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

{"title":"Sentinel lymph node detection with indocyanine green and patent blue dye in cervical cancer: A single-centre feasibility study.","authors":"Marta Preston, Rosemary McBain, Niveditha Rajadevan, Antonia Jones, Deborah Neesham, Orla McNally","doi":"10.1111/ajo.13834","DOIUrl":"https://doi.org/10.1111/ajo.13834","url":null,"abstract":"<p><strong>Background: </strong>Sentinel lymph node (SLN) dissection has been established as standard of care in many tumours. Its use in early cervical cancer is an area of increasing interest and some studies suggest a high detection rate.</p><p><strong>Aim: </strong>To explore feasibility of SLN dissection and establish the patient detection rate in women with early cervical cancer.</p><p><strong>Materials and methods: </strong>All patients with early cervical cancer, International Federation of Gynaecology and Obstetrics (FIGO) 2018 Stage 1, of any histology who underwent SLN dissection from January 2017 to March 2023 were included. Patients were eligible if they had pelvic confined disease; no suspicious lymph nodes on pre-operative imaging or intra-operatively; tumours <4 cm at the time of surgery and no contra-indications to surgery. Patients were excluded if there was a known allergy to dye or less than six months follow-up data.</p><p><strong>Results: </strong>Sixty-two patients were included in the study and 53% had FIGO stage 1b1 disease. The overall bilateral SLN detection rate was 89%, and the side-specific rate was 94%. Where indocyanine green (ICG) was used alone, the bilateral detection rate was 87% and the side-specific rate was 93%. Where ICG was used with patent blue dye (PTB) the bilateral detection rate was 92% and the side-specific rate was 96%. Where PTB was used alone the bilateral detection rate was 85% and the side-specific rate was 92%. The node positive rate was 6% (7/124) which included isolated tumour cells in four patients.</p><p><strong>Conclusion: </strong>SLN dissection with ICG or PTB is feasible in early-stage cervical cancer.</p>","PeriodicalId":55429,"journal":{"name":"Australian & New Zealand Journal of Obstetrics & Gynaecology","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140878008","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":"Research priorities of endometriosis patients and supporters in Aotearoa New Zealand.","authors":"Katherine Ellis, Rachael Wood","doi":"10.1111/ajo.13831","DOIUrl":"https://doi.org/10.1111/ajo.13831","url":null,"abstract":"<p><strong>Background: </strong>In New Zealand, an estimated 10% of women and people presumed female at birth have endometriosis, a disease characterised by the presence of tissue similar to the lining of the uterus, outside of the uterus.</p><p><strong>Aims: </strong>The purpose of this study was to characterise the research priorities of New Zealand endometriosis patients and their support networks in alignment with an Australian study. This will allow researchers to be able to ensure their research aligns with closing research gaps prioritised by those who directly experience the impacts of the disease.</p><p><strong>Methods and materials: </strong>There were 1262 responses to an online Qualtrics survey advertised through Endometriosis New Zealand's social media accounts and mailing list to reach endometriosis patients and their support networks.</p><p><strong>Results: </strong>Overall, the highest research priorities for surgically or radiologically confirmed endometriosis patients, clinically suspected endometriosis patients, chronic pelvic pain patients, and their parents, partners, family members and friends were the management and treatment of endometriosis, followed by understanding endometriosis' cause, and improved capacity to diagnose endometriosis earlier. The key differences between the priorities of symptomatic participants and supporters were that symptomatic participants placed a significantly higher priority on understanding the cause of endometriosis, and supporters placed a significantly higher priority on improving the diagnosis of endometriosis.</p><p><strong>Conclusions: </strong>There is alignment between the ranking of general research priority areas for endometriosis in Australasia, allowing for clear priorities for future research teams to structure their work around patient-centredness.</p>","PeriodicalId":55429,"journal":{"name":"Australian & New Zealand Journal of Obstetrics & Gynaecology","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140853608","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":"Our evaluation of the paper authored by Sakas","authors":"Hossam Elzeiny","doi":"10.1111/ajo.13809","DOIUrl":"10.1111/ajo.13809","url":null,"abstract":"","PeriodicalId":55429,"journal":{"name":"Australian & New Zealand Journal of Obstetrics & Gynaecology","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140831510","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":"The first International Association of Diabetes and Pregnancy Study Groups summit on the diagnosis of gestational diabetes in early pregnancy: TOBOGM Summit Report.","authors":"Arianne Sweeting, Freya MacMillan, David Simmons","doi":"10.1111/ajo.13823","DOIUrl":"https://doi.org/10.1111/ajo.13823","url":null,"abstract":"<p><p>The first International Association of Diabetes and Pregnancy Study Groups Summit on the diagnosis of gestational diabetes in early pregnancy (Treatment of Booking Gestational Diabetes Mellitus (TOBOGM) Summit) was held on the 17 November 2022 in Sydney, Australia. It sought to use the TOBOGM trial findings to scope the issues involved with early screening, to inform future discussions over possible approaches for diagnosing gestational diabetes mellitus (GDM) in early pregnancy. Most delegates supported testing for early GDM using a one-step 75 g oral glucose tolerance test approach with Canadian Diabetes Association criteria preferred, but highlighted the importance of considering resources, cost, consumer perspectives and equity in translating TOBOGM results into a clinical approach to screening for, and diagnosing, early GDM.