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Australian & New Zealand Journal of Obstetrics & Gynaecology

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https://www.readbyqxmd.com/read/28617944/inequity-in-timing-of-prenatal-screening-in-new-zealand-who-are-our-most-vulnerable
#1
Olivia Payne, Avinesh Pillai, Michelle Wise, Peter Stone
BACKGROUND: In New Zealand (NZ), Maori and Pacific women are less likely to complete prenatal screening for Down's syndrome and other aneuploidies than other ethnic groups. Young women <20 have low rates of completed screening compared with women >20 years. Women living in deprived areas have lower completed screen rates than women living in more affluent areas. Combined first trimester screening has a superior sensitivity (85%) compared with second trimester screening (75%) for trisomy 21...
June 15, 2017: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/28608544/use-of-intravenous-iron-polymaltose-in-the-management-of-iron-deficiency-in-pregnancy-a-retrospective-cohort-study
#2
Alaa Qassim, Rosina G Gergis, Bill Jeffries, Rosalie M Grivell, Luke E Grzeskowiak
BACKGROUND: Intravenous iron polymaltose (IPM) is commonly utilised in pregnancy when oral treatment is not tolerated or where rapid replenishment of iron stores is required, but data on use in pregnancy is scarce. AIM: To examine the use, safety and efficacy of intravenous IPM in pregnancy. METHODS: Retrospective cohort study of pregnant women administered intravenous IPM between January 2014 and January 2016 at a Tertiary teaching hospital in Adelaide, Australia...
June 13, 2017: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/28597496/elevated-anti-mullerian-hormone-in-lean-women-may-not-indicate-polycystic-ovarian-syndrome
#3
Rachel A Bradbury, Paul Lee, Howard C Smith
BACKGROUND: Polycystic ovarian syndrome (PCOS) is a heterogeneous disorder with clinical features shared with functional hypogonadotrophic hypogonadism (FHH). AIM: To investigate the usefulness of an elevated (>40 pmol/L) anti-Mullerian hormone (AMH) in identifying PCOS and distinguishing PCOS from FHH. MATERIALS AND METHODS: 141 patients with an elevated AMH and body mass index either <20 kg/m(2) (lean) or >30 kg/m(2) (obese) were selected and three subgroups analysed - obese, lean, lean with suspected FHH...
June 9, 2017: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/28580650/maternal-near-misses-at-a-provincial-hospital-in-papua-new-guinea-a-prospective-observational-study
#4
John W Bolnga, Marilyn Morris, Catherine Totona, Moses Laman
BACKGROUND: Maternal near-miss indices are World Health Organisation (WHO) recognised indicators that may improve our understanding of factors associated with maternal morbidity and mortality. In Papua New Guinea (PNG) where maternal mortality is among the highest in the world, only one study has documented near-miss indices in a tertiary-level hospital, but none from provincial hospitals where the majority of under-privileged women access healthcare services. AIMS: To determine the near-miss ratio, maternal mortality index (MMI), and associated maternal indices for Modilon Hospital in Madang Province of PNG...
June 5, 2017: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/28580577/comparison-of-induction-of-labour-regimes-for-termination-of-pregnancy-with-and-without-mifepristone-from-20-to-41%C3%A2-weeks-gestation
#5
Rina Fyfe, Henry Murray
AIM: To investigate the efficacy of mifepristone for induction of labour in pregnancies at 20-41 weeks' gestation, by comparing the outcomes of length of labour and duration of admission in women with and without mifepristone pretreatment. METHOD: In this retrospective cohort study, all women who underwent a medical termination of a singleton pregnancy between 20 and 41 weeks gestation for either a fetal abnormality or fetal death in utero between 1 January, 2009 and 1 January, 2014 were identified...
