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Australian & New Zealand Journal of Obstetrics & Gynaecology

Georgina Hawkins, Joanna Gullam, Laura Belluscio
BACKGROUND: On 22 February 2011 an earthquake (magnitude 6.3) hit Christchurch, New Zealand. Earthquakes have been associated with increased risks of preterm birth (PTB) and other adverse pregnancy outcomes. However, the literature on this subject is scarce. Maternal antenatal stress has been suggested as the link between earthquakes and PTB. In this study the Christchurch earthquake was utilised as a model of maternal stress to assess its effects on PTB rates and other pregnancy outcomes...
March 8, 2018: Australian & New Zealand Journal of Obstetrics & Gynaecology
Robin S Cronin, Minglan Li, Michelle Wise, Billie Bradford, Vicki Culling, Jane Zuccollo, John M D Thompson, Edwin A Mitchell, Lesley M E McCowan
BACKGROUND: For parents who experience stillbirth, knowing the cause of their baby's death is important. A post mortem examination is the gold standard investigation, but little is known about what may influence parents' decisions to accept or decline. AIM: We aimed to identify factors influencing maternal decision-making about post mortem examination after late stillbirth. METHODS: In the New Zealand Multicentre Stillbirth Study, 169 women with singleton pregnancies, no known abnormality at recruitment, and late stillbirth (≥28weeks gestation), from seven health regions were interviewed within six weeks of birth...
March 5, 2018: Australian & New Zealand Journal of Obstetrics & Gynaecology
Helena Trollope, Joyce Pui Yee Leung, Michelle Wise, Cynthia Farquhar, Lynn Sadler
BACKGROUND: Compliance with maternity clinical practice guidelines developed by National Women's Health has been found to be low at audit. OBJECTIVE: To explore the reasons for poor compliance with maternity guidelines by evaluating the quality of a sample of National Women's Health guidelines using a validated instrument and assessing local guideline users' perceptions of and attitudes toward guidelines. DESIGN: Five independent reviewers evaluated the quality of 10 purposively selected guidelines for adherence to the Appraisal of Guidelines Research & Evaluation (AGREE) II instrument standards...
March 5, 2018: Australian & New Zealand Journal of Obstetrics & Gynaecology
Vanessa El-Achi, King Man Wan, James Brown, Drew Marshall, Therese McGee
This retrospective study was conducted to identify the incidence and characteristics associated with readmissions for surgical site infections following caesarean section in a tertiary hospital from 2012 to 2015. Of 6334 patients who underwent caesarean section, 165 (2.6%) were readmitted, most commonly for surgical site infection (25.5%, n = 42). Thirty-seven of these patients (88%) had an emergency caesarean compared to five (12%) following an elective caesarean section. Of the women with surgical site infections, 69% were overweight and 14% had diabetes...
March 5, 2018: Australian & New Zealand Journal of Obstetrics & Gynaecology
Arkadiusz Krzyżanowski, Dariusz Swatowski, Tomasz Gęca, Maciej Kwiatek, Aleksandra Stupak, Sławomir Woźniak, Anna Kwaśniewska
BACKGROUND: Persistent right umbilical vein (PRUV) is usually an isolated finding but it may be accompanied by other fetal malformations. AIMS: We aimed to determine the incidence of prenatally diagnosed PRUV in a referral population, assess the neonatal outcome and discuss the findings together with those from previous publications. MATERIALS AND METHODS: A total of 2360 women with low-risk singleton pregnancies were examined in the second and third trimesters...
March 2, 2018: Australian & New Zealand Journal of Obstetrics & Gynaecology
Debbie Nisbet, Ann Robertson, Blessy Mannil, Vanessa Pincham, Andrew Mclennan
BACKGROUND: Nuchal translucency measurement has an established role in first trimester screening. Accurate measurement requires that technical guidelines are followed. Performance can be monitored by auditing the distribution of measurements obtained in a series of cases. AIMS: The primary aim is to develop an accessible, theory-based educational program for individuals whose distribution of measurements at audit falls outside an acceptable range, and assess operator performance following this intervention...
February 22, 2018: Australian & New Zealand Journal of Obstetrics & Gynaecology
Katherine Culliney, Lesley M E McCowan, Karaponi Okesene-Gafa, Rinki Murphy, Janet Rowan, Rennae S Taylor, Christopher J D Mckinlay
BACKGROUND: In New Zealand, it is recommended that all pregnant women have a haemoglobin A1c (HbA1c) test performed with their booking antenatal bloods to identify previously unrecognised diabetes. However, screening rates in some groups are low. Use of a point-of-care device may improve compliance with screening. AIM: To assess the accuracy of the COBAS b101 point-of-care system referenced against a laboratory method, for measurement of HbA1c levels in pregnant women...
