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Australian & New Zealand Journal of Obstetrics & Gynaecology

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https://www.readbyqxmd.com/read/29344938/a-clinical-audit-on-the-efficacy-and-safety-of-uterine-artery-embolisation-for-symptomatic-adenomyosis-results-in-117-women
#1
Eisen Liang, Bevan Brown, Maxim Rachinsky
BACKGROUND: Uterine artery embolisation (UAE) is a possible uterine-sparing treatment option for women with unsuccessful conservative management for adenomyosis-related heavy menstrual bleeding (HMB) and dysmenorrhoea. AIM: To conduct a clinical audit on the efficacy and safety of UAE for symptomatic adenomyosis. MATERIALS AND METHODS: Retrospective review of 309 women who underwent UAE identified 117 women with magnetic resonance imaging features of adenomyosis (junctional zone thickness ≥ 12 mm)...
January 18, 2018: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/29344940/obstetric-and-neonatal-outcomes-for-women-intending-to-use-immersion-in-water-for-labour-and-birth-in-western-australia-2015-2016-a-retrospective-audit-of-clinical-outcomes
#2
Lucy Lewis, Yvonne L Hauck, Janice Butt, Janet Hornbuckle
BACKGROUND: Research supports water immersion for labour if women are healthy, with no obstetric or medical risk factors. AIMS: To evaluate the obstetric and neonatal outcomes of women intending to use immersion in water for labour or birth. METHODS: Retrospective audit of clinical outcomes for women intending to labour or birth in water conducted between July 2015 and June 2016, at a tertiary maternity hospital in Western Australia. Obstetric and neonatal data were collected from medical records...
January 17, 2018: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/29336014/response-to-yazdani-a-surgery-or-in-vitro-fertilisation-the-simplicity-of-this-question-belies-its-complexity-when-all-you-have-is-a-hammer-everything-looks-like-a-nail
#3
Jason Abbott
This is perhaps the most apt mantra of IVF (in vitro fertilisation) as a treatment in Australasia in this day and age. It is also important to note the truth in the identification of IVF being low skill-based, largely independent of the practitioner, but more importantly costly, and with few exceptions, only available in the private sector. Such revelations really require a rethink of the entire reproductive endocrinology and infertility (CREI) subspecialty. In fact, if there is only one solution to all fertility problems - that of the 'effective IVF procedure' - why not do away completely with the clinician and simply have nurse practitioners who oversee the identified issue of an individual or couple wanting a pregnancy? This in conjunction with the outstanding scientific advances that led to the initiation and promulgation of IVF really would reduce costs by cutting out the unnecessary clinician middle-person who is unimportant in the equation...
January 16, 2018: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/29327350/adopting-innovation-in-gynaecology-the-introduction-of-e-consult
#4
Rebecca Mann, Peter H M van de Weijer
OBJECTIVE: To describe the development of an e-consultation service as part of the triaging and grading process of referrals and to report on the efficacy and safety of such a service. METHODS: All gynaecology e-consults in the study period June 2015 to March 2016 were retrospectively reviewed. The outcomes of interest were the initial reduction in first face-to-face hospital visits, and the rate of re-referrals. Acute admission for the same reason, a subsequent diagnosis of underlying (pre)-malignancy, or patient death from the condition related to the index referral were selected as measures for patient safety...
January 12, 2018: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/29327343/changes-in-out-of-pocket-charges-associated-with-obstetric-care-provided-under-medicare-in-australia
#5
Emily Callander, Haylee Fox
Recent health reforms alongside unregulated provider fees have led to increased attention being given to out-of-pocket healthcare costs. This study utilised annual statistics published by the Department of Health for services provided under the Medicare Benefits Schedule (MBS) from 1992/3 to 2016/17 to identify changes in out-of-pocket charges for obstetric items over time, and estimate the change in demand for obstetric items in response to price increases. Since 1992/3 out-of-pocket charges increased by 1035% for out-of-hospital items and 77% for in-hospital items...
