Journal Of Obstetrics And Gynaecology[JOURNAL]
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200 papers
Foetal sex and nonstress test characteristics.
Schaffir J, McCauley E, Gawrys S … +1 more , Thompson A
J Obstet Gynaecol · 2025 Dec · PMID 40667599 · Publisher ↗
Male foetuses have historically been perceived as more active than females, and foetal movement has been observed to be greater in male foetuses in late pregnancy. Nonstress tests (NSTs), a common form of antepartum asse...
Male foetuses have historically been perceived as more active than females, and foetal movement has been observed to be greater in male foetuses in late pregnancy. Nonstress tests (NSTs), a common form of antepartum assessment, rely on movement in their interpretation. To see if this difference could influence their interpretation, NSTs of patients undergoing clinically indicated testing at 36 weeks' gestation were evaluated. In this cross-sectional observational study, tests were compared between male and female foetuses for maternal indicators of foetal movement and heart rate characteristics including baseline, variability, and number of accelerations. Among 287 foetuses analysed, recordings of foetal movement and heart rate characteristics were similar between the two groups. The results suggest no difference in movement or NST parameters between males and females, and foetal sex should not affect NST interpretation.
A novel machine-learning algorithm to screen for trisomy 21 in first-trimester singleton pregnancies.
Osborne J, Cockcroft C, Williams C
J Obstet Gynaecol · 2025 Dec · PMID 40629904 · Publisher ↗
BACKGROUND: Antenatal screening for Trisomy 21 (T21) in the UK is performed primarily in the first trimester. Nuchal Translucency (NT), gestational age, Free β-HCG and PAPP-A are used in combination, creating the 'combin...
BACKGROUND: Antenatal screening for Trisomy 21 (T21) in the UK is performed primarily in the first trimester. Nuchal Translucency (NT), gestational age, Free β-HCG and PAPP-A are used in combination, creating the 'combined' test. Multivariate Gaussian distribution models then determine the chance of T21 expressed as an odds ratio. This study investigates the use of machine-learning algorithms in the prediction of T21 in first-trimester singleton pregnancies and compares their performance to existing screening models. METHODS: A total of 86,354 anonymised, first trimester, singleton pregnancy screening cases, including 211 with T21, were used to train and test machine-learning models using adaptive boosting technology. Test case results were compared with pregnancy outcome data to assess performance. RESULTS: A machine-learning model was able to outperform current multivariate distribution models (McNemar's = .006, AUC 0.978 vs 0.974). False positive rates were reduced from 3.82% to 2.28% (95% CI: 3.56-4.08 and 2.08-2.48 respectively) and overall screen positive rates were reduced from 4.00% to 2.48% (95% CI: 3.74-4.28 and 2.27-2.70 respectively). CONCLUSIONS: Machine-learning algorithms offer demonstrable improvements to first-trimester singleton T21 screening without major changes to the UK programme. Larger datasets and improved outcome data would likely offer further increases in performance.
Mifepristone-related foetal cardiac adverse events: findings from the postmarketing safety reports.
Liu R, Wang J, Wang Q … +2 more , Zhang Y, Yuan F
J Obstet Gynaecol · 2025 Dec · PMID 40622732 · Publisher ↗
BACKGROUND: This study aimed to analyse the clinical characteristics of mifepristone-associated congenital and foetal cardiac adverse events using data from the U.S. Food and Drug Administration Adverse Event Reporting S...
BACKGROUND: This study aimed to analyse the clinical characteristics of mifepristone-associated congenital and foetal cardiac adverse events using data from the U.S. Food and Drug Administration Adverse Event Reporting System (FAERS). METHODS: A retrospective pharmacovigilance analysis was conducted using FAERS data from Q1 2016 to Q4 2022. Disproportionality analysis was performed using the Bayesian Information Component (IC) to detect potential associations between mifepristone and congenital or foetal cardiac adverse events. RESULTS: A total of 1,130 reports involving mifepristone were identified, of which 18 (1.59%) were related to congenital or foetal cardiac events. Most reports originated from the United States. The most frequently reported events were foetal arrhythmia and foetal heart rate disorder. Notably, foetal arrhythmia showed the strongest signal (IC = 3.13, CI = 1.37). No disproportional signals were detected for structural cardiac malformations. A partial assessment of the Bradford Hill criteria suggested a possible association with functional cardiac anomalies. CONCLUSION: This study did not identify an association between mifepristone exposure and structural congenital heart defects. However, a positive signal for transient foetal heart rhythm abnormalities was observed. Clinicians should remain vigilant for foetal heart rate irregularities following maternal mifepristone use and consider enhanced cardiac monitoring during labour and delivery to enable early detection and management.
