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Australian & New Zealand Journal of Obstetrics & Gynaecology

Jemma Wohling, Nicole Edge, David Pena-Leal, Rui Wang, Ben Willem Mol, Gustaaf Dekker
BACKGROUND: The long-acting oxytocic agent; carbetocin, has been consistently shown to reduce the need for additional uterotonics at caesarean section, but not postpartum haemorrhage (PPH). While promising, current evidence is limited by heterogenicity in study design and findings. AIMS: To examine whether carbetocin confers clinical or economic benefit compared to oxytocin at caesarean section in an all-risk Australian population. MATERIALS AND METHODS: A retrospective cohort study was undertaken of all singleton caesarean sections at a public tertiary hospital from 2008 to 2010 (n = 2499)...
November 9, 2018: Australian & New Zealand Journal of Obstetrics & Gynaecology
Maya Frank Wolf, Jonathan Singer-Jordan, Oleg Shnaider, Ala Aiob, Inshirah Sgayer, Jacob Bornstein
INTRODUCTION: The incidence of placenta accreta (PA) has markedly increased in the United States, from 1/30 000 in 1950 to 1/731 deliveries in 2011. Although placenta praevia after prior caesarean sections (CS) is the most important risk factor for PA, other risk factors make up 1-5% of PA occurrences. At our referral hospital, we use the pre-caesarean prophylactic balloon catheter with or without post-surgery embolisation in a hybrid room. Here, we evaluate the role of prior CS and placenta praevia on the outcome of this procedure...
November 8, 2018: Australian & New Zealand Journal of Obstetrics & Gynaecology
Prathima Chowdary, Kate Stone, Tony Ma, Emma Readman, Kate McIlwaine, Marilla Druitt, Lenore Ellett, Melissa Cameron, Peter Maher
BACKGROUND: To establish whether the ultrasound findings of minimal endometriosis are confirmed at laparoscopy and that a correlation can be established as to the anatomical sites in this mild form of the disease. AIMS: Patients with pain and suspicion of endometriosis had an ultrasound scan by a sonologist with expertise in endometriosis as part of their pre-operative workup. MEASUREMENTS AND MAIN RESULTS: The clinical histories of 53 patients who had laparoscopy to investigate pelvic pain were reviewed...
November 8, 2018: Australian & New Zealand Journal of Obstetrics & Gynaecology
Kaushalya Arulpragasam, Grace Hyanes, Mathias Epee-Bekima
BACKGROUND: Emergency peripartum hysterectomy (EPH) is a life-saving obstetric procedure reserved for conditions where medical treatment and conservative surgery have failed. EPH is associated with significant morbidity and mortality. AIM: To examine the incidence, indications, risk factors, maternal and neonatal outcomes of EPH in a tertiary hospital in Western Australia (WA). METHODOLOGY: A retrospective case-note analysis of all cases of EPH performed at King Edward Memorial Hospital in WA between the years 2006 and 2016...
November 8, 2018: Australian & New Zealand Journal of Obstetrics & Gynaecology
Hayden Anthony Homer
Recurrent miscarriage (RM), also known as recurrent pregnancy loss, is a distressing condition affecting around 1% of couples trying to conceive It can be very frustrating for both clinicians and patients as, despite intensive workup, no clear underlying pathology is forthcoming in at least 50% of couples. This leads to despair for patients and leaves clinicians at a loss for how to help. Desperation in both camps can promote the uptake of investigations and interventions of unproven benefit. The pathophysiology underpinning RM is incredibly diverse, involving areas such as haematology, endocrinology, immunology and genetics...
November 4, 2018: Australian & New Zealand Journal of Obstetrics & Gynaecology
Kassam Mahomed, Sonia Anwar, Jessika E Geer, Emma Ballard, Satomi Okano
BACKGROUND: Preterm birth is associated with significant perinatal morbidity and mortality. The fetal fibronectin test (fFN) is used to manage women presenting with threatened preterm labour (TPTL). AIM: To evaluate the use of fFN in women presenting with TPTL with regard to hospital admission, tertiary hospital transfer and use of tocolytics and steroids in our hospital, against recommended guidelines. The ability of fFN <10 ng/mL, 10-49 ng/mL, 50-199 ng/mL and >200 ng/mL to predict outcome was also examined...
