The Australian and New Zealand Journal of Obstetrics and Gynaecology via MedWorm.com

Variations in blood lipid profile, thrombotic system, arterial elasticity and psychosexual parameters in the cases of surgical and natural menopause

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Fri, 26 Feb 2010 00:00:00 +0100

In this study, comparing four different parameters in women with surgical menopause because of ovariectomy in reproductive age and in women with natural menopause, the effect of withdrawal of ovarian hormones on both groups was investigated. The patient groups in this study were constituted of 100 women in reproductive age who had undergone total abdominal hysterectomy + bilateral salpingo-oophorectomy and 50 women with natural menopause referred to out-patient's clinic within the same period. The findings for four different parameters were recorded one day before the surgery and at 3rd month post-operatively in surgical menopause group and at the day of referral to outpatient clinic in natural menopause group. The parameters planned to be recorded were blood lipid profile, thrombotic syst...

Maternal perception of foetal movement compared with movement detected by real-time ultrasound: An exploratory study

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Fri, 26 Feb 2010 00:00:00 +0100

In this exploratory study, women perceived 35.8% of 763 foetal movements seen on 14 ultrasound scans, with increased sensitivity when movements involved more than one foetal body part (adjusted odds ratio (OR) 1.92, 95% confidence interval (CI) 1.232[ndash]2.999), contacted the uterus (adjusted OR: 2.57, 95% CI: 1.653[ndash]3.995) and were of increasing duration (adjusted OR: 9.33, 95% CI: 5.616[ndash]15.513). These findings may inform future studies of the importance of and ability to improve women's perception of foetal movements. (Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

Uptake of the Perinatal Society of Australia and New Zealand perinatal mortality audit guideline

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Fri, 26 Feb 2010 00:00:00 +0100

Conclusions: Effective implementation programmes are urgently required to address suboptimal uptake of best practice guidelines on perinatal mortality audit in Australia and New Zealand. (Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

Erratum

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Thu, 11 Feb 2010 00:00:00 +0100

(Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

Editor's response

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Thu, 11 Feb 2010 00:00:00 +0100

(Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

Comment on multiple unknown abbreviations in learned journal articles

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Thu, 11 Feb 2010 00:00:00 +0100

(Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

Laparoscopic management of primary hepatic pregnancy

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Thu, 11 Feb 2010 00:00:00 +0100

A 30-year-old woman presented with epigastric pain with elevated serum human chorionic gonadotropin level (hCG), absence of intrauterine gestational sac and absence of an abnormal adnexal mass on pelvic ultrasonography. Laparoscopy revealed a ruptured hepatic ectopic pregnancy. This was removed by laparoscopic suctioning and haemostasis secured with Surgicel® Fribrilla[trade] Absorbable Hemostat. Intramuscular methotrexate was administered post-operatively. Patient recovered uneventfully and serum hCG returned to normal. (Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

Transvaginal repair of caesarean scar dehiscence

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Thu, 11 Feb 2010 00:00:00 +0100

(Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

Myomectomy scar ectopic pregnancy

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Thu, 11 Feb 2010 00:00:00 +0100

(Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

Effect of lifestyle factors and hormone therapy on heart function by serial echocardiography in postmenopausal women

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Thu, 11 Feb 2010 00:00:00 +0100

Conclusion: Our findings add to the evidence that oestrogen given to postmenopausal women has a mixed effect on the heart, with effect best shown when started early. (Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

Persistence and malignant sequelae of gestational trophoblastic disease: Clinical presentation, diagnosis, treatment and outcome

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Thu, 11 Feb 2010 00:00:00 +0100

Conclusion: Serial HCG levels remain the best monitor to determine therapeutic response. Categorisation of 'high risk' by five factors is useful in treatment. Albeit a small series, clinical outcome is favourable with a five-year survival of 89.7%. (Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

Risk Malignancy Index (RMI) in patients with abnormal pelvic mass: Comparing RMI 1, 2 and 3 in an Australian population

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Thu, 11 Feb 2010 00:00:00 +0100

(Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

Women who miscarry: The effectiveness and clinical utility of the Kessler 10 questionnaire in screening for ongoing psychological distress

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Thu, 11 Feb 2010 00:00:00 +0100

Conclusions: The K10 is effective in identifying women at risk for ensuring psychological symptoms following miscarriage. (Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

Intra-uterine bupivacaine and levobupivacaine

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Thu, 11 Feb 2010 00:00:00 +0100

Conclusion: Intrauterine levobupivacaine or bupivacaine is effective in decreasing the pain associated with the endometrial biopsy and curettage under propofol sedation. (Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

Mifepristone and second trimester pregnancy termination for fetal abnormality in Western Australia: Worth the effort

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Thu, 11 Feb 2010 00:00:00 +0100

Conclusions: The introduction of mifepristone priming prior to second trimester medical termination with misoprostol has resulted in a significant reduction in the duration of the termination procedure and length of inpatient stay. These observed benefits of mifepristone provide objective support for the decision to permit use of this medication in Australia. (Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

Informing policy for the Australian context – Costs, outcomes and cost savings of prenatal carrier screening for cystic fibrosis

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Thu, 11 Feb 2010 00:00:00 +0100

Conclusions: Under some scenarios, prenatal CF carrier screening is cost saving to the health system; however, this is not conclusive and depends on several factors. Cost remains a potential barrier due to the substantial level of funding required in the short term. Feasibility and psychosocial, ethical and legal implications of screening need to be considered. Additionally, consultation is required with the Australian community on the acceptability and/or desire for prenatal CF carrier screening. (Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

The trouble with clinical indicators: Intact lower genital tract following childbirth in NSW Hospitals, 2003–2005

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Thu, 11 Feb 2010 00:00:00 +0100

Conclusion: The risk-adjusted funnel plot is a useful graphical tool which may overcome the shortcomings of league tables. We need to become more sophisticated in our use of clinical indicators for comparing hospital performances. (Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

Influence of duration of sexual cohabitation on the risk of hypertension in nulliparous parturients in Ibadan: A cohort study

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Thu, 11 Feb 2010 00:00:00 +0100

Conclusion: It was concluded that increased length of sexual cohabitation prior to conception reduces the risk of gestational hypertension. (Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

Use of additional oxytocin to reduce blood loss at elective caesarean section: A randomised control trial

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Thu, 11 Feb 2010 00:00:00 +0100

Conclusion: An additional oxytocin infusion after 5 IU oxytocin bolus infusion at elective C/S may reduce blood loss and required blood transfusion. (Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

An Australian and New Zealand survey of practice of the use of oxytocin at elective caesarean section

