Aust N Z J Obstet Gynaecol
· 2026 Apr · PMID 42032851
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BACKGROUND: The genital mycoplasmas, Ureaplasma parvum, Ureaplasma urealyticum and Mycoplasma hominis commonly colonise the female genital tract and occasionally cause invasive infection. Our microbiology laboratory, whi...BACKGROUND: The genital mycoplasmas, Ureaplasma parvum, Ureaplasma urealyticum and Mycoplasma hominis commonly colonise the female genital tract and occasionally cause invasive infection. Our microbiology laboratory, which services a specialist maternity referral hospital, is unique in manufacturing specialised in-house blood culture media for detecting mycoplasma bacteraemia. This audit aimed to review the proportion of patients with a positive blood culture for a genital mycoplasma species over a 19-year period and to describe clinical management and outcomes for these patients. METHODS: Data was extracted from the laboratory information system to identify all mycoplasma blood culture bottles collected from 2000 to 2018 for women > 18 years at the Royal Women's Hospital in Victoria, Australia. Clinical and demographic data for women with a blood culture positive for a genital mycoplasma species over the period 2008-2018 were extracted from the hospital medical records. RESULTS: The average annual blood culture positivity rate for a genital mycoplasma was 0.56%. Thirty-eight women had a blood culture positive for Ureaplasma spp. (n = 28) or Mycoplasma hominis (n = 13); three women had both organisms isolated from a single blood culture. Most women had a genital mycoplasma isolated in the early post-partum period (66%) or associated with early pregnancy loss (23%). 57% of women received antibiotics which would be expected to have activity against mycoplasmas. No adverse outcomes were recorded within 30 days, regardless of whether mycoplasma-active antibiotics were prescribed. CONCLUSION: Genital mycoplasma bacteraemia may occur in the early post-partum period or be associated with early pregnancy loss. It is unclear whether this represents transient bacteraemia or whether women benefit from directed antimicrobial therapy.
Risni HW, Wei L, Hickey M
… +3 more, Grzeskowiak L, Ilomäki J, Brauer R
Aust N Z J Obstet Gynaecol
· 2026 Apr · PMID 42032843
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Menopausal hormone therapy (MHT) is a mainstay treatment for menopausal symptoms. While international studies report rising MHT use, trends in Australia remain unclear. Using a 10% random sample of Pharmaceutical Benefit...Menopausal hormone therapy (MHT) is a mainstay treatment for menopausal symptoms. While international studies report rising MHT use, trends in Australia remain unclear. Using a 10% random sample of Pharmaceutical Benefits Scheme (PBS) data from 2014 to 2023, we analysed the prevalence of MHT dispensing among women aged 45-64. Overall prevalence of MHT dispensing remained stable (relative annual change: 0.42%, 95% CI -0.50 to 1.35). Use of transdermal and intrauterine device (IUD) MHT increased (5.89%, 95% CI 3.88-7.91 and 10.22%, 95% CI 9.48-10.95, respectively), and vaginal MHT decreased (-1.47%, 95% CI -2.30 to -0.63), while oral MHT appeared stable (0.66%, 95% CI -0.04 to 1.36). This study offers a clearer understanding of how MHT use in Australia has changed over the last decade.
