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

{"title":"Pregnancy in women with mitochondrial disease—A literature review and suggested guidance for preconception and pregnancy care","authors":"Lisa Hui, Pema Hayman, Ali Buckland, Michael C Fahey, David A Mackey, Andrew J Mallett, Daniel R Schweitzer, Clare P Stuart, Wai Yan Yau, John Christodoulou","doi":"10.1111/ajo.13874","DOIUrl":"https://doi.org/10.1111/ajo.13874","url":null,"abstract":"Mitochondrial donation to reduce the risk of primary mitochondrial disease transmission from mother to child is now permitted under Australian law as part of a clinical trial. The energy demands of pregnancy have the potential to worsen mitochondrial disease symptoms and severity in affected women. We conducted a systematic literature review on mitochondrial disease in pregnancy; five cohort studies and 19 case reports were included. For many women with mitochondrial disease, pregnancy does not have a negative effect on health status. However, serious adverse outcomes may occur. We provide suggested guidelines for preconception counselling and antenatal care.","PeriodicalId":8599,"journal":{"name":"Australian and New Zealand Journal of Obstetrics and Gynaecology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142222794","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to the abstracts of Annual Scientific Meeting of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG), 28 October – 1 November 2023","authors":"","doi":"10.1111/ajo.13829","DOIUrl":"https://doi.org/10.1111/ajo.13829","url":null,"abstract":"","PeriodicalId":8599,"journal":{"name":"Australian and New Zealand Journal of Obstetrics and Gynaecology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140842360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigation of the quality and health literacy demand of online information on pelvic floor exercises to reduce stress urinary incontinence","authors":"Brydie Willburger, Zhuoran Chen, Kylie J. Mansfield","doi":"10.1111/ajo.13830","DOIUrl":"https://doi.org/10.1111/ajo.13830","url":null,"abstract":"BackgroundMany women are embarrassed to discuss pelvic floor exercises with health professionals during pregnancy; instead they search the internet for information on pelvic floor exercises.AimsThis project investigated the quality and health literacy demand in terms of readability, understandability and actionability of information available on the internet relating to pelvic floor exercises.Materials and MethodsAn analysis was conducted on 150 websites and 43 videos obtained from three consecutive Google searches relating to pelvic floor exercises. Websites were assessed for Health on the Net certification. Readability was assessed using a readability calculator, and understandability/actionability of website and video information was assessed using the Patient Education Materials Assessment Tool (PEMAT) for Print or Audiovisual Materials.ResultsLess than one‐third (24%) of the websites were certified for quality. The median readability score for the websites was grade 9 and the websites and videos both rated highly for understandability and actionability. The median understandability score for the website information was 87%, and the median actionability score was 71%. The median understandability score of the video information was 95.5% and the median actionability score was 100%. The understandability and actionability of video information was also significantly greater than that for website information (<jats:italic>P</jats:italic> &lt; 0.01).ConclusionClinicians could consider directing patients to video‐based resources when advising online pelvic floor exercise resources for women during pregnancy, especially those with lower health literacy.","PeriodicalId":8599,"journal":{"name":"Australian and New Zealand Journal of Obstetrics and Gynaecology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140831543","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Why does hormonal contraception and menopausal hormonal treatment have such a small effect on breast cancer risk?","authors":"John A. Eden","doi":"10.1111/ajo.13825","DOIUrl":"https://doi.org/10.1111/ajo.13825","url":null,"abstract":"Oestrogen is considered by many to be a major cause of breast cancer, and yet hormonal contraception and menopausal hormonal therapy have a paradoxically small effect on breast cancer risk. Also, in the oestrogen‐only arm of the Women's Health Initiative, subjects given oestrogen had a reduced risk of breast cancer compared to controls. Initiation of breast cancer likely begins early in life, in the long‐lived ER<jats:sup>−</jats:sup>PR<jats:sup>−</jats:sup> breast stem cell. The main mitogen of ER<jats:sup>+</jats:sup>PR<jats:sup>+</jats:sup> breast cancers is oestrogen derived from local breast fat and the tumour itself, rather than circulating oestrogens. Progesterone is relatively breast neutral, but progestins in the laboratory have been shown to expand malignant breast stem cell number.","PeriodicalId":8599,"journal":{"name":"Australian and New Zealand Journal of Obstetrics and Gynaecology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140831545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antenatal health and perinatal outcomes of Pacific Islander women in Australia with and without gestational diabetes: A ten‐year