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Thu, 11 Feb 2010 00:00:00 +0100

Conclusions: There are wide variations in the usage of oxytocin at elective caesarean section in Australia and New Zealand, most likely due to a lack of high level evidence to guide practice. Appropriately designed clinical trials are needed to provide evidence to support future practice. (Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

The impact of the baby bonus on maternity services in New South Wales

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Thu, 11 Feb 2010 00:00:00 +0100

Conclusions: The increase in births following the introduction of the baby bonus has significantly impacted maternity services in NSW. (Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

A review of maternal deaths at Goroka General Hospital, Papua New Guinea 2005–2008

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Thu, 11 Feb 2010 00:00:00 +0100

Conclusions: Better outreach services to provide health information and antenatal care, with specific counselling about the need for supervised delivery, are urgently required in the Eastern Highlands Province that GGH serves if numbers of maternal deaths are to be reduced. Working through churches in the region may be the most appropriate way to provide information and services to women because a majority of women adhere to Christianity and can be reached in this way. (Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

Lifestyle factors in people seeking infertility treatment – A review

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Thu, 11 Feb 2010 00:00:00 +0100

Conclusions: Advice on modifiable lifestyle factors should be given to people presenting for infertility treatment to help them make positive changes that may improve their chances of pregnancy and delivering a healthy, live baby. Developing a guideline for this would be a prudent step towards helping clinicians to implement this aspect of preconception care. (Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

A golden anniversary for ANZJOG: The 'red journal' 50 years on

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Mon, 01 Feb 2010 00:00:00 +0100

(Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

Comment on: Uterine compression sutures for post-partum bleeding with atony; modification of the B-Lynch suture. Aust NZJ Obstet Gynaecol 2009; 49: 67–70

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Mon, 21 Dec 2009 00:00:00 +0100

(Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

Retained intrauterine fetal bone as a rare cause of secondary infertility

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Mon, 21 Dec 2009 00:00:00 +0100

Retention of intrauterine fetal bone is a rare cause of secondary infertility that should be considered when ultrasound demonstrates strongly shadowing echodensities in the endometrial space. It seems that the bone acts as an intrauterine contraceptive device as long as it is present in the cavity. Hysteroscopy is both diagnostic and therapeutic, with a generally good prognosis for future fertility in the absence of coexisting factors. (Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

Severe autonomic dysfunction complicated by hyperemesis gravidarum causing unstable blood pressure in pregnancy

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Mon, 21 Dec 2009 00:00:00 +0100

(Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

Pneumomediastinum and subcutaneous emphysema in labour: Two case reports

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Mon, 21 Dec 2009 00:00:00 +0100

(Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

Metastatic choriocarcinoma following a term, live birth

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Mon, 21 Dec 2009 00:00:00 +0100

(Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

Ultrasound diagnosis of spontaneous bilateral tubal pregnancy

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Mon, 21 Dec 2009 00:00:00 +0100

(Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

Risk factors on the menstrual cycle of healthy Taiwanese college nursing students

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Mon, 21 Dec 2009 00:00:00 +0100

Conclusions: Early menarche might be related to menstrual dysfunction in addition to late menarche, obesity and psychological stress. Moreover, obese students are at the highest risks for longer cycles and cycle irregularity. (Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

Efficacy of micronised vaginal progesterone versus oral dydrogestrone in the treatment of irregular dysfunctional uterine bleeding: A pilot randomised controlled trial

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Mon, 21 Dec 2009 00:00:00 +0100

Conclusions: Vaginal micronised progesterone could be an alternative to oral preparations in the treatment of dysfunctional uterine bleeding. This needs to be further evaluated in adequately controlled randomised trials against other effective treatments. (Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

Should liquid-based cytology be performed prior to colposcopy? A comparison of the accuracy, unsatisfactory rates and cost in a tertiary referral setting

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Mon, 21 Dec 2009 00:00:00 +0100

Conclusion: In high prevalence setting, LBC showed no statistically significant difference in sensitivity and specificity from CC for the detection of CIN. A reduction in unsatisfactory smears was evident, but at significant additional cost. (Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

Endometrial local injury improves the pregnancy rate among recurrent implantation failure patients undergoing in vitro fertilisation/intra cytoplasmic sperm injection: A randomised clinical trial

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Mon, 21 Dec 2009 00:00:00 +0100

Conclusion: The results suggest that pregnancy outcome increases through IVF or ICSI after endometrial biopsy. (Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

Characteristics of sentinel lymph nodes' metastatic involvement in early stage of vulvar cancer

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Mon, 21 Dec 2009 00:00:00 +0100

Conclusion: The SLN biopsy performed by an experienced team is a feasible method, with high accuracy in patients with early-stage vulvar cancer. Prognostic value of micrometastases should be confirmed in further studies. (Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

Intraperitoneal chemotherapy for advanced epithelial ovarian malignancy: Lessons learned

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Mon, 21 Dec 2009 00:00:00 +0100

Conclusions: This study demonstrates the feasibility and practicality of and lessons learned from initial experiences with IP chemotherapy for ovarian cancer in Australia. (Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

Depression, anxiety and body image after treatment for invasive stage one epithelial ovarian cancer

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Mon, 21 Dec 2009 00:00:00 +0100

Conclusion: This study shows that psychological issues are common in women treated for stage I EOC. Reproduction after FSS is feasible and led to the birth of healthy babies in about half of patients who wished to have another child. Further prospective studies with standardised instruments are required. (Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

Analysis of risk factors for persistent gestational trophoblastic disease

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Mon, 21 Dec 2009 00:00:00 +0100

Conclusion: These findings support the application of the following two factors in risk prediction for molar pregnancies: > 12 weeks to become HCG negative and interval from last pregnancy < 12 months. They will contribute to a greater awareness of persistent disease and assist in early detection and effective chemotherapy. (Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

Is detrusor hypertrophy in women associated with voiding dysfunction?

