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Australian & New Zealand Journal of Obstetrics & Gynaecology

Alex Mowat, Vivien Wong, Judith Goh, Hannah Krause, Anita Pelecanos, Peta Higgs
BACKGROUND: Sacrospinous colpopexy is an effective vaginal apical support operation. Due to morbidity associated with traditional approaches which require wide dissection, slim-line suture delivery devices have been introduced in the hope of reducing morbidity without compromise to outcomes. AIM: The aim of our series was to report outcomes and complications (particularly buttock pain and blood loss) of the sacrospinous colpopexy using the Capio suturing device and evaluate it against published results using the Miya hook...
September 22, 2017: Australian & New Zealand Journal of Obstetrics & Gynaecology
Alaa Qassim, Ben W Mol, Rosalie M Grivell, Luke E Grzeskowiak
BACKGROUND: Intravenous (IV) iron in pregnancy is useful where oral iron is not tolerated or a rapid replenishment of iron is required. AIMS: To review the literature on the efficacy and safety of different IV iron preparations in the management of antenatal iron-deficiency anaemia (IDA). MATERIALS AND METHODS: We searched MEDLINE, Embase and Scopus from inception to June 2016. Eligible studies were randomised controlled trials (RCTs) and observational studies, involving administration of IV iron (ferric carboxymaltose (FCM), iron polymaltose (IPM) or iron sucrose (IS)), regardless of comparator, to manage antenatal IDA...
September 18, 2017: Australian & New Zealand Journal of Obstetrics & Gynaecology
Subashini Gnanendran, Jemma Porrett, Cindy Woods, Maryke Buttrose, Clare Jukka, Jane Hollins, Stephen Robson, Caroline de Costa
In 2013-2014 we undertook a randomised controlled trial (RCT) to determine whether the daily ingestion of dark chocolate during pregnancy could reduce the incidence of pre-eclampsia in primigravidae. However, after two years we had not succeeded in recruiting more than 3.5% of the number of participants required to answer the research question, and the trial was halted. We also reviewed the literature on this topic and found it to be limited. We report here our findings and discuss the difficulties facing researchers in this area...
September 15, 2017: Australian & New Zealand Journal of Obstetrics & Gynaecology
Carol Cornsweet Barber, Jessica Steadman
This study examined self-rated symptoms of distress (Depression Anxiety and Stress Scale-DASS-21 and Perceived Stress Scale-PSS-4) among 93 pregnant women and a comparison group of 93 non-pregnant women matched on age and educational attainment. There were no significant differences between the groups, either on mean levels of distress or on proportions above a clinical cut-off point. Overall, 22%, 31% and 16% of pregnant women reported experiencing at least moderate levels of depression, anxiety and stress, respectively...
September 14, 2017: Australian & New Zealand Journal of Obstetrics & Gynaecology
Chloe Higgins, Martin Healey, Sameer Jatkar, Beverley Vollenhoven
BACKGROUND: There is currently limited evidence available regarding ideal timing for frozen embryo transfer (FET). Demonstrating that delaying FETs has few clinical benefits would allow patients to proceed with FET at their earliest convenience. AIMS: To examine whether the time interval between stimulation cycle and subsequent FET affects pregnancy and live birth rates. MATERIALS AND METHODS: This retrospective cohort study, based in a multi-site private in vitro fertilisation (IVF) clinic categorised women into two groups: those having FET cycles administered within 25-35 days or 50-70 days of IVF stimulation cycle and embryo freeze...
September 14, 2017: Australian & New Zealand Journal of Obstetrics & Gynaecology
Flurina Michelotti, Christopher Flatley, Sailesh Kumar
BACKGROUND: Shoulder dystocia is an uncommon and unpredictable obstetric emergency. It is associated with significant neonatal, maternal and medico-legal consequences. AIM: To ascertain the impact shoulder dystocia has on severe neonatal and maternal outcomes specific to the type of manoeuvre. MATERIALS AND METHODS: This was a retrospective study of 48 021 term singleton vaginal deliveries the Mater Mothers' Hospital in Brisbane between 2007 and 2015...