June 5, 2017: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/28580578/cervical-cancer-in-women-under-25%C3%A2-years-of-age-in-queensland-australia-to-what-extent-is-the-diagnosis-made-by-screening-cytology
#6
REVIEW
Edwina L Morgan, Karen Sanday, Alison Budd, Ian G Hammond, James Nicklin
INTRODUCTION: The current Australian National Cervical Screening Program (NCSP) involves biennial, cytology-based screening of women from the age of 18 years. From December, 2017 this will change to a five-yearly human papilloma virus-based screening commencing at age 25. There is some concern that the new program may delay the opportunistic detection of cervical cancers in women under 25 years. AIM: (1) To review all cases of invasive cervical cancer in Queensland women under the age of 25 over the last 28 years...
June 4, 2017: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/28567743/the-use-of-selective-progestin-receptor-modulators-sprm-and-more-specifically-ulipristal-acetate-in-the-practice-of-gynaecology
#7
REVIEW
Serge Rozenberg, Julie Praet, Eliza Pazzaglia, Christine Gilles, Yannick Manigart, Jean Vandromme
This review discusses the development of selective progestin receptor modulators (SPRM) for use in women's health and specifically the use of ulipristal acetate (UPA) as emergency contraception (EC) and as a treatment for symptomatic fibroids in women who want to preserve their fertility or avoid a hysterectomy. As an EC, UPA 30 mg should be recommended for women, within 102 h of unprotected intercourse. As a treatment of fibroids, UPA (5 mg daily dose) should be administered for periods of three months as a pre-surgical strategy, reducing bleeding and fibroid size and facilitating surgery...
June 1, 2017: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/28508566/initial-observation-of-cin2-does-not-appear-to-reduce-quality-of-life-in-women-under-25%C3%A2-years-of-age
#8
Katayoun Taghavi, Sára Morell, Jillian Lamb, Helene MacNab, Carrie Innes, Kate Coffey, Jonathan Williman, Bryony Simcock, Peter Sykes
BACKGROUND: Although the patient perspective is implicit in the practice of medicine, research evaluating this remains scarce. In a climate where clinicians and policy-makers constantly strive to achieve more patient-centred models of care, this omission warrants attention. AIM: To assess health-related quality of life (HrQoL) in women under 25 years of age with cervical intra-epithelial neoplasia grade 2 (CIN2) receiving conservative management (colposcopy follow-up, with treatment if necessary) compared with those receiving immediate excisional treatment with large loop excision of the transformation zone (LLETZ)...
May 16, 2017: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/28508414/cervical-cerclage-placed-before-14%C3%A2-weeks-gestation-in-women-with-one-previous-midtrimester-loss-a-population-based-cohort-study
#9
Margaret E Harpham, Charles S Algert, Christine L Roberts, Jane B Ford, Antonia W Shand
BACKGROUND: Cervical cerclage is used in an attempt to reduce recurrence risk of preterm birth, but evidence for use is limited. AIMS: To compare pregnancy outcomes among women with a single previous midtrimester delivery when managed with or without a cervical cerclage. MATERIALS AND METHODS: Population-based cohort study of all women in New South Wales, Australia with a singleton pregnancy ending in birth/miscarriage ≥14 and <28 weeks, between 2003 and 2011...
May 16, 2017: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/28503761/diabetes-among-m%C3%A4-ori-women-with-self-reported-past-gestational-diabetes-mellitus-in-a-new-zealand-m%C3%A4-ori-community
#10
David Simmons, Shejil Kumar, Nic Crook, Elaine Rush
BACKGROUND: Gestational diabetes mellitus (GDM) is a risk factor for subsequent development of type 2 diabetes mellitus (T2DM). We have investigated the extent of this risk among Māori women without known diabetes. MATERIALS AND METHODS: We recruited 2786 Māori women aged 28-86 years between 2004 and 2006, without diagnosed diabetes from the Waikato and Southern Lakes regions, via media, community and general practitioner channels, and invited them for an oral glucose tolerance test (OGTT)...