Hill MG, Humphries A, Wilson J
… +4 more, Harvey AD, Cronin R, Thompson JMD, Sadler LC
Aust N Z J Obstet Gynaecol
· 2026 Apr · PMID 42032840
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BACKGROUND: Mediolateral episiotomy (MLE) is a common procedure. Whether it modifies the risk of obstetric anal sphincter injury (OASI) in nulliparous and parous people is unclear. AIMS: We performed a retrospective coho...BACKGROUND: Mediolateral episiotomy (MLE) is a common procedure. Whether it modifies the risk of obstetric anal sphincter injury (OASI) in nulliparous and parous people is unclear. AIMS: We performed a retrospective cohort study to assess if MLE was associated with decreased OASI. MATERIALS AND METHODS: A retrospective cohort study including all unassisted vaginal births from 36 weeks' from 2008 to 2021 was assembled. Analysis was separated for first and subsequent vaginal births, adjusting for maternal height, body mass index (BMI), ethnicity, prior caesarean birth (if no previous vaginal birth) or pre-delivery parity (if there was a previous vaginal birth), smoking status, augmentation of labour, induction of labour, length of second stage, caregiver type, socioeconomic deprivation quintile, gestational age, baby head circumference, baby birthweight and use of epidural using Generalized Linear Models. RESULTS: There were 49 363 unassisted vaginal births. Of these, 20 201 were first vaginal births (19 082 nullipara and 1119 with one prior caesarean birth), 27 825 subsequent vaginal births, and 1337 unknown vaginal birth status. Episiotomy and OASI were recorded in 28.6% and 3.6% of first and 9.1% and 0.8% of subsequent vaginal births, respectively. Among first vaginal births, there was no association between episiotomy and OASI in univariable (RR 1.00 (0.86, 1.17)) or multivariable analysis (RR 0.91 (0.77, 1.09)). Among subsequent vaginal births, episiotomy was associated with increased odds of OASI in univariable (RR 2.21 (1.57, 3.13)) and multivariable analysis (RR 1.55 (1.08, 2.22)). CONCLUSION: Our findings do not support the use of MLE for first births and suggest harm for subsequent births.
BACKGROUND: This study investigated the association between gestational serum adiponectin (APN) levels and postpartum glycaemic outcomes in women with gestational diabetes mellitus (GDM). METHODS: A total of 96 GDM patie...BACKGROUND: This study investigated the association between gestational serum adiponectin (APN) levels and postpartum glycaemic outcomes in women with gestational diabetes mellitus (GDM). METHODS: A total of 96 GDM patients were enrolled. Baseline demographic and biochemical data were collected. Serum APN levels were measured longitudinally across three gestational stages and postpartum using an enzyme-linked immunosorbent assay. Based on 1-year follow-up data, patients were classified into favourable (normal glucose metabolism) and unfavourable (prediabetes or type 2 diabetes mellitus [T2DM]) outcome groups. Statistical analyses included -tests, non-parametric tests, Cox proportional hazards models, and Kaplan-Meier survival curves to assess the associations between APN levels and outcomes. RESULTS: At 1-year follow-up, 54.17% had favourable outcomes with higher APN levels, while 45.83% had unfavourable outcomes characterised by older age, higher BMI, and a higher prevalence of family history. T2DM patients had lower APN than those with prediabetes. Cox regression identified postpartum APN as an independent protective factor (Hazard Ratio [HR] = 0.720, 95% confidence interval [CI]: 0.60-0.85, < 0.001), with each 1-μg/mL increase reducing risk by 27%. Significant risk factors included age (HR = 1.10, 95% CI: 1.01-1.20), pre-pregnancy BMI (HR = 2.06, 95% CI: 1.03-4.14), family history (HR = 2.58, 95% CI: 1.22-5.46), fasting glucose (HR = 1.41, 95% CI: 1.17-1.70), and 1-hour OGTT glucose (HR = 1.20, 95% CI: 1.02-1.40). The low-APN group showed significantly higher cumulative incidence of metabolic dysfunction. CONCLUSIONS: Gestational APN levels are strongly associated with postpartum metabolic outcomes in GDM. Low APN is an independent risk factor for adverse outcomes, and its dynamic changes reflect metabolic recovery capacity.
BACKGROUND: This study aimed to systematically evaluate the effects of psychological interventions during pregnancy on the intervention outcomes and incidence rate in women with postpartum depression. METHODS: Databases...BACKGROUND: This study aimed to systematically evaluate the effects of psychological interventions during pregnancy on the intervention outcomes and incidence rate in women with postpartum depression. METHODS: Databases (PubMed, Medline, Web of Science, Cochrane Library, EMBASE) were searched from inception to December 2024 for randomised controlled trials assessing prenatal psychological interventions (e.g., mindfulness, psychosocial support) in pregnant women without severe mental illness. Primary outcomes included Edinburgh Postnatal Depression Scale (EPDS), Patient Health Questionnaire-9 (PHQ-9), Perceived Stress Scale-10 (PSS-10), Spielberger State-Trait Anxiety Inventory (STAI) scores, and PPD incidence within 6 weeks postpartum. Quality was assessed using the Cochrane risk-of-bias tool; meta-analysis was performed with RevMan 5.3. RESULTS: A total of 10 articles were included, with 6700 study subjects in total, including 3345 in the intervention group and 3355 in the control group, all of which were randomised controlled trials. The incidence rate of postpartum depression in the intervention group was significantly reduced (OR = 0.73, 95% CI [0.57-0.95], = 0.02). The scores of EPDS, PHQ-9, PSS-10, and STAI in the intervention group were all lower than those in the control group. CONCLUSION: Psychological interventions during pregnancy can significantly reduce postpartum depression-related scale scores and incidence rates, and improve depressive symptoms, anxiety, and perceived stress. However, due to the heterogeneity of intervention types, this study cannot determine the optimal intervention method and thus provides preliminary evidence for clinical prevention. Clinicians should select interventions based on resource availability and individual characteristics of pregnant women, while future studies should focus on direct comparisons of different intervention types to provide more targeted guidance.