January 12, 2018: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/29280479/assisted-reproductive-technology-art-cumulative-live-birth-rates-following-preimplantation-genetic-diagnosis-for-aneuploidy-pgd-a-or-morphological-assessment-of-embryos-a-cohort-analysis
#6
Evelyn Lee, Georgina Mary Chambers, Lyndon Hale, Peter Illingworth, Leeanda Wilton
BACKGROUND: Preimplantation genetic diagnosis for aneuploidy (PGD-A) for all 24 chromosomes improves implantation and clinical pregnancy rates per single assisted reproductive technology (ART) cycle. However, there is limited data on the live-birth rate of PGD-A over repeated cycles. AIM: To assess the cumulative live-birth rates (CLBR) of PGD-A compared with morphological assessment of embryos of up to three 'complete ART cycles' (fresh plus frozen/thaw cycles) in women aged 37 years or older...
December 27, 2017: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/29280134/a-retrospective-pilot-study-to-determine-whether-the-reproductive-tract-microbiota-differs-between-women-with-a-history-of-infertility-and-fertile-women
#7
Bryan A Wee, Mark Thomas, Emma Louise Sweeney, Francesca D Frentiu, Melanie Samios, Jacques Ravel, Pawel Gajer, Garry Myers, Peter Timms, John A Allan, Wilhelmina M Huston
BACKGROUND: We know very little about the microbiota inhabiting the upper female reproductive tract and how it impacts on fertility. AIMS: This pilot study aimed to examine the vaginal, cervical and endometrial microbiota for women with a history of infertility compared to women with a history of fertility. MATERIALS AND METHODS: Using a retrospective case-control study design, women were recruited for collection of vaginal, cervical and endometrial samples...
December 26, 2017: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/29271485/prophylactic-insertion-of-large-bore-peripheral-intravenous-catheters-in-maternity-patients-for-postpartum-haemorrhage-a-cohort-study
#8
Joan Webster, Emily Larsen, Catriona Booker, Janelle Laws, Nicole Marsh
BACKGROUND: Insertion of a 16 or 18 gauge peripheral intravenous catheter is a potentially painful intervention but one frequently experienced by pregnant women when admitted to hospital. Although the rationale for this practice is 'in case of an emergency bleed', evidence for using large-bore catheters in this population is absent. AIMS: (i) To identify the proportion of 18 gauge or larger peripheral catheters inserted into maternity patients; and (ii) to investigate the proportion of women who require blood products during their perinatal period...
December 22, 2017: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/29271471/progesterone-concentrations-and-dosage-with-frozen-embryo-transfers-what-s-best
#9
Surabhi Kumble Basnayake, Michelle Volovsky, Luk Rombauts, Tiki Osianlis, Beverley Vollenhoven, Martin Healey
BACKGROUND: There is a lack of consensus on the optimal dose and form of progesterone supplementation during frozen-thawed embryo transfer with hormone replacement therapy. AIMS: We aim to identify the serum progesterone concentration on day 16 most likely to result in positive pregnancy outcomes. MATERIALS AND METHODS: We undertook a retrospective study of 4582 women who underwent frozen embryo transfer with hormone replacement therapy, or natural frozen embryo transfer, over 14 years at a multi-site private in vitro fertilisation clinic...
December 22, 2017: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/29271100/managing-opioid-overdose-in-pregnancy-with-take-home-naloxone
#10
Julie Blandthorn, Ellen Bowman, Laura Leung, Yvonne Bonomo, Paul Dietze
Programs have recently been established in Australia and internationally to allow wider access to naloxone to people at risk of opioid overdose yet there are no guidelines relating to the administration of naloxone to pregnant women, particularly regarding dose requirements and resuscitative measures peculiar to pregnancy. This paper provides practical guidelines to health workers in relation to any complications that may arise during opioid overdose response (including the administration of naloxone) for pregnant women and the follow up required ensuring best possible outcomes for mother and baby...
