Aust N Z J Obstet Gynaecol
· 2026 Apr · PMID 41913695
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BACKGROUND AND AIM: Poor control of maternal asthma during pregnancy may increase the risk of pregnancy complications and adverse perinatal outcomes. The present review provides an update on the current knowledge of the...BACKGROUND AND AIM: Poor control of maternal asthma during pregnancy may increase the risk of pregnancy complications and adverse perinatal outcomes. The present review provides an update on the current knowledge of the association between asthma control during pregnancy and pregnancy complications, which are pre-eclampsia, low birth weight (LBW), pre-term birth, and small for gestational age (SGA). METHODS: This review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. RESULTS: A total of 14 studies fulfilled the predefined criteria for inclusion in the present review. The included studies revealed that the presence of maternal asthma per se is associated with an increased risk of SGA, whereas the observations were contradictory in relation to pre-eclampsia, LBW and pre-term birth. Asthma exacerbations and uncontrolled asthma during pregnancy were associated with an increased risk of pre-eclampsia. The studies did, however, not consistently suggest an increased risk of LBW, pre-term birth or SGA associated with asthma exacerbations during pregnancy. CONCLUSIONS: Apart from small for gestational age, maternal asthma itself is not associated with a higher risk of pregnancy complications and adverse perinatal outcomes. However, asthma exacerbations and uncontrolled asthma during pregnancy increase the risk of pre-eclampsia.
Aust N Z J Obstet Gynaecol
· 2026 Apr · PMID 41913689
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Endometriosis is underpinned by dysfunctional immune responses resulting in failure to clear ectopic endometrial lesions from the peritoneal cavity. The pelvic milieu comprising immature dendritic cells, dysfunctional cy...Endometriosis is underpinned by dysfunctional immune responses resulting in failure to clear ectopic endometrial lesions from the peritoneal cavity. The pelvic milieu comprising immature dendritic cells, dysfunctional cytotoxic lymphocytes, and an imbalance in production of interleukin-12 isoforms including Type I/II interferons (IFNs) is thought to play a major role in this process. The recent discovery of an immunomodulating lipidic peptide, designated IK14004, that activates natural killer (NK) and CD8+ T cells, skews IL-12 signalling towards the IL-12p70 isoform and uncouples production of Type I from Type II IFNs may enable earlier diagnosis of endometriosis and could also have therapeutic benefit.
Ngov A, Elhindi J, Blumenthal C
… +1 more, McGee T
Aust N Z J Obstet Gynaecol
· 2026 Apr · PMID 41906327
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BACKGROUND: Pregnancy after sleeve gastrectomy is increasingly common but outcomes data are limited. AIMS: To evaluate perinatal outcomes following sleeve gastrectomy compared to a matched non-bariatric control group wit...BACKGROUND: Pregnancy after sleeve gastrectomy is increasingly common but outcomes data are limited. AIMS: To evaluate perinatal outcomes following sleeve gastrectomy compared to a matched non-bariatric control group with similar pre-pregnancy BMI. MATERIALS AND METHODS: We undertook a retrospective cohort study (2016-2022) of pregnant women with prior sleeve gastrectomy (n = 520) versus no bariatric surgery (n = 58 777). Following matching for maternal age, pre-pregnancy body mass index, parity, smoking, Australian vs. overseas-born and delivery year, there were 469 post-sleeve gastrectomy and 915 matched control pregnancies. The main outcome measures were gestational diabetes, gestational hypertension/preeclampsia, large-for-gestational-age (LGA) and small-for-gestational-age (SGA) infants, perinatal mortality, preterm birth, neonatal unit admission, major congenital anomalies and caesarean births. Outcomes' assessment utilised univariable and multivariable conditional logistic regression models, conditioned by matching strata. Surgery-pregnancy interval impact was separately explored. RESULTS: Compared with matched controls, post-sleeve gastrectomy pregnancies had a lower risk of gestational diabetes at 5.4% vs. 16.6% (aRR 0.26 (95% CI: 0.14-0.45)), gestational hypertension/preeclampsia 1.1% vs. 6.1% (aRR 0.24 (95% CI: 0.08-0.69)), LGA infants 6.0% vs. 14.1% (aRR 0.34 (95% CI: 0.20-0.58)), and neonatal unit admission 13.9% vs. 19.0% (aRR 0.67 (95% CI: 0.47-0.98)), but almost double the risk of SGA infants 14.5% vs. 8.3% (aRR 1.92 (95% CI: 1.22-3.04)). Surgery-pregnancy interval < 12 months versus ≥ 12 months was associated with greater likelihood of inadequate gestational weight gain but no outcomes' differences. CONCLUSIONS: Pregnancy following sleeve gastrectomy carries increased SGA risk, possibly due to unrecognised hypoglycaemia and/or nutrient deficiency. These pregnancies require additional patient education, nutrient monitoring and supplementation, and fetal surveillance.