September 14, 2017: Australian & New Zealand Journal of Obstetrics & Gynaecology
Katherine Collins, Raoul Oehmen, Shailender Mehta
BACKGROUND: Rates of pre-gestational obesity and gestational diabetes mellitus (GDM) are increasing in Australia. While both are established risk factors for neonatal hypoglycaemia, the additive effect of both risks on neonatal hypoglycaemia is not well understood. AIMS: To determine the influence of obesity on neonatal hypoglycaemia among infants born to GDM mothers. The authors hypothesise the presence of a greater frequency and severity of neonatal hypoglycaemia in infants born to obese GDM women...
September 13, 2017: Australian & New Zealand Journal of Obstetrics & Gynaecology
Stephen J Robson, Robert J Norman
No abstract text is available yet for this article.
September 5, 2017: Australian & New Zealand Journal of Obstetrics & Gynaecology
James Nicklin
There has been a significant increase in minimally invasive surgery in gynaecology over the last 15 years, with approximately only one-third of hysterectomies for benign disease now performed via laparotomy. While robotic surgery offers considerable technical advantages over conventional laparoscopy and is associated with only a modest learning curve, the improvement in clinical outcomes is marginal and there are several disadvantages. There are increased set-up and operating times, the need to accommodate and maintain large sophisticated equipment, and the requirement for additional training...
August 31, 2017: Australian & New Zealand Journal of Obstetrics & Gynaecology
Margaret Flood, Wendy Pollock, Susan J McDonald, Mary-Ann Davey
BACKGROUND: The postpartum haemorrhage (PPH) rate in Victoria in 2009 for women having their first birth, based on information reported to the Victorian Perinatal Data Collection (VPDC), was 23.6% (primiparas). Prior to 2009 PPH was collected via a tick box item on the perinatal form. Estimated blood loss (EBL) volume is now collected and it is from this item the PPH rate is calculated. Periodic assessment of data accuracy is essential to inform clinicians and others who rely on these data of their quality and limitations...
August 31, 2017: Australian & New Zealand Journal of Obstetrics & Gynaecology
Rosemarie Anne Boland, Peter Graham Davis, Jennifer Anne Dawson, Michael J Stewart, Jacqui Smith, Lex William Doyle
BACKGROUND: Our aim was to report perinatal characteristics of very preterm births before arrival (BBAs) at a hospital, and perinatal and infant mortality rates up to one year, comparing BBAs with births in a hospital. MATERIALS AND METHODS: A population-based cohort study of 22-31 weeks' gestation births in the state of Victoria, Australia from 1990-2009. BBAs were defined as unintentional births at home or on route to hospital. Perinatal data were obtained from the Department of Health and Human Services, Victoria...
August 30, 2017: Australian & New Zealand Journal of Obstetrics & Gynaecology
Sumathi Rajendran, Ritu Mogra, Ying Li, Bradley de Vries, Jon Hyett
BACKGROUND: In the investigation of abnormal uterine bleeding, hysteroscopy with endometrial biopsy is considered the gold standard. Fly Thru™ imaging is a new application used to generate virtual hysteroscopy clips. AIMS: We aimed to investigate the feasibility and diagnostic accuracy of sonohysterogram with virtual hysteroscopy as an alternative to outpatient diagnostic hysteroscopy. MATERIALS AND METHODS: Two separate cohorts of women were recruited...
August 30, 2017: Australian & New Zealand Journal of Obstetrics & Gynaecology
Leonoor van Eerden, Christianne J M de Groot, Gerda G Zeeman, Godelieve C M Page-Christiaens, Eva Pajkrt, Johannes J Duvekot, Frank P Vandenbussche, Swan G Oei, Hubertina C J Scheepers, Jim van Eyck, Johanna M Middeldorp, Antoinette C Bolte
BACKGROUND: In this study we determined the outcome of subsequent pregnancies after termination of pregnancy for preeclampsia, with the purpose of presenting data useful for counselling these women on future pregnancies. STUDY DESIGN: The cohort consisted of 131 women with a history of termination of pregnancy for preeclampsia. RESULTS: Data of 79 pregnancies were available for analysis, including 13 women with chronic hypertension and 16 women with thrombophilia...
