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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
Sushena Krishnaswamy, Euan M Wallace, Jim Buttery, Michelle L Giles
BACKGROUND: Women's decisions regarding vaccination during pregnancy are heavily influenced by maternity care provider (MCP) recommendations. Understanding why MCPs may not recommend vaccination is central to improving vaccination rates. AIMS: To examine the knowledge, attitudes and practice of Australian MCPs to maternal vaccination. METHODS: We surveyed obstetricians, midwives and general practitioners (GPs) between September and November 2016...
September 7, 2018: Australian & New Zealand Journal of Obstetrics & Gynaecology
Christine Akers, Helen Savoia, Stefan Kane, Philip Crispin, Anastazia Keegan, Erica Wood, Bridget Glazebrook, Linley Bielby, Amanda K Davis
The Serious Transfusion Incident Reporting program (STIR) commenced haemovigilance in relation to RhD immunoglobulin (Ig) administration in 2015. During two years of reporting, 21 reports relating to RhD Ig administration were received. Thirty-three percent (7/21) were related to omission of RhD Ig, putting women at risk of RhD alloimmunisation and adverse consequences in future pregnancies. A recent case reported to STIR highlights poor communication and misinterpretation of pathology results leading to significant morbidity from haemolysis in the fetus...
September 5, 2018: Australian & New Zealand Journal of Obstetrics & Gynaecology
Sandra G Downing, Rebecca Wright, Tonia Marquardt, Emily Callander
BACKGROUND: Threatened preterm labour is a common reason for medical transfer from remote communities; however, many transferred women do not deliver preterm. A tool for prediction of preterm birth such as fetal fibronectin may reduce transfers and related social and economic costs. AIM: To review the use of fetal fibronectin testing in women transferred for threatened preterm labour from Cape York to Cairns Hospital between 2011 and 2015 and determine the role testing could play in reducing transfers and associated costs...
September 3, 2018: Australian & New Zealand Journal of Obstetrics & Gynaecology
Jeremy F Tuohy, Jane E Harding, Caroline A Crowther, Frank H Bloomfield
BACKGROUND: Antenatal corticosteroids (ANC) reduce mortality and morbidity in preterm babies, but prescription practices vary. AIMS: To assess obstetricians' compliance with the recommendations of the Australian and New Zealand clinical practice guidelines on use of ANC. MATERIALS AND METHODS: An anonymous online questionnaire was distributed to Fellows of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists. RESULTS: All respondents reported prescribing an initial course of ANC according to the guidelines if preterm birth at 28 weeks' gestation was expected within 24 or 72 h...
September 3, 2018: Australian & New Zealand Journal of Obstetrics & Gynaecology
Renato Seracchioli, Diego Raimondo, Simona Del Forno, Deborah Leonardi, Lucia De Meis, Valentina Martelli, Alessandro Arena, Roberto Paradisi, Mohamed Mabrouk
BACKGROUND: Retrodisplacement of the uterus (retroflexion and/or retroversion) may be associated with pelvic pain symptoms and posterior deep infiltrating endometriosis (DIE). Previous studies in symptomatic women with retrodisplacement of the uterus showed the efficacy of hysteropexy in terms of pain symptoms improvement. AIM: To evaluate sonographic, clinical and surgical outcomes of a hysteropexy technique MATERIALS AND METHODS: Laparoscopic round ligament plication and tilting of the uterine fundus in women with uterine retrodisplacement and posterior deep infiltrating endometriosis was performed...
August 23, 2018: Australian & New Zealand Journal of Obstetrics & Gynaecology
Carole Y Fisher, Jon Adams, Jane E Frawley, Louise D Hickman, David W Sibbritt
Conventional treatments for cyclic perimenstrual pain and discomfort, while numerous and diverse, have drawbacks including side effects, interference with women's reproductive function and, importantly, failure to address symptoms. Many women turn to herbal medicine to treat a myriad of menstrual symptoms. Clinical evidence supports the efficacy of Vitex agnus-castus but other medicinal herbs typically used by Western herbalists for treating menstrual symptoms are unsupported by clinical trials. This raises concerns around the efficacy and safety of these herbs...