</p>","PeriodicalId":55429,"journal":{"name":"Australian & New Zealand Journal of Obstetrics & Gynaecology","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140856765","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":"Reply to perinatal outcomes after regional analgesia during labour","authors":"Kara Thompson,&nbsp;Nisha Khot","doi":"10.1111/ajo.13811","DOIUrl":"10.1111/ajo.13811","url":null,"abstract":"","PeriodicalId":55429,"journal":{"name":"Australian & New Zealand Journal of Obstetrics & Gynaecology","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140609719","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":"Editor-in-chief's introduction to ANZJOG 64(2)","authors":"Scott W. WHITE","doi":"10.1111/ajo.13818","DOIUrl":"https://doi.org/10.1111/ajo.13818","url":null,"abstract":"<p>Welcome to the April 2024 issue of <i>ANZJOG</i>. Thank you to the many contributors to <i>ANZJOG</i> who have submitted manuscripts and contributed to the peer review process as this maintains the journal as a source of robust clinical science for clinicians and researchers in Australia and New Zealand and further afield.</p><p>This issue begins with two stimulating articles about severe maternal morbidity. Most of us are fortunate to live and work in locations with historically low rates of maternal mortality, although there remain lessons to be learned and improvements to be made from the rare but tragic maternal deaths that still occur. Although there are robust and well-resourced processes for review of maternal mortality, the recognition, review and reporting of severe maternal morbidity are much less systematic, resulting in missed opportunities for the detection and improvement of system-level weaknesses which underlie preventable severe adverse maternal outcomes. The review by Frost et al. provides an excellent overview of the current situation of maternal morbidity review in Australia. The authors conclude by outlining a number of key steps towards implementing a systematic maternal morbidity review jurisdictionally and nationally.<span>¹</span> In their editorial, MacDonald et al. go further, calling upon us, clinicians and researchers, to make the case for progress in this area and to drive it.<span>²</span> Major change will require policy and resource attention from government, but we can take valuable action prior to that: to demonstrate why this is important, our willingness to work towards improvements in maternal and related health outcomes and to spur policymakers into action.</p><p>This issue also includes reports of two randomised controlled trials. Fahy et al. present their trial of placental cord drainage at caesarean section.<span>³</span> This practice has been shown to reduce the duration of the third stage of labour at vaginal birth although without a clinically significant reduction in blood loss. The authors compared placental cord drainage to delayed cord clamping at planned caesarean section, finding no significant differences between the two groups, and concluded that this study supports the routine use of delayed cord clamping.</p><p>The second trial compared sonographer-performed ultrasound-guided embryo transfer versus standard embryo transfer, including rates of intrauterine air bubble visualisation, clinical pregnancy and live birth as outcomes.<span>⁴</span> Of these, only air bubble visualisation was significantly different between the groups, with sonographer-performed ultrasound proving beneficial. Given the resource implications of sonographer assistance and the lack of impact on clinical outcomes, this study does not provide compelling evidence to change standard practice in routine cases.</p><p>Two groups present systematic reviews of gynaecological interes","PeriodicalId":55429,"journal":{"name":"Australian & New Zealand Journal of Obstetrics & Gynaecology","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajo.13818","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140559546","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":"A study protocol for live and deceased donor uterus transplantation as a treatment for women with uterine factor infertility","authors":"Jana Pittman,&nbsp;Mats Brännström,&nbsp;Neill Keily,&nbsp;Brigitte Gerstl,&nbsp;Elena Cavazzoni,&nbsp;Henry Pleass,&nbsp;Mianna Lotz,&nbsp;Natasha Rogers,&nbsp;Germaine Wong,&nbsp;Wayne Hsueh,&nbsp;Ashraf Hanafy,&nbsp;Jason A. Abbott,&nbsp;Rebecca Deans","doi":"10.1111/ajo.13810","DOIUrl":"10.1111/ajo.13810","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Uterus transplantation (UTx) is an emerging treatment option for women with uterine factor infertility (UFI) or the absence of a functional uterus. This is the study protocol for the first human UTx clinical trial in Australia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>This protocol outlines the approved training program used to plan, diagnose, screen, and treat patients who may be eligible for UTx using living and deceased donors. This multi-site clinical research study includes three tertiary hospital sites within New South Wales (NSW), Australia – Prince of Wales, Royal Hospital for Women and Westmead Hospitals. Our UTx protocol is based on that used by our collaborative partner, the inaugural UTx team in Gothenburg, Sweden. The Swedish UTx team provides ongoing preceptorship for the Australian UTx team. Ethics approval for six UTx procedures using living or deceased donors (Western Sydney Local Health District Human Research Ethics Committee: 2019/ETH138038) was granted in 2020.