Journal Of Obstetrics And Gynaecology[JOURNAL]
Sun
200 papers
Predictive performance of multiple anthropometric obesity indicators for female infertility risk: a cross-sectional study.
Yang Y, Xie Q, Lin Y … +6 more , Li S, Dong C, Peng J, Yu J, Wang Y, Wu Y
J Obstet Gynaecol · 2026 Dec · PMID 42234112 · Publisher ↗
BACKGROUND: Various obesity metrics are used to assess female infertility risk, but their relative prognostic value remains unclear. This cross-sectional study systematically evaluated 16 anthropometric indices to identi...
BACKGROUND: Various obesity metrics are used to assess female infertility risk, but their relative prognostic value remains unclear. This cross-sectional study systematically evaluated 16 anthropometric indices to identify the most effective predictors. METHODS: Using National Health and Nutrition Examination Survey (NHANES) 2017-2020 data ( = 1154 reproductive-aged women), we applied a three-phase framework: (1) weighted restricted cubic spline (RCS) models were applied to examine potential non-linear associations between 16 anthropometric obesity indicators and female infertility risk, with univariate analyses used to assess their statistical associations, (2) two model states ('real-world settings' and 'ideal-world settings') were constructed based on the union and intersection of indicator datasets, and weighted logistic regression models were developed for each state and (3) predictive performance and clinical utility were assessed using receiver operating characteristic (ROC) curves, calibration curves and decision curve analysis (DCA), with key diagnostic metrics compared to identify optimal predictors. RESULTS: Thirteen obesity indicators showed predictive value for infertility; Anthropometric Body Shape Index (ABSI) exhibited a U-shaped association, whereas the others demonstrated positive linear relationships. Body mass index (BMI), Weight-Adjusted Waist Index (WWI) and Conicity Index (CI) demonstrated relatively better predictive performance (AUC > 0.65), with WWI showing slightly stronger association with infertility than the other indicators in both model states (adjusted OR = 1.40, 95% CI: 1.10-1.77; AUC = 0.656; results were consistent across the two model states). CONCLUSIONS: Thirteen obesity indicators predicted infertility; ABSI was U-shaped, others were linear. WWI was slightly superior, though differences were modest.
Re-defining Care: Australia's First Outpatient Manual Vacuum Aspiration Service for the Surgical Management of Miscarriage.
Walker B, Townsend B, Nugent R … +1 more , Seed E
Aust N Z J Obstet Gynaecol · 2026 Jun · PMID 42227025 · Publisher ↗
BACKGROUND: Outpatient manual vacuum aspiration (MVA) has been recently implemented in Australia as an option for the management of first-trimester miscarriage. In other international settings, it has been shown to be a...
BACKGROUND: Outpatient manual vacuum aspiration (MVA) has been recently implemented in Australia as an option for the management of first-trimester miscarriage. In other international settings, it has been shown to be a safe and effective alternative to suction dilatation and curettage (D&C). Our study presents the outcomes of outpatient MVA under local anaesthetic compared to suction D&C under general anaesthetic. This service is the first to be established in Australia. AIMS: To evaluate the safety and efficiency of manual vacuum aspiration curettage (MVA) as a management option for early pregnancy loss, to determine if this procedure is equivalent to conventional surgical treatment. MATERIALS AND METHODS: A retrospective clinical audit was conducted at a regional tertiary teaching hospital to compare the rates of complications (haemorrhage, return to theatre, procedure failure and readmission) and length of stay between suction dilatation (D&C) and MVA for the management of first-trimester miscarriage. RESULTS: MVA was associated with significantly less blood loss (p < 0.001) and length of stay (p < 0.001) compared with suction D&C. Overall readmission rates were similar between the two groups, with MVA more likely to be complicated by retained products of conception, whilst patients undergoing a D&C were more likely to be readmitted with pain or endometritis. CONCLUSIONS: MVA is a safe alternative to suction D&C for the management of first-trimester miscarriage, with reduced hospital length of stay compared with D&C.
Climacteric symptoms among full-time working HRT never-users in different work environments: a cross-sectional study.
Lipasti M, Jalava-Broman J, Sillanmäki L … +2 more , Mäkinen J, Rautava P
J Obstet Gynaecol · 2026 Dec · PMID 42201899 · Publisher ↗
BACKGROUND: Climacteric symptoms affect a large and growing proportion of women worldwide. Furthermore, women are increasingly participating in the workforce. Many women do not use treatment for their symptoms; however,...