November 4, 2018: Australian & New Zealand Journal of Obstetrics & Gynaecology
Elizabeth A McCarthy, Rebecca Williamson, Alexis Shub
BACKGROUND: Historically, pre-pregnancy diabetes (PPDM) is a recognised risk factor for poor pregnancy outcome. Co-existing pathology and adverse social determinants including rural-metropolitan inequities in health and healthcare access may confer additional risks. Multidisciplinary care before, during and after pregnancy can improve outcomes for women with PPDM and their infants. The extent to which rural Australian women and their families share in improved outcomes is unknown. We aimed to summarise maternal characteristics and pregnancy outcomes for women with PPDM, including women in rural settings and examine applications of existing clinical guidelines to rural Australian practice...
October 31, 2018: Australian & New Zealand Journal of Obstetrics & Gynaecology
Johanna E Chan, Ari Samaranayaka, Helen Paterson
BACKGROUND: Perinatal depression has wide-ranging impacts on the health of mothers, babies and their families. Previously published data suggest seasonal variation in the prevalence of perinatal depression, as well as possible variation with gestation. AIMS: To describe the prevalence of perinatal depression in a New Zealand population; to describe the trend in depression over gestational age; and to assess the influence of season on perinatal depression. MATERIALS AND METHODS: We performed a secondary analysis of data from a prospective cohort of 260 women in Dunedin, New Zealand...
October 29, 2018: Australian & New Zealand Journal of Obstetrics & Gynaecology
Wai Yoong, Allen Lavina, Ahmad Ali, Viswapriya Sivashanmugarajan, Abha Govind, Morgan McMonagle
BACKGROUND: Surgical packing should not be seen as a 'bail out' for the less skilled obstetrician who is unable to control obstetric haemorrhage using conventional techniques. Rather, this should be considered in cases of coagulopathy or where haemorrhage persists from raw surfaces, venous plexuses and inaccessible areas. MATERIALS AND METHODS: Data from seven women who underwent abdomino-pelvic packing for intractable postpartum bleeding were collected. The primary outcome was success of intra-abdominal packing and secondary outcomes included estimated blood loss, units transfused, length of stay and postoperative complications...
October 24, 2018: Australian & New Zealand Journal of Obstetrics & Gynaecology
Kirsten L B Jensen, Meredith J Temple-Smith, Jade E Bilardi
BACKGROUND: Miscarriage can result in significant psychological morbidity. Research suggests health professionals play a role in shaping women's experience of miscarriage. AIMS: This study explored the views and practices of Australian health professionals in caring for women experiencing miscarriage. MATERIALS AND METHODS: Twelve health professionals from disciplines including medicine, midwifery and sonography were purposively sampled. Semi-structured interviews were recorded, transcribed and subjected to thematic analysis...
October 19, 2018: Australian & New Zealand Journal of Obstetrics & Gynaecology
Matthew Lynch, Richard De Abreu Lourenco, Martin Flattery, Marion Haas
BACKGROUND: Relative to the oral contraceptive pill, uptake of long-acting reversible contraceptive methods (LARCs) in Australia continues to be lower than might be suggested by the evidence on their clinical and economic benefits. AIM: To undertake a critical appraisal of published economic evaluations of LARCs to assess the generalisability of their results to the Australian healthcare context. MATERIALS AND METHODS: A search of the literature was conducted to identify studies of economic evaluations of LARCs using the Medline, Embase and PubMed databases...
October 12, 2018: Australian & New Zealand Journal of Obstetrics & Gynaecology
Lulusha Jayawardena, Penelope Sheehan
BACKGROUND: Growth charts customised for maternal height, weight, ethnicity and parity have been proposed as more effective at detecting infants who are small for gestational age (SGA) than routine screening with symphysio-fundal height measurement alone. Our non-randomised, prospective cohort study assessed antenatal SGA detection rates in a general maternity cohort following the introduction of the Perinatal Institute's Growth Assessment Protocol (GAP) program (consisting of customised growth chart software for plotting symphysio-fundal height, staff training and serial auditing)...
October 9, 2018: Australian & New Zealand Journal of Obstetrics & Gynaecology
Leigh Duncan
No abstract text is available yet for this article.