August 23, 2018: Australian & New Zealand Journal of Obstetrics & Gynaecology
Anisha Parambi, Miranda Davies-Tuck, Kirsten R Palmer
BACKGROUND: Currently, little evidence exists to guide mode of delivery in pregnant women with super obesity. There is a trend toward elective caesarean delivery in this population with little evidence of improved maternal or neonatal outcomes. AIM: Our study compares maternal and neonatal outcomes based on planned mode of delivery and aimed to identify predictors for a successful vaginal delivery. MATERIALS AND METHODS: This retrospective observational study explored maternal and neonatal outcomes of women with a body mass index ≥50 who birthed following a singleton pregnancy at ≥36 weeks gestation over a 10 year period at a single centre in Melbourne, Australia...
August 13, 2018: Australian & New Zealand Journal of Obstetrics & Gynaecology
Selma M Mourad, Cate Curtis, Guy Gudex, Margaret Merrilees, John Peek, Lynn Sadler
BACKGROUND: The Patient-Centred Questionnaire-Infertility (PCQ-Infertility) has proven to be a reliable instrument to assess the extent of patient-centredness of fertility care in European countries. AIMS: To validate the PCQ-Infertility in New Zealand (NZ) and to compare results with international experience. MATERIALS AND METHODS: A cross-sectional 46-item questionnaire study among 409 women undergoing publicly funded fertility care (intrauterine insemination or in vitro fertilisation / intracytoplasmic sperm injection) in three fertility clinics in the Northern Auckland region was performed between October 2015 and September 2016...
August 13, 2018: Australian & New Zealand Journal of Obstetrics & Gynaecology
Natasha Pritchard, Anthea Lindquist, Richard Hiscock, Prerna Diksha, Susan P Walker, Michael Permezel
BACKGROUND AND AIM: Large-for-gestational-age (LGA) infants are at increased risk of intrapartum complications. However, some infants classified as LGA may be appropriate-for-gestational-age (AGA) if adjusted for maternal stature. We determined whether customisation of birthweight centiles by maternal height, or height and weight, improves the detection of LGA infants at risk of complications. METHODS: We conducted a retrospective analysis of 38 246 term, singleton nulliparous women...
August 8, 2018: Australian & New Zealand Journal of Obstetrics & Gynaecology
Ronit Cukierman, Sarah Heland, Kirsten Palmer, Peter Neil, Fabricio da Silva Costa, Daniel L Rolnik
OBJECTIVE: To examine the association between inter-twin delivery interval and short-term perinatal outcomes of the second twin after vaginal delivery of the first twin. METHODS: Retrospective cohort study including twin pregnancies with a vaginal delivery of the first twin between January 2011 and September 2017 in a tertiary hospital in Melbourne, Australia. The main outcome measure was a composite of adverse neonatal outcome (at least one of perinatal death, admission to neonatal intensive care unit (NICU), endotracheal intubation, Apgar <7 at five minutes and cord lactate >4...
August 8, 2018: Australian & New Zealand Journal of Obstetrics & Gynaecology
Alice E Burton, Sujatha Thomas
BACKGROUND: The incidence of both sexually transmitted infection (STI) and preterm birth is high among Indigenous women in the Northern Territory, Australia. It was hypothesised that these factors are linked. AIMS: To analyse whether antenatal STI is associated with preterm birth among Northern Territory Indigenous women. MATERIALS AND METHODS: A retrospective case-control study was conducted at a tertiary maternity hospital in the Northern Territory...
July 29, 2018: Australian & New Zealand Journal of Obstetrics & Gynaecology
Zongjian Yang, Hai Phung, Louise Freebairn, Rosalind Sexton, Alexandra Raulli, Paul Kelly
AIMS: Maternal overweight and obesity in pregnancy are known to increase the risk of a range of complications and adverse pregnancy outcomes. This study estimates the population-level contribution of maternal overweight and obesity to adverse pregnancy outcomes. METHODS: Data derived from the Australian Capital Territory (ACT) Maternal and Perinatal Data Collection were analysed. A total of 24 161 women who had a singleton birth in 2009-2015, with maternal weight and height information available, were included...