BACKGROUND: Endometriosis is heterogeneous, and evidence for individualised postoperative management is limited. We assessed whether postoperative hormonal therapy exposure is associated with one-year changes in pain dom...BACKGROUND: Endometriosis is heterogeneous, and evidence for individualised postoperative management is limited. We assessed whether postoperative hormonal therapy exposure is associated with one-year changes in pain domains after first-time endometriosis surgery and explored factors related to treatment allocation. METHODS: Retrospective cohort study (Erlangen, 09/2019-06/2024) of premenopausal women (18-45 years) undergoing first minimally invasive surgery for endometriosis-associated pain with one-year follow-up. Patients were classified into four hormonal therapy (HT) patterns based on baseline and follow-up status: HT none ( = 73), HT initiation ( = 57), HT discontinuation ( = 21), and HT continuation ( = 38). For each pain domain, adjusted analysis of covariance (ANCOVA) models estimated one-year follow-up Numeric Rating Scale (NRS) differences, and therapy-group effects were tested using robust Wald omnibus tests with Holm multiplicity adjustment across domains, and post-hoc contrasts were Holm-adjusted within domains and interpreted only for domains with significant omnibus tests. HT-group membership was analysed using multinomial logistic regression. RESULTS: After multiplicity adjustment across domains, therapy-group differences were observed only for dysmenorrhoea/pelvic pain ( < 0.001). Within this domain, only HT initiation was associated with lower one-year follow-up scores versus HT none (adjusted difference -2.39 NRS points, 95% confidence interval (CI) -3.58 to -1.21; < 0.001), whereas other contrasts were not significant after within-domain multiplicity correction. No domain-level evidence of between-group differences was found for dyspareunia, dysuria, or dyschezia. Younger age was associated with HT initiation (odds ratio (OR) 0.92, 95% CI 0.86-0.98; = 0.012) and continuation (OR 0.82, 95% CI 0.74-0.91; < 0.001). CONCLUSION: HT initiation was associated with lower one-year dysmenorrhoea/pelvic pain scores, while other domains showed no consistent differences. Younger patients were more likely to initiate or continue hormonal therapy, suggesting non-random allocation. Given the observational design and potential residual confounding, findings are hypothesis-generating and support symptom-profile-guided postoperative management; prospective studies with standardised regimens and domain-specific outcomes are needed.
Peacock L, Nyamutora T, Palmer K
… +3 more, Andrews T, Lord B, Bowles KA
Aust N Z J Obstet Gynaecol
· 2026 Apr · PMID 42007586
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BACKGROUND: Gynaecological chronic pelvic pain (CPP) has a high prevalence among adult women. This pain can be debilitating and life-impacting, affecting quality of life across all dimensions of health. Many barriers to...BACKGROUND: Gynaecological chronic pelvic pain (CPP) has a high prevalence among adult women. This pain can be debilitating and life-impacting, affecting quality of life across all dimensions of health. Many barriers to specialised care exist, leading women to rely on unscheduled general care like emergency departments or in the out-of-hospital. OBJECTIVE: The review aimed to investigate evidence regarding pain management for women presenting to acute, non-specialist settings for gynaecological CPP. Secondary aims were to identify areas of suboptimal care and potential for improvement of patient outcomes. METHODS: A scoping review was conducted using the Joanna Briggs Institute scoping review framework with the PRISMA extension. Academic and grey literature were searched. RESULTS: Initially, 1563 records were identified, with 50 from grey literature and 801 from citation screening. Nineteen were included for descriptive analysis. Key themes were pharmacological agents, holistic care and ongoing care. Appraisal of the literature showed varying quality. CONCLUSION: This scoping review highlights the need to define clinicians' roles in managing gynaecological CPP exacerbations in acute, non-specialist settings. It identifies gaps in best-practice pain assessment, management and clinician education, with guidelines and recommendations often of poor quality. Effective CPP management requires a multidisciplinary and biopsychosocial approach and, despite limitations, clinicians can enhance knowledge and practice scope to improve patient outcomes.
