstetrics & Gynaecology
Yishay Weill, Raphael N Pollack
BACKGROUND: External cephalic version (ECV) in the presence of a uterine scar is still considered a relative contraindication despite encouraging studies of the efficacy and safety of this procedure. We present our experience with this patient population, which is the largest cohort published to date. AIMS: To evaluate the efficacy and safety of ECV in the setting of a prior caesarean delivery. MATERIALS AND METHODS: A total of 158 patients with a fetus presenting as breech, who had an unscarred uterus, had an ECV performed...
September 14, 2016: Australian & New Zealand Journal of Obstetrics & Gynaecology
Jamie Bryant, Amy Waller, Emilie Cameron, Alexis Hure, Rob Sanson-Fisher
BACKGROUND: As a precaution against acquiring food-borne illnesses, guidelines recommend women avoid some foods during pregnancy. AIMS: To examine among women receiving antenatal care: (i) level of knowledge and self-reported adherence to guidelines about foods that should be avoided during pregnancy; and (ii) associated socio-demographic characteristics. METHODS: Women attending a public outpatient clinic who were: pregnant or had recently given birth; 18 years or older; able to complete an English language survey with minimal assistance; and had at least one prior antenatal appointment for their current pregnancy, were asked to complete a cross-sectional survey...
September 14, 2016: Australian & New Zealand Journal of Obstetrics & Gynaecology
E Sun Paik, Yoo-Young Lee, Minhee Shim, Hyun Jin Choi, Tae-Joong Kim, Chel Hun Choi, Jeong-Won Lee, Byoung-Gie Kim, Duk-Soo Bae
OBJECTIVE: The aim of this study was to analyse patterns and timing of recurrence and their association with clinical outcomes in recurrent epithelial ovarian cancer (EOC) patients with no gross residual disease after primary debulking surgery (PDS). METHODS: This study was conducted on 303 EOC patients with no residual disease after PDS who were treated at the Samsung Medical Center from 2002 to 2012. By reviewing electronic medical records, information on date of clinical/pathological recurrence and pattern of disease presentation for each relapse were retrieved...
September 9, 2016: Australian & New Zealand Journal of Obstetrics & Gynaecology
April Morrow, Sean Seeho, Kristine Barlow-Stewart, Jane Fleming, Bettina Meiser, Janan Karatas
BACKGROUND: Pre-implantation genetic diagnosis (PGD) is a molecular diagnostic technique in which embryos are tested for specific genetic abnormalities to enable the selection of those unaffected by the condition. Previous Australian evidence suggested that women who are not informed about PGD by their obstetrician feel disempowered about not being given this option. AIMS: This study aimed to explore obstetrician knowledge regarding PGD and identify barriers to referral...
September 9, 2016: Australian & New Zealand Journal of Obstetrics & Gynaecology
Sean Copson, Katrina Calvert, Puvaneswary Raman, Elizabeth Nathan, Mathias Epee
BACKGROUND: Cord prolapse is an uncommon obstetric emergency, with potentially fatal consequences for the baby if prompt action is not taken. Simulation training provides a means by which uncommon emergencies can be practised, with the aim of improving teamwork and clinical outcomes. AIMS: This study aimed to determine if the introduction of a simulation-based training course was associated with an improvement in the management of cord prolapse, in particular the diagnosis to delivery interval...
September 7, 2016: Australian & New Zealand Journal of Obstetrics & Gynaecology
Sally K Abell, Jacqueline A Boyle, Barbora de Courten, Georgia Soldatos, Euan M Wallace, Sophia Zoungas, Helena J Teede
BACKGROUND: There are no contemporary cohorts examining pregnancy outcomes in women with type 2 diabetes (T2D) in Australia. AIM: To compare pregnancy outcomes in women with and without T2D, and assess effects of body mass index (BMI) and glycaemic control on outcomes. MATERIALS AND METHODS: An historical cohort study was conducted of all singleton births > 20 weeks gestation at a specialist maternity network in Australia from 2010 to 2013...
September 5, 2016: Australian & New Zealand Journal of Obstetrics & Gynaecology
Edward Springhall, Euan M Wallace, Lynne Stewart, Michelle Knight, Joanne C Mockler, Miranda Davies-Tuck
BACKGROUND: Postpartum haemorrhage (PPH) rates are increasing worldwide. The rate is particularly high in women undergoing an induced or augmented labour. In response to this, we altered our hospital's protocol for the management of the third stage of labour to recommend Syntometrine, in preference to oxytocin alone, for women being induced or augmented. We set out to assess the impact of the protocol change on the PPH rate. MATERIALS AND METHODS: A random sample of 1200 women who had a singleton, term vaginal birth before and after the protocol change was taken...
September 5, 2016: Australian & New Zealand Journal of Obstetrics & Gynaecology
Emily R Ingram, Iain K Robertson, Kathryn J Ogden, Amanda E Dennis, Joanne E Campbell, Anne M Corbould
BACKGROUND: Gestational diabetes mellitus (GDM) is associated with life-long increased risk of type 2 diabetes: affected women are advised to undergo oral glucose tolerance testing (OGTT) at 6-12 weeks postpartum, then glucose screening every 1-3 years. AIMS: We investigated whether in women with GDM, antenatal clinical factors predicted postpartum abnormal glucose tolerance and compliance with screening. MATERIALS AND METHODS: In women with GDM delivering 2007 to mid-2009 in a single hospital, antenatal/obstetric data and glucose tests at 6-12 weeks postpartum and during 5...
August 23, 2016: Australian & New Zealand Journal of Obstetrics & Gynaecology
Hon C Cheng, Anita Pelecanos, Renuka Sekar
BACKGROUND: Peripartum hysterectomy is commonly performed for catastrophic postpartum haemorrhage uncontrolled by conservative medical and surgical therapies. Currently, information about the incidence and indications for peripartum hysterectomy are not well defined in Australia. AIMS: Evaluate the incidence and indications of peripartum hysterectomy in the Royal Brisbane and Women's Hospital (RBWH) between 2000 and 2014. MATERIALS AND METHODS: A 15-year retrospective cohort study of peripartum hysterectomies at RBWH was conducted...
August 17, 2016: Australian & New Zealand Journal of Obstetrics & Gynaecology
Maritza T Farrant, Kathryn Williamson, Malcolm Battin, William M Hague, Janet A Rowan
We compared, in 733 women with gestational diabetes mellitus treated with metformin and/or insulin, rates of neonatal hypoglycaemia in those who had received a dextrose/insulin infusion during labour and prior to delivery (n = 132) with those who did not (n = 601). Women who had infusions were more likely to have been treated with insulin (87.1% vs 70.4%, P < 0.01) and have higher mean capillary glucose values (measured four times daily) in the two weeks prior to delivery (P < 0.01). They had lower mean (SD) glucose values in the 12 h prior to delivery (5...
August 17, 2016: Australian & New Zealand Journal of Obstetrics & Gynaecology
Joanne B McKenna, Katrina Parkin, Ying Cheng, Kate H Moore
BACKGROUND: One subjective long-term evaluation of the tension-free vaginal tape (TVT) success rate in obese women showed a worse prognosis in the obese, but objective studies have been limited to short-term follow-up (less than two years). AIM: To determine whether the long-term objective cure rate in obese/morbidly obese women who underwent TVT was reduced, compared to non-obese women (at five or more years). MATERIALS AND METHODS: Body mass index (BMI) was collected on patients undergoing TVT procedure...
August 17, 2016: Australian & New Zealand Journal of Obstetrics & Gynaecology
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