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Mon, 21 Dec 2009 00:00:00 +0100

Conclusions: Contrary to the situation in men, increased DWT in women does not seem to be associated with symptoms or signs of voiding dysfunction. Therefore, DWT cannot be used as a predictor of voiding difficulty in women. (Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

Outpatient hysteroscopy: Factors influencing post-procedure acceptability in patients attending a tertiary referral centre

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Mon, 21 Dec 2009 00:00:00 +0100

Conclusions: The acceptability rate for women attending for outpatient hysteroscopy during the audit period was 88.7%. Pain was a significant determinant of procedure acceptability; however, the acceptability rate was not influenced by analgesia or type of anaesthetic administered. (Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

Conservative management of clinically diagnosed placenta accreta following vaginal delivery

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Mon, 21 Dec 2009 00:00:00 +0100

Placenta accreta can result in substantial maternal morbidity and mortality. Conservative management of placenta accreta following vaginal delivery is discussed in this case series. These cases demonstrate serial ultrasonographic resorption of placenta accreta left in situ following vaginal delivery with minimal blood product requirements and preservation of fertility. (Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

Women's expectations of management in their next pregnancy after an unexplained stillbirth: An Internet-based empirical study

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Mon, 21 Dec 2009 00:00:00 +0100

Conclusions: The women surveyed wanted increased fetal surveillance and early delivery, but not necessarily elective caesarean section. (Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

Role of general practitioners in primary maternity care in South Australia and Victoria

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Mon, 21 Dec 2009 00:00:00 +0100

Conclusions: This study shows that community-based medical practitioners, general practitioners in particular, are major providers of maternity care despite the emergence of primary midwifery models of care. With 25% of the population living outside metropolitan areas in both states, providing access to choice and continuity of care for women living in regional and rural areas will be a challenge for maternity reform. (Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

The St. George Homebirth Program: An evaluation of the first 100 booked women

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Mon, 21 Dec 2009 00:00:00 +0100

Conclusion: The St. George Hospital homebirth program has provided reassuring outcomes for the first 100 women it has cared for over the past four years. Wider availability of this service could be achieved provided there is the appropriate close collaboration between providers and effective processes for consultation, referral and transfer. The outcomes of women and babies in publicly funded homebirth programs deserve further study, and the development of a national prospective database of all planned homebirths would contribute to this knowledge. (Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

Blood transfusion for caesarean delivery complicated by placenta praevia

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Mon, 21 Dec 2009 00:00:00 +0100

Conclusions: Gestational age at delivery and type of surgery required are predictors of transfusion during caesarean for placenta praevia. Arterial balloon occlusion does not appear to increase transfusion risk and may be considered as one of the techniques in management. (Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

Maternal and neonatal outcomes of pregnancies complicated by asthma in an Australian population

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Mon, 21 Dec 2009 00:00:00 +0100

Conclusion: The presence of maternal asthma during pregnancy increases the risk of stillbirth for the male fetus and is associated with changes in fetal growth, but does not increase the incidence of a preterm delivery. (Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

IVIG – Is it the answer? Maternal administration of immunoglobulin for severe fetal red blood cell alloimmunisation during pregnancy: A case series

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Mon, 21 Dec 2009 00:00:00 +0100

(Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

Trends and determinants of caesarean sections births in Queensland, 1997–2006

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Mon, 21 Dec 2009 00:00:00 +0100

Conclusions: The CS rate in Queensland in 2006 was higher than in any other Australian state. The increase in Queensland's CS rates can be attributed to both the rising number of primary caesarean births and the rising number of repeat caesareans. (Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

Trends in induction of labour, 1998–2007: A population-based study

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Mon, 21 Dec 2009 00:00:00 +0100

Conclusions: The pharmacological agents used for induction of labour have changed over the past decade. An important area for future research is to investigate how the dosage of oxytocin and prostaglandin affects pregnancy outcomes. (Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

Is hysteroscopy mandatory in all women with post-menopausal bleeding and thickened endometrium on scan?

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Mon, 21 Dec 2009 00:00:00 +0100

(Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

Endoscopic surgery for female infertility: A review of current management

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Mon, 21 Dec 2009 00:00:00 +0100

(Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

Opinion: Integration of diagnostic and management perspectives for placenta accreta

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Mon, 21 Dec 2009 00:00:00 +0100

The 2007 New South Wales/Queensland Royal Australian and New Zealand College of Obstetricians and Gynaecologists Annual Scientific Meeting convened a panel to discuss multidisciplinary perspectives on the management of placenta accreta, percreta or increta. While it was anticipated that this panel would stimulate discussion, the cohesion between the approaches was underestimated. This document represents an integration of the perspectives of the invited speakers at this presentation, with backgrounds in maternal[ndash]fetal medicine, gynaecological oncology, radiology and general obstetrics and gynaecology. (Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

The kindest or the cruellest cut?

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Tue, 01 Dec 2009 00:00:00 +0100

(Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

Ovarian cancer screening: Still waiting for the right answer

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Thu, 24 Sep 2009 16:59:36 +0100

(Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

Erratum

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Wed, 23 Sep 2009 23:00:00 +0100

(Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

Abstracts from the RANZCOG Annual Scientific Meeting 23–29 March 2009, Auckland

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Wed, 23 Sep 2009 23:00:00 +0100

(Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

Comment on: Association of maternal pre-pregnancy weight with birth defects: Evidence from a case–control study in Western Australia. Aust N Z J Obstet Gynaecol 2009; 49: 11–15

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Wed, 23 Sep 2009 23:00:00 +0100

(Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

Preventing repeat abortions

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Wed, 23 Sep 2009 23:00:00 +0100

(Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

Reply

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Wed, 23 Sep 2009 23:00:00 +0100

(Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

Comment on: The early pregnancy assessment project: The effect of cooperative care in the emergency department for management of early pregnancy complications. Aust N Z J Obstet Gynaecol 2009; 49: 110–114

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Wed, 23 Sep 2009 23:00:00 +0100

(Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

Post-partum pneumoperitoneum: Not a surgical emergency

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Wed, 23 Sep 2009 23:00:00 +0100

(Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

Uterine perfusion following laparoscopic clipping of uterine arteries at myomectomy

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Wed, 23 Sep 2009 23:00:00 +0100

Laparoscopic clipping of uterine arteries facilitates laparoscopic myomectomy with minimal blood loss. This paper shows the return to normal myometrial perfusion following this procedure with literary evidence of the safety and efficacy of this technique. (Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

Primary aldosteronism and pregnancy: A case report

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Wed, 23 Sep 2009 23:00:00 +0100

(Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

The obstructed hemivagina, ipsilateral renal anomaly, uterus didelphys triad

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Wed, 23 Sep 2009 23:00:00 +0100

We present a case series of four patients with the triad of uterus didelphys, obstructed hemivagina and ipsilateral renal agenesis managed between 2005[ndash]2009 at a tertiary centre for paediatric and adolescent gynaecology. (Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

Treatment of suction termination of pregnancy-retained products with misoprostol markedly reduces the repeat operation rate

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Wed, 23 Sep 2009 23:00:00 +0100

A six-year audit of clinical outcomes following the treatment of suction termination of pregnancy-retained products of conception symptoms with 200 µg of misoprostol orally or sublingually three times a day for six doses showed that it was 93% effective and it reduced the repeat dilation and curettage rate by 79.6% (P < 0.001). (Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