December 22, 2017: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/29266192/caesarean-section-wound-infection-surveillance-information-for-action
#11
Simon M Scheck, Timothy Blackmore, Dushyant Maharaj, Fali Langdana, Rosalie E Elder
Surgical site infection (SSI) following caesarean section is common, resulting in significant morbidity. Several factors are known to contribute to wound infection, including maternal, procedural and antibiotic factors. We sought to clarify these issues and sought opportunities to make improvements. A retrospective cohort study was performed assessing all women who underwent caesarean section in 2014 and 2015 at Wellington Hospital. Any women with culture-positive wound samples within 30 days of surgery were identified, and clinical notes reviewed...
December 21, 2017: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/29218704/sacral-neuromodulation-for-pelvic-pain-and-pelvic-organ-dysfunction-a-case-series
#12
Thierry Vancaillie, Lauren Kite, Elizabeth Howard, Jason Chow
BACKGROUND: The use of neuromodulation is growing and it is an established therapy for conditions such as bladder dysfunction. It is an increasingly used therapy for the management of chronic perineal pain but little research is currently available looking at its efficacy. AIM: We present a series of 52 patients who underwent placement of a neuromodulator, the majority of whom suffered from perineal pain, with most placements via the sacral hiatus. METHOD: Patients were asked to complete a survey recalling their symptoms prior to implantation and describing their symptoms and experience after...
December 8, 2017: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/29218703/epidemic-of-large-babies-highlighted-by-use-of-intergrowth21st-international-standard
#13
Felicity J Park, Brad de Vries, Jon A Hyett, Adrienne Gordon
OBJECTIVE: To compare birth weights in central Sydney to the INTERGROWTH21st international standard to describe current trends in relation to optimal growth and to define areas that may benefit from improved obstetric surveillance and intervention. METHODS: Retrospective analysis of prospectively collected cohort. DESIGN: hospital-based cohort study. SETTING: Sydney Local Health District, Australia. POPULATION OR SAMPLE: women with singleton pregnancies who had first trimester screening for aneuploidy between 16 April, 2010 and 9 March, 2012...
December 8, 2017: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/29205283/clinician-factors-associated-with-prescribing-nicotine-replacement-therapy-in-pregnancy-a-cross-sectional-survey-of-australian-obstetricians-and-general-practitioners
#14
Yael Bar-Zeev, Billie Bonevski, Maree Gruppetta, Laura Twyman, Lou Atkins, Kerrin Palazzi, Christopher Oldmeadow, Gillian S Gould
The use of nicotine replacement therapy in pregnancy has been debated but evidence suggests that it is safer than smoking. A cross-sectional survey was conducted with: (i) general practitioners and obstetricians from a college database; and (ii) general practitioners with a special interest in Indigenous health. General practitioners had higher odds of prescribing compared to obstetricians. Reading guidelines, confidence, viewing nicotine replacement therapy as safe, effective and with good adherence, also significantly increased the odds of prescription...
December 4, 2017: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/29192961/the-incidence-and-outcome-of-clinically-significant-antibodies-detected-in-rhesus-d-positive-pregnant-women-of-the-northern-territory
#15
Lauren Andersson, Ferenc Szabo
BACKGROUND: Haemolytic disease of the fetus/newborn secondary to clinically significant non-Rhesus-D antibodies has risen in importance since the advent of immunoprophylactic anti-D administration to Rhesus-D negative women. Of interest is the incidence of these antibodies in Rhesus-D positive women, who receive less frequent antenatal alloantibody screening. This is of particular concern if the antibodies arise late in pregnancy and may go undetected. AIMS: To assess the proportion of Rhesus-D positive pregnant women with late developing clinically significant antibodies for haemolytic disease of the fetus/newborn, and whether these resulted in adverse fetal outcomes...
