Journal Of Obstetrics And Gynaecology[JOURNAL]
Sun
200 papers
Midwifery-led continuity-of-care education affects health literacy, empowerment and childbirth fear: a quasi-experimental study.
Oğlak SC, Koç Ö, Sönmez T
J Obstet Gynaecol · 2026 Dec · PMID 41524508 · Publisher ↗
BACKGROUND: According to the World Health Organisation, antenatal care should ensure continuity, respect and evidence-based education. Fear of childbirth (FOC), affecting 20-40% of women globally, contributes to prolonge...
BACKGROUND: According to the World Health Organisation, antenatal care should ensure continuity, respect and evidence-based education. Fear of childbirth (FOC), affecting 20-40% of women globally, contributes to prolonged labour, higher caesarean rates and negative birth experiences. In Türkiye, where midwifery-led support remains limited, this study examined how pregnant women's health literacy influences empowerment and FOC within antenatal care and evaluated the effectiveness of the midwifery-led continuity-of-care (MLCC) model. METHODS: A quasi-experimental study with a comparative group design was conducted online between April 2024 and April 2025 using digital maternal communities and antenatal platforms in Türkiye. The intervention consisted of four structured online sessions based on the MLCC model, focusing on pregnancy adaptation, labour preparation, birth preferences and postpartum care. A total of 81 pregnant women participated, with 40 in the intervention group receiving MLCC-based antenatal education and 41 in the control group receiving standard care. Participants self-selected into groups, and data were collected online using validated scales: MHELIP, PRES and W-DEQ (Version A). All analyses were performed using SPSS 25.0 software. Independent samples -tests and Pearson's correlations were used for analysis, and multiple regression was performed to identify predictors of empowerment and FOC. All statistical values were verified and reported as mean ± SD with exact values. RESULTS: Pregnant women in the intervention group had significantly higher health literacy and empowerment scores and significantly lower FOC scores than those in the control group ( <.05). Health literacy was positively correlated with empowerment ( = .748) and negatively correlated with FOC ( = -.710). CONCLUSIONS: The intervention reduced fear and increased empowerment, likely through improved knowledge, self-efficacy and perceived control during pregnancy. The MLCC model enhanced health literacy and empowerment while reducing FOC. Structured education models integrated into antenatal care can support women's autonomy and psychological preparedness for birth.
Success of oocyte retrieval in modified natural cycle assisted reproductive techniques: a retrospective cohort study.
Lv Y, Wu S, Miao M … +5 more , Tian Y, Chen H, Zhang J, Tian W, Xue F
J Obstet Gynaecol · 2026 Dec · PMID 41518116 · Publisher ↗
BACKGROUND: This study investigates how clinical factors and hormonal levels affect oocyte retrieval in modified natural cycles, aiming to improve understanding and enhance treatment protocols. METHODS: A retrospective a...
BACKGROUND: This study investigates how clinical factors and hormonal levels affect oocyte retrieval in modified natural cycles, aiming to improve understanding and enhance treatment protocols. METHODS: A retrospective analysis of data from 306 women undergoing fertilisation (IVF)/intracytoplasmic sperm injection (ICSI) at a fertility clinic (2018-2023) was conducted. Clinical factors and hormonal levels were analysed. Follicular development was monitored via ultrasound. RESULTS: Baseline comparisons between the oocyte retrieval and non-retrieval groups showed no significant differences in age, body mass index, infertility types, duration, associated conditions (e.g. tubal issues, ovulation disorders and endometriosis) or assisted reproductive methods ( > 0.05). After human chorionic gonadotropin (HCG) injection, both groups showed significant increases in progesterone, oestradiol and luteinising hormone levels ( < 0.0001). Before HCG injection, the retrieval group had significantly higher levels of progesterone, oestradiol and LH ( < 0.05), with oestradiol remaining higher afterward ( < 0.01). There were significant differences between the two groups on anti-Müllerian hormone levels ( ˂ 0.05). No significant differences were found in follicle-stimulating hormone, total testosterone, thyroid hormone levels and antral follicle count ( > 0.05). CONCLUSIONS: In conclusion, the findings suggest that clinical factors do not impact oocyte retrieval in modified natural cycle assisted reproductive techniques. However, high hormone levels on the day of HCG injection in the study subjects may indicate a greater possibility of successful oocyte retrieval.
Gamma-glutamyl transferase to high-density lipoprotein cholesterol ratio and endometriosis: a population-based study.
Zheng Z, Wu J, Sun Z … +3 more , Li X, Shi Q, Xu M
J Obstet Gynaecol · 2026 Dec · PMID 41494840 · Publisher ↗
BACKGROUND: The gamma-glutamyl transferase (GGT) to high-density lipoprotein (HDL) ratio (GGT/HDL) has recently emerged as a potential biomarker for metabolic and liver diseases. This study aimed to investigate the assoc...