The effect of elevated serum estradiol levels on the day of human chorionic gonadotropin injection on pregnancy outcomes in an assisted reproduction program

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Wed, 23 Sep 2009 23:00:00 +0100

Conclusion: Frozen thawed embryos obtained from controlled ovarian hyperstimulation cycles resulted in similar clinical and ongoing pregnancy rates as those obtained in previous fresh embryo transfer cycles. (Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

Discrepancies between clinical staging and pathological findings of operable cervical carcinoma with stage IB–IIB: A retrospective analysis of 818 patients

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Wed, 23 Sep 2009 23:00:00 +0100

Conclusions: There are significant discrepancies between clinical stage and pathological results. Pelvic examination has its limitations in staging determination. Thus for operable cervical cancer, clinical stage alone is not reliable for selecting postoperative therapies and surgical staging system may be considered. (Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

Magnetic resonance imaging for assessment of deep endometrial invasion for patients with endometrial carcinoma

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Wed, 23 Sep 2009 23:00:00 +0100

Conclusion: In patients with endometrial cancer, MRI is limited in its ability to detect deep myometrial invasion. The combination of MRI findings and tumour histology or grade can be helpful in determining if lymphadenectomy is necessary. (Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

A pilot survey of the impact of menstrual cycles on adolescent health

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Wed, 23 Sep 2009 23:00:00 +0100

Conclusions: The Web-based survey was a successful approach to collecting information and could be used in a larger study. (Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

Randomised double-blind trial of the effect of vitamin C on dyspareunia and vaginal discharge in women receiving doxycycline and triple sulfa for chlamydial cervicitis

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Wed, 23 Sep 2009 23:00:00 +0100

Conclusion: Adding vitamin C to doxycycline and triple sulfa was more efficient than standard regimen (doxycycline and triple sulfa without vitamin C) in treating chlamydial cervicitis. (Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

Cryotherapy as the treatment modality of postcoital bleeding: A randomised clinical trial of efficacy and safety

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Wed, 23 Sep 2009 23:00:00 +0100

Conclusion: Our study demonstrated that cryotherapy is a safe and an effective treatment for postcoital bleeding. (Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

An anonymous survey of registrar training in the use of Kjelland's forceps in Australia

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Wed, 23 Sep 2009 23:00:00 +0100

Large series suggest that, when used with appropriate care and skill, rotational deliveries with Kjelland's forceps are a safe and useful procedure. We surveyed obstetric trainees in Australia to assess their experience with, and intentions to use, Kjelland's forceps. The response rate was 65%, and it was uncommon for even senior trainees to have performed more than ten Kjelland's forceps rotations during their training. Ninety-four per cent of final-year trainees stated they did not intend to use Kjelland's forceps in their consultant practice. (Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

Kjelland's forceps in the new millennium. Maternal and neonatal outcomes of attempted rotational forceps delivery

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Wed, 23 Sep 2009 23:00:00 +0100

Conclusions: Prudent use of Kjelland's forceps by experienced operators is associated with a very low rate of adverse maternal and neonatal outcomes. Training in this important obstetric skill should be reconsidered urgently, before it is lost forever. (Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

Fetal macrosomia and pregnancy outcomes

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Wed, 23 Sep 2009 23:00:00 +0100

Conclusion: Macrosomia was associated with an increased risk of adverse maternal and neonatal health outcomes. Optimal management strategies of macrosomic pregnancies need evaluation. (Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

Castor oil for induction of labour: Not harmful, not helpful

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Wed, 23 Sep 2009 23:00:00 +0100

Conclusions: Castor oil for induction of labour had no effect on time to birth nor were there any harmful effects observed in this large series. Our findings leave no justification for recommending castor oil for this purpose. (Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

Postnatal testing for diabetes in Australian women following gestational diabetes mellitus

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Wed, 23 Sep 2009 23:00:00 +0100

Conclusions: Specialist diabetes care in non-tertiary educated women, or a team approach to management with diabetes education and obstetric care may act to reinforce the need for postnatal diabetes testing in accordance with the ADIPS guidelines. Individualised follow up from a health professional and provision of written information following a GDM pregnancy may also encourage return for postnatal testing in this high-risk group. (Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

A comparison of the Perinatal Society of Australia and New Zealand-Perinatal Death Classification system and relevant condition at death stillbirth classification systems

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Wed, 23 Sep 2009 23:00:00 +0100

Conclusion: The proportion of stillbirths classified as unexplained was less with ReCoDe compared with PSANZ-PDC but rates with either method were low compared with earlier classification systems. Fetal growth restriction was listed as the primary condition more commonly with ReCoDe compared with PSANZ-PDC because of different definitions. (Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

Twin deliveries and place of birth in NSW 2001–2005

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Wed, 23 Sep 2009 23:00:00 +0100

Conclusions: Both infant and maternal morbidity increase from 39 weeks gestation. Delivery of twins before 36 weeks at smaller hospitals (< 500 deliveries per annum) should be avoided. A twin pregnancy where there is a [ge] 20% difference in estimated fetal weights should be considered for referral to a tertiary obstetric unit. (Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

Term breech singletons and caesarean section: A population study, Australia 1991–2005

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Wed, 23 Sep 2009 23:00:00 +0100

Conclusion: Planned caesarean section is the standard method of birth for term breech singletons in Australia. Active measures including external cephalic version should be supported to reduce the rate of caesarean section where clinically indicated. Retention of a skilled clinical workforce is essential in the provision of the latter and to assist the minority of women having vaginal breech births. Breech presentation is not a major factor in the overall rise in caesarean section experienced by Australia since 1996. (Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

Caesarean scar ectopic pregnancy: A single centre case series

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Wed, 23 Sep 2009 23:00:00 +0100

Conclusions: The diagnosis of CSP can be challenging, and awareness of this condition is needed, particularly as the incidence is increasing. There does not appear to be a clear association between number of prior caesarean deliveries and CSPs. No consistent management strategy was evident in our series, being based predominantly on patient factors and consultant resources rather than CSP features. (Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

Population screening and early detection of ovarian cancer in asymptomatic women

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Wed, 23 Sep 2009 23:00:00 +0100

The National Breast and Ovarian Cancer Centre position statement: 'Population screening and early detection of ovarian cancer in asymptomatic women', was developed and agreed following a Forum in February 2009 attended by key Australian stakeholders. The final position statement and supporting background information have been endorsed by key Australian colleges and agencies. Position statement on population screening and early detection of ovarian cancer in asymptomatic women There is currently no evidence that any test, including pelvic examination, CA125 or other biomarkers, ultrasound (including transvaginal ultrasound), or combination of tests, results in reduced mortality from ovarian cancer. There is no evidence to support the use of any test, including pelvic examination, CA125 or o...

