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    5147 results match your criteria Australian and New Zealand Journal of Obstetrics and Gynaecology[Journal]

    1 OF 103

    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.
    Aust N Z J Obstet Gynaecol 2018 Jan 17. Epub 2018 Jan 17.
    Women and Newborn Health Service, King Edward Memorial Hospital, Subiaco, Western Australia, Australia.
    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. Read More

    A clinical audit on the efficacy and safety of uterine artery embolisation for symptomatic adenomyosis: Results in 117 women.
    Aust N Z J Obstet Gynaecol 2018 Jan 18. Epub 2018 Jan 18.
    Sydney Adventist Hospital Clinical School, University of Sydney, Wahroonga, New South Wales, Australia.
    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). Read More

    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.
    Aust N Z J Obstet Gynaecol 2018 Jan 16. Epub 2018 Jan 16.
    School of Women's and Children's Health, UNSW, Sydney, Australia.
    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. Read More

    Adopting innovation in gynaecology: The introduction of e-consult.
    Aust N Z J Obstet Gynaecol 2018 Jan 12. Epub 2018 Jan 12.
    Head of Division Child & Women and Family Services, Waitemata District Health Board, Auckland, New Zealand.
    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. Read More

    Changes in out-of-pocket charges associated with obstetric care provided under Medicare in Australia.
    Aust N Z J Obstet Gynaecol 2018 Jan 12. Epub 2018 Jan 12.
    Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, Queensland, Australia.
    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. Read More

    Assisted reproductive technology (ART) cumulative live birth rates following preimplantation genetic diagnosis for aneuploidy (PGD-A) or morphological assessment of embryos: A cohort analysis.
    Aust N Z J Obstet Gynaecol 2017 Dec 27. Epub 2017 Dec 27.
    Melbourne IVF, East Melbourne, Vic, Australia.
    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. Read More

    A retrospective pilot study to determine whether the reproductive tract microbiota differs between women with a history of infertility and fertile women.
    Aust N Z J Obstet Gynaecol 2017 Dec 26. Epub 2017 Dec 26.
    Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Qld, Australia.
    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. Read More

    Prophylactic insertion of large bore peripheral intravenous catheters in maternity patients for postpartum haemorrhage: A cohort study.
    Aust N Z J Obstet Gynaecol 2017 Dec 22. Epub 2017 Dec 22.
    Royal Brisbane and Women's Hospital, Herston, Queensland, Australia.
    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. Read More

    Progesterone concentrations and dosage with frozen embryo transfers - What's best?
    Aust N Z J Obstet Gynaecol 2017 Dec 22. Epub 2017 Dec 22.
    Monash IVF Pty Ltd, Melbourne, Victoria, Australia.
    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. Read More

    Managing opioid overdose in pregnancy with take-home naloxone.
    Aust N Z J Obstet Gynaecol 2017 Dec 22. Epub 2017 Dec 22.
    Centre for Population Health, Behaviours and Health Risks Program, Burnet Institute, Melbourne, Victoria, Australia.
    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. Read More

    Caesarean section wound infection surveillance: Information for action.
    Aust N Z J Obstet Gynaecol 2017 Dec 21. Epub 2017 Dec 21.
    Wellington Regional Hospital, Capital and Coast District Health Board, Wellington, New Zealand.
    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. Read More

    Sacral neuromodulation for pelvic pain and pelvic organ dysfunction: A case series.
    Aust N Z J Obstet Gynaecol 2017 Dec 8. Epub 2017 Dec 8.
    The Royal Hospital for Women and Prince of Wales Private Hospital, Sydney, New South Wales, Australia.
    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. Read More

    Epidemic of large babies highlighted by use of INTERGROWTH21st international standard.
    Aust N Z J Obstet Gynaecol 2017 Dec 8. Epub 2017 Dec 8.
    RPA Women and Babies, Royal Prince Alfred Hospital, Sydney, Australia.
    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. Read More


    Surgery or in vitro fertilization: The simplicity of this question belies its complexity.
    Aust N Z J Obstet Gynaecol 2017 Dec;57(6):676-678
    University of Queensland, St Lucia, Queensland, Australia.
    Unlike surgery, assisted reproduction, particularly in vitro fertilisation (IVF), requires a low skill base, is largely practitioner independent, is highly effective, quality controlled, reproducible and consistent in the management of endometriosis-associated infertility. Ultimately, however, the decision to proceed to IVF or surgery is dependent on the woman, her reproductive expectations, her specific disease pattern, her support and family network and the resources available in a given health care setting. Read More

    Clinician factors associated with prescribing nicotine replacement therapy in pregnancy: A cross-sectional survey of Australian obstetricians and general practitioners.
    Aust N Z J Obstet Gynaecol 2017 Dec 4. Epub 2017 Dec 4.
    School of Medicine and Public Health, The University of Newcastle, Callaghan, New South Wales, Australia.
    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. Read More