February 22, 2018: Australian & New Zealand Journal of Obstetrics & Gynaecology
Kassam Mahomed, Kellie Wild, Christopher R Weekes
BACKGROUND: Pre-labour rupture of membranes (PROM) at term is a common event with early induction of labour reducing infectious morbidity without increasing the caesarean rate. Syntocinon is commonly used for induction but prostaglandins are also routinely used. Large studies have shown no difference in the maternal and neonatal outcomes with either method. AIM: To assess the safety and efficacy of vaginal prostaglandin (PG) compared to syntocinon for induction of labour in term-PROM...
February 22, 2018: Australian & New Zealand Journal of Obstetrics & Gynaecology
Sam Lepine, Beverley Lawton, Stacie Geller, Peter Abels, Evelyn J MacDonald
BACKGROUND: Sepsis is a life-threatening systemic condition that appears to be increasing in the obstetric population. Clinical detection can be difficult and may result in increased morbidity via delays in the continuum of patient care. AIMS: To describe the burden of severe maternal morbidity (SMM) caused by sepsis in New Zealand and investigate the potential preventability. METHODS: A multidisciplinary expert review panel was established to review cases of obstetric sepsis admitted to intensive care or high-dependency units over an 18 month span in New Zealand...
February 20, 2018: Australian & New Zealand Journal of Obstetrics & Gynaecology
Tal Goldstein Akavia, Yakir Segev, Edith Balan, Efraim Siegler
INTRODUCTION: Cervical punch biopsies are a common ambulatory procedure, performed routinely by gynaecologists. The aim of the present study was to assess the efficacy of forced coughing as a pain-reducing technique during cervical punch biopsy compared to a control group. MATERIALS AND METHODS: The study was a prospective randomised-control trial. The study group comprised 90 women who underwent cervical punch biopsies during investigation of abnormal Pap test results...
February 7, 2018: Australian & New Zealand Journal of Obstetrics & Gynaecology
Tammy Hine, Yun Zhao, Andrea Begley, Sheila Skeaff, Jill Sherriff
BACKGROUND: Iodine requirements increase during pregnancy and although national recommendations for daily iodine supplementation (150 µg) exist, there is no research related to the uptake of these recommendations by pregnant women in Western Australia. AIMS: To investigate the use of iodine-containing supplements and associations with their use in a sample of Western Australian pregnant women. MATERIALS AND METHODS: A cross-sectional study was conducted on pregnant women attending antenatal clinics in a public tertiary hospital for women and neonates in Perth during 2012 and 2013 (n = 425)...
February 7, 2018: Australian & New Zealand Journal of Obstetrics & Gynaecology
Charlotte Paul, Katrina J Sharples, Judith Baranyai, Ronald W Jones, David Cg Skegg
BACKGROUND: An unethical clinical study that entailed withholding treatment from women diagnosed with cervical intraepithelial neoplasia 3 (CIN3) was conducted at National Women's Hospital, Auckland, New Zealand. Women with microinvasive carcinoma of the cervix also had treatment withheld. AIMS: To describe the management and outcomes for women with microinvasive carcinoma for many of whom conventional treatment was withheld. MATERIALS AND METHODS: Retrospective cohort study of women with a diagnosis of stage 1A cervical carcinoma at National Women's Hospital...
February 6, 2018: Australian & New Zealand Journal of Obstetrics & Gynaecology
Hannah Kluckow, Leeanne Panisis, Jessie Lauri, Anna Jatubatu, Dukyeon Kim, Laura Hodges, Kirsten I Black
BACKGROUND: The Solomon Islands is a Pacific nation with a maternal mortality of 114 per 100 000 births. Around 57% of pregnancies are unintended and only 15% of women attend their first antenatal visit in the first 12 weeks as recommended by the World Health Organization. AIMS: We sought to examine the socio-demographic predictors of unintended pregnancy and late antenatal booking (>18 weeks) among women attending antenatal care in Honiara. MATERIALS AND METHODS: From January 2014 to May 2015 we undertook a cross-sectional survey using a structured questionnaire on women presenting to the National Referral Hospital and community clinics in Honiara for antenatal care...
January 31, 2018: Australian & New Zealand Journal of Obstetrics & Gynaecology
Alexandra Mowat, Bernadette Brown, Anita Pelecanos, Victoria Mowat, Malcolm Frazer
OBJECTIVE: To establish whether the infusion method trial of void (TOV) after a mid-urethral sling procedure, in contrast to the standard auto-fill TOV, permits discharge home from recovery, as these procedures are eminently suited to same day discharge, and the delay in achieving a successful TOV often keeps the patient in hospital overnight. METHOD: A randomised controlled trial performed between December 2014 and April 2016 at the University Hospital, enrolling 40 women undergoing a mid-urethral sling procedure for stress urinary incontinence...