Buntain H, Kumar S, Paganoti CF
… +3 more, Holland O, Ellwood D, Da Silva Costa F
Aust N Z J Obstet Gynaecol
· 2026 Apr · PMID 41891330
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The increasing use of third trimester ultrasound within Australia's hybrid maternity care model reflects growing recognition of its value-even among publicly funded pregnant women. Emerging evidence suggests benefits suc...The increasing use of third trimester ultrasound within Australia's hybrid maternity care model reflects growing recognition of its value-even among publicly funded pregnant women. Emerging evidence suggests benefits such as improved detection of fetal growth abnormalities, malpresentation and structural anomalies. Whilst concerns remain about cost-effectiveness and provoking unnecessary interventions, these must be weighed against potentially improved perinatal outcomes. With evolving research, the role of a routine 36-week ultrasound in low-risk Australian pregnancies warrants reconsideration.
Loughnan SA, Horey D, Wojcieszek AM
… +13 more, Andrews C, Gautam R, Carty M, Ellwood D, Forbes M, Gordon A, Jennings B, Lohan A, Laporte J, Seeho S, Shand A, Boyle FM, Flenady V
Aust N Z J Obstet Gynaecol
· 2026 Apr · PMID 41891316
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Drever N, Moreno MC, Mohammadpour Z
… +4 more, O'Brien C, Melville C, Black K, de Costa C
Aust N Z J Obstet Gynaecol
· 2026 Apr · PMID 41886781
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BACKGROUND: There is a lack of evidence regarding the impact of body weight on the safety of surgical abortion. STUDY DESIGN: We performed a systematic review and meta-analysis of observational studies reporting the effe...BACKGROUND: There is a lack of evidence regarding the impact of body weight on the safety of surgical abortion. STUDY DESIGN: We performed a systematic review and meta-analysis of observational studies reporting the effects of obesity on perioperative anaesthetic and surgical outcomes during surgical abortion. Analytical observational studies examining individuals undergoing surgical abortion up to 28 weeks gestation were eligible for inclusion if they reported perioperative anaesthetic or surgical outcomes in participants with body mass index (BMI) in two groups: BMI < 30 kg/m and BMI ≥ 30 kg/m. Sub-analyses were performed comparing outcomes in those with BMI < 30 kg/m and ≥ 40 kg/m. RESULTS: Eight retrospective cohort studies were included, comprising 9912 obese and 31 672 non-obese participants. 1770 participants had BMI ≥ 40 kg/m and only 71 had BMI ≥ 50 kg/m. BMI ≥ 30 kg/m was not associated with an increase in major surgical adverse outcomes (RR [95% CIs] 1.16 [0.83-1.62]) compared to BMI < 30 kg/m. BMI ≥ 40 kg/m was associated with increased risk of major complications (RR [95% CIs] 2.60 [1.28-5.28]) based on low-quality evidence from two studies on second-trimester surgical abortion. Anaesthetic adverse outcomes were rare and not increased by BMI ≥ 30 kg/m (RR [95% CIs] 1.02 [0.50-2.06]) or BMI ≥ 40 kg/m (RR [95% CIs] 2.0 [0.55-7.24]). CONCLUSIONS: Anaesthetic and surgical risks are not increased by BMI ≥ 30 kg/m. Individuals with BMI ≥ 40 kg/m may have increased risk of major surgical complications. The lack of sufficient data on those in the BMI ≥ 40 kg/m and BMI ≥ 50 kg/m categories underscores the need for further research to ensure high-quality abortion care for this population.