November 28, 2017: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/29168563/pelvic-examination-may-be-meaningfully-taught-to-novices-and-be-used-to-predict-operating-times-for-laparoscopic-excision-of-endometriosis-in-one-surgical-procedure
#16
Mominah Bhatti, Ashradha Ketheeswaran, Amy Arnold, Erin Nesbitt-Hawes, Rebecca Deans, HaRyun Won, Jason Abbott
OBJECTIVE: To investigate whether pelvic examination may be meaningfully taught to novice medical students and its accuracy in predicting operating times for laparoscopic excision of endometriosis at a single surgical procedure. METHODS: Women with suspected endometriosis scheduled for laparoscopy underwent pelvic examination to estimate operative time by medical students (novices), trainees, senior clinicians with <10 years surgical experience (experts) and ≥10 years (masters)...
November 23, 2017: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/29168561/combination-therapy-with-mifepristone-and-misoprostol-for-the-management-of-first-trimester-miscarriage-improved-success
#17
Angela Dunford, Rina Fyfe
BACKGROUND: First trimester miscarriage affects 20% of pregnancies. Medical management has a high degree of patient acceptance and does not increase the risk of infection. Mifepristone is an anti-progesterone shown to improve outcomes when used in conjunction with misoprostol for first trimester abortion. However, there have been conflicting results when it has been added to treatment regimens for miscarriage. METHODS: We performed a retrospective cohort analysis of women presenting to the Acute Gynaecology Service of our tertiary referral centre for miscarriage management from December 2010 until December 2013...
November 23, 2017: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/29168558/outcomes-in-women-undergoing-robotic-assisted-laparoscopic-hysterectomy-compared-to-conventional-laparoscopic-hysterectomy-at-a-tertiary-hospital-in-western-australia
#18
Vinita A Rajadurai, Jason Tan, Stuart G Salfinger, Paul A Cohen
BACKGROUND: Robotic-assisted laparoscopic hysterectomy (RALH) is associated with improved outcomes compared to open surgery in patients with endometrial cancer but data are conflicting when comparing RALH to conventional total laparoscopic hysterectomy (TLH). In October 2014, a RALH program was established in Perth, Western Australia. AIM: To compare outcomes in patients undergoing RALH with a matched cohort undergoing TLH. MATERIALS AND METHODS: A retrospective matched cohort study compared outcomes in 45 patients who underwent RALH with 45 controls who were patients treated with TLH...
November 23, 2017: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/29148563/evaluation-of-the-nz-guidelines-for-screening-for-persistent-postpartum-hyperglycaemia-following-gestational-diabetes
#19
Ruth C E Hughes, Chris Florkowski, Joanna E Gullam
BACKGROUND: Recent New Zealand guidelines recommend annual glycated haemoglobin (HbA1c) measurements from three months postpartum, replacing the glucose tolerance test (GTT) at six weeks, to screen for persistent hyperglycaemia following gestational diabetes. Data suggest that this screening approach may miss cases of type 2 diabetes, but are they detected at subsequent screening and will screening rates improve? AIMS: Our aim was to evaluate the effectiveness of HbA1c monitoring in improving screening rates following gestational diabetes and in detecting postpartum hyperglycaemia...
November 17, 2017: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/29139107/antenatal-influenza-and-pertussis-vaccine-uptake-among-aboriginal-mothers-in-western-australia
#20
Kennia Lotter, Annette K Regan, Tyra Thomas, Paul V Effler, Donna B Mak
BACKGROUND: Antenatal influenza and pertussis vaccination prevent serious disease in mothers and infants. Aboriginal individuals are at increased risk of infection yet little is known about vaccine coverage among Aboriginal mothers. AIMS: To estimate the uptake of influenza and pertussis vaccination among pregnant Aboriginal women in Western Australia and identify barriers and enablers to vaccination. MATERIALS AND METHODS: Four hundred Aboriginal women, aged ≥18 years, who gave birth to a live infant between April and October 2015, were randomly selected and invited to participate in telephone interviews...
November 14, 2017: Australian & New Zealand Journal of Obstetrics & Gynaecology
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