The Australian & New Zealand journal of obstetrics & gynaecology
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Aust N Z J Obstet Gynaecol · Oct 2009
Incidence and risk factors predicting blood transfusion in caesarean section.
Routine preoperative evaluation for caesarean section (CS) has commonly included a blood type and screen evaluation due to risk of blood transfusion. However, there have been no objective local data to support such practices. ⋯ In the absence of significant risk factors for haemorrhage at CS in a tertiary setting, routine blood type and screen testing does not enhance patient care. In the rare event that a patient without previously identifiable risk factors requires an urgent blood transfusion, O negative blood could be given in the interim pending formal determination of type and cross-match.
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Aust N Z J Obstet Gynaecol · Aug 2009
Detection and management of decreased fetal movements in Australia and New Zealand: a survey of obstetric practice.
Decreased fetal movement (DFM) is associated with increased risk of adverse pregnancy outcome. However, there is limited research to inform practice in the detection and management of DFM. ⋯ While monitoring fetal movement is an important part of antenatal care in Australia and New Zealand, variation in obstetric practice for DFM is evident. Large-scale randomised controlled trials are required to identify optimal screening and management options. In the interim, high quality clinical practice guidelines using the best available advice are needed to enhance consistency in practice including advice provided to women.
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Aust N Z J Obstet Gynaecol · Aug 2009
Uterine papillary serous carcinoma: patterns of failure and survival.
To evaluate the outcome in patients with uterine papillary serous carcinoma (UPSC). ⋯ We recommend optimal cytoreduction surgery with the aim of leaving no macroscopic disease at the end of the operation. Vaginal brachytherapy should be considered as a component of adjuvant radiotherapy. Abdominal failure was the commonest mode of failure in our cohort of patients.
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Aust N Z J Obstet Gynaecol · Jun 2009
Practice GuidelineGuidelines for the management of hypertensive disorders of pregnancy 2008.
This is the Executive Summary of updated guidelines developed by the Society of Obstetric Medicine of Australia and New Zealand for the management of hypertensive diseases of pregnancy. They address a number of challenging areas including the definition of severe hypertension, the use of automated blood pressure monitors, the definition of non-proteinuric pre-eclampsia and measuring proteinuria. ⋯ The guidelines stress the need for experienced team management for women with pre-eclampsia and mandatory hospital protocols for treatment of hypertension and eclampsia. New areas addressed in the guidelines include recommended protocols for maternal and fetal investigation of women with hypertension, preconception management for women at risk of pre-eclampsia, auditing outcomes in women with hypertensive diseases of pregnancy and long-term screening for women with previous pre-eclampsia.
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Aust N Z J Obstet Gynaecol · Jun 2009
Population rates of haemorrhage and transfusions among obstetric patients in NSW: a short communication.
We estimated the population rates of obstetric haemorrhage and transfusion among women giving birth, utilising data collected in a review of the delivery admissions of 1200 randomly selected women in New South Wales in 2002. The estimated population obstetric haemorrhage rate was 13.1% (11.4% post-partum haemorrhage (PPH), 2.2% antepartum haemorrhage) and the transfusion rate was 1.06% (0.9% vaginal births, 1.6% of caesarean sections). When variations in definitions and denominators were accounted for, the difference in PPH rates among vaginal births (13.1%) and caesarean sections (6.3%) disappeared, suggesting PPH is under-ascertained for women delivered by caesarean section.