Australian & New Zealand Journal of Obstetrics & Gynaecology最新文献

{"title":"Psychological Assessment and Motivations of Potential Donors Within the First Australian Uterine Transplant Trial.","authors":"Brigitte Gerstl, Hayley Mallinder, Tamika Baker, Pia Euler-Vestey, Eva Kehag, Meredith Stone, Denise Lawrence, Hayley Pippard, Kaushalya Arulpragasam, Anna Walch, Finn Campion, Brittany McGill, Rebecca Deans","doi":"10.1111/ajo.13934","DOIUrl":"https://doi.org/10.1111/ajo.13934","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to investigate the psychological characteristics, motivations and experiences of potential living donors assessed for the first uterus transplant (UTx) clinical trial in Australia.</p><p><strong>Design: </strong>Mixed methods study.</p><p><strong>Setting: </strong>Tertiary hospital.</p><p><strong>Patient(s): </strong>Seven female potential UTx donors.</p><p><strong>Intervention(s): </strong>A mixed-methods design was used to evaluate seven self-referred potential uterus donors for the UTx program. Potential donors underwent rigorous clinical and psychological screening, including self-reported psychological assessments. Additionally, five potential donors participated in semi-structured interviews conducted by the study social worker.</p><p><strong>Main outcome measure(s): </strong>Scores from measures of quality of life, depression, anxiety and stress, along with thematic analysis from semi-structured interviews.</p><p><strong>Result(s): </strong>Thematic analysis identified six key themes: feelings about donating a uterus, health history, informed consent, impact of donation, relationships, and access to educational resources. Several sub-themes were also identified, including awareness of surgical complications and dynamics of relationships and sexuality. Quantitative results indicated clinical levels of depression, anxiety, and stress in some donors. Overall, the quality-of-life scores of the donors were comparable to those of the general Australian female population.</p><p><strong>Conclusion(s): </strong>The study provides a deeper understanding of the psychological profiles and motivations of potential UTx donors in Australia. It reveals the complexity of donor motivations, which include altruistic desires to help others experience pregnancy, and practical considerations. The findings emphasise the need for rigorous psychological screening and continuous support to address potential mental health challenges. These insights are valuable for developing future UTx protocols and support systems to ensure donor wellbeing.</p>","PeriodicalId":55429,"journal":{"name":"Australian & New Zealand Journal of Obstetrics & Gynaecology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143016891","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Uptake of Quitline Telephone Counselling by Women Who Smoke During Pregnancy.","authors":"Cheryl Bailey, David Ellwood, Philippa Middleton, Aleena M Wojcieszek, Vicki Flenady, Christine Andrews","doi":"10.1111/ajo.13933","DOIUrl":"https://doi.org/10.1111/ajo.13933","url":null,"abstract":"<p><strong>Background: </strong>While many pregnant women accept referrals for smoking cessation support, the uptake of telephone counselling appointments is unknown.</p><p><strong>Aims: </strong>To determine the uptake rate of Quitline appointments among Australian pregnant women who smoke after being referred by a healthcare provider.</p><p><strong>Materials and methods: </strong>Data on attendance at telephone counselling appointments, number of appointments attended, gestational age at referral, referral source and smoking cessation upon completion of the program were requested from Quitline. Descriptive analysis of trends over time were undertaken using retrospective data from six Australian jurisdictions between 2016 and 2023 for pregnant women referred to Quitline by healthcare providers.</p><p><strong>Results: </strong>A total of 7503 pregnant women who smoke were referred to Quitline in the study period. More than half (n = 4072, 54%) did not attend any telephone counselling appointments, 24% (n = 1812) attended one appointment, 10% (n = 725) two, 5% (n = 359) three and only 7% (n = 535) attended four or more appointments. Gestational age at referral was available for 1203 women in Queensland, with 52% (n = 624) attending their first phone appointment between 1 and 20 weeks of pregnancy and 48% (n = 579) attending between 21 and 40 weeks. The overall referred smoking cessation rate in this cohort was 4% and 52% for those completing the program.</p><p><strong>Conclusions: </strong>The Quitline referral model for smoking cessation support for pregnant women is suboptimal. Comprehensive and consistent routinely collected data are urgently needed to monitor Quitline services for pregnant women who smoke across Australia. Further research is needed to understand the barriers to referral and uptake.</p>","PeriodicalId":55429,"journal":{"name":"Australian & New Zealand Journal of Obstetrics & Gynaecology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143016892","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cystic Spaces in the Endometrium on Ultrasound and Correlations With Pathological Diagnosis: A Contemporary Retrospective Cohort Study in a Tertiary Centre.","authors":"Rosemary McBain, Karen Reidy, Ricardo Palma-Dias, Martin Healey","doi":"10.1111/ajo.13914","DOIUrl":"https://doi.org/10.1111/ajo.13914","url":null,"abstract":"<p><strong>Objectives: </strong>To determine the correlation between the ultrasound finding of cystic spaces in the endometrium and endometrial hyperplasia or cancer.