BACKGROUND: The gamma-glutamyl transferase (GGT) to high-density lipoprotein (HDL) ratio (GGT/HDL) has recently emerged as a potential biomarker for metabolic and liver diseases. This study aimed to investigate the association between GGT/HDL ratio and endometriosis using a population-based dataset from the National Health and Nutrition Examination Survey (NHANES). METHODS: Data from NHANES 1999 to 2006 were used to assess the relationship between the GGT/HDL ratio and endometriosis. The diagnosis of endometriosis was based on self-reported data from the Reproductive Health Questionnaire. The GGT/HDL ratio was calculated and Ln-transformed for analysis. Multivariable logistic regression and sensitivity analysis were used to estimate the odds ratio (OR) for endometriosis in relation to the GGT/HDL ratio. RESULTS: A total of 3815 individuals were included, with 307 diagnosed with endometriosis. The Ln-transformed GGT/HDL ratio was positively associated with the endometriosis. Each unit increase in the Ln-GGT/HDL ratio was associated with a 22% higher likelihood of endometriosis (OR = 1.220, 95% CI: 1.003-1.483, = 0.046). Sensitivity analyses including the use of original GGT/HDL value, the further adjustments of covariates, the exclusion of those with CVD and liver diseases confirmed the robustness of this association. CONCLUSIONS: This study found a significant positive association between the GGT/HDL ratio and endometriosis. Higher GGT/HDL levels may serve as a potential biomarker for identifying women at risk of endometriosis.
Prospective longitudinal study of long-term voiding outcomes after laparoscopic sacrocolpopexy for pelvic organ prolapse.
Aichner S, Studer A, Frey J … +3 more , Brambs C, Krebs J, Christmann-Schmid C
J Obstet Gynaecol · 2025 Nov · PMID 41487084 · Publisher ↗
BACKGROUND: In this prospective follow-up longitudinal study, we investigated the long-term impact of laparoscopic sacrocolpopexy (SCP) on voiding dysfunction present prior to surgery in women with symptomatic pelvic org...
BACKGROUND: In this prospective follow-up longitudinal study, we investigated the long-term impact of laparoscopic sacrocolpopexy (SCP) on voiding dysfunction present prior to surgery in women with symptomatic pelvic organ prolapse (POP). METHODS: Women from a previously published study who underwent SCP for symptomatic POP with objective and/or subjective voiding dysfunction between 01/2019 and 08/2021 were contacted and invited to attend an additional long-term follow-up visit for a clinical re-evaluation identical to the preoperative and postoperative visit (6-12 weeks). The postoperative outcome was assessed using uroflowmetry, the POP-Q quantification system and the validated German version of the Australian Pelvic Floor Questionnaire. RESULTS: Forty-nine of the 84 women seen at the mid-term follow-up returned for a long-term visit, with a mean follow-up period of 20.3 ± 6.5 months. A significant ( < 0.001) objective improvement in POP correction was seen (for Ba, C and Bp) at the long-term visit. A significant ( < 0.001) overall decrease in median postvoid residual volume was achieved (preoperative: 90 ml, mid-term: 10 ml, long-term: 15 ml). Furthermore, the maximal flow rate significantly ( = 0.003) increased and there was a decrease in voiding time ( = 0.048), with no significant difference found between mid- and long-term assessments. Similarly, subjective parameters improved significantly, concerning prolonged urine stream, sensation of incomplete bladder emptying and straining to void (all values < 0.001). In the same way, a significant improvement was observed in subjective reports regarding overactive bladder symptoms and POP complaints (all values < 0.001), with no change between mid- and long-term analysis, while no change was noted in dyspareunia over time. CONCLUSIONS: Laparoscopic SCP performed for symptomatic POP provides durable anatomical correction and is associated with significant mid- and long-term improvements in both objective voiding function and patient-reported symptoms.
and pregnancy outcomes: a retrospective study of 20,040 cases.
Nie J, Liu Y, Cai P … +2 more , Chen Y, Zhang C
J Obstet Gynaecol · 2026 Dec · PMID 41455101 · Publisher ↗
BACKGROUND: To investigate the association between maternal (GBS) colonisation in late pregnancy and pregnancy outcomes, with a focus on GBS colonisation risk factors and the role of colonisation density in influencing...
BACKGROUND: To investigate the association between maternal (GBS) colonisation in late pregnancy and pregnancy outcomes, with a focus on GBS colonisation risk factors and the role of colonisation density in influencing maternal and neonatal health. METHODS: This retrospective study analysed clinical data from 20,040 pregnant women at 35-37 weeks of gestation between January 2020 and January 2023. GBS colonisation was assessed using rectovaginal swabs, followed by culture, PCR quantification, and antibiotic susceptibility testing. Demographic and clinical characteristics, maternal outcomes, and neonatal outcomes were compared between GBS-positive and GBS-negative groups. Further stratified analysis was conducted on the impact of high GBS colonisation on maternal and neonatal outcomes. Logistic regression was used to identify independent risk factors for GBS colonisation. RESULTS: GBS colonisation was detected in 505 of 20,040 women (2.52%). Among the 236 isolates tested, all were sensitive to penicillin. Significant risk factors for GBS colonisation included maternal age ≥35 years, gestational diabetes mellitus, and coexisting vaginitis ( < 0.05). The incidence of puerperal infection, PROM, postpartum haemorrhage, premature birth, and neonatal pneumonia were significantly higher in the GBS-positive group than in the GBS-negative group ( < 0.05). Stratification by colonisation density revealed that women with high GBS colonisation had elevated rates of puerperal infection (23.01% vs. 14.29%), PROM (34.51% vs. 19.13%), and postpartum haemorrhage (18.58% vs. 8.93%) compared to those with lower GBS colonisation ( < 0.05). Neonatal outcomes also varied by colonisation density: neonatal infection (14.16% vs. 6.89%) and premature birth (16.81% vs. 9.69%) were significantly more common in the high-colonisation group. CONCLUSIONS: Maternal GBS colonisation, especially with high density, increases adverse outcomes. Risk factors include age ≥35, vaginitis, and diabetes. Routine screening and targeted prophylaxis are essential.
