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Australian & New Zealand Journal of Obstetrics & Gynaecology

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https://www.readbyqxmd.com/read/28345753/outcomes-of-women-diagnosed-and-treated-for-low-risk-gestational-trophoblastic-neoplasia-at-the-queensland-trophoblast-centre-qtc
#1
Lisanne Verhoef, David Baartz, Shona Morrison, Karen Sanday, Andrea Janet Garrett
BACKGROUND: Gestational trophoblastic neoplasia (GTN) is classified as a highly curable group of pregnancy-related malignancies; however, approximately 15% will be persistent and require chemotherapy. Up to 25% of these women will develop resistance and 2% will develop disease relapse after initial chemotherapy. Despite the need for further chemotherapy in these women, cure rates are high. OBJECTIVE: To evaluate the outcomes of women diagnosed with low-risk GTN, assessing the type of treatment, the number of chemotherapy cycles received, development of resistance or disease relapse, survival, and to assess the feasibility of changing to a new drug regimen...
March 27, 2017: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/28345139/utility-of-%C3%AE-hcg-monitoring-in-the-follow-up-of-medical-management-of-miscarriage
#2
Scott G Petersen, Anneliese R Perkins, Kristen S Gibbons, Julia I Bertolone, Kassam Mahomed
OBJECTIVE: To evaluate the percentage change in total βeta-unit human chorionic gonadotropin (βhCG) levels (%ΔβhCG) in the prediction of treatment outcomes following intravaginal misoprostol for missed miscarriage before 13 weeks. METHODS: A secondary analysis of a randomised controlled study of medical management of miscarriage was performed. Total βhCG levels were collected before misoprostol (baseline) and after a planned seven day interval (follow-up), when a transvaginal ultrasound (TVUS) reported a gestational sac as present or not...
March 27, 2017: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/28345217/fatigue-and-training-of-obstetrics-and-gynaecology-trainees-in-australia-and-new-zealand
#3
Paige E Tucker, Paul A Cohen, Max K Bulsara, Jade Acton
BACKGROUND: Several studies have linked doctor fatigue with adverse patient events and an increase in risk to doctors' personal safety and wellbeing. The present study assesses the rostering structure of Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) trainees and its association with trainees' reported fatigue levels, training opportunities and wellbeing, which were secondary outcomes of a larger study of trainee working hours which has been separately reported...
March 26, 2017: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/28338231/caesarean-risk-in-obese-women-at-term-a%C3%A2-retrospective-cohort-analysis
#4
Rachael Nugent, Caroline de Costa, Venkat Vangaveti
BACKGROUND: Obesity in pregnancy is a growing health problem conferring higher risk to both the woman and her infant. Internationally, peak bodies offer little guidance regarding the method and timing of delivery in these patients. Our hypothesis is that induction of labour (IOL) at term will not increase the caesarean section (CS) rate when compared to expectant management. AIMS: To compare perinatal outcomes between IOL and expectant management in obese women at term...
March 24, 2017: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/28326546/public-private-differences-in-short-term-neonatal-outcomes-following-birth-by-prelabour-caesarean-section-at-early-and-full-term
#5
Nicole Adams, Kristen S Gibbons, David Tudehope
BACKGROUND: Prelabour caesarean section (CS) at early term (37(0) -38(6)  weeks) is associated with higher rates of adverse short-term neonatal outcomes and higher costs than those performed at full term (39(0) -40(6)  weeks). Prelabour CS is more common in private than in public hospitals in Australia, particularly at early term. AIMS: To evaluate the impact of hospital sector (public or private) and timing of delivery on short-term neonatal outcomes following prelabour CS at term...
March 22, 2017: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/28326545/ovulation-monitoring-and-fertility-knowledge-their-relationship-to-fertility-experience-in-a-cross-sectional-study
#6
Antoinette Righarts, Nigel P Dickson, Lianne Parkin, Wayne R Gillett
BACKGROUND: Various aspects of fertility knowledge, including the timing of the fertile window, have consistently been found to be poor. Limited evidence also suggests ovulation monitoring to time intercourse could be common. However, there have been no studies that compare these two aspects of fertility and women's fertility/infertility experiences. AIM: To examine the frequency of ovulation monitoring and its relationship with fertility knowledge and experience...
March 22, 2017: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/28326541/manipulating-the-baby-biome-what-are-the-issues
#7
Lai-Yang Lee, Suzanne M Garland, Michelle L Giles, Andrew J Daley
Establishing a baby biome through the controversial practice of 'vaginal seeding' has generated interest among the general public and healthcare providers alike. We discuss the potential risks of this practice and offer a harm minimisation approach to managing women requesting vaginal microbiome transfer after delivery by caesarean section.