</p><p><strong>Materials and methods: </strong>We performed a retrospective cohort study at a tertiary teaching hospital in Victoria, Australia, between January 2014 and December 2016. Patients who had a tertiary ultrasound where the endometrium was assessed and underwent endometrial sampling in the subsequent year were included.</p><p><strong>Results: </strong>There were 1614 patients who were included, and 154 (9.5%) had endometrial cystic spaces on ultrasound. Sensitivity, specificity, positive predictive value and negative predictive value for a histological finding of polyps were 16.3%, 93.4%, 51.3% and 72.3%, respectively; for endometrial hyperplasia without atypia (EH no A) 40.7%, 91.0%, 7.1% and 98.9%, respectively; for hyperplasia with atypia (EH with A) 25.0%, 90.8%, 5.2%, 98.4%, respectively and for endometrial cancer were 19.5%, 90.7%, 5.2% and 97.7%, respectively. When adjusted for age, endometrial thickness and the presence of polyps on ultrasound, cystic spaces increased the odds of a histologic diagnosis of polyps (adjusted odds ratio (aOR) 2.13 (95% CI 1.41-3.21) P < 0.001) or EH no A (aOR 5.20 (95% CI 2.06-13.12) P < 0.001) and reduced the odds of endometrial cancer (aOR 0.26 (0.08-0.81) P = 0.02).</p><p><strong>Conclusion: </strong>Cystic spaces on ultrasound are more likely to indicate the presence of EH no A or an endometrial polyp than endometrial cancer. As one in ten patients who had cystic spaces on tertiary ultrasound had a pathologic diagnosis of EH with A or carcinoma, there remains a need for sampling in this group until better data are available.</p>","PeriodicalId":55429,"journal":{"name":"Australian & New Zealand Journal of Obstetrics & Gynaecology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143016889","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond COVID-19: Reported clinical practices in maternity care in Victoria during the COVID-19 pandemic and implications for the future - A statewide review.","authors":"Della A Forster, Rebecca Hyde, Robyn Matthews, Charlie A Benzie","doi":"10.1111/ajo.13904","DOIUrl":"https://doi.org/10.1111/ajo.13904","url":null,"abstract":"<p><strong>Background: </strong>In Australia, during the COVID-19 pandemic many routine pregnancy visits were replaced by telehealth, along with changes to routine screening and visitor policies. Many providers plan to continue these changes.</p><p><strong>Aims: </strong>Describe changes to maternity care provision across the state of Victoria during the COVID-19 pandemic.</p><p><strong>Materials and methods: </strong>A population-based cross-sectional design was used. Managers of maternity services (public and private) were invited to complete a questionnaire by telephone or online exploring changes to care delivery, telehealth practices, perceived impact of changes and future telehealth implementation.</p><p><strong>Results: </strong>Fifty per cent of maternity service managers (34/68; 27 public, six private) responded (March-April 2021). Around 50% of all pregnancy visits became telehealth, with multiple combinations of face-to-face and telehealth visits; 92% conducted the first (booking) appointment via telehealth. No specific gestational visit was conducted face-to-face by all services. Visits most likely to be face-to-face were at 39 and 40 weeks gestation (65%). For telehealth appointments, there was an ad hoc approach to routine screening, eg, measuring blood pressure (11% did not advise at all), fetal growth (26%-no specific strategy) and fetal heart rate (15%-no specific strategy). Over half (52%) would consider maintaining telehealth post-pandemic.</p><p><strong>Conclusions: </strong>Even in a single state, there was great variation in what constitutes telehealth, when pregnant women should have face-to-face visits, and what routine screening in pregnancy should be maintained. This is concerning given over half the services are planning to continue telehealth post-pandemic, despite the lack of evidence of safety, efficacy and input from women and clinicians.</p>","PeriodicalId":55429,"journal":{"name":"Australian & New Zealand Journal of Obstetrics & Gynaecology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143016888","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Increasing Use of Antenatal Magnesium Sulphate Prior to Preterm Birth for Preventing Cerebral Palsy in Australia and New Zealand, 2012-2020: A Binational Registry Study.","authors":"Emily Shepherd, Sarah McIntyre, Alice Rumbold, Tasneem Karim, Shona Goldsmith, Amy Keir, Amanda Poprzeczny, Rod W Hunt, Nadia Badawi, Christopher J D Mckinlay, Caroline A Crowther, Lisa Yelland","doi":"10.1111/ajo.13937","DOIUrl":"https://doi.org/10.1111/ajo.13937","url":null,"abstract":"<p><p>We assessed the use of magnesium sulphate prior to preterm birth for preventing cerebral palsy in an Australian and New Zealand registry study. Use increased markedly from 32.3% (2012) to 78.8% (2020) (p < 0.001). Binational approaches to sustain and explore the feasibility of further increasing use, informed by evolving evidence and guidelines, are needed.</p>","PeriodicalId":55429,"journal":{"name":"Australian & New Zealand Journal of Obstetrics & Gynaecology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143016890","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"E-Poster Abstracts","authors":"","doi":"10.1111/ajo.3_13921","DOIUrl":"10.1111/ajo.3_13921","url":null,"abstract":"<p>C CHAN, T VANCAILLIE and E HOWARD</p><p><b>Introduction:</b> In 2017, a senate inquiry was undertaken after hundreds of Australian women reported serious pain and side effects from the use of transvaginal mesh implants, including incontinence, dyspareunia, persistent pain. In response to the high numbers of severely affected women, we customised our clinical approach with dual consult (pain physician and pain education osteopath) to maximise patient outcomes.