    The incidence and outcome of clinically significant antibodies detected in Rhesus-D positive pregnant women of the Northern Territory.
    Aust N Z J Obstet Gynaecol 2017 Nov 28. Epub 2017 Nov 28.
    Department of Haematology, Royal Darwin Hospital, Darwin, Northern Territory, Australia.
    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. Read More

    Pelvic examination may be meaningfully taught to novices and be used to predict operating times for laparoscopic excision of endometriosis in one surgical procedure.
    Aust N Z J Obstet Gynaecol 2017 Nov 23. Epub 2017 Nov 23.
    School of Women's and Children's Health, UNSW, Sydney, New South Wales, Australia.
    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). Examination and intraoperative findings were compared and stage of disease recorded. Read More

    Combination therapy with mifepristone and misoprostol for the management of first trimester miscarriage: Improved success.
    Aust N Z J Obstet Gynaecol 2017 Nov 23. Epub 2017 Nov 23.
    Division of Obstetrics and Gynaecology, John Hunter Hospital, Newcastle, NSW, Australia.
    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. Read More

    Outcomes in women undergoing robotic-assisted laparoscopic hysterectomy compared to conventional laparoscopic hysterectomy at a tertiary hospital in Western Australia.
    Aust N Z J Obstet Gynaecol 2017 Nov 23. Epub 2017 Nov 23.
    Bendat Family Comprehensive Cancer Centre, St John of God Subiaco Hospital, Subiaco, Perth, Australia.
    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. Read More

    Evaluation of the NZ guidelines for screening for persistent postpartum hyperglycaemia following gestational diabetes.
    Aust N Z J Obstet Gynaecol 2017 Nov 17. Epub 2017 Nov 17.
    Department of Obstetrics and Gynaecology, University of Otago, Christchurch, New Zealand.
    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.

    Materials And Methods: During 2015 in Christchurch, all women with gestational diabetes were offered HbA1c and GTT measurements at three months postpartum and subsequent annual HbA1c measurements were recommended. Read More

    Antenatal influenza and pertussis vaccine uptake among Aboriginal mothers in Western Australia.
    Aust N Z J Obstet Gynaecol 2017 Nov 14. Epub 2017 Nov 14.
    School of Medicine, University of Notre Dame Fremantle, Fremantle, Western Australia, Australia.
    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. Read More

    Quality of information about success rates provided on assisted reproductive technology clinic websites in Australia and New Zealand.
    Aust N Z J Obstet Gynaecol 2017 Nov 12. Epub 2017 Nov 12.
    Victorian Assisted Reproductive Treatment Authority, Melbourne, Victoria, Australia.
    Background: Many factors influence the chance of having a baby with assisted reproductive technologies (ART). A 2016 Australian Competition and Consumer Commission (ACCC) investigation concluded that ART clinics needed to improve the quality of information they provide about chance of ART success.

    Aim: To evaluate changes in the quality of information about success rates provided on the websites of ART clinics in Australia and New Zealand before and after the ACCC investigation. Read More

    Rheumatic heart disease in pregnancy: How can health services adapt to the needs of Indigenous women? A qualitative study.
    Aust N Z J Obstet Gynaecol 2017 Nov 6. Epub 2017 Nov 6.
    Faculty of Health, University of Technology Sydney, Ultimo, Sydney, NSW, Australia.
    Objectives: To study rheumatic heart disease health literacy and its impact on pregnancy, and to identify how health services could more effectively meet the needs of pregnant women with rheumatic heart disease.

    Materials And Methods: Researchers observed and interviewed a small number of Aboriginal women and their families during pregnancy, childbirth and postpartum as they interacted with the health system. An Aboriginal Yarning method of relationship building over time, participant observations and interviews with Aboriginal women were used in the study. Read More

    Unplanned pregnancies in New Zealand.
    Aust N Z J Obstet Gynaecol 2017 Nov 2. Epub 2017 Nov 2.
    Department of Sociology, Gender & Social Work, University of Otago, Dunedin, New Zealand.
    Background: Unplanned pregnancies can bring risk. It is important to have an accurate count of unplanned pregnancies, but to date there is no precise number for New Zealand or Australia.

    Aims: This analysis estimates the number and proportion of pregnancies in New Zealand that are unplanned. Read More

    Antenatal haemoglobin A1c centiles: does one size fit all?
    Aust N Z J Obstet Gynaecol 2017 Nov 2. Epub 2017 Nov 2.
    Department of Obstetrics and Gynaecology, University of Otago, Christchurch, New Zealand.
    Background: In New Zealand, haemoglobin A1c measurements are routinely offered at booking, preferably before 20 weeks gestation, to detect pre-existing hyperglycaemia. A haemoglobin A1c <5.9% (41 mmol/mol) is considered normal based on the reference range for the non-pregnant population. Read More

    Moderate to late preterm intrauterine growth restriction: A restrospective, observational study of the indications for delivery and outcomes in an Australian perinatal centre.
    Aust N Z J Obstet Gynaecol 2017 Oct 27. Epub 2017 Oct 27.
    Sunshine Hospital, Western Health, Melbourne, Victoria, Australia.
    Background: The management of preterm intrauterine growth restriction is limited to fetal surveillance and timely delivery. Despite the existence of evidence-based guidelines, uncertainty regarding the optimal timing of delivery is common, and management remains individualised for each patient.