Incidence and risk factors predicting blood transfusion in caesarean section

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Tue, 18 Aug 2009 23:00:00 +0100

Conclusion: In the absence of significant risk factors for haemorrhage at CS in a tertiary setting, routine blood type and screen testing does not enhance patient care. In the rare event that a patient without previously identifiable risk factors requires an urgent blood transfusion, O negative blood could be given in the interim pending formal determination of type and cross-match. (Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

Prospective randomised multicentre trial with the birth trainer EPI-NO® for the prevention of perineal trauma

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Tue, 18 Aug 2009 23:00:00 +0100

Conclusions: Training with EPI-NO® increases significantly the likelihood of having an intact perineum and reduces the episiotomy rate. (Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

Population-based carrier screening for cystic fibrosis in Victoria: The first three years experience

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Tue, 18 Aug 2009 23:00:00 +0100

Conclusion: Carrier screening for CF by obstetricians and general practitioners by cheek swab sample can be successfully undertaken prior to pregnancy or in the early stages of pregnancy. (Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

Systematic multidisciplinary approach to reporting perinatal mortality: Lessons from a five-year regional review

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Tue, 18 Aug 2009 23:00:00 +0100

Conclusions: Causes of perinatal death for the ACT and surrounding New South Wales region are similar to other states using this classification system. The following are considered important lessons to promote accurate perinatal mortality reporting: (i) a universal reporting system for Australia utilising a multidisciplinary team; (ii) a high perinatal autopsy rate, especially in the critical area of antepartum death with no identifiable cause; and (iii) standardised definitions for avoidability. Attention to these areas may prompt further research and changes in practice to further reduce perinatal mortality. (Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

What do our readers think of ANZJOG?

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Thu, 30 Jul 2009 11:27:14 +0100

(Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

Whither gynaecological surgery?

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Tue, 28 Jul 2009 23:00:00 +0100

(Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

The future of obstetrics and gynaecological generalists and gynaecological surgery

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Tue, 28 Jul 2009 23:00:00 +0100

(Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

Re – Vitthala et al. Use of Bakri balloon in post-partum haemorrhage: A series of 15 cases

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Tue, 28 Jul 2009 23:00:00 +0100

(Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

Atypical antipsychotic (clozapine) self-poisoning in late pregnancy presenting with absent fetal heart rate variability without acidosis and delayed peristalsis in the newborn baby: A case report

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Tue, 28 Jul 2009 23:00:00 +0100

A case of an attempted suicide with atypical antipsychotic (clozapine) in late pregnancy is reported. Toxic effects of clozapine in the mother as well as in the fetus and newborn were observed. It should be remembered as a rare cause of unexplained loss of consciousness in pregnant women, a cause of abnormalities on fetal cardiotocogram as well as a cause of delayed peristalsis in a newborn baby. (Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

A primary ovarian hydatid cyst

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Tue, 28 Jul 2009 23:00:00 +0100

(Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

The TFS mini-sling for uterine/vault prolapse repair: A three-year follow-up review

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Tue, 28 Jul 2009 23:00:00 +0100

Conclusions: The longer-term results from the TFS posterior sling are encouraging. The procedure is evolving, and more studies are required. (Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

Osteopontin expression correlates with invasiveness in cervical cancer

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Tue, 28 Jul 2009 23:00:00 +0100

Conclusion: Osteopontin may have a potential use as a diagnostic factor for cervical cancer and osteopontin expression is closely correlated with carcinogenesis and invasion of cervical cancer. (Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

Contraception and pregnancy then and now: Examining the experiences of a cohort of mid-age Australian women

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Tue, 28 Jul 2009 23:00:00 +0100

Conclusions: While surveys indicate that 66[ndash]70% of Australian women use a contraceptive method, more than half of unplanned pregnancies apparently occur in women using contraception. The modern Australian woman, in common with her predecessors, still faces significant challenges in her fertility management. This survey provides a longitudinal perspective on contraceptive use in relation to pregnancy and highlights the issue of efficacy of contraceptives in real-life situations. (Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

Relevance of gastrointestinal symptoms in endometriosis

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Tue, 28 Jul 2009 23:00:00 +0100

Conclusion: Gastrointestinal symptoms are nearly as common as gynaecological symptoms in women with endometriosis and do not necessarily reflect bowel involvement. (Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

Risk factors for and timing of death of extremely preterm infants

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Tue, 28 Jul 2009 23:00:00 +0100

This study examined risk factors for timing and cause of death for extremely preterm infants [ge] 23 weeks and < 28 weeks. There were 479 liveborn infants and 98 deaths reviewed over a ten-year period. Thirty-two deaths (33%) occurred on the first day of life and 72 (75%) in the first month of life. Lower gestation and intrauterine growth restriction were significant risk factors for death. Most deaths occurred in the first month of life and at the lowest gestation in the first week. (Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

Fetal extrasystole may predict poor neonatal outcome

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Tue, 28 Jul 2009 23:00:00 +0100

Extrasystoles particularly premature atrial contractions noted during labour on the fetal heart rate monitoring strip are usually thought to be benign. In pregnancies complicated by fetal infection and/or the fetal inflammatory response syndrome, there are some data that extrasystoles noted during the intrapartum period may be related to neonatal sepsis and eventual poor neonatal outcome including death or neonatal encephalopathy. Additional observations are needed to substantiate this hypothesis. (Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

Retrospective analysis of outcome of pregnancy in women with congenital heart disease: Single-centre experience from North India

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Tue, 28 Jul 2009 23:00:00 +0100

Conclusion: Maternal and perinatal outcome is better in acyanotic CHD compared to cyanotic CHD. Surgical correction of cardiac lesions prior to conception improves outcome. (Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

The outcomes of pregnancies following a prenatal diagnosis of fetal exomphalos in Western Australia

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Tue, 28 Jul 2009 23:00:00 +0100

Conclusions: In the the majority of cases of prenatally detected exomphalos the pregnancy was interrupted secondary to chromosomal or structural abnormalities. In only 10.6% of prenatally recognised fetuses with exomphalos was the disorder truly isolated with neonatal survival occurring. (Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

Detection and management of decreased fetal movements in Australia and New Zealand: A survey of obstetric practice

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Tue, 28 Jul 2009 23:00:00 +0100