May 15, 2017: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/28488309/medical-students-experience-of-performing-female-pelvic-examinations-opportunities-and-barriers
#11
Harsh Bhoopatkar, Andy Wearn, Anna Vnuk
BACKGROUND: Teaching and learning female pelvic examination within the undergraduate medical curriculum offers some potential challenges. One such is the extent to which students are provided practice opportunities with patients in the clinical setting. AIMS: To quantify how many pelvic examinations, on real patients, have been performed by medical students at the point of graduation, and to explore opportunities and barriers to performing these examinations. MATERIALS AND METHODS: A retrospective study using a self-completed, anonymous, electronic survey was developed as part of a multi-centre study...
May 10, 2017: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/28421604/comparison-of-adverse-pregnancy-outcomes-based-on-the-new-iadpsg-2010-gestational-diabetes-criteria-and-maternal-body-mass-index
#12
Shan Jiang, David Chipps, Wah N Cheung, Max Mongelli
BACKGROUND: The diagnostic criteria for gestational diabetes (GDM) have been controversial following the International Association for Pregnancy Study Groups (IADPSG) 2010 recommendations to lower the diagnostic fasting blood sugar level threshold. AIM: To assess the pregnancy-related outcomes of women according to the different diagnostic criteria for GDM adjusting for body mass index categories. METHOD: A retrospective observational cohort study was conducted on 4081 pregnant women with positive 50 g glucose challenge test but without pre-gestational diabetes...
April 19, 2017: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/28419409/anti-m%C3%A3-llerian-hormone-exhibits-a-great-variation-in-infertile-women-with-different-ovarian-reserve-patterns
#13
Umit Gorkem, Ferit Kerim Kucukler, Cihan Togrul, Tayfun Gungor
BACKGROUND: Several conflicting studies with results on the biological variability of serum anti-Müllerian hormone (AMH) levels have been reported. Most of the studies have not focused on whether the level of AMH fluctuations shows variability by a baseline ovarian follicular reserve. AIM: To reveal whether intracyclic variation in AMH levels occurs among women with adequate, high and diminished ovarian reserve patterns. STUDY DESIGN: In this prospective cross-sectional study, 171 infertile women between the ages of 18 and 42 years were recruited...
April 17, 2017: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/28397253/are-women-s-needs-being-met-by-specialist-health-services-managing-urinary-incontinence-in-the-remote-top-end-nt
#14
Alexandra Bonner, Jacqueline Boyle
BACKGROUND: Urinary incontinence (UI) is likely to be high in Aboriginal women in rural Australia due to risk factors including high body mass index, parity and diabetes. However, UI appears to be under-reported with limited information on whether women access appropriate care. AIMS: To assess whether women who access specialist gynaecological services in rural and remote Top End Northern Territory (NT) through the specialist outreach program (SONT) are receiving care for UI aligned with best practice...
April 10, 2017: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/28386942/the-effects-of-gestational-use-of-antidepressants-and-antipsychotics-on-neonatal-outcomes-for-women-with-severe-mental-illness
#15
Jacqueline Frayne, Thinh Nguyen, Kellie Bennett, Suzanna Allen, Yvonne Hauck, Helena Liira
BACKGROUND: Psychotropic medication use occurs in 8% of pregnancies, with rates increasing, and often multiple medications prescribed. AIMS: This study aims to determine if the use of psychotropic medication, in a cohort of women with severe mental illness, increases rates of special care nursery admission and reports differences between antidepressant and antipsychotic medication use either alone or in combination. METHODS: A retrospective database analysis from a cohort with severe mental illness in pregnancy identified 268 pregnant women who were grouped according to medication type...