BACKGROUND: Climacteric symptoms affect a large and growing proportion of women worldwide. Furthermore, women are increasingly participating in the workforce. Many women do not use treatment for their symptoms; however, little is known about how untreated women experience climacteric symptoms. This study examined the occurrence and severity of climacteric symptoms among full-time working women before treatment and compared their experiences across two different work environments. METHODS: A cross-sectional study was conducted in a group of Finnish women aged 52-66 years who had never used any treatment for their climacteric symptoms and were employed full-time. The data were obtained from two population-based postal surveys. Statistical techniques were used to analyse the data. RESULTS: The most common symptoms among all participants ( = 338) were hot flushes (80%), sweats (72%), and sleeping problems (72%). The most severe symptoms were hot flushes, sweats, and loss of sexual desire; 12% of participants experienced each of these as severe. Regarding symptom categories, vasomotor symptoms and loss of sexual desire were the most common and the most severe. Participants in either low-strain or high-strain jobs ( = 164) most often experienced five (15%) or 10 (13%) different symptoms out of 12 presented in the study questionnaire. Participants in high-strain jobs ( = 79) experienced a higher number of symptoms ( = 0.019) and more often urinary incontinence ( = 0.008) and depressive symptoms ( = 0.043) than those in low-strain jobs ( = 85). Furthermore, they experienced more severe sweats ( = 0.038). CONCLUSIONS: Hot flushes, sweats, sleeping problems, and loss of sexual desire were both common and severe among full-time working untreated women. In addition, symptoms were more troublesome among women in high-strain than low-strain jobs. Therefore, healthcare professionals should pay special attention to the above symptoms and to women in high-strain jobs.
Retraction Statement: Prevalence and risk factors of iron-deficiency anaemia among pregnant women in rural districts of Menoufia governorate, Egypt.
J Obstet Gynaecol · 2026 Dec · PMID 42172548 · Publisher ↗
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Association between miR-155 expression and Th17/Treg balance in URPL patients: a single-centre retrospective study.
Chen Y, Xu M, Li L … +3 more , Dong M, Wang H, Zhang M
J Obstet Gynaecol · 2026 Dec · PMID 42155009 · Publisher ↗
BACKGROUND: Unexplained recurrent pregnancy loss (URPL) is frequently associated with T helper 17 cells/regulatory T cells (Th17/Treg) imbalance, but the association between microRNA (miR)-155 and Th17/Treg imbalance rem...
BACKGROUND: Unexplained recurrent pregnancy loss (URPL) is frequently associated with T helper 17 cells/regulatory T cells (Th17/Treg) imbalance, but the association between microRNA (miR)-155 and Th17/Treg imbalance remains unclear. Therefore, this study preliminarily analysed this association in URPL patients. METHODS: This retrospective study analysed 189 URPL patients (the live birth group: 112; the non-live birth group: 77) and 91 healthy pregnant women. miR-155, Th17 cells, Treg cells, and Th17/Treg-related cytokines were measured, and the association between miR-155 and Th17/Treg balance was evaluated. The discriminatory performance of miR-155 for adverse pregnancy outcomes (APOs) in URPL was explored with receiver operating characteristic (ROC) curves, and APOs-associated factors were analysed with logistic regression. RESULTS: Serum miR-155 expression showed a graded decline: control group > live birth group > non-live birth group (all < 0.001). The non-live birth group presented elevated Th17 cells, interleukin (IL)-17, IL-6, and Th17/Treg ratios but reduced Treg cells, IL-10, and transforming growth factor-beta 1 (TGF-β1) compared to other groups (all < 0.001). miR-155 expression was correlated negatively with Th17 cells, Th17/Treg ratios, IL-17, and IL-6 and positively with Treg cells, IL-10, and TGF-β1 (all < 0.001). For APOs in URPL patients, miR-155 expression had a strong discriminatory performance (area-under-the-curve = 0.801). Th17/Treg ( = 1.048) and miR-155 ( = 0.048) were independently associated with APOs in URPL (both < 0.05). CONCLUSIONS: Serum miR-155 is reduced in URPL patients and is associated with Th17/Treg imbalance. miR-155 may serve as an exploratory marker to aid in distinguishing APOs in URPL patients, however, its value requires external validation through prospective, multicentre studies.
Type 2 diabetes remission in gynaecologic oncology patients completing an acute preoperative weight loss protocol: a case series.
Frerichs HD, Wowdzia JB, Batara J … +3 more , Aubrey C, Pin S, Chapelsky S
J Obstet Gynaecol · 2026 Dec · PMID 42145191 · Publisher ↗
BACKGROUND: The objective of this study was to review type 2 diabetes (T2D) remission and glycaemic improvement in gynaecologic oncology patients with class 3 obesity undergoing preoperative weight loss. METHODS: This wa...
BACKGROUND: The objective of this study was to review type 2 diabetes (T2D) remission and glycaemic improvement in gynaecologic oncology patients with class 3 obesity undergoing preoperative weight loss. METHODS: This was a case series of 92 gynaecologic oncology patients with BMI ≥40 kg/m and T2D who underwent preoperative weight loss with a low-calorie liquid meal replacement. Patients were classified as high or low likelihood of remission based on diabetes duration, glycated haemoglobin (A1C) and insulin use. Data were summarised descriptively and Fisher's exact test and paired -test were used as inferential statistics using SAS 9.4. RESULTS: Twenty-one patients with a mean age of 57.8 (SD = 11.7) years completed a weight loss protocol of median 14 (IQR = 10.5-16.5) weeks. Eighteen (86%) had endometrioid endometrial carcinoma or atypical endometrial hyperplasia. Initial mean BMI and A1C were 48.0 (SD = 6.7) kg/m and 8.2% (SD = 2.3%). After the protocol, mean BMI and A1C were 43.1 (SD = 5.5) kg/m and 7.1% (SD = 1.7%). On average, A1C decreased 1.1% (95% CI: 0.5-1.6, < 0.05) after weight loss. 3/21 patients experienced diabetes remission. The rate of remission was 2/6 and 1/15 for patients coded as high and low likelihood of remission ( = 0.18). CONCLUSIONS: Weight, BMI and A1C were significantly reduced by preoperative weight loss in gynaecologic oncology patients with T2D. There was a low rate of diabetes remission, with most patients having clinical characteristics predictive of a low likelihood of remission.
