The Australian & New Zealand journal of obstetrics & gynaecology
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Aust N Z J Obstet Gynaecol · Dec 2020
Well-being, obstetrics and gynaecology and COVID-19: Leaving no trainee behind.
The COVID-19 pandemic has significantly disrupted training in obstetrics and gynaecology. Past pandemics have been shown to result in significant psychological morbidity. ⋯ This contributes to burnout, anxiety and depression. We share technology-based suggestions as well as institutional, departmental and self-care tips on how to maintain trainees' mental well-being during the fight against COVID-19.
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Aust N Z J Obstet Gynaecol · Dec 2020
Obstetric outcomes in major vs minor placenta praevia: A retrospective cohort study.
Placenta praevia (PP) is a rare obstetric condition associated with significant maternal and perinatal morbidity. Traditionally, the degree of PP has been classified into minor and major; however, there are very few robust studies that compare the maternal outcomes of these types of PP. ⋯ The degree of PP significantly impacts obstetric outcomes, with major PP associated with worse maternal morbidity antenatally, intraoperatively and postpartum. Therefore, to optimise patient care, this study emphasises the importance of identifying and distinguishing between different types of PP.
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Aust N Z J Obstet Gynaecol · Dec 2020
The risk of adverse maternal outcomes in cases of placenta praevia in an Australian population between 2007 and 2017.
Placenta praevia is characterised by an inferior placental margin that overlies or falls within 20 mm of the endocervical os. It remains a common cause of antepartum haemorrhage and is associated with adverse maternal and neonatal outcomes. ⋯ Antepartum and postpartum haemorrhage in cases of placenta praevia are predictors of several adverse outcomes. However, the high rate of term deliveries reaffirms the current practice of expectant management.
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Aust N Z J Obstet Gynaecol · Oct 2020
Meta AnalysisCOVID-19 and pregnancy: A review of clinical characteristics, obstetric outcomes and vertical transmission.
Since its emergence in December 2019, COVID-19 has spread to over 210 countries, with an estimated mortality rate of 3-4%. Little is understood about its effects during pregnancy. ⋯ Sixty articles were included in this review. Some pregnant participants may have been included in multiple publications, as admission dates overlap for reports from the same hospital. However, a total of 1287 confirmed SARS-CoV-2 positive pregnant cases are reported. Where universal testing was undertaken, asymptomatic infection occurred in 43.5-92% of cases. In the cohort studies, severe and critical COVID-19 illness rates approximated those of the non-pregnant population. Eight maternal deaths, six neonatal deaths, seven stillbirths and five miscarriages were reported. Nineteen neonates were SARS-CoV-2 positive, confirmed by reverse transcription polymerase chain reaction of nasopharyngeal swabs. [Correction added on 2 September 2020, after first online publication: the number of neonates indicated in the preceding sentence has been corrected from 'Thirteen' to 'Nineteen'.] CONCLUSIONS: Where universal screening was conducted, SARS-CoV-2 infection in pregnancy was often asymptomatic. Severe and critical disease rates approximate those in the general population. Vertical transmission is possible; however, it is unclear whether SARS-CoV-2 positive neonates were infected in utero, intrapartum or postpartum. Future work should assess risks of congenital syndromes and adverse perinatal outcomes where infection occurs in early and mid-pregnancy.
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Aust N Z J Obstet Gynaecol · Aug 2020
Demand for global health training among obstetrics and gynaecology trainees in Australia and New Zealand: Insights from the TIGHT study.
Global health (GH) training aims to equip clinicians with the skills and knowledge to practise in international and cross-cultural environments. Interest among obstetrics and gynaecology trainees is unknown. ⋯ There is significant demand for GH training among RANZCOG trainees. These findings should inform the development of accredited rotations in RLEs and the cultivation of safe and effective global women's health training pathways. Ideally, these arrangements should be underpinned by mutually beneficial partnerships with both educational and development objectives.