January 31, 2018: Australian & New Zealand Journal of Obstetrics & Gynaecology
Julia Keating, Malcolm Barnett, Vanessa Watkins, Stella May Gwini
BACKGROUND: The association between an incomplete placenta and postpartum haemorrhage (PPH) is well documented; however, the significance of ragged or incomplete membranes has not been explored as an independent risk factor for PPH. AIMS: To explore the association between the completeness of the amniotic and chorionic membranes and the risk of PPH, independent to placental status. MATERIALS AND METHODS: 37 176 birth records were retrospectively extracted from the period 1 July, 2008 to 30 June, 2016 from the databases of two public hospitals in Melbourne, Australia...
January 30, 2018: Australian & New Zealand Journal of Obstetrics & Gynaecology
Andrew J Vallely, Pamela J Toliman, Claire Ryan, Glennis Rai, Johanna Wapling, Josephine Gabuzzi, Antonia Kumbia, Benny Kombuk, Zure Kombati, Lisa M Vallely, Angela Kelly-Hanku, Handan Wand, Sepehr N Tabrizi, Glen D L Mola, John M Kaldor
BACKGROUND: Papua New Guinea (PNG) has among the highest estimated burdens of cervical cancer globally but currently has no national cervical screening program. Visual inspection of the cervix with acetic acid (VIA) is a low-cost screening strategy endorsed by the World Health Organization that has been adopted in many low-resource settings but not previously evaluated in PNG. AIM: To evaluate the association between VIA examination findings and high-risk HPV (hrHPV) infection; and the impact of concomitant genital Chlamydia trachomatis, Neisseria gonorrhoeae and Trichomonas vaginalis on the interpretation of VIA findings...
January 30, 2018: Australian & New Zealand Journal of Obstetrics & Gynaecology
Harish Kalra, Nicole Reilly, Marie-Paule Austin
BACKGROUND: There is limited information relating to routine depression screening and psychosocial assessment programs in private maternity settings in Australia. AIMS: To describe the psychosocial profile of a sample of private maternity patients who participated in a depression screening and psychosocial risk assessment program as part of routine antenatal care, and to explore women's experience of receiving this component of pregnancy care. MATERIALS AND METHODS: We conducted a retrospective medical records audit of 455 consecutive women having a routine psychosocial assessment and referral...
January 30, 2018: Australian & New Zealand Journal of Obstetrics & Gynaecology
Lisa Hui, Jenna Barclay, Alice Poulton, Briohny Hutchinson, Jane L Halliday
BACKGROUND: Advances in technology can bring great benefits to human health, but their implementation may be influenced by socioeconomic factors, particularly in the field of prenatal screening for Down syndrome. AIM: To analyse screening test indications for, and diagnostic yield of, invasive prenatal diagnostic testing (PNDx) according to socioeconomic status. METHODS: Retrospective analysis of population-based data on PNDx and karyotype results for 2014-2015 in the Australian state of Victoria...
January 30, 2018: Australian & New Zealand Journal of Obstetrics & Gynaecology
Stephen J Robson, Caroline de Costa, Cindy Woods, Pauline Ding, Ajay Rane
Rising rates of caesarean section (CS) have been attributed, in part, to maternal-choice CS (MCCS). There are few published data regarding maternal and perinatal risks comparing MCCS with planned vaginal birth (VB) in uncomplicated first pregnancies to inform choice. We report the results of a pragmatic patient-preference cohort study of private patients in Australia: 64 women planning MCCS and 113 women planning VB. There were few differences in outcome between the two groups. The study highlighted the well-recognised difficulties in undertaking prospective research into MCCS...
January 23, 2018: Australian & New Zealand Journal of Obstetrics & Gynaecology
Alex Ades, Sneha Parghi, Mehrnoosh Aref-Adib
BACKGROUND: Cervical insufficiency is a significant cause of morbidity and mortality. Cervical cerclage is one option in the management of cervical insufficiency. AIM: To evaluate obstetric outcomes following insertion of a pre-pregnancy laparoscopic transabdominal cerclage in women at high risk for pre-term labour and/or mid-trimester pregnancy loss. METHODS: A prospective observational study of consecutive women who underwent laparoscopic transabdominal cerclage from 2007 to 2017...
January 23, 2018: Australian & New Zealand Journal of Obstetrics & Gynaecology
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