Clinical Utility of Stillbirth Investigations in Australia: A Cohort Study.
Marsden T, Cheng M, Khong TY … +20 more , Dahlstrom JE, Ellwood D, Moghimi A, Prystupa S, Obrien C, Cassim FS, Martin S, Coory M, Boyle FM, Shukralla H, Kent AL, Varikara AK, Hannaford P, Frost J, Perry-Keene J, Pomare G, Wong YP, Tan GC, Flenady V, Sexton J
Aust N Z J Obstet Gynaecol · 2026 Jun · PMID 42130018 · Full text
BACKGROUND: Stillbirths impact over two million parents globally every year. Despite current knowledge, technology, and investigations, many stillbirths remain unexplained and are not fully investigated. An important ste...
BACKGROUND: Stillbirths impact over two million parents globally every year. Despite current knowledge, technology, and investigations, many stillbirths remain unexplained and are not fully investigated. An important step forward in addressing this gap is determining which investigations produce the highest utility in identifying the cause of death (COD). AIMS: The objective of this study is to identify and define the usefulness or utility of investigations in determining COD among a cohort of stillbirths. MATERIALS AND METHODS: Prospective cohort study from 2013 to 2018 comprising 695 stillbirths. An expert panel blinded to COD assessed the clinical utility of investigations using a purpose-built tool. A stepwise approach was applied, categorising investigations into three groups: clinical and laboratory investigations; placental pathology; and autopsy examination. Clinical utility of the investigations was defined as the proportion of cases in which each test contributed to the identification of the COD. RESULTS: Placental pathology had the highest clinical utility (87%), followed by comprehensive maternal history (82%), genetic analysis (75%), maternal blood investigations for infection (64%), fetal-maternal haemorrhage (FMH) (57%), and fetal autopsy (47%). Placental pathology and genetic analysis were useful across all clinical scenarios, while autopsy was most beneficial when the clinical scenario was unknown. A COD was established in 528 cases (76%), with 310 cases (47%) identified post-placental examination. CONCLUSIONS: The investigations with the highest clinical utility were placental pathology, comprehensive maternal history, genetic analysis, maternal blood investigations, FMH, and fetal autopsy. This study supports a core set of investigations, supplemented by selective tests based on the clinical scenario.
Results of breast cancer risk assessment and hereditary cancer genetic testing in community obstetrics and gynaecology practice following a prospective quality Improvement initiative.
Waldman R, DeFrancesco M, Feltz J … +7 more , Welling D, Neiman W, Smith E, Schneider L, Lenz L, Johansen Taber K, Adkins R
J Obstet Gynaecol · 2026 Dec · PMID 42127212 · Publisher ↗
BACKGROUND: Clinical guidelines recommend hereditary cancer risk assessment (HCRA) to identify candidates for genetic counselling and testing based on personal and family history. Incorporating genetic testing into HCRA...
BACKGROUND: Clinical guidelines recommend hereditary cancer risk assessment (HCRA) to identify candidates for genetic counselling and testing based on personal and family history. Incorporating genetic testing into HCRA improves risk stratification and management. We previously showed that process improvements increase genetic testing completion rates. This study describes outcomes of routine genetic testing in a community obstetrics and gynaecology (OB/GYN) setting. METHODS: A prospective, single-arm quality improvement initiative was conducted at five U.S. OB/GYN practices (July 2021-November 2022). A guideline-based online screening tool and virtual patient education were implemented. Genetic testing used a 48-gene hereditary pan-cancer panel (MyRisk). The remaining lifetime breast cancer risk was estimated using Tyrer-Cuzick 7.0.2 alone or a combined risk score (CRS). RESULTS: Of 1,285 patients meeting guideline criteria, 439 (34.2%) completed testing. Among 367 (88.0%) without a clinically significant mutation and with valid risk estimates, 233 (63.5%) had lifetime breast cancer risk <20% and 66 (18.0%) had risk ≥20% by both Tyrer-Cuzick and CRS. Discordance between Tyrer-Cuzick and CRS occurred in 68 (18.5%) patients: 49 (13.4%) were <20% by CRS but ≥20% by Tyrer-Cuzick; 19 (5.2%) were ≥20% by CRS but <20% by Tyrer-Cuzick. Overall, 134 (36.5%) had lifetime risk ≥20% by either model. Fifteen pathogenic variants were identified in 14 (3.2%) patients, including CHEK2 (n = 4), HOXB13, MITF, PALB2 (n = 2 each), and BRCA2, PMS2, MSH6, RAD51C, BRIP1 (n = 1 each). CONCLUSION: Most patients undergoing genetic testing did not carry an inherited mutation; however, over one-third of those without a mutation had lifetime breast cancer risk ≥20% based on Tyrer-Cuzick and/or CRS. These findings underscore the importance of routine HCRA and individualised management based on comprehensive risk assessment.