Aust N Z J Obstet Gynaecol
· 2026 Apr · PMID 41885247
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OBJECTIVE: This study explores the experiences of pregnant women with HDP in Eastern Indonesia, focusing on how they perceive the condition, access care, and manage the emotional and practical challenges during pregnancy...OBJECTIVE: This study explores the experiences of pregnant women with HDP in Eastern Indonesia, focusing on how they perceive the condition, access care, and manage the emotional and practical challenges during pregnancy. METHODS: A qualitative phenomenological design was used, involving in-depth interviews with 15 pregnant women diagnosed with HDP across three primary healthcare centers in Eastern Indonesia. Data were collected using semi-structured interviews, transcribed verbatim, and analysed thematically. RESULTS: Four themes emerged: (1) Emotional distress and psychological burden following HDP diagnosis; (2) Uncertainty in knowledge and care, exacerbated by inconsistent medical information and limited provider communication; (3) Diverse coping strategies, ranging from active information seeking to avoidance and reliance on social support; and (4) Self-management combining medical advice, lifestyle changes, and traditional practices. These findings reveal critical gaps in health education, communication, and culturally appropriate care delivery. CONCLUSION: This study highlights the need for context-specific, culturally sensitive approaches to HDP management. Interventions should strengthen patient-provider communication, standardise care practices, and integrate health education at the primary level. Understanding women's lived experiences is essential to improving maternal outcomes in low-resource settings and reducing Indonesia's maternal mortality rate.
Corbett GA, Murphy L, Hokey E
… +10 more, Brien MO, McEvoy A, McDonnell B, Hill K, Davis A, Wilson Z, Callanan S, Luethe L, Corcoran S, McAuliffe FM
Aust N Z J Obstet Gynaecol
· 2026 Apr · PMID 41885217
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BACKGROUND: Research on spontaneous preterm birth (sPTB) is deeply important to the patients it serves. There is an absence of the patient's voice on the experience of research participation. MATERIALS/METHODS: This pros...BACKGROUND: Research on spontaneous preterm birth (sPTB) is deeply important to the patients it serves. There is an absence of the patient's voice on the experience of research participation. MATERIALS/METHODS: This prospective mixed-method study examined the experience of participants of a preterm birth research study. Recruited patients had significant risk factors for spontaneous preterm birth and were offered enrolment in a preterm birth study. Participants enrolled in early pregnancy and continued participation until 6 weeks postpartum. At the postnatal visit, they completed a survey on their experience of participation. Responses were analysed using reflexive thematic analysis. RESULTS: In total, 112 women completed the study participation survey. Motivations for recruitment included the altruistic goal of protecting other women and families from spontaneous preterm birth (54.5%, 61/112) and interest in the scientific rationale of the study rooted in the microbiome (10.7%, 12/112). 91.0% enjoyed participating in the study. Participant satisfaction with enrolment related to perception of improved clinical care (26.8%, 30/112), continuity of care with the research team (20.5%, 23/112), perceived improved clinical outcome they attributed to study participation (9.8%, 11/112) and symptom benefit from the intervention (1/8%, 2/112). CONCLUSIONS: Women at risk of spontaneous preterm birth were motivated for study participation by the goal of protecting other women and families from preterm birth. Participant satisfaction related to perceived improved clinical care and continuity of care. Participants had a strong appetite for results dissemination. These findings highlight the willingness of patients to participate in research, even in the setting of a pregnancy at risk of preterm birth.