Conclusions: While monitoring fetal movement is an important part of antenatal care in Australia and New Zealand, variation in obstetric practice for DFM is evident. Large-scale randomised controlled trials are required to identify optimal screening and management options. In the interim, high quality clinical practice guidelines using the best available advice are needed to enhance consistency in practice including advice provided to women. (Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

Using botulinum toxin for pelvic indications in women

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Tue, 28 Jul 2009 23:00:00 +0100

Conclusions: A single class I study supports the use of BoNT for refractory pelvic floor spasm; however, further adequately powered class I studies for this indication and for provoked vestibulodynia are warranted. (Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

Ectopic pregnancy: Challenging accepted management strategies

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Tue, 28 Jul 2009 23:00:00 +0100

Ectopic pregnancy is still the number one cause of maternal deaths in early pregnancy. The diagnostic capabilities of transvaginal ultrasound to confirm an EP are well founded. In fact, ultrasound technology, particularly the introduction of high-resolution transvaginal probes, has been the driving force behind the revolutionary change towards conservative management strategies in ectopic pregnancy care. Clinically stable women, however, with a scan diagnosis of a tubal ectopic pregnancy still routinely undergo surgery or are given methotrexate (MTX) at presentation. Conservative management for ectopic pregnancy may be considered in the context of clinical stability. Reassessment at 48 h allows evaluation of the trophoblast activity or 'trophoblastic load'. Falling serum hCG levels at 48 h...

To mesh or not to mesh

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Tue, 28 Jul 2009 23:00:00 +0100

We are in the midst of an increasingly acrimonious discussion regarding the use of mesh in pelvic reconstructive surgery. Modern mesh kits, aggressively marketed by biotech companies, have become widespread. At times, they are used inappropriately, and significant complications such as pain syndromes and erosion are not uncommon. While conventional alternatives such as sacrospinous colpopexy and Burch colposuspension are not without their problems either, the discussion surrounding mesh use has a character never encountered before in urogynaecology. Many colleagues feel that the resolution of this conflict may be found in large randomised controlled trials such as the PROSPECT trial currently being planned in the UK. I feel that such a trial may well do more harm than good, unless certain ...

Maternal and neonatal outcomes following diabetes in pregnancy in Far North Queensland, Australia

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Sun, 07 Jun 2009 04:00:00 +0100

Conclusion: The local cohort had poorer outcomes probably reflecting a more disadvantaged. Few differences were found between local Indigenous groups. (Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

Maternal height and length of gestation: Does this impact on preterm labour in Asian women?

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Tue, 02 Jun 2009 04:00:00 +0100

Conclusions: In our population, maternal height has an influence on gestational length, and the lower three quartiles was associated with increased odds of labour at > 32 to < 37 weeks. This effect should be taken into consideration in the adoption of international recommendations in obstetric management and intervention. (Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

Maternal sleep deprivation is a risk factor for small for gestational age: A cohort study

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Tue, 02 Jun 2009 04:00:00 +0100

Conclusions: Risk factors for SGA less than 5th centile were sleep deprivation and shift work and exposure to physical and chemical hazards during 2nd and 3rd trimesters, less walking hours and alcohol consumption during 3rd trimester. Poor weekly gestational weight gain may be considered as a predictor of delivering an SGA infant. (Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

Outcome in women with no endocervical component on cervical cytology after treatment for high-grade cervical dysplasia

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Tue, 02 Jun 2009 04:00:00 +0100

Conclusion: The lack of an endocervical component was not statistically significantly associated with a higher incidence of either high-grade or low-grade abnormalities. Therefore, women who have had previous treatments for high-grade abnormalities do not need to have earlier repeat smears or intervention if the cytology lacks an endocervical component. (Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

Uterine papillary serous carcinoma: Patterns of failure and survival

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Tue, 02 Jun 2009 04:00:00 +0100

Conclusion: We recommend optimal cytoreduction surgery with the aim of leaving no macroscopic disease at the end of the operation. Vaginal brachytherapy should be considered as a component of adjuvant radiotherapy. Abdominal failure was the commonest mode of failure in our cohort of patients. (Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

Do maternal- or pregnancy-associated disease states affect blood pressure in the early neonatal period?

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Tue, 02 Jun 2009 04:00:00 +0100

Conclusions: Maternal- or pregnancy-associated disease states appear to influence BP in the early neonatal period. Diabetes and altered placental perfusion were associated with higher BP readings. Clinical significance of these statistically elevated BPs in the early neonatal period is unknown. (Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

Mid-trimester amniotic fluid C-reactive protein, ferritin and lactate dehydrogenase concentrations and subsequent risk of spontaneous preterm labour

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Tue, 02 Jun 2009 04:00:00 +0100

Conclusion: Mid-trimester LDH is found to be quite effective in the prediction of preterm delivery. Pre-existing intrauterine inflammatory process early in gestation may be an important risk factor for preterm delivery. (Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

Bowel resection for severe endometriosis: An Australian series of 177 cases

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Tue, 02 Jun 2009 04:00:00 +0100

Conclusions: Our study adds to the growing body of literature describing colorectal resection for severe endometriosis. Overall, the surgery appeared to be well tolerated, demonstrating the role for this surgery. (Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

Unexplained fetal death: Are women with a history of fetal loss at higher risk?

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Wed, 08 Apr 2009 04:00:00 +0100

Conclusion: The current practice of closely monitoring pregnant women with a history of fetal loss or death should continue as this study suggests they may have a higher risk of poor obstetric outcome. Larger studies are needed to confirm the association between previous pregnancy loss and UFD. (Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

Comparison of three management strategies for patients with atypical squamous cells of undetermined significance, after six months delay: A three-year experience in an Iranian university hospital

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Mon, 30 Mar 2009 04:00:00 +0100

Conclusions: Although less complicated than colposcopy, the repeat Pap smear triage algorithm for ASCUS may underdiagnose some women with high-grade CIN, when compared with colposcopy. Considering the high sensitivity of HPV testing, it may be useful as an alternative to the current policy of six-month repeat cytology for women with ASCUS results. (Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

Knowledge of emergency contraception amongst tertiary students in far North Queensland

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Sat, 21 Mar 2009 04:00:00 +0100

Conclusion: A significant lack of information regarding the availability, methods of action and limitations of EC was noted in this well-educated population. There was also a high proportion of participants who felt unable to access EC in a pharmacy where they might be known, a factor limiting accessibility of the method in small town and community settings. (Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

Pregnancy outcome in the setting of extremely low first trimester PAPP-A levels

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Wed, 18 Mar 2009 04:00:00 +0100