Heavy Menstrual Bleeding: Experiences and Learnings From Patient Survey.
Jacka M, Ward M, Guerin K … +1 more , Dalton R
Aust N Z J Obstet Gynaecol · 2026 Jun · PMID 42116120 · Full text
BACKGROUND: Heavy menstrual bleeding (HMB) affects 1 in 4 women. It is often debilitating for those experiencing it, resulting in negative impacts on quality of life. Prompted by a national call for better insights into...
BACKGROUND: Heavy menstrual bleeding (HMB) affects 1 in 4 women. It is often debilitating for those experiencing it, resulting in negative impacts on quality of life. Prompted by a national call for better insights into the management of HMB, the authors sought to collect patient feedback regarding access to HMB treatment alongside satisfaction with care, including treatment side effects, decision regret and the alignment of patient and clinician treatment goals. AIMS: This study aimed to gather patient feedback on the management of HMB treatment access, satisfaction, side effects, decision regret and alignment of patient and clinician treatment goals. METHODS: A retrospective recall survey was distributed to eligible participants at a single referral centre in regional Victoria, Australia. The survey was sent out to 1241 women who received treatment for heavy menstrual bleeding (HMB) between 01/01/2018 and 01/05/2023. RESULTS: There were 150 respondents to the survey, with 84% reporting a wait time of less than 2 months to see a clinician. Satisfaction with symptom control was reported by 96.9% of hysterectomy patients, while 9.3% reported intolerable side effects and 7.7% expressed regret. Symptom control was less effective for oral hormones (39.5%), non-oral hormones (62.5%) and Mirena (48.4%), which also had higher rates of intolerable side effects (47.2%, 62.5% and 42%) and regret (18%, 41.7% and 27.4%). CONCLUSION: The study underscores the need for personalised patient care in managing HMB, emphasising the importance of educating patients about treatment outcomes to support informed decision-making.
Second stage labour duration and pelvic floor outcomes in primiparous women delivering macrosomic foetuses: a prospective study.
Jin J, Fan Y, Wang M … +3 more , Wu J, Zhu J, Ruan H
J Obstet Gynaecol · 2026 Dec · PMID 42108740 · Publisher ↗
BACKGROUND: To investigate the association between the duration of the second stage of labour (SSL) and early postpartum pelvic floor dysfunction (PFD) in primiparous women delivering macrosomic foetuses. METHODS: 200 el...
BACKGROUND: To investigate the association between the duration of the second stage of labour (SSL) and early postpartum pelvic floor dysfunction (PFD) in primiparous women delivering macrosomic foetuses. METHODS: 200 eligible primiparous women were stratified by SSL duration into Group A (t ≥ 3h), Group B (2h ≤ t < 3h), and Group C (t < 2h). At six weeks postpartum, transperineal ultrasound was performed to determine bladder neck position and levator ani hiatus (LAH) area. Pelvic floor muscle (PFM) strength was evaluated using the Oxford scale, while PFM function was measured via vaginal pressure testing. The occurrences of stress urinary incontinence (SUI) and pelvic organ prolapse (POP) were recorded. RESULTS: The incidence of POP was significantly higher in Group A (23.33%) compared with Group B (6.67%) and C (5%) ( < 0.05). Weak PFM strength was observed in 56.67% of women in Group A versus 21.67% and 21.25% in Groups B and C, respectively (P < 0.05). Vaginal pressure in Group A (class I fibres: 61.38 ± 4.97; class II fibres: 80.63 ± 3.18) was markedly lower than in Group B (I: 78.35 ± 5.08; II: 93.73 ± 4.39) and C (I: 76.55 ± 4.49; II: 92.10 ± 4.40) ( < 0.001). Muscle fatigue was notably higher in Group A (I: 8.65 ± 0.95; II: 3.98 ± 0.65) compared with Group B (I: 4.78 ± 0.61; II: 2.28 ± 0.49) and C (I: 4.25 ± 0.56; II: 2.53 ± 0.55) (P < 0.001). LAH area during Valsalva was significantly larger in Group A (25.48 ± 3.77) than in Groups B (18.55 ± 2.87) and C (17.68 ± 2.72) ( < 0.001), with corresponding LAH expansion rate of 75%, 40%, and 43.75% ( < 0.05). CONCLUSION: A prolonged SSL (≥ 3 h) is associated with weaker PFM strength, greater muscle fatigue, enlarged levator hiatus, and a higher incidence of POP in primiparous women delivering macrosomic foetuses.
The Incidence of Negative Laparoscopy for Pelvic Pain Stratified by Level of Training and Location of Service Provision.