McDuff L, de Gouveia Belinelo P, Lawrance S
… +2 more, Mehta S, Sunanda G
Aust N Z J Obstet Gynaecol
· 2026 Apr · PMID 41885190
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BACKGROUND: COVID-19 infection during pregnancy has been associated with adverse outcomes; however, most investigations were conducted early in the pandemic. The high rates of vaccination in Western Australia during peak...BACKGROUND: COVID-19 infection during pregnancy has been associated with adverse outcomes; however, most investigations were conducted early in the pandemic. The high rates of vaccination in Western Australia during peak transmission present a unique opportunity to reassess the impact of COVID-19 infection in pregnancy. AIMS: This study aimed to investigate the impact of COVID-19 infection in pregnancy on adverse obstetric and neonatal outcomes. MATERIALS AND METHODS: The retrospective case-control study conducted at a tertiary centre in Western Australia compared COVID-19 positive and negative pregnancies from March to November 2022. Data from 404 participants (223 positive and 181 negative participants) were analysed. Bivariate and multivariate analyses, adjusted for confounders, were used to assess adverse outcomes. RESULTS: COVID-19 infection was significantly associated with lower cord blood pH (p = 0.012); but no other adverse obstetric or neonatal outcomes (p > 0.05). Among COVID-19 positive cases, the timing of infection by trimester did not significantly impact adverse outcomes. However, a shorter interval between COVID-19 infection and delivery was associated with higher rates of caesarean sections (p = 0.018) and neonatal comorbidities (p = 0.007). Analysis of COVID-19 severity on outcomes was limited by the small sample size (n = 4). CONCLUSIONS: COVID-19 infection during pregnancy was not associated with clinically significant adverse outcomes, likely influenced by the predominant Omicron strain and high vaccination rates. Limitations of this study included lack of universal screening and a small sample size. Notwithstanding, this study provides valuable insights that reflect the current COVID-19 landscape, underscoring the need for an updated understanding as context surrounding COVID-19 infection evolves.
Smith A, Badrak S, Pinto J
… +2 more, Alichniewicz K, Boothroyd C
Aust N Z J Obstet Gynaecol
· 2026 Apr · PMID 41885178
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BACKGROUND: Sperm selection tools are used in assisted reproduction to isolate spermatozoa with the least DNA fragmentation (DF) to optimize fertilization, improve pregnancy outcome and reduce genetic abnormalities in th...BACKGROUND: Sperm selection tools are used in assisted reproduction to isolate spermatozoa with the least DNA fragmentation (DF) to optimize fertilization, improve pregnancy outcome and reduce genetic abnormalities in the offspring. AIMS: This study aims to compare the sperm DF after three different sperm selection tools were performed on split samples from the neat (unprocessed, control) semen sample. (1) Density gradient centrifugation (DGC). (2) Density gradient centrifugation with swim-up (DGC + swim-up). (3) Microfluidic chip (ZyMot). The primary outcome was the DF of spermatozoa after sperm selection tool as measured by Halosperm test. Scientific time taken to perform the test and the cost of consumables were recorded. MATERIALS AND METHODS: This was a prospective assessor blinded controlled trial between split semen samples conducted at Care Fertility (Australia) in 2024/2025 to compare DF after sperm selection. For each sample, a routine semen analysis was performed, and residual sample was split for processing by sperm selection tools. RESULTS: Thirty participants consented and underwent the trial. Neat (control) semen: mean sperm DF = 9.5% DGC: mean sperm DF = 4.83% AUD34.11 consumables + 60 min scientific time. DGC+Swim-up: mean sperm DF = 1.8% AUD34.73 consumables + 90 min scientific time. Microfluidic Chip mean sperm DF = 0.06% AUD143.46 consumables + 30 min scientific time. CONCLUSIONS: Microfluidic chip is highly effective at selecting sperm with the least DF and is faster to perform than DGC +/- Swim up.
Ward C, Bhatt R, Nathan E
… +2 more, McCuaig R, Dickinson JE
Aust N Z J Obstet Gynaecol
· 2026 Apr · PMID 41885106
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In March 2024 there was a significant change to abortion legislation in Western Australia, which until this time had operated under some of the most restrictive laws in Australia. These legislative modifications have pro...In March 2024 there was a significant change to abortion legislation in Western Australia, which until this time had operated under some of the most restrictive laws in Australia. These legislative modifications have provided abortion access consistent with contemporary women's reproductive rights. We present a snap-shot of the impact of this abortion legislative change in the state's largest obstetric and gynaecology hospital, reviewing access to abortion care over a 12 month period straddling this change. The most significant has been the increased access to post-20 week gestation abortion care and the expansion of a specific abortion care service.