Menstrual management using hormonal medications in adolescents and young adults with developmental disability: a systematic review and a meta-analysis.
Moussaoui D, Laqua J, Crofts VL … +4 more , Nemitz-Piguet CM, Héritier-Barras AC, Merglen A, Yaron M
J Obstet Gynaecol · 2025 Dec · PMID 40576248 · Publisher ↗
BACKGROUND: Adolescents with developmental disability (DD) may experience similar menstrual disorders as their peers, as well as unique challenges associated with their underlying conditions. They have access to the same...
BACKGROUND: Adolescents with developmental disability (DD) may experience similar menstrual disorders as their peers, as well as unique challenges associated with their underlying conditions. They have access to the same hormonal medications as the general population, but little is known about the effects of menstrual management in adolescents with DD. The aim of this study was to assess the efficacy, satisfaction with, side effects and complications of hormonal medications that are used for menstrual management in adolescents and young adults with DD. METHODS: A systematic review was performed in Medline, Embase, Cochrane library and PsycNet, using keywords related to menstrual management, hormonal medications, adolescents and disability. Meta-analyses of proportions were conducted for outcomes that could be combined across studies. RESULTS: Of the 2088 articles identified, 20 studies were included. The total number of participants was 3317 and varied significantly across studies (from 14 to 1560 individuals). Menstrual management was associated with a reduction in bleeding and high rates of amenorrhoea. We found that 45.4% (95% CI, 32.1-59%) of levonorgestrel-intrauterine device users experienced amenorrhoea. Satisfaction was high with all methods and correlated with the reduction in bleeding. Breakthrough bleeding was the most common side effect and the primary reason for ceasing or switching medication. No case of venous thromboembolism was reported. CONCLUSIONS: Menstrual management was associated with improvement in menstrual symptoms and high levels of satisfaction in adolescents with DD. Side effects and complication rates were low in this population. This should support the use of menstrual management in adolescents with DD, who deserve similar access to menstrual health care as their peers.
Analysis of deliveries using the Robson Classification System in a Brazilian hospital: a cross-sectional observational study.
Perin POM, Berbel C, Costa ML … +1 more , Guida JPS
J Obstet Gynaecol · 2025 Dec · PMID 40560744 · Publisher ↗
BACKGROUND: The rising caesarean section rates are a global concern, highlighted by the World Health Organisation due to the adverse impacts associated with the overuse of this intervention. This study assessed the use o...
BACKGROUND: The rising caesarean section rates are a global concern, highlighted by the World Health Organisation due to the adverse impacts associated with the overuse of this intervention. This study assessed the use of Robson Classification (RC) in a Brazilian university hospital from 2016 to 2020. METHODS: A retrospective observational study was conducted from 2016 to 2020, including 9723 deliveries in a tertiary maternity hospital located in southeastern Brazil. Demographic, obstetric, and delivery data were considered to ascertain the RC. Caesarean section rates were calculated for each group and their absolute and relative contributions to the overall rate. Additionally, indications for induction and caesarean section were described. RESULTS: The overall caesarean section rate was 38.9%, with a predominance of Group 5 (women with a previous caesarean section), which accounted for 37.1% of all caesarean sections. Group 1 (nulliparous women with spontaneous labour) had a caesarean section rate of 17%, while Group 10 (preterm pregnancies) showed a rate of 50.7%. The main indications for caesarean sections were foetal distress (24.5%), repeat caesarean section (16.8%), and dystocia (10.9%). Labour inductions occurred in 22% of cases, primarily due to post-term pregnancy (35.7%) and premature rupture of membranes (23.4%). CONCLUSIONS: The RC was an effective tool for monitoring and comparing obstetric practices, identifying the groups with the highest contributions to caesarean section rates. Specific strategies, such as protocols to encourage vaginal birth after caesarean (VBAC) and improvements in induction management, could help reduce unnecessary interventions. This study underscores the importance of implementing evidence-based guidelines to improve obstetric and neonatal outcomes.
Pregnancy outcome in women with hearing disability: systematic review and meta-analysis.