Shyamsunder A, Ng C, El-Hamawi Z … +4 more , Krones D, Nesbitt-Hawes E, Deans R, Abbott J
Aust N Z J Obstet Gynaecol · 2026 Jun · PMID 42104671 · Full text
AIM: Systematic reduction of negative laparoscopy for pelvic pain is crucial to reducing surgical morbidity, improving diagnostic accuracy and minimising cost. This study aims to determine the incidence and consider the...
AIM: Systematic reduction of negative laparoscopy for pelvic pain is crucial to reducing surgical morbidity, improving diagnostic accuracy and minimising cost. This study aims to determine the incidence and consider the underlying causes of negative laparoscopy in women presenting with pelvic pain. METHODS: A 5-year, retrospective cohort study was undertaken for women undergoing laparoscopy for pelvic pain. Patient selection was from an Australian tertiary public hospital with both non-fellowship trained gynaecologists and an Australasian Gynaecological Endoscopic Surgery (AGES) accredited training programme (fellowship trained) as well as one private clinic comprising two fellowship trained gynaecologists. Data was collected from the medical records. A 'negative' laparoscopy was defined either visually or by vision and negative biopsy on histology. The rate of negative laparoscopy in the public and private sector was compared using an odds ratio. RESULTS: Of 1309 women, 174 (13%) had a negative laparoscopy. The negative laparoscopy rate was significantly higher amongst non-fellowship trained gynaecologists compared to those with fellowship training (OR = 2.48; 95% CI: 1.76-3.43, p < 0.05). Visually negative laparoscopy was made in 48/174 (28%) of cases, all from the public sector, with 41/48 (85%) of laparoscopies without biopsy performed by non-fellowship trained gynaecologists. A 56% discordance between intraoperative visualisation and histopathological findings was identified. CONCLUSION: Overall, negative laparoscopy rates are low compared to previously reported data. The discrepancy between the healthcare sectors likely relates to patient factors, surgical training, and clinician bias. Peritoneal biopsy for symptomatic patients undergoing laparoscopy should be considered due to the potential to miss superficial disease.
Agouti signalling protein and triglyceride-glucose index in early pregnancy with gestational diabetes: a prospective cohort study.
Wei X, Gong H, Zhang Q … +3 more , Dong S, Wei J, Lu Y
J Obstet Gynaecol · 2026 Dec · PMID 42101196 · Publisher ↗
OBJECTIVE: Agouti signalling protein (ASIP) is an adipokine regulating appetite and energy balance. This study aimed to investigate the association of first-trimester serum ASIP and triglyceride-glucose (TyG) index with...
OBJECTIVE: Agouti signalling protein (ASIP) is an adipokine regulating appetite and energy balance. This study aimed to investigate the association of first-trimester serum ASIP and triglyceride-glucose (TyG) index with the development of gestational diabetes mellitus (GDM). METHODS: This prospective study enrolled 231 singleton pregnant women (GDM, n = 42; non-GDM, n = 189). Serum ASIP, the TyG index, and routine metabolic parameters were measured during the first (8-12 gestational weeks) and second (24-28 gestational weeks) trimesters. GDM was diagnosed at 24-28 weeks via a standard 75-g oral glucose tolerance test. RESULTS: Both serum ASIP levels and TyG index were significantly elevated in the GDM group compared to the non-GDM group during both trimesters (all P < 0.001). First-trimester ASIP and TyG index correlated positively with second-trimester fasting plasma glucose, 2-hour postprandial glucose, and homeostatic model assessment of insulin resistance, and inversely with quantitative insulin sensitivity check index and Bennett insulin sensitivity index (all P < 0.01). After adjustment, both ASIP and TyG index in the first trimester remained independent risk factors for GDM (ASIP: adjusted odds ratio [a OR] = 1.031, 95% confidence interval [CI] 1.015-1.047, P = 0.019; TyG: a OR = 5.445, 95% CI 1.936-15.319, P < 0.001), with consistent associations across age and body mass index subgroups (interaction P > 0.05). The combination of ASIP and TyG index in the first trimester yielded an AUC of 0.788 for GDM prediction, with a sensitivity of 76.2%, specificity of 68.8%, positive predictive value of 35.2%, and negative predictive value of 92.9%. Its predictive performance improved in the second trimester, achieving an AUC of 0.894, with corresponding values of 92.9%, 72.0%, 42.4%, and 97.9%, respectively. CONCLUSIONS: Elevated first-trimester serum ASIP and TyG index are associated with an increased risk of GDM, and correlate with increased insulin resistance and dysglycaemia during pregnancy.
Experiences and Perceptions of Doctors, Nurses, and Midwives Providing Abortion Care in Australia: A Scoping Review.
Edmondson K, De Costa C, A Grimes H … +1 more , Nagle C
Aust N Z J Obstet Gynaecol · 2026 Jun · PMID 42087560 · Full text
BACKGROUND: Doctors, nurses, and midwives are key providers of abortion care for women in Australia. Providing abortion care is a challenging, contentious, and sometimes perilous occupation. Recent changes in the Austral...
