The Australian & New Zealand journal of obstetrics & gynaecology
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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.
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Establishing a baby biome through the controversial practice of 'vaginal seeding' has generated interest among the general public and healthcare providers alike. We discuss the potential risks of this practice and offer a harm minimisation approach to managing women requesting vaginal microbiome transfer after delivery by caesarean section.
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Aust N Z J Obstet Gynaecol · Apr 2017
Comparative StudyDeclining invasive prenatal diagnostic procedures: A comparison of tertiary hospital and national data from 2012 to 2015.
In recent years, the superior accuracy of maternal plasma cell-free DNA-based prenatal screening has resulted in >50% national decline in amniocenteses and chorionic villus sampling (CVS), creating new implications for specialist training. ⋯ Our tertiary centre experienced a relatively smaller decline in prenatal diagnostic procedures compared with national figures, largely due to an increase in testing for ultrasound abnormalities. Our results demonstrate the increasing contribution of first trimester ultrasound in the detection of fetal abnormalities in the cell-free DNA era and the continued viability of specialist training in invasive procedures.
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Aust N Z J Obstet Gynaecol · Feb 2017
Clinicians' perceptions of women's experiences of endometriosis and of psychosocial care for endometriosis.
Endometriosis is a complex, chronic condition with known psychological and social implications for women. Little is known about clinicians' perceptions of the psychosocial aspects of endometriosis and associated care. ⋯ The findings of this research demonstrate clinicians' need for further support in the provision of psychosocial care for women with endometriosis, potentially through expanded clinical guidelines and professional development opportunities.
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Aust N Z J Obstet Gynaecol · Dec 2016
Case ReportsPerimortem caesarean section: Two cases performed in New Zealand hospitals.
Perimortem caesarean section is a term many obstetricians are familiar with despite few encountering it first-hand. It is estimated the intervention will be needed every 53 000 maternities. ⋯ In New Zealand eight perimortem caesareans were performed from 2006 to 2013. Here we discuss two perimortem caesarean sections performed in two New Zealand hospitals alongside current guidance and recommendations.