April 7, 2017: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/28386930/post-traumatic-stress-disorder-symptoms-in-pregnant-australian-indigenous-women-residing-in-rural-and-remote-new-south-wales-a-cross-sectional-descriptive-study
#16
Beth Mah, Loretta Weatherall, Julie Burrows, Caroline C Blackwell, Josephine Gwynn, Pathik Wadhwa, Eugenie R Lumbers, Roger Smith, Kym M Rae
BACKGROUND: Pregnancy can be a stressful time for many women. There is ample evidence of numerous physical and mental health inequities for Indigenous Australians. For those Indigenous women who are pregnant, it is established that there is a higher incidence of poor physical perinatal outcomes when compared with non-Indigenous Australians. However, little evidence exists that examines stressful events and post-traumatic stress disorder (PTSD) symptoms in pregnant women who are members of this community...
April 7, 2017: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/28374410/intrapartum-and-neonatal-outcomes-in-singleton-pregnancies-following-conception-by-assisted-reproduction-techniques
#17
Kellie M Rozdarz, Christopher J Flatley, Sailesh Kumar
BACKGROUND: To characterise maternal demographics and ascertain whether clinically important differences exist in the intrapartum and neonatal outcomes associated with assisted reproductive technology (ART). MATERIALS AND METHODS: A retrospective study was undertaken between January 2007 and December 2013 of all singleton pregnancies conceived via ART at a major tertiary unit in Brisbane, Australia. Intrapartum outcomes were mode of delivery and indication for emergency caesarean...
April 3, 2017: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/28369907/who-is-and-isn-t-having-babies-with-down-syndrome-in-western-sydney-a-ten-year-hospital-cohort-study
#18
Rebecca M Moses, James H W Brown, Dale C Wright, Hayley Diplock, Sarah J Melov, Therese Mary McGee
BACKGROUND: Screening for Down syndrome (DS) is a key component of antenatal care, recommended to be universally offered to women irrespective of age or background. Despite this, the diagnosis of DS is often not made until the neonatal period. AIMS: To retrospectively describe and compare the differences in populations with an antenatal diagnosis (AD) and neonatal diagnosis (ND) of DS and to explore why an antenatal diagnosis was not made. MATERIALS AND METHODS: The cohorts were women cared for at Westmead Hospital whose pregnancy received a diagnosis of DS between 2006 and 2015...
March 29, 2017: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/28369759/diagnostic-performance-and-costs-of-contingent-screening-models-for-trisomy-21-incorporating-non-invasive-prenatal-testing
#19
Susannah Maxwell, Peter O'Leary, Jan E Dickinson, Graeme K Suthers
BACKGROUND: Contingent screening for trisomy 21 using non-invasive prenatal testing has the potential to reduce invasive diagnostic testing and increase the detection of trisomy 21. AIM: To describe the diagnostic and economic performance of prenatal screening models for trisomy 21 that use non-invasive prenatal testing as a contingent screen across a range of combined first trimester screening risk cut-offs from a public health system perspective. METHODS: Using a hypothetical cohort of 300 000 pregnancies, we modelled the outcomes of 25 contingent non-invasive prenatal testing screening models and compared these to conventional screening, offering women with a high-risk (1 > 300) combined first trimester screening result an invasive test...
March 29, 2017: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/28369720/the-contribution-of-multiple-pregnancies-from-overseas-fertility-treatment-to-obstetric-services-in-a-western-australian-tertiary-obstetric-hospital
#20
Kylie Anne Waller, Jan E Dickinson, Roger J Hart
BACKGROUND: Increasingly couples are travelling overseas to access assisted reproductive technology, known as cross border reproductive care, although the incidence, pregnancy outcomes and healthcare costs are unknown. AIMS: To determine obstetric and neonatal outcomes for multiple pregnancies conceived through fertility treatment overseas, and estimate cost of these pregnancies to the health system. MATERIALS AND METHODS: Retrospective study of women receiving care for a multiple gestation between July 2013 and June 2015 at Western Australia's sole tertiary obstetric hospital, where conception was by overseas fertility treatment...
March 29, 2017: Australian & New Zealand Journal of Obstetrics & Gynaecology
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