Zhang H, Du Y, Qiu J … +2 more , Wang Y, Song Y
J Obstet Gynaecol · 2025 Dec · PMID 40545948 · Publisher ↗
BACKGROUND: Hearing disabilities are a significant risk factor for adverse pregnancy outcomes. This study aimed to analyse the impact of hearing impairment on maternal and neonatal outcomes, and to evaluate the adequacy...
BACKGROUND: Hearing disabilities are a significant risk factor for adverse pregnancy outcomes. This study aimed to analyse the impact of hearing impairment on maternal and neonatal outcomes, and to evaluate the adequacy of prenatal care among women diagnosed with hearing disabilities. METHODS: A literature search of the PubMed, Medline, Cochrane Library, Embase, and Scopus databases for relevant studies published in English was performed. Two researchers independently performed screening and quality assessments. Adverse maternal outcomes (gestational diabetes, preeclampsia, and caesarean delivery), adverse neonatal outcomes (preterm birth and low birth weight), and utilisation of prenatal care resources were primary outcomes of this review. A comparative effects meta-analysis and a narrative synthesis were performed. RESULTS: Ten retrospective cohort studies comprising 97,251,223 participants, of whom 63,387 had a hearing disability, were included in this review. Meta-analysis revealed a significantly higher risk for gestational diabetes, preeclampsia, eclampsia, caesarean delivery, placental abruption, preterm birth, low birth weight, and adequate-plus utilisation of prenatal care resources. The results were similar in the sensitivity analyses based on different statistical models. There were no statistical differences in pooled estimates of the incidence of chorioamnionitis, although a significantly higher risk was observed when the model was modified. CONCLUSION: Compared to women without disabilities, those with hearing disabilities exhibited a higher risk for adverse maternal and neonatal outcomes and excessive use of prenatal care services.
Association of sleep traits with risk of adverse pregnancy outcomes: a Mendelian randomisation analysis.
Shao S, Shuai Z, Qin C … +5 more , Shao J, Chen C, Song M, Li X, Zhao H
J Obstet Gynaecol · 2025 Dec · PMID 40531950 · Publisher ↗
BACKGROUND: The aims of this study are to investigate the causal relationships between sleep traits and the risk of gestational diabetes mellitus (GDM), preterm birth, and foetal growth restriction (FGR). METHODS: This t...
BACKGROUND: The aims of this study are to investigate the causal relationships between sleep traits and the risk of gestational diabetes mellitus (GDM), preterm birth, and foetal growth restriction (FGR). METHODS: This two-sample Mendelian Randomisation (MR) study was conducted from May to June 2024 to investigate the associations between seven sleep traits and GDM, preterm birth, and FGR. The study utilised data from large-scale genome-wide association study datasets, and specifically focused on individuals of European descent. The main analysis employed inverse-variance-weighted MR, with sensitivity analyses conducted to mitigate potential pleiotropy-induced biases. Additionally, multivariable MR analysis was conducted to adjust for potential confounding factors. RESULTS: Genetically predicted excessive daytime sleepiness (OR 13.67; 95% CI, 1.03-180.59; = 0.047) and sleep apnoea (OR 1.29; 95% CI, 1.00-1.65; = 0.049) were found to be associated with a higher risk of GDM. No sleep trait was associated with either preterm birth or FGR. These results were robust across various sensitivity analyses. In the multivariable MR analysis, adjusting for body mass index (BMI) and smoking, the genetically instrumented excessive daytime sleepiness (OR 14.58; 95% CI 1.67-127.36; = 0.015) and sleep apnoea (OR 1.30; 95% CI 1.02-1.64; = 0.030) were consistently associated with an increased GDM risk. CONCLUSIONS: This study suggests a causal relationship between both excessive daytime sleepiness and sleep apnoea to the development of GDM. Excessive daytime sleepiness and sleep apnoea demonstrate promise as potentially preventable risk factors for GDM.
Managing Acute Behavioural Disturbance in Perinatal Women: A Systematic and State of the Art Review of Guidelines.
Galbally M, Jansen B, Hill R … +4 more , Egan B, Power J, Hodges R, Coleman M
Aust N Z J Obstet Gynaecol · 2025 Dec · PMID 40528660 · Full text
BACKGROUND: Guidelines for managing acute behavioural disturbance typically exclusively focus on care for adults in mental health and related settings, how this should be adapted to safely manage in pregnancy and the ear...
