The Australian & New Zealand journal of obstetrics & gynaecology
-
Aust N Z J Obstet Gynaecol · Aug 2019
Emergency peripartum hysterectomy in a Western Australian population: Ten-year retrospective case-note analysis.
Emergency peripartum hysterectomy (EPH) is a life-saving obstetric procedure reserved for conditions where medical treatment and conservative surgery have failed. EPH is associated with significant morbidity and mortality. ⋯ EPH is associated with significant morbidity. Our study identifies abnormal placentation as the leading cause of EPH.
-
Aust N Z J Obstet Gynaecol · Aug 2019
Are obstetric and gynaecological trainees in Australia and New Zealand adequately trained in the management of the infertile couple?
Increasingly, couples are seeking assistance to conceive. It is not clear whether obstetric and gynaecological trainees in Australia and New Zealand receive adequate training and exposure to infertility training. ⋯ Trainees in Australia and New Zealand have limited access to infertility medicine during training with associated high dissatisfaction rates. Access to training in a private healthcare setting or the expansion of public in vitro fertilisation may improve trainees' experiences.
-
Aust N Z J Obstet Gynaecol · Aug 2019
Clinical and financial evaluation of carbetocin as postpartum haemorrhage prophylaxis at caesarean section: A retrospective cohort study.
The long-acting oxytocic agent; carbetocin, has been consistently shown to reduce the need for additional uterotonics at caesarean section, but not postpartum haemorrhage (PPH). While promising, current evidence is limited by heterogenicity in study design and findings. ⋯ Carbetocin reduced moderate blood loss >500 mL, but not PPH ≥1000 mL. Carbetocin conferred a 20% reduction in secondary uterotonic treatment, as well as lowering direct medical costs.
-
Aust N Z J Obstet Gynaecol · Apr 2019
Acceptability of self-taken vaginal HPV sample for cervical screening among an under-screened Indigenous population.
Human papillomavirus (HPV), the causative agent of cervical cancer, can be screened for using self-collected vaginal samples (self-testing). This may overcome barriers to screening for Māori women who suffer a greater burden of cervical disease than New Zealand European women. ⋯ The findings indicate that with a culturally competent introduction of HPV self-testing, many currently never/under-screened Māori women would be willing to be screened and followed up if necessary. HPV self-testing has the potential to save lives.
-
In New Zealand, it is recommended that all pregnant women have a haemoglobin A1c (HbA1c) test performed with their booking antenatal bloods to identify previously unrecognised diabetes. However, screening rates in some groups are low. Use of a point-of-care device may improve compliance with screening. ⋯ In conclusion, we found that in pregnancy, the COBAS b101 point-of-care system has a small negative bias and modest point accuracy for HbA1c. When used to screen for previously unrecognised diabetes in pregnancy, appropriate COBAS b101 HbA1c point-of-care HbA1c thresholds for a negative and positive result are 7 mmol/mol below and 5 mmol/mol above the clinical threshold, respectively. Values between these limits should be confirmed by laboratory testing.