The Australian & New Zealand journal of obstetrics & gynaecology
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Aust N Z J Obstet Gynaecol · Oct 2017
Working hours of obstetrics and gynaecology trainees in Australia and New Zealand.
The importance of doctors' working hours has gained significant attention with evidence suggesting long hours and fatigue may compromise the safety and wellbeing of both patients and doctors. This study aims to quantify the working hours of The Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) specialist trainees in order to better inform discussions of working hours and safety within our region. ⋯ While 53.1 h/week at work is similar to the average Australian hospital doctor, high rates of long days and 24-h shifts with minimal sleep were reported by RANZCOG trainees in this survey.
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Aust N Z J Obstet Gynaecol · Oct 2017
Fatigue and training of obstetrics and gynaecology trainees in Australia and New Zealand.
Several studies have linked doctor fatigue with adverse patient events and an increase in risk to doctors' personal safety and wellbeing. The present study assesses the rostering structure of Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) trainees and its association with trainees' reported fatigue levels, training opportunities and wellbeing, which were secondary outcomes of a larger study of trainee working hours which has been separately reported. ⋯ Fatigue was frequently reported by RANZCOG trainees with increased working hours and long shifts being significant factors in fatigue levels. Strategies should be developed and trialled to enable trainees to obtain adequate case exposure and teaching without compromising patient and doctor safety.
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Aust N Z J Obstet Gynaecol · Jun 2017
Comparative StudyCustomised management of the third stage of labour.
Postpartum haemorrhage (PPH) rates are increasing worldwide. The rate is particularly high in women undergoing an induced or augmented labour. In response to this, we altered our hospital's protocol for the management of the third stage of labour to recommend Syntometrine, in preference to oxytocin alone, for women being induced or augmented. We set out to assess the impact of the protocol change on the PPH rate. ⋯ Compared to oxytocin, Syntometrine did not reduce the rate of PPH in women with augmented or induced labour. Other approaches to reducing PPH rates are required.
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Aust N Z J Obstet Gynaecol · Jun 2017
Women's questions about medicines in pregnancy - An analysis of calls to an Australian national medicines call centre.
For many medicines, safe use during pregnancy is not established and adherence is often poor due to safety concerns. Therefore, it is important to identify consumers' medicines information needs during pregnancy. ⋯ Pregnant women are concerned about the safety of medication use in pregnancy and a significant proportion overestimate risk. Psychotropic medication and fertility are strong drivers to seek information during preconception. Everyday illnesses and self-medication with OTC medication are a common concern throughout pregnancy, even though many medicines are safe to use.
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Aust N Z J Obstet Gynaecol · Jun 2017
Management of pregnancies complicated by hypertensive disorders of pregnancy: Could we do better?
Hypertensive disorders are among the most common medical problems in pregnancy. Compliance with clinical practice guidelines has potential to translate to significant maternal and perinatal health benefits. ⋯ Current management guidelines for hypertension treatment were generally followed, although aspirin prophylaxis was frequently overlooked, resulting in up to 19 excess PE cases. Uptake of recommendations from the HYPITAT trial was low; however, severe complications were fewer than expected. Overall, this suggests that clinicians appropriately weigh up the likely maternal risk compared to infant benefits of deferred delivery in each case, a key recommendation of HYPITAT-II.