BACKGROUND: Doctors, nurses, and midwives are key providers of abortion care for women in Australia. Providing abortion care is a challenging, contentious, and sometimes perilous occupation. Recent changes in the Australian abortion care landscape mean that it is essential to consider the experiences and perceptions of the abortion workforce and to identify future needs. AIMS: The aim of this review was to collate and report the experiences and perceptions of doctors, nurses, and midwives who provide abortion care in Australia. MATERIALS AND METHODS: A scoping review was utilised to address this question, applying Arksey and O'Malley's framework with enhancements by Levac et al. Research question development and reporting approaches were informed by Joanna Briggs Institute (JBI) Health. RESULTS: In total, 19 articles were included in the review. Studies were predominantly qualitative in nature and encompassed all three clinical groups. Most studies included participants from multiple Australian sites, with five focusing specifically on Victorian participants. Overarching themes included: clinical care provision; person-centred care; social and system-based factors; provider education, training and networks; abortion and the law; ethical challenges; emotional responses; abortion stigma; and conscientious objection. DISCUSSION: The experiences of Australian abortion providers reflect shared challenges relating to: training access; ethical and emotional impacts; abortion stigma; and conscientious objection. Navigating changing system, regulatory, and legal frameworks compounds this complexity. CONCLUSION: Further research into the experiences of abortion providers will inform support interventions. Legislators, regulators, and health service executives must listen to the needs of providers to ensure service sustainability into the future.
Predictors of Successful Outpatient Hysteroscopy: A Retrospective Cohort Study.
Hicks LJ, Ellett L, Healey M … +2 more , Mooney S, Readman E
Aust N Z J Obstet Gynaecol · 2026 Jun · PMID 42083499 · Publisher ↗
BACKGROUND: Outpatient hysteroscopy is increasingly being adopted in Australia as a technique to investigate abnormal uterine bleeding. Appropriate patient selection and pre-procedure counselling are essential for optimi...
BACKGROUND: Outpatient hysteroscopy is increasingly being adopted in Australia as a technique to investigate abnormal uterine bleeding. Appropriate patient selection and pre-procedure counselling are essential for optimisation of patient experience. AIMS: To identify predictors of success at outpatient hysteroscopy. MATERIALS AND METHODS: This is a retrospective cohort study using a prospectively collected hospital-wide audit of all patients attending for awake diagnostic hysteroscopy in the outpatient hysteroscopy service at a tertiary hospital in Melbourne. Possible predictive factors were assessed for their relationship to the procedure outcome, adjusting for the proceduralist. The primary outcome was the probability of procedure completion ('completion'), defined as successful access to the endometrial cavity in the outpatient setting. The secondary outcome was the probability of procedure success ('success'), a composite of access to the cavity, with no reported complications, and the patient reporting a willingness to repeat the procedure as an outpatient again in the future. RESULTS: During the study period, a total of 2 392 outpatient hysteroscopy procedures were attempted. Completion was achieved in 93.4% of cases, and success was seen in 80.6% of cases. Both completion and success were associated with younger age, premenopausal status, and a history of vaginal birth. Previous cervical or tubal surgery, previous Caesarean section birth, and anticipated pain scores were not associated with either outcome. CONCLUSIONS: While hysteroscopic completion and success are high in all groups, premenopausal women with a history of a vaginal birth have the best outcomes and should be encouraged to consider an outpatient procedure where possible.
Bioinformatics analysis implicates ferroptosis and key hub genes in the pathogenesis of endometriosis.
Xu JY, Liu Q
J Obstet Gynaecol · 2026 Dec · PMID 42060917 · Publisher ↗
OBJECTIVE: Endometriosis (EMs) is a chronic gynaecological condition characterised by the ectopic growth of endometrial tissue; however, its molecular mechanisms remain insufficiently understood. Ferroptosis, an iron-dep...
OBJECTIVE: Endometriosis (EMs) is a chronic gynaecological condition characterised by the ectopic growth of endometrial tissue; however, its molecular mechanisms remain insufficiently understood. Ferroptosis, an iron-dependent form of regulated cell death, has been suggested as a potential contributor to its pathogenesis. This study aimed to identify differentially expressed ferroptosis-related genes (DE-FRGs) in EMs through bioinformatics analysis and to explore their underlying molecular mechanisms. METHODS: The gene expression datasets GSE7305 and GSE25628 were obtained from the GEO database. Ferroptosis-related genes (FRGs) were extracted from the FerrDb database. DE-FRGs were identified by intersecting differentially expressed genes (DEGs) with FRGs across the two datasets. Protein-protein interaction (PPI) networks were constructed using STRING and Cytoscape software, while core genes were identified through the cytoHubba plugin. Functional enrichment analysis was performed via the KEGG pathway. RESULTS: A total of 11 DE-FRGs were identified, all of which demonstrated consistently upregulated expression in EMs tissues across both datasets. Four core genes - GATA6, KLF2, BGN and AEBP1 - were selected for further analysis owing to their significant enrichment. KEGG analysis indicated that these genes were particularly enriched in the 'taurine and hypo-taurine metabolism' and 'muscle cell cytoskeleton' pathways. CONCLUSION: This study identified GATA6, KLF2, BGN, and AEBP1 as potential core genes associated with ferroptosis in EMs, highlighting their roles in metabolic and cytoskeletal pathways. These findings provide a novel perspective on the pathogenesis of EMs and suggest new therapeutic targets that warrant further experimental validation.