BACKGROUND: To compare the short-term (three-month) anatomical alterations and subjective outcomes of transobturator tape (TOT), tension-free vaginal tape (TVT), and Burch colposuspension using transperineal ultrasound (...BACKGROUND: To compare the short-term (three-month) anatomical alterations and subjective outcomes of transobturator tape (TOT), tension-free vaginal tape (TVT), and Burch colposuspension using transperineal ultrasound (TPUS). METHODS: This prospective observational study, reported in accordance with TREND guidelines, included 80 women with stress urinary incontinence (SUI) (TOT: 30; TVT: 30; Burch: 20) assigned based on institutional protocols. Pre- and postoperative assessments included TPUS (alpha/beta angles, bladder neck descent) and validated questionnaires (UDI-6, IIQ-7). Multivariate regression models were utilised to adjust for baseline age, BMI, and parity. RESULTS: All procedures resulted in significant intra-group anatomical and symptomatic improvements ( < 0.05). In adjusted analyses, the TVT procedure was associated with a significantly greater reduction in the alpha angle ( = 0.046). Furthermore, TVT showed a statistically significant association with greater UDI-6 score improvement compared with the Burch procedure (Adjusted OR: 0.04; 95% CI: 0.003-0.71; = 0.032). Non-responder analysis confirmed that attrition bias was minimal ( > 0.05). CONCLUSIONS: TOT, TVT, and Burch procedures are all effective in providing significant short-term restoration of anatomy and symptoms. While TVT demonstrated more pronounced anatomical and subjective gains in adjusted models, clinical satisfaction remains high across all techniques. Findings should be interpreted with caution due to the observational design and short follow-up.
Heller-Boersma JG, Edmonds DK, Rose GL
… +1 more, Deans R
Aust N Z J Obstet Gynaecol
· 2026 Apr · PMID 41981890
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BACKGROUND: Variations in Sex Characteristics (VSC) also called Differences in/Disorders of Sex Development (DSD) include a range of conditions of congenital abnormalities of the reproductive system. Either the internal...BACKGROUND: Variations in Sex Characteristics (VSC) also called Differences in/Disorders of Sex Development (DSD) include a range of conditions of congenital abnormalities of the reproductive system. Either the internal and/or external genital tract are affected, presenting as androgenisation of the external genitalia, or incomplete formation of the vagina and uterus, and/or gonads. We previously developed a model of the core psychological impact of diagnosis/medical treatment of one of these conditions, namely utero-vaginal-agenesis or Mayer-Rokitansky-Küster-Hauser Syndrome (MRKH), and a Cognitive-Behavioural Therapy of MRKH (CBT-MRKH) based on this, a randomized-controlled-trial of which showed improved psychological outcomes in participants. AIMS: The current study reviews both the consolidation of CBT-MRKH and its subsequent adaptation to CBT-MRKH/DSD+ to reach a wider VSC/DSD audience, who similarly experience a threat to their sense of self/identity following diagnosis. MATERIALS AND METHODS: A qualitative audit of therapy notes was completed, of both 2 further CBT-MRKH group programs run, and a 3rd and 4th series, of its broadened/deepened CBT-MRKH/DSD+ version. This audit focused on participants' experiences of therapy and impact on view of self/self-beliefs. RESULTS: Participants collectively valued the group support, and the techniques used such as the therapeutic writing tasks and cognitive restructuring of negative beliefs, plus VSC/DSD-specific tools/skills training. The collective quotes illustrate the marked positive changes participants experienced in terms of their view of themselves and their condition, emotions processed, and adaptive self-schemata and coping developed throughout therapy. CONCLUSIONS: Taking the results from CBT-MRKH we were able to apply it to a broader VSC/DSD audience with success.