Conclusion: If the PAPP-A level is [le] 0.2 MoM and the karyotype is normal, there is an increased risk of adverse outcome. Even with PAPP-A below 0.1 MoM, a good outcome can be expected in 60% of cases. Careful morphological assessment is suggested and later monitoring of fetal growth and well-being. (Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

Measurement of cardiac output in normal pregnancy by a non-invasive two-dimensional independent Doppler device

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Wed, 18 Mar 2009 04:00:00 +0100

Conclusion: USCOM appears to be a reliable and fast method to measure cardiac output compared with existing highly complex ultrasounds machines used in cardiology. It is easy to learn, cheap and quite reproducible between different observers. Further research is required to define its place in the management of hypertensive complications during pregnancy. (Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

Perinatal outcome in fetuses with extremely large nuchal translucency measurement

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Wed, 18 Mar 2009 04:00:00 +0100

Conclusions: When the karyotype and morphology scan are normal, the outcome is often good in spite of an extremely large NT. However, even a subtle ultrasound anomaly can indicate a genetic syndrome and echocardiography cannot exclude mild cardiac abnormalities. (Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

Women's knowledge about human papillomavirus and their acceptance of HPV vaccine

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Wed, 18 Mar 2009 04:00:00 +0100

Conclusion: Although less than half of the women had knowledge about HPV, the majority of the women sampled reported that they would accept vaccination for themselves and their children. Health-care providers must focus not only on the diagnosis and treatment of cervical cancer, but must also provide information and education about HPV to women. (Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

Robot-assisted surgery in gynaecology

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Wed, 18 Mar 2009 04:00:00 +0100

Robotic surgery is the latest development in minimal invasive surgery. It provides superior visualisation and dexterity and therefore allows the surgeon to perform complex tasks that would exceed his/her abilities with conventional laparoscopy and would be associated with an increased morbidity if performed by laparotomy. Current evidence demonstrates the feasibility and safety of this technology in gynaecology. The costs of robotic surgery remain one of the main sources of controversy but are expected to come down with further developments of the technology. If evidence-based long-term outcome evaluations show the superiority of robotic surgery in comparison to conventional laparoscopic and open surgery, this technology will have a major impact on gynaecological surgery. (Source: The Aust...

Maternal periodontal disease and perinatal mortality

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Wed, 18 Mar 2009 04:00:00 +0100

Conclusions: Maternal periodontal disease may contribute to perinatal mortality, especially that caused by extreme prematurity. (Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

Antibody responses to Porphyromonas gingivalis outer membrane protein in the first trimester

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Wed, 18 Mar 2009 04:00:00 +0100

Conclusions: These results suggest that a lack of humoral immunity against Pg in early pregnancy is associated with IUGR and some PTB. (Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

Choosing medical or surgical terminations of pregnancy in the first trimester: What is the difference?

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Wed, 18 Mar 2009 04:00:00 +0100

Conclusions: Both medical and surgical first-trimester abortions are safe and effective. It is optimal to be able to offer women choice. Reducing the medical interval to one day does not increase adverse outcomes. (Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

Bioidentical testosterone cream: A rare cause of postmenopausal virilisation

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Tue, 03 Mar 2009 05:00:00 +0100

(Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

Labial fusion causing acute urinary retention in a young adult: A case report

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Tue, 03 Mar 2009 05:00:00 +0100

(Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

The early pregnancy assessment project: The effect of cooperative care in the emergency department for management of early pregnancy complications

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Tue, 03 Mar 2009 05:00:00 +0100

Conclusion: Introduction of the EPAP was successful in creating cultural change and delivering clinical and financial benefits to the hospital, patients and staff. Early gynaecological consultation and bedside ultrasound scanning within the ED were key factors. Similar benefits could be reproduced in other institutions and for other clinical scenarios where a need has been identified. (Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

Prevalence of menopausal symptoms and quality of life after menopause in women from South India

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Tue, 03 Mar 2009 05:00:00 +0100

Conclusion: The age at onset of menopause in southern Karnataka (India) is 48.7 years which is four years more than the mean menopause age for Indian women. This could be attributed to better socioeconomic and health-care facility in this region. (Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

Comparison of TVT and TVT-O in patients with stress urinary incontinence: Short-term cure rates and factors influencing the outcome. A prospective randomised study

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Tue, 03 Mar 2009 05:00:00 +0100

Conclusions: The TVT and TVT-O procedures appear to be equally effective for the treatment of SUI. Also, urethral hypermobility seems to be a factor influencing cure rate of mid-urethral slings. (Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

HuR expression in the nucleus correlates with high histological grade and poor disease-free survival in ovarian cancer

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Tue, 03 Mar 2009 05:00:00 +0100

Conclusions: Our results support the clinical significance of nuclear HuR in ovarian carcinoma and suggest that nuclear HuR may also play a role in the biology of ovarian cancer. These data suggest a more complex model for HuR in ovarian cancer than one limited to cytoplasmic localisation. (Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

Survey of surgical skills of RANZCOG trainees

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Tue, 03 Mar 2009 05:00:00 +0100

Conclusions: Advanced trainees lacked confidence in a range of surgical procedures; and possible weaker areas were identified in the teaching experience of trainers. These limitations must be addressed by medical educators and training program coordinators. (Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

Low-dose mifepristone in treatment of uterine leiomyoma: A randomised double-blind placebo-controlled clinical trial

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Tue, 03 Mar 2009 05:00:00 +0100

Conclusions: Ten milligrams mifepristone for three months is effective in reducing MBL, increasing haemoglobin and reducing uterine and leiomyoma volume with side-effect of endometrial hyperplasia. (Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

Gynaecologists blaze the trail in primary studies and systematic reviews of diagnostic test accuracy

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Tue, 03 Mar 2009 05:00:00 +0100

As the Cochrane Collaboration is poised to begin publishing systematic reviews of diagnostic test accuracy studies in addition to its traditional systematic reviews of treatment effectiveness, we are likely to see a major expansion in the number of primary studies and systematic reviews of diagnostic test accuracy in the medical literature. Obstetricians and gynaecologists have played an important role in initiating this newer area of research. However, the methodology for such studies is challenging and the published literature is riddled with pitfalls. This editorial seeks to simplify the concepts involved in diagnostic test accuracy studies and systematic reviews, to reflect on the early development of this research in our specialty and to envision the future pathway for screening and d...