Combined electrical muscle stimulation and proprioceptive training for pelvic floor dysfunction: a retrospective cohort study.
Li J, Chen H, Gao C … +2 more , Yang L, Lin S
J Obstet Gynaecol · 2026 Dec · PMID 41442525 · Publisher ↗
BACKGROUND: Pelvic floor dysfunction (PFD) commonly affects postpartum women, yet surgical interventions carry invasiveness and recurrence risks. This retrospective study aims to investigate the effects of pelvic floor e...
BACKGROUND: Pelvic floor dysfunction (PFD) commonly affects postpartum women, yet surgical interventions carry invasiveness and recurrence risks. This retrospective study aims to investigate the effects of pelvic floor electrical muscle stimulation (EMS) combined with proprioceptive training (PT) on pelvic floor function and structural integrity in women with PFD. METHODS: A total of 320 women with PFD treated at Ningde Municipal Hospital from October 2022 to December 2024 were stratified into control group, EMS group, PT group and combined group, with 80 patients in each group. All patients received routine pelvic floor functional training; the EMS group additionally received pelvic floor EMS, the PT group received PT and the combined group received pelvic floor EMS following PT. Pelvic floor resting/tonic contraction electromyography (EMG) value, muscle fibre strength, pelvic floor distress inventory-short form 20 (PFDI-20) scores, and pelvic floor ultrasound parameters were assessed before and after treatment. RESULTS: Post-treatment, all groups showed significant improvements in resting/tonic contraction EMG value, muscle fibre strength, PFDI-20 scores and pelvic floor ultrasound parameters (levator ani muscle (LAM) thickness, bladder neck descent, etc.) compared to baseline ( < 0.001). The combined group achieved superior outcomes across all measures ( < 0.0001), with higher EMG value, greater structural restoration (e.g. increased LAM thickness, reduced hiatus area). No baseline differences were observed among groups ( > 0.05), confirming treatment-specific efficacy of the combined approach. CONCLUSIONS: Pelvic floor EMS combined with PT effectively promotes recovery of pelvic floor function and structural integrity in women with PFD. This combined therapy warrants clinical application and dissemination.
Reply: Association of cannabis use with female infertility.
Mark K, Gorelick DA
J Obstet Gynaecol · 2026 Dec · PMID 41427609 · Publisher ↗
Abstract loading — click title to view on PubMed.
Perspectives and Priorities for Endometriosis Multidisciplinary Team Care in Australia: A Qualitative Mixed-Methods Study Involving Patients, Caregivers and Health Professionals.
Cingiloglu P, Pirotta S, Beauchamp A … +11 more , Bell G, Campbell N, Chan K, Chapman L, Christelis N, Morrison S, Rebelo Da Gama RP, Readman E, Mooney SS, Holdsworth-Carson SJ, Tyson K
Aust N Z J Obstet Gynaecol · 2026 Feb · PMID 41423844 · Publisher ↗
BACKGROUND: Endometriosis is a chronic condition affecting 1 in 7 women, girls, and gender-diverse individuals in Australia. It significantly impacts daily life, causing pain, psychological distress and productivity loss...
BACKGROUND: Endometriosis is a chronic condition affecting 1 in 7 women, girls, and gender-diverse individuals in Australia. It significantly impacts daily life, causing pain, psychological distress and productivity loss. Multidisciplinary team (MDT) care is fundamental for managing chronic pain in endometriosis. Nevertheless, limited studies have explored perspectives on MDT care in the Australian context, and there remains a lack of consensus on what a MDT care model should include and how improved continuity of care can be achieved. OBJECTIVE: This study aims to evaluate patient and health professional perspectives on MDT care models for endometriosis and pelvic pain, and to inform decisions about establishing future MDT clinics in Australia. METHODS: A mixed-methods study was co-designed involving an advisory group of 14 members. Surveys capturing quantitative and qualitative data were disseminated to patients/carers and healthcare professionals. Thematic analysis was performed on qualitative data, and consensus statements were developed and refined through focus groups. RESULTS: Participants included 29 healthcare professionals and 24 patients/carers. Recommendations were voiced under six key themes: preferences for clinic environments, staff interactions, holistic support, financial accessibility and resource needs. Patients valued empathetic, experienced clinicians and preferred both options for face-to-face and telehealth interactions. Financial strain was a significant concern, highlighting the need for affordable care. Both groups stressed the importance of up-to-date, evidence-based information and personalised care plans. CONCLUSION: This study underscores the need for person-centred, holistic and accessible MDT clinics for endometriosis in Australia. The consensus statements provide a blueprint for developing such clinics. Implementing these recommendations can enhance endometriosis care quality, improving patient experiences and outcomes. This provides the first steps to better understanding the wants and needs of both patients, carers and HCP in setting up future services as well as modifying existing services.