Tran QTT, Seeho SK, Nippita TA
… +5 more, Morris JM, Le TQ, Tran HN, Pham HT, Ibiebele I
Aust N Z J Obstet Gynaecol
· 2026 Apr · PMID 41885082
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BACKGROUND: Preterm birth leads to adverse neonatal outcomes. Data on neonatal outcomes in middle-income settings like Vietnam are lacking. AIMS: Describe preterm neonatal outcomes in Vietnam. MATERIALS AND METHODS: Retr...BACKGROUND: Preterm birth leads to adverse neonatal outcomes. Data on neonatal outcomes in middle-income settings like Vietnam are lacking. AIMS: Describe preterm neonatal outcomes in Vietnam. MATERIALS AND METHODS: Retrospective cohort study including all live singleton births at 28-36 weeks' gestation in Vietnam from June 2019 to June 2020. Outcomes included neonatal morbidity and mortality and were examined by labour onset and gestational age groups. Logistic regression was used to estimate the odds of neonatal morbidity and mortality following planned birth (labour induction and prelabour caesarean) relative to spontaneous birth. RESULTS: Among 5374 live singleton preterm births, 663 (12.4%) occurred between 28 and 31 weeks, 824 (15.3%) between 32 and 33 weeks and 3887 (72.3%) between 34 and 36 weeks; 2765 (51.5%) births followed spontaneous labour and 2616 (48.5%) were planned births. Mortality rates decreased with increasing gestational age. More than 90% of neonates born at 28-33 weeks had morbidity, with the rate of morbidity decreasing from 34 weeks. The odds of mortality were no different following labour induction (aOR 1.22, 95% CI, 0.72-2.09) or prelabour caesarean (aOR 1.04, 95% CI, 0.63-1.73) compared with spontaneous labour. The odds of morbidity were higher among pregnancies following labour induction (aOR 1.53, 95% CI, 1.31-1.80) and prelabour caesarean section (aOR 2.14, 95% CI, 1.84-2.50) than spontaneous labour. Among planned preterm births < 35 weeks, antenatal corticosteroids were associated with higher morbidity (90.7% vs. 74.3%, p < 0.001) and lower mortality rates (2.5% vs. 5.1%, p = 0.022). CONCLUSIONS: Preterm neonates born before 34 weeks are at particularly high likelihood of morbidity and mortality, with planned preterm birth associated with a higher rate of morbidity.
Sathiyaselvan A, Dawes L, Olivier N
… +3 more, Manley BJ, Groom K, Whitehead CL
Aust N Z J Obstet Gynaecol
· 2026 Apr · PMID 41885078
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Preterm pre-labour rupture of membranes (PPROM) is associated with neonatal and maternal morbidity and mortality. Maternal prophylactic antibiotic therapy after PPROM improves outcomes but there is limited evidence to gu...Preterm pre-labour rupture of membranes (PPROM) is associated with neonatal and maternal morbidity and mortality. Maternal prophylactic antibiotic therapy after PPROM improves outcomes but there is limited evidence to guide the optimal antibiotic regimen. This study surveyed 45 women with PPROM to understand consumer priorities for care, maternal and neonatal outcomes; and inform future PPROM clinical trial design. The highest priorities were prolonging gestation, avoiding brain injury, improving neonatal survival and good childhood respiratory health. Seventy-nine percent of respondents would consider clinical trial participation. Identifying consumer priorities will support both trial design and improved clinical care.
Anderson MB, Cooke E, Thorpe K
… +1 more, Chawla JK
Aust N Z J Obstet Gynaecol
· 2026 Apr · PMID 41882953
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BACKGROUND: Expectant parents report negative experiences of receiving prenatal screening outcomes that indicate a higher-than-expected risk of a genetic condition or anomaly-an unexpected result. Despite clinicians' key...BACKGROUND: Expectant parents report negative experiences of receiving prenatal screening outcomes that indicate a higher-than-expected risk of a genetic condition or anomaly-an unexpected result. Despite clinicians' key role in delivering prenatal screening results, there is limited research on their perspectives regarding their own experiences, knowledge and access to resources and referral information. AIMS: This study aimed to explore clinicians' experiences discussing and delivering genetic screening results and their access to resources. MATERIALS AND METHODS: The present study addresses this gap through a mixed-methods study comprising a cross-sectional survey (n = 51) and qualitative interviews with a subset of respondents (n = 12) to explore their experiences in depth. Quantitative analyses provided descriptive statistics and tested the association of support resources with clinicians' confidence and perceived challenges. RESULTS: Only 55% of clinicians were confident explaining screening and 59% when delivering unexpected results. Only 41% reported they had adequate resources for delivering unexpected results, and 53% had not directed patients to any support services for prenatal screening decision-making in the last 12 months. Resource access was significantly associated with increased confidence (p = 0.029) and decreased perceived challenge (p = 0.013). Qualitative data were analysed through reflexive thematic analysis. Findings show that clinicians are concerned about their knowledge limitations in the context of evolving testing modalities, challenged by fragmented care and communication, and commonly conflate unexpected results with bad news. CONCLUSIONS: Structural and ideological challenges contextualise clinicians' lack of confidence in delivering unexpected results. Clinicians' difficulties and varied approaches to accessing resources and referring patients highlight a need for the provision of education and standardised pathways to improve the experience for expectant parents.