BACKGROUND: Guidelines for managing acute behavioural disturbance typically exclusively focus on care for adults in mental health and related settings, how this should be adapted to safely manage in pregnancy and the early postpartum including in settings such as maternity wards is less clear. AIMS: To undertake a systematic and state of the art review on managing acute behavioural disturbance (ABD) in perinatal (pregnant and postpartum) women. MATERIALS AND METHODS: A systematic review of national and international mental health guidelines for managing perinatal acute behavioural disturbance and a state of the art review synthesis of adult mental health management of acute behavioural disturbance principles, pregnancy and lactation pharmacotherapy principles, and obstetrics risks relevant to perinatal ABD management. RESULTS: Only two published guidelines that included perinatal ABD were identified. Many overarching principles in ABD management are suitable for perinatal women, however adaptation of sedation and physical restraint is necessary to ensure safety in pregnancy. Identified were principles of pharmacological exposure and choice of agent in pregnancy that can be applied to ABD as well as principles in pregnancy that can be utilised for safer physical restraint. CONCLUSION: When managing ABD in pregnancy or postpartum including on maternity wards, many of the guiding principles such as the use of least restrictive practices and de-escalation can be applied without adaptation to perinatal period. However, when pharmacological agents and/or physical restraint are indicated then certain adaptations for pregnancy and lactation are required to ensure the safe care of women and infants.
Management of Molar-Pregnancy and Associated Gestational Trophoblastic Neoplasia at a Specialised Unit: 10-Year Review.
Odgers H, Philp S, Tejada-Berges T
Aust N Z J Obstet Gynaecol · 2026 Feb · PMID 40501286 · Full text
Patients diagnosed with gestational trophoblastic diseases (GTD) can develop malignant gestational trophoblastic neoplasia (GTN). ß-hCG monitoring is important in the early detection of GTN. The primary outcome of this s...
Patients diagnosed with gestational trophoblastic diseases (GTD) can develop malignant gestational trophoblastic neoplasia (GTN). ß-hCG monitoring is important in the early detection of GTN. The primary outcome of this study was to describe ß-hCG monitoring completion rates and time from GTN diagnosis to chemotherapy commencement for patients cared for by a specialised GTD unit within a Gynecologic Oncology department. Secondary outcomes included imaging findings, quantitative ß-hCG levels and gestational age at the time of GTD diagnosis, WHO/FIGO scores and chemotherapy outcomes for those who developed GTN, and the time taken for ß-hCG normalisation for both groups. We collected data for 164 patients with molar pregnancies and 28 patients with GTN requiring chemotherapy. ß-hCG monitoring completion was 93.9%, and the median time to chemotherapy commencement was 7 days. Additional data found a low risk of GTN diagnosis following a negative ß-hCG and high complete response rates to chemotherapy for GTN.
Endometrial hyperplasia and cancer - interrogating clinical data in a metabolically driven disease.
Darwish A, Balega J, Ewies AAA
J Obstet Gynaecol · 2025 Dec · PMID 40500992 · Publisher ↗
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Comparison of Gestational Weight Gain and Maternal and Neonatal Outcomes Among Women With and Without a History of Bariatric Surgery: A Retrospective Cohort Study.
Miegel T, Vincze L, Guthrie T … +4 more , Porteous H, Huxtable S, De Jersey S, Palmer M
Aust N Z J Obstet Gynaecol · 2026 Feb · PMID 40474539 · Publisher ↗
BACKGROUND: Australian bariatric surgery (BSurg) rates more than doubled between 2005 and 2015, with around half being women of childbearing age. Few studies have reported gestational weight gain (GWG), and maternal and...