OnabotulinumtoxinA for Idiopathic Overactive Bladder, Reviewing the Procedure-A Survey of Practice Techniques in Australia and New Zealand.
Kelsey E, Wynn J, Holmes A … +1 more , Mcleod K
Aust N Z J Obstet Gynaecol · 2026 Feb · PMID 41423816 · Publisher ↗
Idiopathic overactive bladder (iOAB) significantly negatively affects patients' quality of life. Intradetrusor OnabotulinumtoxinA (BTN/A) is an effective treatment for refractory iOAB, though optimal procedural technique...
Idiopathic overactive bladder (iOAB) significantly negatively affects patients' quality of life. Intradetrusor OnabotulinumtoxinA (BTN/A) is an effective treatment for refractory iOAB, though optimal procedural techniques remain unclear. This study aims to evaluate current BTN/A practices for iOAB in Australia and New Zealand, focusing on trigonal injection, number of injection sites and anaesthetic modality in BTN/A-naïve female patients. A survey was conducted among specialists, urologists and gynacologists performing BTN/A for iOAB. Variance in the responses to this survey highlights the need for clear guidance and consensus for specialists on the number and location of injections for BTN/A for iOAB patients. Optimisation of procedural techniques could improve outcomes and tolerability for BTN/A injection for iOAB patients and inform further research and guidelines.
Should It Hurt?-Experiences of Out-Patient Clinic-Based Hysteroscopy.
Nunnerley J, Sheppard L, Springer R … +4 more , Joseph K, Shields L, Grace C, Lennox Thompson B
Aust N Z J Obstet Gynaecol · 2026 Feb · PMID 41416620 · Publisher ↗
BACKGROUND: Hysteroscopy is a common minor gynaecological procedure that is increasingly being performed in an outpatient setting. There is currently no effective evidence-based strategy for managing pain in women underg...
BACKGROUND: Hysteroscopy is a common minor gynaecological procedure that is increasingly being performed in an outpatient setting. There is currently no effective evidence-based strategy for managing pain in women undergoing hysteroscopy. It is anticipated that most people will experience mild to moderate pain; however, the literature reports varying numbers of women, up to 40%, who experience severe pain during outpatient hysteroscopy. AIM: This paper reports the qualitative results of interviews with 10 participants in a single-centre mixed-methods cohort study in New Zealand to understand women's experiences of hysteroscopy. METHODS: Data from semi-structured interviews were analysed using Qualitative Description. RESULTS: Three themes describe the participants' experiences of hysteroscopy. Should it hurt? Expectations of the procedure; I did not realize that was an option: control of pain; and right information, at the right time. CONCLUSIONS: Although women experience varying levels of pain during hysteroscopy, their experience of the procedure may be influenced by their expectations of pain, their perception of control over their pain management, and how and when they receive information. Providing information in a range of formats prior, during, and after the procedure may help reduce anxiety and set more accurate expectations. Considering a range of pain relief options during hysteroscopy, including non-pharmacological methods, and ensuring they are readily available in the procedure room may help women better manage their pain or actively participate in pain management and distraction strategies, ultimately enhancing their sense of control.
Impacts on Causes of Perinatal Death After Safer Baby Bundle Implementation in Victoria, Australia.
Mayakaduwage KLB, Farrell T, Selvaratnam RJ … +6 more , Flenady V, Andrews C, Ellwood D, Hudson R, Czarnecki F, Davies-Tuck M
Aust N Z J Obstet Gynaecol · 2026 Feb · PMID 41416561 · Publisher ↗
BACKGROUND: The Safer Baby Bundle (SBB) was introduced in June 2019 and has been associated with a reduction in perinatal mortality. Assessing its early impact on specific causes of perinatal death can inform future inte...