March 22, 2017: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/28304080/maternal-age-is-a-risk-factor-for-caesarean-section-following-induction-of-labour
#8
Liam Dunn, Sailesh Kumar, Michael Beckmann
BACKGROUND: In Australia, more than 20% of women giving birth are 35 years or older. Advanced maternal age (AMA) is a risk factor for stillbirth, and many clinicians now recommend induction of labour (IOL) at around term gestation. The aim of this study is to determine if AMA is associated with emergency caesarean section (CS) following IOL. METHODS: A retrospective cohort study was undertaken using routinely collected de-identified data. Live-born, singleton, cephalic, non-anomalous pregnancies undergoing IOL between 37 + 0 and 42 + 0 weeks were included...
March 17, 2017: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/28303579/endometriosis-in-patients-with-irritable-bowel-syndrome-specific-symptomatic-and-demographic-profile-and-response-to-the-low-fodmap-diet
#9
Judith S Moore, Peter R Gibson, Richard E Perry, Rebecca E Burgell
BACKGROUND: Women with endometriosis are frequently misdiagnosed with irritable bowel syndrome (IBS) for some time before a correct diagnosis is made. Visceral hypersensitivity is a key feature in both conditions. AIMS: To determine if there are distinct symptom patterns in women with IBS and endometriosis, and to determine the response of these women to a low FODMAP diet in comparison to those with IBS alone. MATERIALS AND METHODS: A retrospective analysis of prospectively collected data from women attending a specialist IBS service in Christchurch New Zealand...
March 17, 2017: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/28303569/efficacy-and-safety-of-mifepristone-buccal-misoprostol-for-early-medical-abortion-in-an-australian-clinical-setting
#10
Philip Goldstone, Clara Walker, Katherine Hawtin
BACKGROUND: In 2014, a composite pack containing mifepristone-buccal misoprostol, indicated for use to 63 days gestation replaced the existing regimen for early medical abortion (EMA) in Australia. AIMS: To provide updated efficacy and safety information for the use of mifepristone-buccal misoprostol for EMA in Australia, and assess the effect of patient age and gestational age on efficacy. MATERIALS AND METHODS: Observational cohort study of 15 008 women attending one of 16 Marie Stopes International clinics in Australia for an EMA (gestational age ≤ 63 days) between 1 March 2013 and 30 September 2015...
March 17, 2017: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/28303563/general-practitioners-and-preconception-weight-management-in-new-zealand
#11
Diana Fieldwick, Alesha Smith, Helen Paterson
BACKGROUND: Childhood obesity is a growing concern internationally and a top priority for the World Health Organization. Preconception overweight, obesity and excess gestational weight gain significantly increase childhood obesity risk. Optimising preconception weight is a key preventative measure toward reducing childhood obesity. In 2014, the New Zealand (NZ) Ministry of Health released guidance for health practitioners on healthy weight gain in pregnancy in an effort to reduce the burden of childhood obesity...
March 17, 2017: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/28299785/should-obese-women-s-access-to-assisted-fertility-treatment-be-limited-a-scientific-and-ethical-analysis
#12
Kelton Tremellen, Dominic Wilkinson, Julian Savulescu
Obesity is associated with a reduction in fertility treatment success and increased risks to mother and child. Therefore guidelines of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) suggest that a body mass index exceeding 35 kg/m(2) should be an absolute contraindication to assisted fertility treatment such as in vitro fertilisation IVF. In this paper we challenge the ethical and scientific basis for such a ban. Livebirth rates for severely obese women are reduced by up to 30%, but this result is still far better than that observed for many older women who are allowed access to IVF...
March 16, 2017: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/28299789/menstrual-management-in-developmentally-delayed-adolescent-females
#13
Irene Chuah, Alexandra McRae, Kim Matthews, Ann M Maguire, Katharine Steinbeck
BACKGROUND: Requests for assistance in menstrual management and menstrual suppression are a common, emotive and sometimes controversial aspect of adolescent disability care. AIMS: To review the uptake and outcomes of menstrual suppression among adolescent patients with developmental delay. METHODS: A retrospective review of the medical records of adolescent females with intellectual disability referred for menstrual management to the Paediatric and Adolescent Gynaecology Clinic, Children's Hospital at Westmead, Sydney, for the three-year period between January 1, 2010 and January 1, 2013...
