The Australian & New Zealand journal of obstetrics & gynaecology
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To date, there is a lack of evidence to suggest that a systematic and coordinated approach to prepregnancy care might make a difference. ⋯ These preliminary data provide some optimism that a comprehensive preconception care service may positively influence maternal and neonatal outcomes.
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Aust N Z J Obstet Gynaecol · Oct 2014
Observational StudyCharacteristics of obstetric patients referred to intensive care in an Australian tertiary hospital.
The low mortality rate of 8.4 deaths per 100,000 women giving birth in Australia is well described; however, less is known about the spectrum of morbidity evident in pregnant and postpartum women admitted to an intensive care unit. ⋯ A substantial number of pregnant and postpartum women admitted to ICU did not receive interventions typical of other critical illness, such as mechanical ventilation, inotropes or renal replacement therapy. This confounds the use of an ICU admission as a measure of maternal morbidity.
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Pregnant women have much higher iodine requirements as compared to all other population groups. The National Health and Medical Research Council (NHMRC) recommends pregnant women take a daily iodine supplement of 150 μg to meet their high iodine requirements. ⋯ Despite NHMRC guidelines for iodine supplementation during pregnancy, many women were not taking a sufficient iodine supplement. Pregnant women may be inclined to take an iodine supplement if they had greater knowledge of their increased iodine needs during pregnancy. Medical practitioners are best placed to provide this information to pregnant women.
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Aust N Z J Obstet Gynaecol · Jun 2014
Randomized Controlled Trial Multicenter StudyThe NIFTY study: a multicentre randomised double-blind placebo-controlled trial of nifedipine maintenance tocolysis in fetal fibronectin-positive women in threatened preterm labour.
In an unselected group of women with signs of preterm labour, maintenance tocolysis is not effective in the prevention of preterm birth and does not improve neonatal outcome. Among women with signs of preterm labour, those who are fetal fibronectin positive have an increased risk of preterm birth. We investigated whether maintenance tocolysis with nifedipine would delay delivery and improve neonatal outcome in women with threatened preterm labour and a positive fetal fibronectin status. ⋯ In women with threatened preterm labour who are fetal fibronectin positive, maintenance tocolysis with nifedipine does not seem to prolong pregnancy, nor reduce length of NICU admission.
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Aust N Z J Obstet Gynaecol · Jun 2014
Intrahepatic cholestasis of pregnancy: diagnosis and management; a survey of Royal Australian and New Zealand College of Obstetrics and Gynaecology fellows.
Intrahepatic cholestasis of pregnancy (ICP) is an uncommon obstetric condition characterised by intense maternal pruritis and biochemical abnormality. There is a degree of contention regarding the diagnosis and management of ICP, and currently, there are no nationally accepted guidelines. ⋯ Elevated fasting bile acids and abnormal liver function tests define the diagnosis and inform management of ICP by Australian obstetricians. Routine induction of labour for patients with ICP at 37-38 completed weeks of pregnancy is widely practised in Australia. An evidence-based guideline would assist clinicians who manage such cases in Australia.