Camões-Costa V, Kwok C, Pascoe M
… +2 more, White S, Danielle Mazza AM
Aust N Z J Obstet Gynaecol
· 2026 Apr · PMID 41969241
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BACKGROUND: A prominent barrier to broader intrauterine device (IUD) uptake is the fear of pain and discomfort associated with insertion of the device. AIM: To examine the pain level perceived during IUD insertion and id...BACKGROUND: A prominent barrier to broader intrauterine device (IUD) uptake is the fear of pain and discomfort associated with insertion of the device. AIM: To examine the pain level perceived during IUD insertion and identify factors associated with perceived pain during the insertion procedure. MATERIALS AND METHODS: We conducted a secondary analysis of nationally representative survey data from Australian women using IUDs. We explored self-reported pain perception during IUD insertion retrospectively. We asked women about pregnancy history, mental health and their perceived knowledge about the IUD method they were using at the time of the survey. Ordinal logistic regression was employed to analyse associations between these factors and pain perception. RESULTS: A total of 347 respondents were using an IUD and reported on pain perception during IUD insertion. One in five women reported experiencing severe pain during IUD insertion and approximately one in two women reported experiencing mild or no pain during this procedure. Having a current mental health condition, having more than one previous pregnancy and higher self-perceived knowledge about IUD groups were associated with more perceived pain. CONCLUSIONS: These findings highlight the need for healthcare providers to consider the complex interplay of factors affecting pain perception during IUD insertion, prioritise individualized pain management strategies and address perceived knowledge surrounding IUDs, particularly in women with mental health conditions. Exploring ways to improve the experience of women during IUD insertion may contribute to positive discourse around IUDs and to encourage others to select an IUD as a contraceptive approach.
Hill MG, Humphries A, Wilson J
… +4 more, Harvey AD, Cronin R, Thompson JMD, Sadler LC
Aust N Z J Obstet Gynaecol
· 2026 Apr · PMID 41964135
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BACKGROUND: Episiotomy may be performed during an instrumental vaginal birth. The evidence that the procedure is associated with less obstetric anal sphincter injuries (OASI) in this setting is scarce. AIMS: We undertook...BACKGROUND: Episiotomy may be performed during an instrumental vaginal birth. The evidence that the procedure is associated with less obstetric anal sphincter injuries (OASI) in this setting is scarce. AIMS: We undertook a retrospective cohort study to ascertain whether the performance of episiotomy was associated with fewer obstetric anal sphincter injuries in patients undergoing instrumental births over a 14-year period from one tertiary institution. MATERIALS AND METHODS: Every vaginal birth at Te Toka Tumai Auckland from gestational age 36 weeks was included in a retrospective cohort spanning the years 2008-2021. Forceps-assisted and Vacuum-Extraction and Sequential Instrumental births were included. Univariable analysis was performed for the forceps, Vacuum-extraction and Sequential Instrumental birth strata. Multivariable analysis was performed for all births using generalized linear models including maternal, neonatal and labour characteristics. RESULTS: Between 2008 and 2021 there were 3714 forceps-assisted births, 7793 Vacuum-extraction births and 505 Sequential Instrumental births. The majority of these births were carried out with the use of a mediolateral episiotomy (89%, 66%, and 93.5% respectively) and OASI occurred in 9.5%, 5.2%, and 16.2%. Among people having an instrumental birth (all groups forceps, vacuum-extraction and sequential instrumental births), mediolateral episiotomy was associated with lower relative risks of OASI after adjusting for type of instrument, parity and other clinical and demographic factors (RR 0.68 (0.58-0.80)). CONCLUSION: Mediolateral episiotomy was associated with a lower relative risk of OASI in patients having operative vaginal births.