August 29, 2017: Australian & New Zealand Journal of Obstetrics & Gynaecology
Ahmed Al-Amin, Daniel Lorber Rolnik, Carin Black, Adrienne White, Caroline Stolarek, Shaun Brennecke, Fabricio da Silva Costa
AIM: To compare the performance of three different screening methods (National Institute for Health and Clinical Excellence (NICE) guidelines, American College of Obstetricians and Gynecologists (ACOG) recommendations and Fetal Medicine Foundation (FMF) algorithm) for second trimester prediction of preeclampsia. METHODS: This was a prospective non-intervention study in singleton pregnancies, including women attending for second trimester morphologic ultrasound at 19-22 weeks...
August 29, 2017: Australian & New Zealand Journal of Obstetrics & Gynaecology
Sally B Rose, Susan M Garrett, James Stanley, Susan R H Pullon
BACKGROUND: Long-acting reversible contraception (LARC) effectively protects against pregnancy but provides no protection against sexually transmitted infections (STIs). AIM: To compare rates of chlamydia testing and diagnosis for women initiating long-acting versus oral contraception. MATERIALS AND METHODS: Retrospective cohort study involving data collection for 6160 women initiating post-abortion contraception at a large New Zealand regional public hospital abortion clinic (2009-2012), with chlamydia testing data obtained from the local laboratory during two-year follow up...
August 22, 2017: Australian & New Zealand Journal of Obstetrics & Gynaecology
Claire Whitelaw, Katrina Calvert, Mathias Epee
BACKGROUND: Obstetric emergency simulation training is an evidence-based intervention for the reduction of perinatal and maternal morbidity. In Western Australia, obstetric emergency training has been run using the In Time course since 2006. AIMS: The study aimed to determine if the provision of In Time train the trainer courses to outer metro, rural and remote units in Western Australia had led to sustained ongoing training in those units. Ten years following the introduction of the course, we performed a survey to examine which units are continuing to run In Time, what are the perceived benefits in units still utilising In Time, and what were the barriers to training in units that had discontinued...
August 14, 2017: Australian & New Zealand Journal of Obstetrics & Gynaecology
Frances Hills, Mandy Way, Renuka Sekar
BACKGROUND: Preterm breech delivery is associated with a higher perinatal mortality rate compared with preterm vertex delivery, and some studies suggest caesarean section leads to lower mortality rates. Few studies include infants delivered less than 26 weeks gestation, and where included, results are often not stratified by gestational age. There is also a lack of consistent reporting on neonatal and maternal morbidity outcome measures. AIMS: To determine if mode of delivery for singleton extreme preterm breech fetuses is associated with a difference in perinatal mortality, neonatal and maternal morbidity...
August 11, 2017: Australian & New Zealand Journal of Obstetrics & Gynaecology
James Brown, Supuni Kapurubandara, Emma Gibbs, Jennifer King
BACKGROUND: Obstetric anal sphincter injuries (OASIS) can complicate up to 6% of births and are a major contributor to preventable maternal morbidity. Asian women have a risk of third and fourth degree perineal tears up to four times greater than women of other ethnicities in the same community, but the lack of differentiation of Asian women into regional groups has limited insight into the reasons behind their increased risk. AIMS: To investigate risk of OASIS associated with country of birth...
August 4, 2017: Australian & New Zealand Journal of Obstetrics & Gynaecology
Jonathan M Morris, James Totterdell, Yu Sun Bin, Jane B Ford, Christine L Roberts
BACKGROUND: As age is not modifiable, pregnancy risk information based on age alone is unhelpful for older women. AIM: To determine severe morbidity/mortality rates for women aged ≥35 years according to maternal profile based on parity, pre-existing medical conditions and prior pregnancy complications, and to assess the independent contribution of age. MATERIALS AND METHODS: Population-based record-linkage study using NSW hospitalisation and birth records 2006-2012...
August 4, 2017: Australian & New Zealand Journal of Obstetrics & Gynaecology
Benjamin Stephens, Farah Sethna, Philip Crispin
BACKGROUND: Traditional management of anaemia due to postpartum haemorrhage (PPH) has relied upon salvage therapy with red cell transfusion. Recently published guidance recommends a change in approach toward holistic patient blood management. AIMS: To determine whether postpartum red cell transfusion practices are consistent with best practice and to identify opportunities for improvement. MATERIALS AND METHODS: A retrospective audit of postpartum red cell transfusions was conducted at a tertiary level obstetrics unit...
August 4, 2017: Australian & New Zealand Journal of Obstetrics & Gynaecology
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