BACKGROUND: Australian bariatric surgery (BSurg) rates more than doubled between 2005 and 2015, with around half being women of childbearing age. Few studies have reported gestational weight gain (GWG), and maternal and neonatal outcomes in pregnant women after sleeve gastrectomy. AIMS: This retrospective cohort study compared GWG, maternal and neonatal outcomes of women with and without a history of BSurg from one urban Australian hospital. MATERIALS AND METHODS: Eligible participants were pregnant women with and without a history of BSurg who gave birth between 2016 and 2020. A woman with BSurg was matched to one woman without BSurg based on age, pre-pregnancy body mass index (BMI) and estimated date of confinement. Demographic, pregnancy and GWG outcomes were sourced from hospital data and medical records. Chi-squared and t-tests were used to compare data between groups. RESULTS: There were 210 participants (105 in each group) with a median pre-pregnancy BMI of 30.5 kg/m. The main BSurg type was sleeve gastrectomy (n = 87). Neonates of women post-BSurg had lower birthweights (BSurg: 3175 ± 484 g; non-BSurg: 3419 ± 562 g; p < 0.001). GWG (BSurg: 9 [4.9-13.9]kg; non-BSurg: 8.9 [3-15.3]kg, p = 0.987) and adherence to the Institute of Medicine's GWG recommendations (BSurg: 24%; non-BSurg: 22%, p = 0.897) were similar between groups. Women who conceived < 12 months after BSurg had on average 4.8 kg lower GWG (p < 0.001) and more had insufficient GWG (BSurg < 12 months:61%; BSurg ≥ 12 months: 25%, p = 0.002). CONCLUSION: Neonates of women who had BSurg prior to pregnancy had lower birthweights than neonates of women of similar age, pre-pregnancy BMI and confinement date. Delaying pregnancy for 12 months post-BSurg may be associated with adequate GWG.
Prenatal diagnosis of Type I persistent left superior vena cava and its correlation with congenital cardiac comorbidities.
Li TG, Wu WR
J Obstet Gynaecol · 2025 Dec · PMID 40470892 · Publisher ↗
BACKGROUND: To investigate the occurrence of the persistent left superior vena cava (PLSVC) anomaly and evaluate its postpartum outcomes. METHODS: This retrospective analysis included 425 pregnant women carrying singleto...
BACKGROUND: To investigate the occurrence of the persistent left superior vena cava (PLSVC) anomaly and evaluate its postpartum outcomes. METHODS: This retrospective analysis included 425 pregnant women carrying singleton foetuses diagnosed with PLSVC. Comprehensive data on maternal characteristics and postpartum outcomes were collected. RESULTS: Among the cohort, 307 foetuses (72.2%) were diagnosed with isolated PLSVC, while 118 (27.8%) presented with PLSVC in conjunction with other structural and/or chromosomal abnormalities. The cardiovascular system exhibited the highest incidence of malformations, followed by single umbilical artery (SUA), and abnormalities of the digestive and urinary systems. Foetuses with PLSVC and additional abnormalities had poorer outcomes. The most common cardiovascular abnormality was right heart enlargement, followed by ventricular septal defect (VSD) and either coarctation of the aorta (COA) or interrupted aortic arch (IAA). CONCLUSIONS: Upon diagnosing PLSVC in a foetus, a thorough structural examination is essential. Particular attention should be paid to evaluating the cardiovascular system and identifying the presence of SUA. If associated malformations are detected, continuous monitoring of the right heart, ventricles, and aortic arch is advised to screen for complications such as right heart enlargement, VSD, COA, or IAA.
Association between Life's Essential 8 and mortality in urinary incontinence among US female adults.
Xu X, Liu R
J Obstet Gynaecol · 2025 Dec · PMID 40464698 · Publisher ↗
BACKGROUND: Urinary incontinence (UI) may be associated with cardiovascular disease. Life's Essential 8 (LE8), a recently updated measure of cardiovascular health (CVH), has been investigated for its association with all...
BACKGROUND: Urinary incontinence (UI) may be associated with cardiovascular disease. Life's Essential 8 (LE8), a recently updated measure of cardiovascular health (CVH), has been investigated for its association with all-cause and cardiovascular mortality among US female adults with UI. METHODS: This population-based retrospective cohort study utilised data from 6314 US female adults aged ≥20 years with UI (weighted population: 4.14 million) derived from the National Health and Nutrition Examination Survey (NHANES) 2005-2018, along with their linked mortality data up to December 2019. The LE8 metric, ranging from 0 to 100, was categorised into low, moderate, and high levels. UI status was determined by self-report. Multivariable Cox proportional hazards regression models were employed to assess the associations between LE8 and both all-cause and cardiovascular disease (CVD) mortality. A stratified analysis and sensitivity analysis were also conducted. RESULTS: During a median follow-up period of 92 months (with a maximum of 180 months) among US adult females with UI, 684 all-cause deaths were recorded, including 169 deaths attributable to cardiovascular disease. A 10-point increase in the LE8 score was associated with a 14% reduction in the risk of all-cause mortality (hazard ratio [HR], 0.86; 95% confidence interval [CI], 0.79-0.93) and a 17% reduction in the risk of CVD mortality (HR, 0.83; 95% CI, 0.71-0.97). Physical activity has the most significant effect. In the stratified subgroups and sensitivity analyses, the results remained robust. CONCLUSIONS: An elevated LE8 score was independently correlated with reduced risks of all-cause and cardiovascular mortality among US female adults with UI. Future prospective studies are required to further strengthen our findings.