Boothroyd C, Gee A, Hart R
… +7 more, Hull L, Hunter T, Lew R, Norman R, Rowan K, Stankiewicz M, on behalf CREI subspecialty group
Aust N Z J Obstet Gynaecol
· 2026 Apr · PMID 41940631
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Following the first report of use of intracytoplasmic sperm injection (ICSI) in 1992 there has been a consistent global increase in the use of ICSI to fertilise human oocytes in vitro, though since 2016 there has been a...Following the first report of use of intracytoplasmic sperm injection (ICSI) in 1992 there has been a consistent global increase in the use of ICSI to fertilise human oocytes in vitro, though since 2016 there has been a small reduction in its use in Australia and New Zealand This consensus statement, developed by the subspecialty group in reproductive endocrinology and infertility, reviews the evidence underpinning the use of ICSI. It is concluded that ICSI is an appropriate intervention when there is reduced semen quality or if there is a significant risk of failed fertilisation, though the exact seminal parameters which predict appropriate use of ICSI are uncertain. ICSI is an appropriate intervention when there has been failed or poor fertilisation rates in a previous IVF cycle. ICSI may be used to reduce the risk of recurrent molar pregnancy, but the evidence to support its use after oocyte cryopreservation, in vitro maturation of oocytes (IVM), prior to preimplantation genetic testing (PGT) and when treating HIV sero-discordant couples is lacking, and these are areas requiring further research. ICSI is not necessary in unexplained infertility when a low number of oocytes have been retrieved during the treatment cycle or when the female age is advanced if the semen parameters are normal.
Kourloufas LC, Barnes RA, Flack JR
… +1 more, Wong T
Aust N Z J Obstet Gynaecol
· 2026 Apr · PMID 41940524
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BACKGROUND: Medical nutrition therapy is first-line treatment for Gestational Diabetes Mellitus (GDM). The high popularity of low carbohydrate diets may impact on the acceptability of the diet recommended by dietitians f...BACKGROUND: Medical nutrition therapy is first-line treatment for Gestational Diabetes Mellitus (GDM). The high popularity of low carbohydrate diets may impact on the acceptability of the diet recommended by dietitians for management of GDM. AIMS: This study assessed the experience of women prescribed the Standardised Gestational Diabetes (SGD) diet (45%-50%, 25%-30%, 15%-20% from carbohydrate, fat and protein, respectively). MATERIALS AND METHODS: A cross-sectional survey of women with GDM was undertaken to collect viewpoints on the SGD diet. Pregnant women with pre-gestational diabetes, twins, non-English speakers and women with no or limited English literacy were excluded. Standard care was provided to all participants. The survey was offered at least one week after an individual dietitian review appointment. RESULTS: A total of 135 women completed the survey. The majority perceived the SGD diet carbohydrate amounts and distribution as 'about right'-79.3% (n = 107) and 72.6% (n = 98), respectively. Only 3.7% (n = 5) perceived the advised carbohydrate amount as 'too much' or 'far too much'. Conversely, a considerable proportion reported that they were advised to reduce their intake and to increase meal-snack frequency compared to their usual diet-62.9% (n = 85) and 43.7% (n = 59), respectively. Women reported high rates of diet compliance, with 70.4% (n = 95) 'often' or 'always' following the diet, despite 48.2% (n = 65) reporting the diet being 'challenging' or 'very challenging' to follow. CONCLUSIONS: Despite the popularity of low carbohydrate diets in the general population, our cohort of women with GDM perceived the amount and frequency of carbohydrate intake recommended by dietitians as 'about right'.
Aust N Z J Obstet Gynaecol
· 2026 Apr · PMID 41933469
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BACKGROUND: Promoting awareness of foetal movement (FM) is a recognised approach to addressing preventable stillbirth. However, provision of information is inconsistent, and rates of presentation for decreased FM may var...BACKGROUND: Promoting awareness of foetal movement (FM) is a recognised approach to addressing preventable stillbirth. However, provision of information is inconsistent, and rates of presentation for decreased FM may vary by maternal factors. Information is lacking on maternal views of FM information and knowledge of actions if concerned about FM. AIMS: To describe women's views of FM during late pregnancy in Aotearoa-New Zealand (Aotearoa-New Zealand), including factors that influence maternal actions if concerned. MATERIALS AND METHODS: Online survey of women with singleton third-trimester pregnancies in Aotearoa-New Zealand. Multivariable analysis adjusted for maternal factors. RESULTS: Eligible participants comprised European (1042, 63.5%), Māori (266, 16.2%), Pacific (119, 7.3%), Asian (160, 9.8%) and Other (35, 2.1%). Over half were nulliparous (916, 55.9%) and early third-trimester (median 31, IQR 28-34). Most (1366, 83.3%) had been concerned about FM. Groups that were less likely to seek advice when concerned, included Māori (aOR 0.69, 95% CI 0.51%-0.93%, p = 0.02), Pacific (aOR 0.58, 95% CI 0.38%-0.88%, p = 0.01) and parous (aOR 0.73, 95% CI 0.59%-0.90%, p = 0.003) women. Advice seeking was also less likely with a doctor as the main maternity provider (aOR 0.59, 5% CI 0.39%-0.92%, p = 0.02) compared to a midwife, and those who received fewer than recommended antenatal visits (aOR 0.55, 95% CI 0.34%-0.88%, p = 0.01). CONCLUSIONS: This study identified that FM worries are common in the third-trimester in Aotearoa-New Zealand. Yet, some groups of women were less likely to seek advice when concerned, indicating opportunities to reduce inequity and address barriers to accessing care.