Aust N Z J Obstet Gynaecol
· 2026 Apr · PMID 41879489
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Maternal-assisted caesarean section (MACS) is a modified approach to caesarean section. The patient scrubs and gowns with their surgeon, and following the delivery of the baby's head, the mother helps assist the delivery...Maternal-assisted caesarean section (MACS) is a modified approach to caesarean section. The patient scrubs and gowns with their surgeon, and following the delivery of the baby's head, the mother helps assist the delivery of her baby from her abdomen onto her chest. The aim of MACS is to improve the birth experience, mother-baby bonding, breastfeeding rates, and provide control and agency during the process of elective caesarean section. Patient demand has increased alongside public awareness of the procedure. Here we outline a protocol to perform MACS to guide other clinicians on how to safely incorporate it into their own practice.
Aust N Z J Obstet Gynaecol
· 2026 Apr · PMID 41879417
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BACKGROUND: Vaginal natural orifice transluminal endoscopic surgery (vNOTES) is a novel minimally invasive surgical technique that can be used for hysterectomy. The technique combines the advantages of vaginal hysterecto...BACKGROUND: Vaginal natural orifice transluminal endoscopic surgery (vNOTES) is a novel minimally invasive surgical technique that can be used for hysterectomy. The technique combines the advantages of vaginal hysterectomy, such as shorter operating times and recovery, with the benefits of laparoscopy. AIMS: The aim of this study is to describe and compare patient demographics, procedural characteristics, and outcomes for total laparoscopic (TLH) and vaginal assisted NOTES hysterectomy (VANH). MATERIALS AND METHODS: This is a retrospective cohort study of all VANH surgeries performed by a single surgeon over a two-year period at Caboolture Hospital in Queensland, Australia. Procedural steps and peri-operative care were standardised and for comparison patients were grouped by procedure type. RESULTS: The study sample comprised 150 cases evenly divided between TLH and VANH. On average, VANH was a faster procedure, with higher median blood loss. There was no significant difference in analgesia requirements and there was a trend toward shorter hospital stay. VANH was more often associated with vaginal repair or sacrospinous fixation, and this patient group had the highest blood loss, duration of surgery, and length of stay. There was no significant difference in complications. CONCLUSIONS: With careful patient selection and suitable training, the risks are comparable with TLH and VANH. The benefits are higher for specific patients and the surgical approach at time of hysterectomy should be individualised.