Neonatal Surveillance Gaps in Maternal Graves' Disease: Findings From a Queensland Maternity Hospital.
Pathmanathan U, Wingate A, Teasdale S
Aust N Z J Obstet Gynaecol · 2026 Jun · PMID 42059696 · Full text
BACKGROUND: Graves' disease presents unique challenges in pregnancy due to the risk of neonatal morbidity and mortality from maternal TSH Receptor antibodies (TRAb). A maternity hospital in Queensland has implemented a p...
BACKGROUND: Graves' disease presents unique challenges in pregnancy due to the risk of neonatal morbidity and mortality from maternal TSH Receptor antibodies (TRAb). A maternity hospital in Queensland has implemented a policy to identify at-risk neonates and facilitate follow-up, including cord blood TRAb, thyroid function tests (TFTs), and clinic appointments. AIMS: To evaluate current neonatal follow-up practices for mothers with Graves' disease, assess missed opportunities for biochemical testing and propose recommendations to improve clinical care. MATERIALS AND METHODS: This retrospective audit covered deliveries between 1st January 2018 to 31st December 2022. Baseline characteristics and follow-up were summarised by frequency and percentage. Maternal records were reviewed for demographic data, ultrasound follow up, TRAb titres, TFTs, and treatment details. Corresponding neonatal charts were then reviewed for cord blood TRAb levels, TFTs on days 3-5 and days 10-14, and phone clinic appointments. Neonatal testing was indicated if the mother was positive for thyroid stimulating immunoglobulin (TSI) or if TRAb titres were > 3 times the upper limit of normal. RESULTS: Data from 70 mothers with active or previously treated Graves' disease were analysed; 18 pregnancies met criteria for neonatal testing. Compliance with recommended testing was suboptimal, with variable adherence to TFT testing and only 10% undergoing cord blood TRAb measurement. CONCLUSION: This audit highlights the importance of standardised protocols and ongoing education to optimise neonatal follow-up and improve outcomes for neonates born to mothers with Graves' disease. Recommendations for education, improved documentation and policy updates have been provided with the aim for further audits to ensure ongoing quality improvement.
Modelling Maternal Cytomegalovirus Seroprevalence in Australia Using Maternal Country of Birth: Implications for Antenatal Screening.
Marzan MB, Tripathi T, Dumville L … +3 more , Watson J, Holmes N, Hui L
Aust N Z J Obstet Gynaecol · 2026 Jun · PMID 42059681 · Full text
BACKGROUND: Cytomegalovirus (CMV) is the most common congenital infection and a leading preventable cause of neurodevelopmental disability. Contemporary maternal CMV seroprevalence estimates are needed to inform antenata...
BACKGROUND: Cytomegalovirus (CMV) is the most common congenital infection and a leading preventable cause of neurodevelopmental disability. Contemporary maternal CMV seroprevalence estimates are needed to inform antenatal screening policy in Australia. PURPOSE: To estimate CMV seroprevalence among women referred for antenatal care at a tertiary maternity hospital, identify clinical and sociodemographic associations with serostatus, and model national and hospital-level seroprevalence by maternal country of birth. MATERIALS AND METHODS: CMV serology results from GP antenatal referrals to a Melbourne tertiary hospital over 13 months were analysed. Seroprevalence was stratified by maternal country of birth, grouped by Organisation for Economic Co-operation and Development (OECD) membership. National and hospital-specific seroprevalence were modelled using Australian Bureau of Statistics and research dataset country-of-birth distributions. RESULTS: Of 4377 referrals, 591 (12.5%) included CMV serology; 61.3% were CMV IgG positive. Median gestational age at testing was 5.4 weeks; referral occurred at a median of 9 weeks. Seroprevalence was higher among women born in non-OECD countries (86.6%) versus OECD countries (54.3%) (adjusted OR 6.44, p < 0.001). Modelled national maternal seroprevalence was 63.6%. Across Melbourne public hospitals, estimates ranged from 60% to 74%, reflecting demographic variation. Among 328 women tested for CMV IgM, 17 (5.2%) had positive or equivocal results; one had low avidity IgG, consistent with recent primary infection. CONCLUSIONS: Maternal CMV seroprevalence in this cohort is higher than previously reported and strongly associated with maternal country of birth. These data inform evaluation of antenatal CMV screening feasibility and cost-effectiveness studies in Australia.
Impact of a Routine Third Trimester Ultrasound Policy on Obstetric, Neonatal and Service Delivery Outcomes in an Australian Tertiary Centre.
Kumar P, Gordon A, Fisher E … +6 more , Flores JG, Khan S, Narayan R, Vries BDE, Hyett J, Mogra R
Aust N Z J Obstet Gynaecol · 2026 Jun · PMID 42053190 · Full text
BACKGROUND: Routine third trimester ultrasound scans have been introduced in several maternity centres to increase detection of fetal growth disorders and improve perinatal outcomes. AIMS: To assess changes in obstetric...