Comparison of vaginal moisturisers with ultra-low-dose oestriol and lactobacillus vaginal tablets in women with POP who used a pessary: a randomised controlled trial.
Chinthakanan O, Sarit-Apirak S, Aimjiraku K … +3 more , Wattanayingcharoenchai R, Manonai J, Saraluck A
J Obstet Gynaecol · 2025 Dec · PMID 40464696 · Publisher ↗
BACKGROUND: This study aim to compare the proportion of pessary users reporting satisfaction with ultra-low dose oestriol and Lactobacillus vaginal tablets and vaginal moisturiser. METHODS: A randomised-controlled trial...
BACKGROUND: This study aim to compare the proportion of pessary users reporting satisfaction with ultra-low dose oestriol and Lactobacillus vaginal tablets and vaginal moisturiser. METHODS: A randomised-controlled trial enrolled patients who were able to take care, insert, and remove a pessary themselves and did not use any local oestrogen or vaginal moisturiser for 3 months at a tertiary centre. Participants were randomised to receive either vaginal moisturisers or ultra-low-dose oestriol and Lactobacillus vaginal tablets for 2 months. A single-blinded evaluator assessed outcomes. The oestriol group received one vaginal tablet daily for 6 days followed by two tablets weekly for 8 weeks. The moisturiser group received one application every 3 days for 8 weeks. The primary outcome was the proportion of patients reporting high satisfaction, defined as 'very much improved' or 'much improved', using the Thai version of the Patient Global Impression of Improvement (PGI-I) scale. Secondary outcomes were subjective and objective outcomes of vaginal health. Sixty patients were randomised, of whom one did not complete treatment. RESULTS: The majority of enrolled participants were postmenopausal women with a mean age of 65.54 years, mean BMI of 25.13 kg/m, and advanced-stage POP. The average duration of pessary use was 12-15 months. Patient satisfaction was not significantly different between the oestriol and moisturiser groups at 4 or 8 weeks (93.10% vs. 96.67%, P = 0.61 and 89.66% vs. 93.33%, P = 0.67, respectively). There were no serious adverse events. CONCLUSIONS: Vaginal moisturisers and ultra-low-dose oestriol and Lactobacillus acidophilus vaginal tablets provided high satisfaction in pessary users. Both preparations were comparable in both subjective and objective outcomes.
Optimal timing of hysteroscopic follow-up to prevent the recurrence of intrauterine adhesions: a retrospective study.
Dao S, Zhang L, Liu C … +4 more , Tan H, Yang J, Zou K, Wang S
J Obstet Gynaecol · 2025 Dec · PMID 40455065 · Publisher ↗
BACKGROUND: Intrauterine adhesion (IUA) often recurs after surgery, and hysteroscopic follow-up is essential for early detection. However, the ideal timing for follow-up is uncertain. This study examines how different fo...
BACKGROUND: Intrauterine adhesion (IUA) often recurs after surgery, and hysteroscopic follow-up is essential for early detection. However, the ideal timing for follow-up is uncertain. This study examines how different follow-up timings affect IUA recurrence after surgery. METHODS: All patients (142) who received hysteroscopic surgery in our hospital between 1 January 2021 and 31 November 2024 were retrospectively recruited using the convenience sampling method. The patients were retrospectively divided into two groups based on the timing of postoperative hysteroscopic follow-up. Group A ( 71) underwent a routine follow-up at 3 months postoperatively, whereas Group B ( 71) had an early follow-up at 14 days, with additional follow-ups after each menstrual cycle for 3 months. The primary outcomes measured were uterine cavity morphology and menstrual improvement 3 months post-surgery. The recovery of uterine cavity morphology and menstrual improvement after 3 months of follow-up were compared between the two groups. RESULTS: There was a significant positive correlation between the recovery of uterine cavity morphology and the number of postoperative hysteroscopies in Group B ( = 0.335, < 0.001). After 3 months following the operation, the improvement of menstruation ( = -3.423, = 0.001) and the recovery of uterine morphology ( = -3.741, = 0.001) in Group B were better than those in Group A, and the difference was statistically significant. CONCLUSION: Early and regular hysteroscopy in patients with IUA undergoing hysteroscopic adhesion separation is effective in restoring uterine cavity morphology, preventing re-adhesion and improving menstruation.