Aust N Z J Obstet Gynaecol
· 2026 Apr · PMID 41919615
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BACKGROUND: Preeclampsia has a significant negative impact on maternal and foetal health. Excessive gestational weight gain (eGWG) is defined as weight gain in excess of recommendations as per the Institute of Medicine g...BACKGROUND: Preeclampsia has a significant negative impact on maternal and foetal health. Excessive gestational weight gain (eGWG) is defined as weight gain in excess of recommendations as per the Institute of Medicine guidelines. eGWG is a risk factor for preeclampsia. AIMS: We aimed to investigate the patterns of gestational weight gain, its relationship to the incidence of preeclampsia, trends in blood pressure and pregnancy outcomes within a hospital network in Sydney, Australia. MATERIALS AND METHODS: We conducted a retrospective cohort study within a metropolitan area health network in Sydney, Australia. Participants included all pregnant women who delivered at the facility between 1 January 2018 and 31 August 2024. RESULTS: 44 852 met the inclusion criteria. 958 (2.14%) women developed preeclampsia. More women had eGWG (57%) than those with recommended GWG (rGWG) or inadequate GWG (iGWG). eGWG was associated with increased incidence of caesarean section (35.08%) and postpartum haemorrhage (11.48%). eGWG correlated with increased incidence of preeclampsia (2.61% n = 668, p < 0.001). There appears to be a directly proportional relationship between weight and blood pressure-as body mass index increased, blood pressure also increased. Women with preeclampsia had higher blood pressures throughout the pregnancy compared to non-preeclampsia women. eGWG was associated with higher blood pressure throughout the pregnancy. CONCLUSIONS: Excessive gestational weight gain appears to increase the risk of developing preeclampsia. Pre-pregnancy overweight and obesity increase the risk of excessive gestational weight gain as well as blood pressure and the incidence of preeclampsia. In pregnancy, weight appears to have a positive linear relationship with blood pressure.
Aust N Z J Obstet Gynaecol
· 2026 Apr · PMID 41919601
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BACKGROUND: Guidelines for managing a small symphysial fundal height (SFH) measurement during pregnancy are well established, but guidelines identifying and managing a large SFH measurement at term are not. AIMS: To dete...BACKGROUND: Guidelines for managing a small symphysial fundal height (SFH) measurement during pregnancy are well established, but guidelines identifying and managing a large SFH measurement at term are not. AIMS: To determine the relationship between a large SFH at term and intra-partum risk, and to determine if there is an SFH cut-off that could predict the following adverse outcomes: emergency caesarean section (CS), instrumental delivery, postpartum haemorrhage (PPH) and admission of neonate to the special care nursery (SCN). MATERIALS AND METHODS: A retrospective audit was performed on 775 deliveries at a regional Australian hospital. SFH measurement at term was the primary variable for investigation. The largest measurement taken within 14 days of delivery was accepted as the primary SFH measurement. RESULTS: In primiparous women, an SFH of 36 cm was associated with the lowest incidence of emergency CS (8%) and 35 cm was associated with the lowest incidence of PPH (8%). Both risks trebled at an SFH of 40 cm (24%) and quintupled at 43 cm (42%). In multiparous women the emergency CS rate was not correlated with SFH, but the PPH rate was correlated. CONCLUSIONS: A SFH measurement at term is currently a neglected but useful measurement for triaging women early in labour. An SFH of 36 cm is most reassuring as the parturient is at low risk of an emergency CS or a PPH whereas a SFH of 40 cm or more indicates increased risk and intra-partum care should be modified to reflect this increased risk.