October 4, 2018: Australian & New Zealand Journal of Obstetrics & Gynaecology
Aime Powell, Paul A Cohen, Katrina Spilsbury, Nerida Steel, Penny Blomfield
BACKGROUND: For Australian women with screen-detected adenocarcinoma-in-situ (AIS), an excisional biopsy is mandatory for further assessment, treatment, and to exclude the presence of cervical adenocarcinoma. The only exclusion to this rule is if the woman has a clinically evident invasive cervical malignancy. Excisional treatments should be tailored according to a patient's age and future obstetric needs. To date, practitioner compliance with this recommendation has not been investigated...
October 4, 2018: Australian & New Zealand Journal of Obstetrics & Gynaecology
Jessica A Robertson, Karen Sanday, James Nicklin
BACKGROUND: Malignant ovarian germ cell tumours (MOGCT) are uncommon in the general population and very rare in post-menopausal women. AIMS: To evaluate the demographics, treatment and survival of post-menopausal women with MOGCT treated at the Queensland Centre for Gynaecological Cancer (QCGC) and compare these with pre-menopausal women. MATERIALS AND METHODS: Retrospective analysis was performed of the QCGC database from January 1981 to February 2017...
October 2, 2018: Australian & New Zealand Journal of Obstetrics & Gynaecology
Renae Kirkham, Diana MacKay, Federica Barzi, Cherie Whitbread, Marie Kirkwood, Sian Graham, Paula Van Dokkum, H David McIntyre, Jonathan E Shaw, Alex Brown, Kerin O'Dea, Christine Connors, Jeremy Oats, Paul Zimmet, Jacqueline Boyle, Louise Maple-Brown
BACKGROUND: The postpartum period is a critical time to improve health outcomes for Aboriginal women, particularly for those who have chronic conditions. AIMS: To assess enhanced support methods (for women following diabetes in pregnancy (DIP)) to improve completion rates of recommended postpartum health checks. MATERIALS AND METHODS: Fifty-three Aboriginal women in the Northern Territory (NT) were contacted in the postpartum period to encourage medical check-ups...
October 2, 2018: Australian & New Zealand Journal of Obstetrics & Gynaecology
Marilyn Clarke, Kiarna Brown
No abstract text is available yet for this article.
October 2, 2018: Australian & New Zealand Journal of Obstetrics & Gynaecology
Priya Darshene Janagaraj, Pari Shanmuga Raman Gurusamy, Rosalind Webby
IMPORTANCE: Assessing gaps in antenatal pertussis vaccination to increase coverage. INTRODUCTION: Antenatal pertussis vaccination has been proven effective in reducing pertussis disease in infants. Current guidelines recommend maternal pertussis vaccination from 28 weeks gestation. The aim of this study is to determine antenatal pertussis vaccination coverage in the Northern Territory and potential socio-demographic factors affecting uptake, using validated birth and immunisation data...
September 26, 2018: Australian & New Zealand Journal of Obstetrics & Gynaecology
Glen D L Mola, Holger W Unger
BACKGROUND: In many low- to middle-income countries (LMIC) assisted vaginal birth rates have fallen, while caesarean section (CS) rates have increased, with potentially deleterious consequences for maternal and perinatal mortality. AIMS: To review birth mode and perinatal mortality in a large LMIC hospital with strict labour management protocols and expertise in vacuum extraction. MATERIALS AND METHODS: We conducted a retrospective observational study at Port Moresby General Hospital in Papua New Guinea...
September 13, 2018: Australian & New Zealand Journal of Obstetrics & Gynaecology
Julie C Chen, Sue Jenkins-Marsh, Vicki Flenady, Susan Ireland, Meryta May, Keith Grimwood, Helen G Liley
BACKGROUND: Intrapartum chemoprophylaxis reduces early-onset group B streptococcal disease (EOGBSD) in newborns. Some guidelines advise that intrapartum antibiotics should be offered following universal antenatal screening for GBS carriage and others recommend intrapartum antibiotics based on clinical risk factors alone. Since 1999, Queensland guidelines have recommended a risk factor-based approach. We examined trends in EOGBSD rates over time in Queensland in the setting of these guidelines and whether management of cases reflected the recommendations...
September 11, 2018: Australian & New Zealand Journal of Obstetrics & Gynaecology
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