What is currently known about female genital mutilation and incontinence: a narrative literature review.
Kingston C, Hassan A, Kaur H … +1 more , Cotterill N
J Obstet Gynaecol · 2025 Dec · PMID 40449016 · Publisher ↗
BACKGROUND: An estimated 230 million girls and women are living with female genital mutilation (FGM) which causes ongoing physical and psychological harm. This review aims to explore what is known about FGM and incontine...
BACKGROUND: An estimated 230 million girls and women are living with female genital mutilation (FGM) which causes ongoing physical and psychological harm. This review aims to explore what is known about FGM and incontinence, including the underexamined implications for women's health, and identify gaps in the literature. METHODS: A comprehensive database search was conducted using MEDLINE, CINAHL Plus, APA Psych Info, AMED, Child Development and Adolescent Studies, and PubMed. To gather all relevant complications of FGM, no restrictions were imposed on date or study type. Themes were identified by organising the 20 eligible articles by symptom type. RESULTS: The findings indicate that urological symptoms such as dribbling incontinence, slow micturition, urgency, stress incontinence and overactive bladder are prevalent among women who have undergone FGM. Additional complications include fistulas, pelvic organ prolapse, somatic symptoms, and urinary tract infections. The impact of FGM and incontinence on quality of life and daily activities remains under-explored, with the lived experiences of affected women largely unreported. CONCLUSIONS: FGM has multiple urogynaecological consequences, with more severe forms causing increased symptoms and associated complications. This review highlights the need for further research into the biopsychosocial impacts of FGM and incontinence to provide evidence-based support for affected women.
'Fostering the Future': Exploring Barriers and Enablers to Doctors Pursuing a Clinician Educator Pathway in Obstetrics and Gynaecology.
Van Der Hock S, Holbeach N, Coghlan E
Aust N Z J Obstet Gynaecol · 2025 Dec · PMID 40433836 · Full text
The Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) is committed to developing a sustainable, high-quality clinical education workforce. To train exceptional doctors, exceptional ed...
The Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) is committed to developing a sustainable, high-quality clinical education workforce. To train exceptional doctors, exceptional educators are needed. In order to better understand the barriers and enablers to careers as a clinician-educator in Obstetrics and Gynaecology, further research related to the educator experience is required. We argue that renewed efforts to address these barriers and enablers are needed to support Obstetricians and Gynaecologists with expertise and passion for teaching, as they contribute significantly to the training and sustainability of the current and future medical workforce. Those supports should target the following areas identified from this literature review: institutional support and culture, personal motivation and interest, balance of clinical service and delivery of education and career impact and advancement. Amid rising numbers of medical students, post-pandemic challenges in the hospital and workforce pressures for specialists and general practitioners in Australia, it is essential to prioritise clinical education strategic planning and research. This review contributes to the literature by supporting existing efforts to develop structured educator pathways such as the new RANZCOG Academy of Clinician Educators.
Impact of Metabolic Surgery on Gestational Diabetes Mellitus: A Cohort Analysis.
Wintour J, Afrin S, Buxton N … +2 more , Madzivanyika M, Wynne K
Aust N Z J Obstet Gynaecol · 2026 Feb · PMID 40433829 · Full text
BACKGROUND: With the upsurge of obesity in Australia and worldwide, the incidence of metabolic surgery is increasing in women of reproductive age. Metabolic surgery reduces the rate of gestational diabetes mellitus, howe...