BACKGROUND: The Safer Baby Bundle (SBB) was introduced in June 2019 and has been associated with a reduction in perinatal mortality. Assessing its early impact on specific causes of perinatal death can inform future interventions. AIMS: This study assessed changes in the causes of perinatal death before and after SBB implementation in Victoria, Australia. MATERIALS AND METHODS: A retrospective population-based cohort study included singleton births ≥ 28 weeks' gestation (excluding congenital anomalies and terminations) from 2014 to 2020. Births were categorised into pre-SBB (January 2014-June 2019) and post-SBB (July 2019-December 2020) periods. Chi-squared tests compared changes in perinatal death causes at SBB and non-SBB sites. RESULTS: At SBB sites, stillbirths due to specific perinatal conditions decreased from 0.26 to 0.08/1000 (RR: 0.30, 95% CI: 0.11-0.84, p = 0.015), and unexplained antepartum fetal deaths decreased from 0.86 to 0.45/1000 (RR: 0.53, 95% CI: 0.34-0.82, p = 0.003). No significant changes in any cause of neonatal death were observed. In contrast, non-SBB sites saw increases in stillbirths due to placental dysfunction (0.22 to 0.40/1000, RR: 1.80, 95% CI: 1.09-2.95, p = 0.019) and antepartum haemorrhage (0.15 to 0.31/1000, RR: 2.11, 95% CI: 1.18-3.76, p = 0.010). However, neonatal deaths due to hypoxic peripartum events (0.14 to 0.02/1000, RR: 0.12, 95% CI: 0.02-0.89, p = 0.013) and neurological conditions (0.27 to 0.10/1000, RR: 0.38, 95% CI: 0.16-0.88, p = 0.019) declined. CONCLUSIONS: SBB implementation was associated with a significant reduction in unexplained stillbirths and those due to specific perinatal conditions, without an increase in any cause of neonatal death. These findings support the program's national expansion, with targeted efforts needed to address the remaining causes of stillbirth.
Reach and Impact of the Safer Baby Bundle Among Groups Disproportionately Affected by Stillbirth in Victoria, Australia.
Mayakaduwage KLB, Farrell T, Selvaratnam RJ … +8 more , Flenady V, Andrews C, Ellwood D, Stuart-Butler D, Ah Chee V, Hudson R, Czarnecki F, Davies-Tuck M
Aust N Z J Obstet Gynaecol · 2026 Feb · PMID 41416529 · Publisher ↗
BACKGROUND: Stillbirth disproportionately affects certain maternal demographic groups. The Safer Baby Bundle (SBB) was implemented to reduce stillbirth rates, but its impact across different populations remains unclear....
BACKGROUND: Stillbirth disproportionately affects certain maternal demographic groups. The Safer Baby Bundle (SBB) was implemented to reduce stillbirth rates, but its impact across different populations remains unclear. AIMS: This study evaluated the effect of the SBB on stillbirth and related perinatal outcomes among maternal demographic groups disproportionately affected by stillbirth in Victoria, Australia. MATERIALS AND METHODS: This retrospective population-based cohort study compared outcomes before (Jan 2014-Jun 2019) and after (Jul 2019-Dec 2020) SBB implementation. Singleton births ≥ 28 weeks were included, excluding congenital anomalies and terminations. Relative risks and interrupted time series analyses were used to assess changes in SBB sites. RESULTS: Among 233 462 births (Pre-SBB: 182 892; Post-SBB: 50 570), stillbirth rates decreased among Australian-born (1.96-1.46 per 1000; p = 0.08), European-born (2.70-0; p = 0.028), and non-Indigenous women (2.10-1.60; p = 0.027) but increased among Indigenous women (0-3.75; p = 0.002) and remained unchanged for African-born (4.71-5.16; p = 0.83), South Asian-born (2.10-2.18; p = 0.90), and Middle Eastern-born (1.62-1.50; p = 0.92) women. Similar trends were observed for perinatal mortality. Smoking cessation improved for Australian-born (p < 0.001) and non-Indigenous women (p < 0.001) but was unchanged in other groups. Undelivered severe FGR decreased in Australian-born (p < 0.001), African-born (p = 0.012), and South Asian-born (p < 0.001) mothers. DFM reporting improved across all groups. Early-term iatrogenic birth trends declined for Australian-born (p = 0.010) and non-Indigenous women (p = 0.022) but remained unchanged for other groups. CONCLUSIONS: The SBB was associated with stillbirth reductions in Australian-born and non-Indigenous women but had limited impact on migrant and Indigenous populations. Culturally tailored strategies are needed to ensure equitable outcomes.
Prediction of MBS Item Codes for Endometriosis Surgery Using Transvaginal Ultrasound.
McClenahan P, Mak J, Uzuner C … +5 more , Gil A, Eathorne A, Espada M, Reid S, Condous G
Aust N Z J Obstet Gynaecol · 2026 Feb · PMID 41416444 · Publisher ↗
BACKGROUND AND AIMS: In March 2022, updates in the Australian Medicare Benefits Schedule relating to endometriosis surgery were made relating to item numbers 35637, 35631 and 35632 (division of 35638) and 35641. Updated...