Hart M, Atkinson A, Goransson L
… +13 more, Kapoor Y, Rogerson K, Schapel C, Chilvers K, Edwards E, Grieco Hazewinkel A, Harwood A, Hornby S, Ladanchuk T, Hosking C, McKenna L, Wise E, Beales D
Aust N Z J Obstet Gynaecol
· 2026 Apr · PMID 41879375
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BACKGROUND: Pelvic mesh complication clinics (PMCCs) were established in each Australian state following a senate enquiry into the use of artificial mesh implants for the management of pelvic organ prolapse and stress ur...BACKGROUND: Pelvic mesh complication clinics (PMCCs) were established in each Australian state following a senate enquiry into the use of artificial mesh implants for the management of pelvic organ prolapse and stress urinary incontinence. AIMS: This study aimed to describe the characteristics and clinical care pathways of women presenting to a PMCC at a tertiary hospital in Western Australia. The relationships between neuropathic pain symptoms and depression anxiety stress scale (DASS) scores with referral to pain medicine and psychology, respectively, were investigated. MATERIALS AND METHODS: A retrospective cohort study utilising clinical files of 74 women who attended a mesh complications clinic between 2017 and 2024. RESULTS: The mean age of women presenting to the PMCC was 60.6 years, with concerns including urinary leakage (82.4%), bowel symptoms (78.6%), pelvic pain (98.6%), possible/highly likely neuropathic pain (56.8%) and dyspareunia (78.7%). The median wait from referral acceptance to urogynaecologist consultation was 185 days (quartile one, quartile three; 116, 367). Management included topical oestrogen (83.8%), referral to physiotherapy (87.8%) and pain medicine (87.4%) with median (quartile one, quartile three) wait to referral of 0 (0,0) and 0 (0,14) days, respectively. A greater proportion of those categorised as possibly/highly likely to have neuropathic pain were referred to pain medicine (p = 0.005). Only 13.5% were referred to psychology, with no association between those referred and higher combined score on the DASS (p = 0.205). CONCLUSIONS: Most women attending a PMCC reported a variety of urogynaecological and pain symptoms, requiring an evidence-based, timely, individualised and multidisciplinary management approach.
Aust N Z J Obstet Gynaecol
· 2026 Apr · PMID 41879351
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A rescue cervical cerclage is an emergency procedure aimed to prolong pregnancy and reduce the risk of preterm birth for women with an open cervix. This retrospective study assessed risk factors, perioperative management...A rescue cervical cerclage is an emergency procedure aimed to prolong pregnancy and reduce the risk of preterm birth for women with an open cervix. This retrospective study assessed risk factors, perioperative management and outcomes for all attempted rescue cerclage over 3 years in a large tertiary hospital in Australia. Data were obtained from maternity and hospital-level records. Thirty pregnancies were included, with 27 rescue cerclage performed. Women with rescue cerclage had continuation of pregnancy for a mean of 9.5 weeks, with low rates of perioperative complications, and a mean gestation at birth of 30 weeks.
Hamilton M, Kearney L, Thompson JMD
… +1 more, Nugent R
Aust N Z J Obstet Gynaecol
· 2026 Apr · PMID 41879350
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AIM: This study aims to identify factors associated with spontaneous vaginal birth in nulliparous women. MATERIAL AND METHODS: Design: Retrospective cohort study. SETTING: All public and private maternity units in Queens...AIM: This study aims to identify factors associated with spontaneous vaginal birth in nulliparous women. MATERIAL AND METHODS: Design: Retrospective cohort study. SETTING: All public and private maternity units in Queensland, Australia. POPULATION: Nulliparous women who labour and birth a singleton baby at term from 1st January 2017-31st December 2018. MAIN OUTCOME MEASURE: Non-instrumental spontaneous vaginal birth. Data from Perinatal Data Collection and Queensland Admitted Patient Data Collection were extracted. Participants were categorised by labour onset (spontaneous or induced). Multivariable stepwise regression models identified independent predictive factors associated with spontaneous vaginal birth. RESULTS: 37 569 participants were included. Younger maternal age compared to 40+ was associated with higher odds of spontaneous vaginal birth (spontaneous labours < 20: OR 3.723, 20-24: OR 2.545, 25-29 OR 2.062, 30-34 OR 1.522 and induced labours < 20 OR 4.345, 20-24 OR 3.031, 25-29 OR 2.031, 30-34 OR 1.641). Advanced gestation ≥ 42 weeks decreased spontaneous vaginal birth odds versus 38 weeks (spontaneous OR 0.445, induced 0.334). Breech presentation lowered SVB odds (spontaneous OR 0.067, induced OR 0.179). Absence of cardiotocography (spontaneous OR 3.444) and absence of fetal scalp lactate (spontaneous OR 3.885, induced OR 3.081) increased spontaneous vaginal birth likelihood. Women without epidurals (spontaneous OR 2.981, induced OR 2.552) were more likely to have spontaneous vaginal birth. CONCLUSIONS: The characteristics with the largest magnitude of effect on spontaneous vaginal birth were similar in both spontaneous and induced labours. Interventions during spontaneous labour were associated with reduced odds of spontaneous vaginal birth.