retrospective cohort study","authors":"Annabel S. Jones, Jessica Deitch, Christopher Yates, Peter Shane Hamblin, Glyn Teale, Dev Kevat, I‐Lynn Lee","doi":"10.1111/ajo.13826","DOIUrl":"https://doi.org/10.1111/ajo.13826","url":null,"abstract":"BackgroundPacific Islander (PI) women in Australia have an increased risk of gestational diabetes (GDM); however, their perinatal outcomes are poorly understood.AimThe aim was to determine the maternal characteristics and perinatal outcomes of PI women with and without GDM compared to Australian/European (AE)–born women.MethodsA retrospective analysis of perinatal outcomes of singleton deliveries &gt;20 weeks’ gestation between 1 January 2011 and 31 December 2020 was conducted at a tertiary provider (Melbourne, Australia). Antenatal details and birth outcomes were extracted from the Birth Outcome Systems database. <jats:italic>t</jats:italic>‐Tests and χ<jats:sup>2</jats:sup>, univariate and multivariable logistic regression analyses assessed the relationship between ethnicity and outcomes.ResultsOf 52,795 consecutive births, 24,860 AE women (13.3% with GDM) and 1207 PI‐born women (20.1% with GDM) were compared. PI women had significantly greater pre‐pregnancy body mass index (BMI) and significantly lower rates of smoking and nulliparity. PI women with GDM had higher rates of pre‐eclampsia (<jats:italic>P</jats:italic> &lt; 0.001), large‐for‐gestational age (LGA) neonates (<jats:italic>P</jats:italic> = 0.037) and neonatal hypoglycaemia (<jats:italic>P</jats:italic> = 0.017) but lower rates of small‐for‐gestational age neonates (<jats:italic>P</jats:italic> = 0.034). Neonatal intensive care unit (NICU)/special care nursery requirements did not increase. After having adjusted for covariates, PI women's risk of LGA neonates (adjusted odds ratio (aOR): 1.06, 95% confidence interval (CI): 0.86–1.31) was attenuated; however, risk of pre‐eclampsia (aOR: 1.49, 95% CI: 1.01–2.21) and neonatal hypoglycaemia (aOR: 1.40, 95% CI: 1.01–1.96) still increased. They were less likely to require a primary caesarean section (aOR: 0.86, 95% CI: 0.73–0.99).ConclusionPI women have higher BMI and GDM rates, contributing to an increased likelihood of adverse perinatal outcomes. BMI is a modifiable risk factor that could be addressed prenatally.","PeriodicalId":8599,"journal":{"name":"Australian and New Zealand Journal of Obstetrics and Gynaecology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140798065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing preconception health in Australia to support better outcomes in the first 2000 days – A critical need for building a core indicator framework","authors":"Asvini K. Subasinghe, Kirsten I. Black, Edwina Dorney, Jacqueline A. Boyle","doi":"10.1111/ajo.13815","DOIUrl":"https://doi.org/10.1111/ajo.13815","url":null,"abstract":"In 2021, the Preconception Health Network Australia co‐developed preconception health core indicators identified as critical to ensuring optimal maternal and child outcomes following conception. We conducted an audit of perinatal databases across each state and territory to identify whether preconception core indicator data were available. Seven health domains co‐developed by the Preconception Health Network were mapped against the data collected in the perinatal databases. Indicator data were lacking across all seven health domains, with data missing for social determinants of health indicators. Better data linkage and developing a national evidence‐based framework would allow ongoing monitoring of women's preconception health nationally.","PeriodicalId":8599,"journal":{"name":"Australian and New Zealand Journal of Obstetrics and Gynaecology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140626625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Obstetrician views on Fetal Pillow® device use and research in Aotearoa New Zealand: A cross‐sectional survey","authors":"Lynn Sadler, Robin Cronin, Erena Browne, Amanda Harvey, Meghan G Hill","doi":"10.1111/ajo.13824","DOIUrl":"https://doi.org/10.1111/ajo.13824","url":null,"abstract":"BackgroundThere is anecdotal evidence of Fetal Pillow® use, but no formal local information on clinician practices and perspectives.AimsTo assess obstetrician use of the Fetal Pillow®, knowledge of relevant research, and interest in a proposed randomised controlled trial in Aotearoa New Zealand.Materials and MethodsAnonymous cross‐sectional survey of practising obstetricians and obstetric trainees in Aotearoa New Zealand distributed by the Royal Australian and New Zealand College of Obstetricians and Gynaecologists.ResultsOf 136 respondents (69% specialists and 31% trainees), 130 had heard of the Fetal Pillow® device, and 108 had used it at least once (43% more than ten times). The device was available in 17/21 units represented. The 108 users of the device reported this was most commonly on collegial advice (63%) or after personal experience of a difficult delivery (33%) and most (80%) believed it reduced maternal morbidity. Only around one‐third of the 130 respondents who had heard of the device agreed there was adequate research demonstrating its efficacy for maternal (36%) and neonatal (30%) morbidity. The majority reported they would change practice in response to a randomised trial, although they were more likely to start use (81% of current non‐users) than stop (53% of