BACKGROUND AND AIMS: In March 2022, updates in the Australian Medicare Benefits Schedule relating to endometriosis surgery were made relating to item numbers 35637, 35631 and 35632 (division of 35638) and 35641. Updated codes aligned with rASRM Stages 1, 2, 3 and 4 endometriosis respectively. This study aims to assess an IDEA consensus-based ultrasound rASRM predicting MBS item. MATERIALS AND METHODS: Retrospective multicentre study conducted across five countries and six centres. Data collection from August 2018 to November 2019 assessing ultrasound staged rASRM (rASRM-U). Subgroup analysis was performed, dichotomizing rASRM-U and MBS items into low and high stages. RESULTS: 273 patients were included, 54 excluded due to incomplete data. 219 remained for analysis. Predicting MBS item by rASRM-U stage showed weak agreement with a weighted Kappa value of 0.31 (0.24 to 0.38, 95% CI). rASRM-U predicted a 0.68 higher surgical stage supporting 'over-staging'. Although generally poor for low-stage item numbers, there was a sensitivity of 0.96 and specificity of 0.44 predicting item 35641. Dichotomised staging shows sensitivity in rASRM-U predicting high-stage of 0.99 with specificity of 0.34 and NPV of 0.95. Prediction of low-stage shows sensitivity of 0.34, specificity of 0.99, and NPV of 0.79. CONCLUSION: The IDEA consensus-based rASRM-U has relatively poor agreement with corresponding MBS item numbers, tending to predict 'higher' stages. This model is unlikely to predict low stages incorrectly. Although unable to accurately predict individual item numbers for endometriosis surgery, this system identifies high versus low surgical complexity when ultrasound and surgical groups are dichotomized; thus, it could allow improved surgical and financial planning.
Resecting Beyond the Central Pelvic Compartment in Pelvic Exenterations for Gynaecological Malignancies: Outcomes From a Tertiary Unit.
Kong CY, Galbraith NJ, McCormick A … +15 more , Haddock A, Ratcliffe M, Telfer J, Lo S, Fairbairn N, Palmer M, Teahan S, Morton S, Lindsay R, Burton K, Siddiqui N, Roxburgh CS, Chong PS, Steele CW, Quinn M
Aust N Z J Obstet Gynaecol · 2026 Feb · PMID 41410155 · Full text
BACKGROUND: Pelvic exenterations (PE) in solid organ gynaecological malignancies have historically been confined to the central pelvic compartment but an expansion of resection extent to include the lateral compartment i...
BACKGROUND: Pelvic exenterations (PE) in solid organ gynaecological malignancies have historically been confined to the central pelvic compartment but an expansion of resection extent to include the lateral compartment is now technically feasible. There remains uncertainty about its influence on outcomes. METHODS: Retrospective study of consecutive patients undergoing PE for non-ovarian gynaecological malignancies in a tertiary referral unit. Two groups were assessed and compared: standard resections including but not beyond the pelvic sidewall (SR); and extended resections beyond the pelvic side wall (lateral compartment excisions; internal iliac vessels and/or obturator internus/piriformis resection and/or bone resection) (ER). RESULTS: Thirty-one patients underwent 32 PE: of these, 21 patients underwent SR (65.6%) with 11 who underwent ER (34.4%). Clear microscopic resection margins (R0) were achieved in 72.7% for ER versus 90.5% for SR. The overall 30-day major complication rate (≥Clavien-Dindo III) was 45.5% for the ER group versus 19.9% for SR. Median length-of-stay for ER was longer than for SR (38 vs. 18.5 days). The 1-year DFS for ER was 66.7% versus 77.8% for SR. The 2-year DFS for ER group was 60% versus 57.1% for SR. CONCLUSIONS: In this study of contemporary patients, the short-term patient outcomes of ER were consistent with other similar cohorts in the literature and comparable to SR in this cohort. There is an urgent need for larger multicentre studies to clarify the influence of PE resectional extent on resection margin status, patient outcomes and survival.
Oral Misoprostol for Induction of Labour: An Initial Australian Experience.
Hettiarachchi NV, Janssens S, Beckmann M … +1 more , Sharif R
Aust N Z J Obstet Gynaecol · 2026 Feb · PMID 41408968 · Publisher ↗
BACKGROUND: Misoprostol, a prostaglandin E1 analogue, is widely used internationally for the induction of labour (IOL) but was recently approved in Australia in a 25-μg oral tablet form (Angusta). While previous studies...
BACKGROUND: Misoprostol, a prostaglandin E1 analogue, is widely used internationally for the induction of labour (IOL) but was recently approved in Australia in a 25-μg oral tablet form (Angusta). While previous studies suggest oral misoprostol may reduce Caesarean section rates secondary to uterine hyperstimulation compared to vaginal Dinoprostone, its efficacy and feasibility in an Australian clinical setting remain unclear. This study evaluates the implementation of oral misoprostol for the IOL in multiparous women at a tertiary maternity hospital. AIMS: To assess the clinical outcomes, patient satisfaction, and resource implications of introducing oral misoprostol for labour induction, comparing it to the established vaginal Prostaglandin E2 (PGE2) protocol. MATERIALS AND METHODS: A clinical protocol for oral misoprostol induction was developed following a literature review and expert consultation. A retrospective service evaluation was conducted after the first 100 patients, comparing key labour and birth outcomes between oral misoprostol and historical vaginal PGE2 cohorts. Data were extracted from hospital records, and propensity score matching was applied to balance baseline characteristics. Patient satisfaction was assessed via a survey. RESULTS: No significant differences were found in induction-to-delivery time, mode of birth, oxytocin use or adverse neonatal outcomes. Epidural use was higher in the oral misoprostol group. Medication costs and staffing requirements were also increased. Patient satisfaction was comparable between groups. CONCLUSIONS: In a setting with an early artificial rupture of membranes (ARM) protocol, oral misoprostol did not provide clear advantages over vaginal PGE2. Further research is needed to optimise induction protocols in the Australian context.