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Results from surgeries and live births will be published. Data will be prospectively entered into the registry of the International Society of Uterus Transplantation (ISUTx), a sub-section of The Transplantation Society (TTS). Trial Id: ACTRN12622000917730.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>A multidisciplinary research team has been formed between three tertiary hospitals in Sydney – The Royal Hospital for Women, Prince of Wales and Westmead Hospitals; and with the Swedish UTx, University of Gothenburg. The Swedish team pioneered animal and human UTx studies since 1998, including publishing the first live birth after UTx. (1) This Australian trial commenced in January 2023.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Uterus transplantation gives women with UFI the opportunity to be gestational and genetic mothers. It is a complex procedure for both the donor and recipient, with medical and surgical risks. An extensive multidisciplinary approach is required to optimise patient safety and graft outcomes. This protocol outlines our Australian UTx team strategy for screening, recruitment, surgical approach, and clinical management of UTx recipients and donors.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55429,"journal":{"name":"Australian & New Zealand Journal of Obstetrics & Gynaecology","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajo.13810","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140319894","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":"Severe maternal morbidity – we need more action to prevent harm","authors":"Evelyn Jane MacDonald,&nbsp;Beverley Lawton,&nbsp;Francesca Storey,&nbsp;Kendall Stevenson,&nbsp;John David Tait,&nbsp;Peter Stone","doi":"10.1111/ajo.13813","DOIUrl":"10.1111/ajo.13813","url":null,"abstract":"<p>Reviewing severe maternal morbidity (SMM) is considered a marker of the quality of maternity care, as in high income countries (HIC) maternal mortality is thankfully now rare.<span>¹</span> SMM disrupts maternal (and wider family) wellbeing, causing considerable personal and public cost. SMM preventability review has the potential to reduce this and the associated harm. To do this, we must identify its occurrence, review these cases, and analyse findings to develop appropriate system improvements.</p><p>As Joanne Frost and her colleagues in this current <i>Australian and New Zealand Journal of Obstetrics and Gynaecology</i> state, there is currently no national consensus or agreement in Australia on terms to use, definitions to follow and therefore no ability to compare inter-state data on the rates and causes of SMM. There is also no defined process to assess preventability in Australia and without this at the outset it is difficult to see how change would be effected. While in Aotearoa (New Zealand), our Health Research Council has previously funded research to enable national SMM preventability reviews, across both countries there appears to be no will by our respective governments to provide ongoing funding to enable routine SMM preventability reviews to take place.<span>²</span> No funding is currently available at regional, state, or national levels, and there is no apparent plan for these reviews to become ‘business as usual’. This is regrettable, as opportunities are being missed to improve poor maternal and baby outcomes.</p><p>There is no global agreement on how to define and implement SMM or maternal near-miss (MNM) reviews. There is not even agreement on what to call it. Professor Marion Knight stated four years ago in an editorial for another equally high-quality journal, – ‘As we publish yet more studies (re)defining severe maternal morbidity, should we be questioning whether it is time to draw a line on this research waste and instead initiate a truly international consensus process?’<span>³</span></p><p>And ‘ay, there is the rub’.<span>⁴</span> How do we initiate a ‘truly international consensus process’? A systematic review of global practices in monitoring of MNM/SMM showed inconsistencies in monitoring with low /middle income countries (LIC/MIC) using predominantly the World Health Organization (WHO) definition of MNM and tools, and high-income countries (HIC) using the SMM definition tools such as the Geller tool for reviewing preventability. The authors concluded that global standardising was ‘not feasible at this time’.<span>⁵</span> Even a good news recent systemic review and meta-analysis of the WHO MNM criteria uptake in LIC showed that despite good uptake in these countries enabling some intercountry comparisons, there was still the need in individual countries for contextual adaptations.