March 15, 2017: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/28299777/recurrent-vulvovaginal-candidiasis-a-review-of-guideline-recommendations
#14
REVIEW
Alexia Matheson, Danielle Mazza
BACKGROUND: Recurrent vulvovaginal candidiasis (VVC) is a difficult-to-manage condition that affects 5-8% of women of reproductive age. Current treatment regimes have high relapse rates, resulting in poor quality of life for the women affected. AIM: To compare the quality and content of current guidelines concerned with recurrent VVC and to develop a summary of recommendations to assist in the management of women with this condition. METHODS: Relevant clinical guidelines were identified through a search of several databases (MEDLINE, SCOPUS and The Cochrane Library) and relevant websites...
March 15, 2017: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/28299774/working-hours-of-obstetrics-and-gynaecology-trainees-in-australia-and-new-zealand
#15
Jade Acton, Paige E Tucker, Max K Bulsara, Paul A Cohen
BACKGROUND: The importance of doctors' working hours has gained significant attention with evidence suggesting long hours and fatigue may compromise the safety and wellbeing of both patients and doctors. This study aims to quantify the working hours of The Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) specialist trainees in order to better inform discussions of working hours and safety within our region. METHODS: An anonymous, online survey of RANZCOG trainees was conducted...
March 15, 2017: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/28295174/predictors-of-mode-of-birth-and-duration-of-labour-following-induction-using-prostaglandin-vaginal-gel
#16
Michael Beckmann, Kristen Gibbons, Vicki Flenady, Sailesh Kumar
BACKGROUND AND AIMS: Using data from a randomised controlled trial (RCT) comparing two policies of prostaglandin (PGE2) vaginal gel induction of labour (IOL) at term, this study aimed to determine: (i) demographic/clinical factors that predict IOL outcomes; and (ii) clinical characteristic(s) of women who would benefit from a policy of amniotomy once technically possible as opposed to giving more PGE2. MATERIAL AND METHODS: Following an initial PGE2 dose, women were randomised to amniotomy or repeat-PGE2...
March 13, 2017: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/28295168/using-the-nippita-classification-system-for-women-undergoing-induction-of-labour-in-a-large-metropolitan-maternity-service-bringing-simplicity-and-certainty-to-an-important-quality-improvement-process
#17
Mary A Biro, Christine E East
In 2015 Nippita and colleagues developed a novel system to classify women undergoing induction of labour (IOL), which sought to overcome the problems of indication-based classification. We explored the utility and feasibility of this new system at Monash Health in Melbourne. We found overall induction rates of 24.7% compared with the New South Wales rates of 25.4% reported by Nippita et al. The classification system was easy to apply because it uses routinely and accurately collected data. There was no misinterpretation of the classification groups...
March 13, 2017: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/28295167/poorer-detection-rates-of-severe-fetal-growth-restriction-in-women-of-likely-refugee-background-a%C3%A2-case-for-re-focusing-pregnancy-care
#18
Mary Anne Biro, Christine East
BACKGROUND: Severe fetal growth restriction (FGR) (< third centile) in a singleton pregnancy undelivered by 40 weeks is one of a number of Victorian Perinatal Services Performance Indicators, which aim to provide a measure of the quality and safety of maternity care. Women of refugee background have been found to have poorer perinatal outcomes compared to others and these outcomes can in part be explained by previous history. However, less access to and engagement with pregnancy care may also be contributing factors...
March 13, 2017: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/28295165/declining-invasive-prenatal-diagnostic-procedures-a-comparison-of-tertiary-hospital-and-national-data-from-2012-to-2015
#19
Kristine Johnson, Joanne Kelley, Virginia Saxton, Susan P Walker, Lisa Hui
BACKGROUND: In recent years, the superior accuracy of maternal plasma cell-free DNA-based prenatal screening has resulted in >50% national decline in amniocenteses and chorionic villus sampling (CVS), creating new implications for specialist training. OBJECTIVE: To compare the annual figures on amniocenteses and CVS in a tertiary hospital with national population-based trends between 2012 and 2015. METHODS: Retrospective study examining the amniocentesis and CVS procedures performed in a tertiary hospital between 2012 and 2015...
March 13, 2017: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/28294284/the-aetiology-of-chronic-vulval-pain-and-entry-dyspareunia-a-retrospective-review-of-525-cases
#20
Victoria Harris, Gayle Fischer, Jennifer A Bradford
BACKGROUND: There are few published data about the incidence of diagnoses or treatment outcomes, for chronic vulval pain. AIMS: To document diagnoses and treatment outcomes in a cohort of chronic vulval pain presentations. MATERIALS AND METHODS: A retrospective case review of the patient database of a private vulval clinic between January 2011 and March 2015. RESULTS: Five hundred and twenty-five out of 3360 patients (15...
March 13, 2017: Australian & New Zealand Journal of Obstetrics & Gynaecology
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