BACKGROUND: Routine third trimester ultrasound scans have been introduced in several maternity centres to increase detection of fetal growth disorders and improve perinatal outcomes. AIMS: To assess changes in obstetric and neonatal outcomes and service delivery following implementation of a routine third trimester ultrasound policy in a tertiary hospital in Australia. MATERIALS AND METHODS: A single-centre retrospective cohort study was conducted comparing a pre-policy cohort that received ultrasound scans measuring biometry and fetal Dopplers when deemed clinically necessary during the third trimester with a post-policy cohort in which all pregnant women were offered an ultrasound at 35-37 weeks gestation. Results of the ultrasound were communicated to the obstetric team. Primary study outcomes were changes to service delivery, obstetric and neonatal outcomes and detection of fetal growth abnormalities. Differences in proportions were compared using the chi-squared test. RESULTS: In the pre-policy cohort, there were 4826 singleton deliveries ≥ 35 weeks gestation and 34% of these women received a third trimester scan, compared to 4499 deliveries in the post-policy cohort in which 81% received a scan. There was a statistically significant increase in detection of LGA fetuses from 27% to 43% but no significant change in SGA detection or preterm birth rates post policy implementation. Early term births (37-38 + 6 weeks) increased (26.9% vs. 31.2%; p < 0.001) along with induction of labour (33.5% vs. 38.2%; p < 0.001). There was no decrease in stillbirths or adverse neonatal outcomes. CONCLUSION: The benefits of implementing routine third trimester scans in 'real-world' clinical practice remain unclear given these findings.
'Do You Tell Them Not to Kiss Their Child?' Implementing Congenital Cytomegalovirus Prevention Guidelines in General Practice: A Qualitative Study.
Rode N, Smithers-Sheedy H, Swinburn K … +3 more , Tripathi T, Waight E, Hui L
Aust N Z J Obstet Gynaecol · 2026 Jun · PMID 42047490 · Full text
Congenital cytomegalovirus (CMV) is a known cause of childhood-onset disability. Australian guidelines recommend all pregnant women be informed about CMV risk-reduction strategies. We conducted semi-structured interviews...
Congenital cytomegalovirus (CMV) is a known cause of childhood-onset disability. Australian guidelines recommend all pregnant women be informed about CMV risk-reduction strategies. We conducted semi-structured interviews with six Australian General Practitioners (GPs) who had completed a CMV eLearning module to explore their education experience and identify barriers and facilitators to including CMV in routine antenatal counselling. Data were analysed inductively. GPs found the module 'engaging' and 'relevant' to their practice. Barriers to routine CMV antenatal counselling included system, practitioner and patient factors, with GPs identifying measures to address these issues and facilitate routine counselling in line with national recommendations.
Profiling Relationships Between Abdominal Pain, Gastrointestinal Symptoms and Pelvic Pain Bothersomeness in Young Females.
Von Felten C, Warr C, Tinetti A … +5 more , Murphy S, Hug L, Ayonrinde OT, Beales D, Waller R
Aust N Z J Obstet Gynaecol · 2026 Apr · PMID 42032856 · Full text
BACKGROUND: Abdominal pain, gastrointestinal symptoms and pelvic pain are common complaints of young females seeking healthcare. These symptoms can co-exist and become recurrent, impacting on quality of life. AIM: This s...
BACKGROUND: Abdominal pain, gastrointestinal symptoms and pelvic pain are common complaints of young females seeking healthcare. These symptoms can co-exist and become recurrent, impacting on quality of life. AIM: This study investigated the relationships between abdominal pain and gastrointestinal symptoms at 17-years of age and pelvic pain bothersomeness (PPB) at 22-years of age in young females. MATERIALS AND METHODS: A cross-sectional observational study utilising 17 and 22-year Gen2 female data of the Raine Study (n = 584). Abdominal pain and gastrointestinal symptoms at 17 years were: frequency, consistency and/or pain of bowel movements, bloating, nausea, vomiting, analgesia for cramps and laxative use in the preceding 3 months. At 22 years, PPB was determined by the Urogenital Distress Inventory Short Form (UDI-6). Additional health-related variables were analysed to understand the symptom patterns of participants. RESULTS: 17-year-old females, with abdominal pain and gastrointestinal data who answered the UDI-6 for PPB (n = 450); 347 (77%) were not bothered by PPB, 64 (14%) reported mild PPB and 39 (9%) reported moderate-severe PPB at 22-years (p = 0.168). Symptoms of varied stool consistency, vomiting, nausea and laxative use, but not isolated abdominal pain, at 17-years were significantly associated with PPB at 22-years. Co-variants of depression, anxiety, bullying, living with a partner, poor sleep and smoking showed increased prevalence with severity of PPB. CONCLUSION: Gastrointestinal symptoms in adolescence were associated with pelvic pain bothersomeness (PPB) in young adulthood. Early detection of abdomino-pelvic symptoms may be useful to allow early, targeted and multi-disciplinary management to optimise physical and mental health outcomes.
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