<span>⁶</span></p><p>Surely the conversation needs to change. A se","PeriodicalId":55429,"journal":{"name":"Australian & New Zealand Journal of Obstetrics & Gynaecology","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajo.13813","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140319895","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":"Health needs, treatment decisions and experience of traditional complementary and integrative medicine use by women with diminished ovarian reserve: A cross-sectional survey","authors":"Alison Maunder,&nbsp;Susan Arentz,&nbsp;Mike Armour,&nbsp;Michael F Costello,&nbsp;Carolyn Ee","doi":"10.1111/ajo.13805","DOIUrl":"10.1111/ajo.13805","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Women with diminished ovarian reserve (DOR) have fewer eggs than would be expected at their age. It is estimated that 10% of women seeking fertility treatment are diagnosed with DOR. However, the success rate of medically assisted reproduction (MAR) is significantly lower in women with DOR, thus many seek additional approaches.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To explore the health needs of women with DOR, treatment options and experience of treatment including traditional complementary integrative medicine (TCIM).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Anyone with a diagnosis of DOR, living in Australia or New Zealand, aged over 18 were invited to complete an online survey distributed via fertility support networks and social media platforms from April to December 2021.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Data from 67 respondents were included. The main aspects of health that were impacted by DOR were fertility (91.0%) and mental health (52.2%). The main treatment recommended was MAR with most women either currently using MAR (38.8%) or having previously used MAR (37.3%). TCIM was widely used with 88.1% of women utilising supplements, 74.6% consulting with TCIM practitioners, and 65.7% adopting self-care practices. The main reasons for using TCIM were to improve fertility or support pregnancy, and to support general health and well-being.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Women with DOR have additional health needs apart from infertility, most notably mental health support. The main form of treatment utilised is MAR, despite DOR being challenging for fertility clinicians. TCIM was widely used, and respondents perceived benefits related to improving fertility, supporting pregnancy, or improving well-being through use of acupuncture, meditation, naturopathy, massage, yoga.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55429,"journal":{"name":"Australian & New Zealand Journal of Obstetrics & Gynaecology","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajo.13805","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140186393","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":"Improving accuracy of outcome prediction for infants born extremely preterm using a digital tool: Translating ‘NIC-PREDICT’ into clinical practice, the first steps","authors":"Rosemarie A. Boland,&nbsp;Jeanie L.Y. Cheong,&nbsp;Michael J. Stewart,&nbsp;Stefan C. Kane,&nbsp;Lex W. Doyle","doi":"10.1111/ajo.13808","DOIUrl":"10.1111/ajo.13808","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Many clinicians overestimate mortality and disability rates in infants born extremely preterm. We developed a digital tool (‘NIC-PREDICT’) that predicts infant mortality and survival with and without major disability in infants born 23–27 weeks' gestation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>To determine if clinicians could use NIC-PREDICT accurately, and if their perceptions of infant outcomes improved after its release in 2021.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>Midwives, nurses, obstetricians, neonatologists and paediatricians working in tertiary and non-tertiary hospitals in Victoria were asked to use NIC-PREDICT to estimate three mutually exclusive outcomes: (i) mortality; (ii) survival free of major disability; and (iii) survival with major disability for six different scenarios where a liveborn infant was offered survival-focused care after birth. The proportions who completed the survey (responded to all six scenarios) and the proportions able to provide 100% accurate results for all scenarios were determined. Estimates of the three outcomes were compared with true rates.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 85 clinicians responded: 70 (82%) completed the survey, with an overall accuracy of 76%. Overall, predictions of mortality were accurate (mean difference from true value 0.7% (95% confidence interval (CI) −0.7, 2.1) <i>P</i> = 0.33), as were predictions of survival without major disability (mean difference − 0.7 (95% CI –3.0, 1.7) <i>P</i> = 0.58). However, survival with major disability was overestimated by 4.9% ((95% CI 1.7, 8.0) <i>P</i> = 0.003).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Most perinatal clinicians who responded used NIC-PREDICT correctly to estimate expected outcomes in infants born extremely preterm who are offered intensive care. Undue pessimism about survival with major disability remains an ongoing concern.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55429,"journal":{"name":"Australian & New Zealand Journal of Obstetrics & Gynaecology","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajo.13808","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140001404","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}