    Aims: To provide recent Australian data on the indications for delivery of moderate to late preterm growth restricted infants and the outcomes of these deliveries. Read More

    The evidence for laser treatments to the vulvo-vagina: Making sure we do not repeat past mistakes.
    Aust N Z J Obstet Gynaecol 2017 Oct 25. Epub 2017 Oct 25.
    School of Women's and Children's Health, Gynaecological Research and Clinical Evaluation (GRACE) Unit, Royal Hospital for Women, UNSW, Sydney, NSW, Australia.
    Following menopause, up to 49% of women will experience genitourinary symptoms such as vaginal itching, dryness, dyspareunia and incontinence as a result of oestrogen deficiency. Treatments such as vaginal lubricants and moisturisers only temporarily relieve symptoms, while local oestrogen treatments are often unacceptable or unsafe for many women. Recently, a novel laser treatment has been proposed as a non-invasive, long-term solution to vulvo-vaginal and urinary symptoms. Read More

    Redesigning induction of labour processes.
    Aust N Z J Obstet Gynaecol 2017 Oct 25. Epub 2017 Oct 25.
    Mater Health, Brisbane, Qld, Australia.
    Background: An 'in-hours' birth represents a desired outcome following induction of labour (IOL) in terms of safety, efficiency and satisfaction. Women booked for IOL are often not commenced at their allocated times, and these sometimes complex births happen after-hours.

    Aims: To measure the effect of an 11:00 hours commencement time for IOL. Read More

    Phone calls to an Australian pregnancy and lactation counselling service regarding use of galactagogues during lactation - the MotherSafe experience.
    Aust N Z J Obstet Gynaecol 2017 Oct 23. Epub 2017 Oct 23.
    MotherSafe, Royal Hospital for Women, Sydney, NSW, Australia.
    Galactagogues represent substances used to enhance breast milk production. Between 2001 and 2014 we identified 2034 phone calls regarding the use of galactagogues made to MotherSafe. The majority involved discussion of domperidone (n = 1884; 92. Read More

    Polycystic ovarian syndrome: Prevalence and impact on the wellbeing of Australian women aged 16-29 years.
    Aust N Z J Obstet Gynaecol 2017 Oct 19. Epub 2017 Oct 19.
    Department of Medicine, Royal Melbourne Hospital, University of Melbourne, Parkville, Australia.
    Background: Polycystic ovarian syndrome (PCOS) is the most common condition among reproductive-aged women. However, its exact prevalence is unknown.

    Aims: To determine the prevalence of PCOS in Australian women aged 16-29 years using the National Institutes of Health (NIH) criteria compared to self-reported PCOS, to compare co-morbidities between the groups and to determine the most distressing aspect of a diagnosis of PCOS for these young women. Read More

    Hospital admission and surgical approach to tubal ectopic pregnancy in Australia 2000 to 2014: A population-based study.
    Aust N Z J Obstet Gynaecol 2017 Oct 11. Epub 2017 Oct 11.
    Australian National University Medical School, Canberra, Australian Capital Territory, Australia.
    Background: There are several accepted approaches to management of ectopic pregnancy, both surgical and non-surgical. When a surgical approach is used, there appears to be an equipoise between tubal preservation and removal. We sought to determine the patterns of surgical management of ectopic pregnancy in Australia since the year 2000. Read More

    Maternal adherence with recommendations for folic acid and iodine supplements: A cross-sectional survey.
    Aust N Z J Obstet Gynaecol 2017 Oct 9. Epub 2017 Oct 9.
    Department of Human Nutrition, University of Otago, Otago, New Zealand.
    We conducted a survey of 535 New Zealand women to determine supplement use pre-pregnancy, during pregnancy and while breastfeeding to evaluate adherence with national recommendations for folic acid and iodine supplementation. Our findings suggest that despite these women being well-educated and motivated to complete an online survey, there was low adherence to recommendations for folic acid and iodine supplements. Only 38% of women reported supplement intake that met both folic acid and iodine recommendations. Read More

    Does previous caesarean section at full dilatation increase the likelihood of subsequent spontaneous preterm birth?
    Aust N Z J Obstet Gynaecol 2017 Sep 28. Epub 2017 Sep 28.
    Department of Women's Health and Neonatology, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia.
    Background: There is emerging evidence that caesarean section at full dilatation is associated with an increased risk of subsequent spontaneous preterm birth.

    Aim: To investigate the association between caesarean section at full dilatation and spontaneous preterm birth in subsequent pregnancies.

    Materials And Methods: This was a retrospective cohort study of women who had two consecutive births at Royal Prince Alfred Hospital, 1989-2015. Read More

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