</p><p><b>Aims:</b> The aim of this pilot study is to substantiate that neuroscience-based pain education, as an integral component of management, can benefit patient's understanding, emotions, and coping skills related to their pain experience.</p><p><b>Methods:</b> Thirty-three patients who presented (and consented for research) in the past six months with pelvic pain were randomly identified within the database of the Women's Health and Research Institute of Australia and asked a series of pre-selected questions.</p><p><b>Results:</b> Twenty-one patients participated. Nineteen patients responded that it was their first experience of a dual consult. Twenty patients found the experience valuable with a score of 4 or 5 on a 5-point Likert scale with the greatest value of the dual consult being the opportunity to ask more questions.</p><p>Similarly, twenty and sixteen patients responded with a score of 4 or 5 for recommending to family and for finding what they paid for worth it respectively.</p><p><b>Discussion:</b> This small-cohort retrospective audit supports that single-session neuroscience-based education (listening to and explaining individualised management) is valuable in conjunction with spending time to clinically examine patients. This pilot qualitative study calls for further research into the impact of dual consultation on outcome measures.</p>","PeriodicalId":55429,"journal":{"name":"Australian & New Zealand Journal of Obstetrics & Gynaecology","volume":"65 S1","pages":"53-83"},"PeriodicalIF":1.4,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajo.3_13921","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142973417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Main Program Abstracts","authors":"","doi":"10.1111/ajo.13921","DOIUrl":"10.1111/ajo.13921","url":null,"abstract":"","PeriodicalId":55429,"journal":{"name":"Australian & New Zealand Journal of Obstetrics & Gynaecology","volume":"65 S1","pages":"4-33"},"PeriodicalIF":1.4,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajo.13921","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142973415","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Static Poster Abstracts","authors":"","doi":"10.1111/ajo.2_13921","DOIUrl":"10.1111/ajo.2_13921","url":null,"abstract":"","PeriodicalId":55429,"journal":{"name":"Australian & New Zealand Journal of Obstetrics & Gynaecology","volume":"65 S1","pages":"40-53"},"PeriodicalIF":1.4,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajo.2_13921","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142973416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Three Minute Thesis Abstracts","authors":"","doi":"10.1111/ajo.1_13921","DOIUrl":"10.1111/ajo.1_13921","url":null,"abstract":"","PeriodicalId":55429,"journal":{"name":"Australian & New Zealand Journal of Obstetrics & Gynaecology","volume":"65 S1","pages":"33-40"},"PeriodicalIF":1.4,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajo.1_13921","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142973339","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"'Screening should not be based on ability to pay': Australian healthcare providers' and consumers' perspectives on public funding for non-invasive prenatal testing.","authors":"Cecilia Pynaker, Molly Johnston, Catherine Mills, Katie Vasey, Michelle Taylor-Sands, Hilary Bowman-Smart, Lisa Hui","doi":"10.1111/ajo.13915","DOIUrl":"https://doi.org/10.1111/ajo.13915","url":null,"abstract":"<p><strong>Background: </strong>Non-invasive prenatal testing (NIPT) does not receive any Medicare rebate. This study investigated the views of Australian healthcare providers and consumers on public funding of NIPT.</p><p><strong>Materials and methods: </strong>Two anonymous online, cross-sectional surveys were conducted from September 2022 to January 2023. Surveys targeted maternity healthcare professionals ('providers'), and individuals who had recently conceived a pregnancy ('consumers'). Quantitative data were analysed using χ² test. Free-text responses were analysed by inductive content analysis.</p><p><strong>Results: </strong>Responses from 381 providers and 630 consumers were analysed. The overwhelming majority of providers (96.8%) identified financial cost as a consumer barrier to NIPT access. Public funding for NIPT was supported by 86.4% of providers and 90.4% of consumers, with free-text responses citing equity, clinical, health economic, reproductive autonomy, and ethical justifications. Of the 145 consumers who did not use NIPT in a recent pregnancy, 63.1% rated cost as an 'important/very important' factor in foregoing NIPT. NIPT non-users were younger, had lower household income and education, and were more likely to live in a rural or remote area than consumers who used NIPT.</p><p><strong>Conclusion: </strong>Maternity healthcare providers and consumers are highly supportive of public funding for NIPT as a first-line screening test on clinical, equity, health economic, and ethical grounds. Our results confirm the presence of significant socioeconomic disparities between NIPT users and non-users, with cost being the most important factor impeding equitable access to best practice in prenatal screening. Further research and advocacy are needed to achieve equitable access to best practice in antenatal care.</p>","PeriodicalId":55429,"journal":{"name":"Australian & New Zealand Journal of Obstetrics & Gynaecology","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142973414","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}