July 19, 2018: Australian & New Zealand Journal of Obstetrics & Gynaecology
Sana Usman, Helen Barton, Charlotte Wilhelm-Benartzi, Christoph C Lees
BACKGROUND: Intrapartum ultrasound has been proposed as a method of assessing labour progress but its acceptability has not been comprehensively assessed. AIMS: We evaluated the acceptability of intrapartum ultrasound in women having vaginal examination (VE) and ultrasound (US) assessment (transabdominal (TA) and transperineal (TP)) prior to delivery, with and without regional analgesia (RA). MATERIALS AND METHODS: Women at 24-42 weeks gestation were included in a prospective observational cohort study...
July 19, 2018: Australian & New Zealand Journal of Obstetrics & Gynaecology
Raymond Li, Jade Lodge, Christopher Flatley, Sailesh Kumar
BACKGROUND: Maternal smoking is associated with a number of adverse outcomes with a dose-dependent increase in risk. The aim of this study was to evaluate the obstetric and perinatal outcomes in women who smoked during pregnancy. METHODS: This was a retrospective cohort study of women who smoked during pregnancy and birthed at a major perinatal centre in Australia between January 2000 and April 2017. The study cohort was compared to a cohort of women who did not smoke in pregnancy...
July 17, 2018: Australian & New Zealand Journal of Obstetrics & Gynaecology
Alex Ades, Mehrnoosh Aref-Adib, Sneha Parghi, Phoebe Hong
BACKGROUND: Transabdominal cerclage can reduce the risk of preterm birth in women with cervical insufficiency. AIMS: This study evaluated outcomes following insertion of a laparoscopic transabdominal cerclage in pregnant women. MATERIALS AND METHODS: A retrospective observational study. PATIENTS: pregnant women who underwent laparoscopic transabdominal cerclage from 2011 to 2017. Eligible women had cervical insufficiency and were not suitable for a transvaginal cerclage...
July 9, 2018: Australian & New Zealand Journal of Obstetrics & Gynaecology
Orit Abdalla, Cindy Woods, Caroline de Costa
The records of women attending a large Australian regional hospital for antenatal care were retrospectively analysed to determine what proportion had undergone or been offered first trimester screening for fetal abnormalities; only 609 (54%) of 1114 women had undergone or been offered screening. Younger women, multiparous women and women living in rural Australia were less likely to be offered screening. Barriers to screening and solutions for overcoming these need to be identified to improve access and equality in antenatal screening for all women...
July 9, 2018: Australian & New Zealand Journal of Obstetrics & Gynaecology
Jonathan A S Nettle, Helen C Mcnamara, Jacobus M Du Plessis
BACKGROUND: There is a paucity of information regarding perineal injuries in women who achieve vaginal birth after caesarean section (VBAC). AIMS: To ascertain the rate of severe perineal injuries in women achieving VBAC at a major tertiary obstetric hospital, and to determine if vaginal birth is more likely to be associated with perineal injuries in women with one previous caesarean section compared with nulliparous women. MATERIALS AND METHODS: A retrospective cohort study was undertaken of women with singleton pregnancies at term who delivered vaginally between 2013 and 2016...
June 26, 2018: Australian & New Zealand Journal of Obstetrics & Gynaecology
Therese M McGee, Beata Gidaszewski, Marjan Khajehei, Toni Tse, Emma Gibbs
BACKGROUND: Both silicone and latex single-balloon Foley catheters are available for cervical ripening but no literature exists to compare them. Local experience suggested more frequent insertion-related accidental rupture of the membranes (acROM) with silicone. AIMS: To compare the performance of silicone versus latex catheters with respect to acROM and other outcomes. MATERIALS AND METHODS: Women undergoing outpatient Foley catheter cervical ripening were randomised to a silicone or latex catheter...
June 26, 2018: Australian & New Zealand Journal of Obstetrics & Gynaecology
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