users). Most (70%) respondents agreed they would encourage patients to participate in a randomised trial.ConclusionsThe Fetal Pillow® is available in most maternity units in Aotearoa New Zealand. The majority of obstetric clinicians believe it reduces maternal morbidity, while acknowledging the lack of scientific evidence. Most would support a randomised trial.","PeriodicalId":8599,"journal":{"name":"Australian and New Zealand Journal of Obstetrics and Gynaecology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140626615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Percutaneous tibial nerve stimulation for the overactive bladder: A single‐arm trial","authors":"Hnin Yee Kyaw, Hannah G. Krause, Judith T.W. Goh","doi":"10.1111/ajo.13822","DOIUrl":"https://doi.org/10.1111/ajo.13822","url":null,"abstract":"AimsWe hypothesise that PTNS is a safe and effective treatment for OAB. Overactive bladder (OAB) is estimated to affect 11.8% of women worldwide, causing diminished quality of life. Lifestyle modifications, muscarinic receptor antagonist and beta‐adrenoreceptor agonist remain the mainstay of treatment but are limited by their efficacy and adverse effects. Access to third‐line therapies of intravesical botulinum toxin type A or sacral neuromodulation is limited by their invasive nature. Percutaneous tibial nerve stimulation (PTNS) has emerged as a non‐invasive treatment option for OAB.MethodsThis study was a single‐arm trial of women requesting third‐line treatment for OAB. The primary treatment outcome was patient‐reported visual analogue score (VAS) improvement of at least 50%. Secondary outcome measures were Urinary Distress Inventory Short Form (UDI‐6) score and two‐day bladder diary. Patients also provided feedback on adverse effects encountered.ResultsIn the 84 women recruited, initial treatment protocol showed a success rate of 77.2% among those who completed treatment based on VAS, with a statistically significant improvement in mean UDI‐6 score of 20.13 (<jats:italic>P</jats:italic> &lt; 0.01, standard deviation: 12.52). Continued success following tapering protocol of 60.8% and a mean maintenance protocol of 14.2 months was achieved. No adverse effects were reported.ConclusionThe results from this study are in concordance with previously published literature on the effectiveness and safety of PTNS as a treatment modality for OAB. Further randomised controlled trials to evaluate the optimal treatment protocol are warranted to establish a standardised regime.","PeriodicalId":8599,"journal":{"name":"Australian and New Zealand Journal of Obstetrics and Gynaecology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140626505","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Authors response to Letter to the Editor regarding ‘Perinatal outcomes after regional analgesia during labour’","authors":"Janna Lawson, Roshan Selvaratnam","doi":"10.1111/ajo.13827","DOIUrl":"https://doi.org/10.1111/ajo.13827","url":null,"abstract":"","PeriodicalId":8599,"journal":{"name":"Australian and New Zealand Journal of Obstetrics and Gynaecology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140609870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improvements from a small‐group multidisciplinary pain self‐management intervention for women living with pelvic pain maintained at 12 months","authors":"Karen Joseph, Jessica Mills","doi":"10.1111/ajo.13817","DOIUrl":"https://doi.org/10.1111/ajo.13817","url":null,"abstract":"BackgroundA small‐group multidisciplinary pain self‐management program for women living with pelvic pain, with or without endometriosis, was developed to address identified unmet treatment needs. Following completion, over 80% of participants demonstrated clinically significant improvement across a number of domains. There was no clinically significant deterioration on any measure and benefits continued at three months follow‐up.AimsThis study examines patient‐reported outcomes at 12 months following program completion to ascertain maintenance of these improvements.Materials and methodsSelf‐report measures assessed quality of life across the Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials domains prior to, at completion and 12 months following participation.ResultsAt 12 months follow‐up, improvement was seen in mean group scores for all baseline measures for 57% of participants who returned valid 12‐month follow‐up data, with clinically significant improvement seen for within‐subject scores for 50% of these participants for pain severity and also for pain‐related activity interference. Improvements were also reported in key predictors of long‐term outcomes, pain self‐efficacy and catastrophic worry, with 92% reporting improvement in each of these two constructs. There were 83% of respondents who reported feeling both improvement in overall sense of wellbeing and improvement in their physical ability compared to before the program.ConclusionsResults suggest that a six‐week multidisciplinary small‐group intervention increases participants' abilities to self‐manage pain and improves quality of life with lasting clinically significant improvements.","PeriodicalId":8599,"journal":{"name":"Australian and New Zealand Journal of Obstetrics and Gynaecology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140567421","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}