Expert consensus for the management of gastroesophageal reflux disease in pregnancy: collaborative insights from experts in India.
Singh AP, Koduri KK, Kalapala R … +15 more , Kumari SS, Patel M, Balamba P, Chandrasekar TS, Kumar A, Wagh G, Khanna Y, Hegde V, Gorthi S, Lakshmi Rathna M, Inavolu P, Rughwani H, Khanna R, Bhatia S, Reddy DN
J Obstet Gynaecol · 2025 Oct · PMID 41404836 · Publisher ↗
BACKGROUND: Gastroesophageal reflux disease (GERD) is common during pregnancy. In India, its management varies and is often based on Western guidelines, which may not reflect local dietary patterns, drug availability, or...
BACKGROUND: Gastroesophageal reflux disease (GERD) is common during pregnancy. In India, its management varies and is often based on Western guidelines, which may not reflect local dietary patterns, drug availability, or diagnostic constraints. To address this gap, an expert panel of Indian gastroenterologists and gynaecologists aimed to develop consensus recommendations tailored for Indian practice. METHODS: Modified Delphi consensus method was followed. Steering committee with three gastroenterologists was formed. This committee reviewed available literature and identified 65 relevant articles, based on which 9 pilot consensus statements were formed. An expert panel comprising 9 gastroenterologists and 6 gynaecologists located pan-India was formed. Pre-reads were circulated a month in advance, and 15 experts discussed evidence and pilot statements during the consensus meeting. Based on the discussion, modified statements were shared with the experts through a Google form for voting using a 5-point Likert scale. Consensus was defined as ≥80% agreement. Results were analysed by the steering committee, followed by a virtual meeting to finalise statements. The manuscript was drafted and circulated for final approval. RESULTS: Six consensus statements were finalised, with 100% agreement. (1a) Symptoms of gastroesophageal reflux are common during pregnancy. (1b) Gastroesophageal reflux is associated with poor health-related quality of life in pregnancy. (2) Diagnosis of gastroesophageal reflux during pregnancy should be based on symptoms. (3) Endoscopy must be postponed to the post-partum period, except in the presence of alarm symptoms. (4) Lifestyle changes are recommended as the first step in management. (5) Alginates/antacids should be preferred as the first-line pharmacological treatment after lifestyle changes. (6) Histamine-2 receptor antagonists or proton pump inhibitors are effective and may be used if symptoms are not controlled by alginates/antacids alone. CONCLUSION: These consensus statements provide practical guidance for diagnosing and managing GERD in pregnancy, emphasising symptom-based diagnosis, lifestyle interventions, and judicious pharmacological therapy.
Reducing Perinatal Mortality in Victoria, Australia: Early Insights From the Safer Baby Bundle Implementation.
Mayakaduwage KLB, Farrell T, Selvaratnam RJ … +7 more , Flenady V, Andrews C, Ellwood D, Hudson R, Czarnecki F, Wallace EM, Davies-Tuck M
Aust N Z J Obstet Gynaecol · 2026 Feb · PMID 41386728 · Publisher ↗
BACKGROUND: The Safer Baby Bundle (SBB) was introduced in Victoria, Australia, to reduce stillbirth and perinatal mortality. Evaluating its impact is critical to informing its national rollout. AIMS: This study assessed...
BACKGROUND: The Safer Baby Bundle (SBB) was introduced in Victoria, Australia, to reduce stillbirth and perinatal mortality. Evaluating its impact is critical to informing its national rollout. AIMS: This study assessed the early effect of SBB implementation on stillbirth and perinatal mortality rates in Victoria. MATERIALS AND METHODS: A retrospective population-based cohort study of singleton births ≥ 28 weeks was conducted, comparing outcomes before (January 2014-June 2019) and after (July 2019-December 2020) SBB implementation. Congenital anomalies and terminations were excluded. Interrupted time series analyses and relative risks compared outcomes at SBB and non-SBB sites. RESULTS: There were 398,273 pre-SBB and 108,024 post-SBB births. In SBB sites, a trend towards reduced stillbirth from 2.08 to 1.64/1000 was observed (RR: 0.79, 95% CI: 0.62-1.00, p = 0.05) along with a significant reduction in perinatal mortality from 2.52 to 2.02/1000 (RR: 0.80, 95% CI: 0.65-0.99, p = 0.041). While in non-SBB sites, rates of stillbirth (p = 0.58) and perinatal mortality (p = 0.53) remained unchanged. Pre-implementation, early term iatrogenic births rose monthly by 0.20% in SBB (p < 0.001) and 0.15% in non-SBB sites (p < 0.001). Post-implementation, monthly trends in SBB sites reduced by 0.14% (p = 0.015) with no further significant increases, while non-SBB sites continued to rise by 0.18% per month (p < 0.001). No significant changes were seen in caesarean section, induction of labour, late preterm birth, neonatal death, or neonatal intensive care unit admission trends in SBB sites. CONCLUSIONS: SBB implementation was associated with reduced perinatal mortality without increasing iatrogenic or neonatal harm. These findings support its national implementation to improve perinatal outcomes in Australia.