Uterine compression sutures for post-partum bleeding with atony; modification of the B-Lynch suture

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Tue, 03 Mar 2009 05:00:00 +0100

We have described a modification of the B-Lynch uterine compression suture which is simple and effective. This technique apposes the anterior and posterior uterine walls, obliterating the cavity and thereby provides effective control of post-partum haemorrhage as a result of uterine atony. It comprises of vertical compression sutures and is distinct from B-Lynch and Haymen's suture by having an additional firm puncture just below the uterine fundus. This means that the suture is transfixed at the uterine fundus, thus eliminating the risk of the sutures sliding off at the uterine fundus. (Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

Obstetric implications of current Australian product information for thyroid-related medications

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Tue, 03 Mar 2009 05:00:00 +0100

(Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

A comparison of tramadol and pethidine analgesia on the duration of labour: A randomised clinical trial

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Tue, 03 Mar 2009 05:00:00 +0100

Conclusion: Both 100 mg tramadol and 50 mg pethidine provide moderate analgesia in first stage of labour. Tramadol seems to cause a shorter duration of labour and lower incidence of maternal side-effects. However, its analgesic efficacy was not found to be as effective as pethidine, especially in the second stage of labour. (Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

Small for gestational age preterm infants and relationship of abnormal umbilical artery Doppler blood flow to perinatal mortality and neurodevelopmental outcomes

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Tue, 03 Mar 2009 05:00:00 +0100

Conclusion: Fetuses that are SGA with abnormal UA Doppler studies remain at significant risk of perinatal death, perinatal morbidity and long-term neurodevelopmental disability, associated with their increased risk of preterm birth. (Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

Early onset, severe fetal growth restriction with absent or reversed end-diastolic flow velocity waveform in the umbilical artery: Perinatal and long-term outcomes

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Tue, 03 Mar 2009 05:00:00 +0100

Conclusion: The overall perinatal survival rate for pregnancies complicated by early onset, severe growth restriction with an EFW of < 501 g and AREDF is low. When delivery occurs for fetal indications, the majority of these women require classical CS. Short-term neonatal morbidity is high though none of the survivors had cerebral palsy. (Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

Antenatal screening practice for infectious diseases by general practitioners in Australia

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Tue, 03 Mar 2009 05:00:00 +0100

Conclusion: This study highlights the need for more education and resources to increase HIV testing rates and to improve follow-up of an HCV-exposed infant. (Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

Body fat composition and weight changes during pregnancy and 6–8 months post-partum in primiparous and multiparous women

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Tue, 03 Mar 2009 05:00:00 +0100

Conclusion: The findings could represent more exaggerated physiological responses to the pregnant state in the primiparous woman as compared to multiparous women. (Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

The selective use of rapid aneuploidy screening in prenatal diagnosis

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Tue, 03 Mar 2009 05:00:00 +0100

Conclusion: The selective use of prenatal RAS results in a reasonably high detection rate for chromosomal anomalies. Liberalisation of RAS, however, is an expensive cytogenetic model. An approach based on some predictive level of risk combined with resource funding levels may be a more pragmatic approach. (Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

Selective fetoscopic laser ablation in 100 consecutive pregnancies with severe twin–twin transfusion syndrome

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Tue, 03 Mar 2009 05:00:00 +0100

Conclusions: These results for the management of severe TTTS are comparable to the best reported international series. Long-term follow-up is required and more research needs to be undertaken to further improve these results. (Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

Clinical predictive factors for preterm birth in women with threatened preterm labour or preterm premature ruptured membranes?

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Tue, 03 Mar 2009 05:00:00 +0100

Conclusions: If the reliable and reproducible prediction of preterm delivery becomes possible using the four factors extracted in this study, further evaluation of these factors may lead to clarification of the mechanism of preterm delivery. (Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

Association of maternal pre-pregnancy weight with birth defects: Evidence from a case–control study in Western Australia

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Tue, 03 Mar 2009 05:00:00 +0100

Conclusions: Our findings were consistent with similar, statistically significant studies in the literature. Weight reduction prior to pregnancy in obese women may be a means of primary prevention of birth defects. (Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

An overview of the literature on congenital lower urinary tract obstruction and introduction to the PLUTO trial: Percutaneous shunting in lower urinary tract obstruction

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Tue, 03 Mar 2009 05:00:00 +0100

Congenital lower urinary tract obstruction (LUTO) comprises a heterogeneous group of pathologies causing obstruction to the urethra, the most common being posterior urethral valves. Such pathology is often associated with high perinatal mortality and varying degrees of perinatal and infant morbidity. A high proportion of LUTO may be visualised during routine second trimester (and first trimester) ultrasound giving rise to the possibility of determining individual fetal prognosis and treatments such as vesico-amniotic shunting, with a view to altering pathogenesis. The aims of the percutaneous shunting in low urinary tract obstruction (PLUTO) trial are to determine the effectiveness of these treatments and accuracy of the investigations with the primary outcome measures being perinatal mort...

Hereditary angioedema and pregnancy

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Tue, 03 Mar 2009 05:00:00 +0100

Conclusion: Our study showed that women with HAE have greatly reduced or absent attacks in the last two trimesters of pregnancy, although, during the post-partum period, the majority of women experienced increased frequency and severity of attacks. (Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

As good as it gets in fetal therapy?

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Sun, 01 Feb 2009 05:00:00 +0100

(Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

Re: Alcohol and pregnancy: The pivotal role of the obstetrician

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Mon, 22 Dec 2008 05:00:00 +0100

(Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

Successful pregnancy outcome in a patient with moyamoya disease

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Mon, 22 Dec 2008 05:00:00 +0100

(Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

Primary psoas muscle abscess in pregnancy

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Mon, 22 Dec 2008 05:00:00 +0100

We present a case of a primary iliacus-psoas muscle abscess in pregnancy causing back pain with delayed diagnosis and treatment. Understanding the clinical presentation of iliacus-psoas muscle abscess helps with considering it in the differential diagnosis of back pain during pregnancy. (Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

Gamete donors' and recipients' evaluation of donor counselling: A prospective longitudinal cohort study

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Mon, 22 Dec 2008 05:00:00 +0100

Conclusions: This study suggests that counselling is beneficial for those contemplating donor procedures, particularly donors, and that most have a positive attitude towards disclosure after counselling. (Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)

The diagnosis and treatment of Mullerian adenosarcoma of the uterus

The Australian and New Zealand Journal of Obstetrics and Gynaecology — Mon, 22 Dec 2008 05:00:00 +0100

Conclusions: The most common symptom of adenosarcoma of the uterus is abnormal uterine bleeding. Younger patients are more often misdiagnosed. Clinical stage and age of the patient are closely related to prognosis. Surgery is the primary treatment, and chemotherapy may be somewhat beneficial. (Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)