BACKGROUND: With the upsurge of obesity in Australia and worldwide, the incidence of metabolic surgery is increasing in women of reproductive age. Metabolic surgery reduces the rate of gestational diabetes mellitus, however, the risk remains about that for the general population. AIM: To evaluate maternal and perinatal outcomes of consecutive women with GDM post-metabolic surgery presenting to an endocrine antenatal clinic in a single tertiary centre. METHODS: A retrospective cohort study of women with GDM after metabolic surgery were audited between 2020 and 2024. RESULTS: This cohort of 36 women were aged 32.9 (± 4.7) years and 3.3 (±2.0) years post-surgery with the majority undergoing sleeve gastrectomy (97.2%). Gestational diabetes was diagnosed at 25 (±6) weeks. Screening identified carbohydrate inadequacy or inconsistency (18/36, 50%) and micronutrient deficiency (34/36, 94.4%) were common, with 26/36 (72.2%) women deficient in more than one micronutrient. Insulin therapy was required in 16 women. Recurrent hypoglycaemia occurred in 10 (27.8%) women. Women birthed at 38 (±1) weeks, with unplanned Caesarean delivery in six (16.7%) women. Composite adverse neonatal outcomes occurred in 22/36 (61.1%) of births. Hypoglycaemia (< 2.6 mmol/L) occurred in 8/36 (22.2%) of neonates; 1/36 (2.8%) were small-for-gestational age, and 2/36 (5.6%) large-for-gestational age. A higher neonatal birthweight was observed in women with reported pre-pregnancy BMI ≥ 30 kg/m and women requiring insulin. CONCLUSION: Nutritional deficiencies occur commonly in women with gestational diabetes after metabolic surgery. There was a high rate of composite adverse neonatal outcome suggesting that these pregnancies may be higher risk. Further research is required to evaluate the optimal methods of screening and recommended glycaemic targets.
Prevalence and Severity of Endometriosis at Laparoscopic Treatment of Tubal Ectopic Pregnancy.
Dean J, Lee S, Reddington C … +3 more , Cheng C, Amir M, Healey M
Aust N Z J Obstet Gynaecol · 2026 Feb · PMID 40433820 · Publisher ↗
BACKGROUND: Endometriosis may have a causal role in ectopic pregnancies. AIMS: To observe the prevalence and staging of endometriosis in women at the time of laparoscopic treatment of tubal ectopic pregnancy. METHODS: Pr...
BACKGROUND: Endometriosis may have a causal role in ectopic pregnancies. AIMS: To observe the prevalence and staging of endometriosis in women at the time of laparoscopic treatment of tubal ectopic pregnancy. METHODS: Prospective observational cohort study carried out in a tertiary obstetrics and gynaecology hospital. Seventy participants with ectopic pregnancy requiring laparoscopic treatment were recruited. A pre-operative questionnaire was completed by patients regarding symptoms of endometriosis and gynaecological history. A post operative questionnaire was completed by the surgical team regarding site of ectopic pregnancy, presence or absence of endometriosis and severity of endometriosis. RESULTS: After the exclusion of patients with non-tubal ectopic pregnancies, results were examined for 65 patients. Of the 65 histologically confirmed ectopic pregnancies, 36 had laparoscopically confirmed endometriosis, demonstrating a prevalence rate of 55% in our cohort. r-ARSM stage I or II (minimal or mild) disease made up 92% (33/36) of cases. There was little correlation between severity of patient symptoms and severity of endometriosis on laparoscopic evaluation. CONCLUSION: This study demonstrates endometriosis is significantly more common in women with surgically managed tubal EP compared to the general population.
'That Doesn't Sound Right': A Qualitative Study Exploring the Information Seeking Behaviour of Current Long-Acting Reversible Contraceptive Users in Australia.
Caddy C, Temple-Smith M, Coombe J
Aust N Z J Obstet Gynaecol · 2025 Dec · PMID 40433819 · Full text
OBJECTIVE(S): Accessible and accurate information about long-acting reversible contraception (LARC) is important in addressing misperceptions and ensuring consumers can make informed decisions about their use, yet little...
OBJECTIVE(S): Accessible and accurate information about long-acting reversible contraception (LARC) is important in addressing misperceptions and ensuring consumers can make informed decisions about their use, yet little is known about consumers' experiences of searching for and being provided information about LARC. METHODS: Individual semi-structured 'Zoom' interviews were conducted with people living in Australia aged 18-45, who were currently using a LARC or whose LARC was removed within the past 6 months. Data were analysed using reflexive thematic analysis. RESULTS: A total of 23 interviews were conducted between October 2022-January 2023. Participants were actively engaged in seeking information about LARC prior to initiation and/or during its use. Participants sought information from a variety of sources to validate, or support information previously acquired and made judgements on the accuracy of different sources. Hearing the experiences of other LARC users was highly valued and viewed as providing information not available from other sources, especially in regard to expected side effects. Although healthcare providers were seen as the best source of information, many participants reported dissatisfaction with clinical interactions. CONCLUSION: Consumers used a variety of information sources when making decisions about LARC and highly valued hearing other LARC users experiences. Healthcare providers and organisations should consider incorporating lived experiences of LARC into evidence-based information to meet the needs of consumers.
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