Microplastics and Intimate Toys: A Concerning Trend?
de Costa CM, Robson SJ
Aust N Z J Obstet Gynaecol · 2026 Feb · PMID 41386709 · Publisher ↗
Micro- and nanoplastics (MNPs) are ubiquitous in the modern world. Humans are exposed to MNPs through inhalation and ingestion, with a small amount of transdermal uptake. MNPs recently have been identified in the human p...
Micro- and nanoplastics (MNPs) are ubiquitous in the modern world. Humans are exposed to MNPs through inhalation and ingestion, with a small amount of transdermal uptake. MNPs recently have been identified in the human placenta and endometrium. Although the source of placental MNPs is consistent with haematogenous spread, the presence of MNPs in the endometrium is more puzzling. As small particles can move retrograde from the vagina to the fallopian tubes, two unsuspected MNP sources are tampons and intimate toys. Intimate toys, in particular, might well be an important source of reproductive tract MNPs with intercourse as a potential co-vector.
Prognostic value of systemic immune-inflammation index in cervical cancer: a systematic review and meta-analysis.
Zhan Q, Xu N, Fan J … +2 more , Wang J, Li F
J Obstet Gynaecol · 2025 Dec · PMID 41378768 · Publisher ↗
BACKGROUND: A growing body of evidence indicates that the systemic immune-inflammation index (SII) is associated with the prognosis of cervical cancer (CC). However, its prognostic value remains controversial. This study...
BACKGROUND: A growing body of evidence indicates that the systemic immune-inflammation index (SII) is associated with the prognosis of cervical cancer (CC). However, its prognostic value remains controversial. This study aimed to comprehensively evaluate the performance of SII in predicting the prognosis of CC. METHODS: Studies on the prognostic potential of SII in CC were acquired from PubMed, Embase, Web of Science, and the Cochrane Library from database inception to July 4, 2024. Outcome measures included progression-free survival (PFS), overall survival (OS), relapse-free survival (RFS), and complete response (CR), which were expressed as hazard ratio (HR) and 95% confidence interval (CI). Sensitivity and subgroup analyses were carried out to evaluate the stability of results and identify potential sources of heterogeneity. RESULTS: Ten cohort studies involving 2007 patients were included in the meta-analysis. High SII levels were significantly associated with reduced OS (HR = 2.45; 95% CI: 1.56-3.86, = 0.001), PFS (HR = 2.93; 95% CI: 1.88-4.58, < 0.00001), and CR (HR = 0.23, 95% CI: 0.11-0.50; = 0.0002) in patients with CC. Subgroup analyses suggested that SII was more effective in predicting outcomes in Asian patients with CC. CONCLUSIONS: High SII levels are significantly associated with reduced OS, PFS, and CR in CC. Therefore, SII is a promising biomarker for predicting outcomes and informing treatment decisions for immunotherapy in CC.
Clinical Outcomes and Women's Experiences of the 'OMGP' Model of Care.
Wilkinson SA, Wilkinson J, Homel N … +2 more , Day K, Laurie J
Aust N Z J Obstet Gynaecol · 2026 Feb · PMID 41367159 · Publisher ↗
BACKGROUND: Women living with diabetes face elevated risks in pregnancy. Fragmented traditional care can leave women feeling disempowered. Continuity of midwifery care offers benefits, leading to the implementation of a...
BACKGROUND: Women living with diabetes face elevated risks in pregnancy. Fragmented traditional care can leave women feeling disempowered. Continuity of midwifery care offers benefits, leading to the implementation of a specialist Obstetric Medicine Midwifery Group Practice (OMGP) at our facility. AIMS: This study evaluated the OMGP model for pregnant women with Type 1 and Type 2 diabetes by comparing maternal/neonatal outcomes and women's experiences with traditional care at a major Queensland hospital. MATERIALS AND METHOD: A mixed-methods pre/post design compared routinely collected data from 56 women in traditional care (Mar-Aug 2023) with 38 women in OMGP (Sep 2023-Feb 2024). Surveys assessed experiences in both groups (17 traditional, 22 OMGP). Quantitative data were analysed using SPSS, and qualitative responses were thematically analysed. RESULTS: The OMGP group showed a significantly higher mean gestational age at delivery (37.4 vs. 36.0 weeks, p = 0.007) and antenatal expressing rate (76.3% vs. 33.9%, p = 0.04). Women in OMGP also reported more positive postnatal home care experiences (p < 0.001). Qualitative data highlighted strengths of OMGP (midwifery care, continuity) versus traditional care weaknesses (fragmented labour care, postnatal support). CONCLUSIONS: OMGP was associated with improved maternal experiences and gestational age at delivery without compromising other clinical outcomes. Integrating specialist medical support with continuity of midwifery care enhances the perinatal journey for women with diabetes.
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