Aust N Z J Obstet Gynaecol
· 2026 Feb · PMID 41367152
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BACKGROUND: Endometriosis, affecting 6%-10% of reproductive-age women, causes chronic pelvic pain, dysmenorrhea, and infertility. Current treatments have limitations and consequently there is rising interest in effects o...BACKGROUND: Endometriosis, affecting 6%-10% of reproductive-age women, causes chronic pelvic pain, dysmenorrhea, and infertility. Current treatments have limitations and consequently there is rising interest in effects of cannabis on pain and inflammation associated with endometriosis. AIMS: This scoping review primarily aimed to characterise the effects of cannabis on endometriosis-associated pain and detail the reported adverse events. MATERIALS AND METHODS: A search was collected on PubMed, MEDLINE (Ovid), and EMBASE (Ovid) databases on 16th January 2024. Studies were included if they were in-human or clinical studies evaluating the effects of cannabis in endometriosis in non-pregnant adults. RESULTS: Thirteen studies, including 4 ongoing studies, were included. All nine completed studies, with 1,787 participants, were cross-sectional. Pain (57.3%-95.5%) was the most common indication for cannabis use, followed by sleep and gastrointestinal distress (15.2%-78.5%). Cannabis was most commonly inhaled (51.6%-80.3%) or ingested (25%-76.9%). Eight (61.5%) studies asked about participants' perception of the efficacy of cannabis. These utilised a range of methods preventing pooling of results. However, most reported improvement in at least a proportion of their studied population. Adverse events were reported by 10.2% to 52.0% of patients, with the most common being "feeling high" (euphoria) and a dry mouth. CONCLUSIONS: Several observational studies have reported that cannabis helped to reduce endometriosis-associated pain. However, there is a paucity of high-quality prospective longitudinal data and randomised controlled trials to evaluate the safety profile an efficacy of medical cannabis in endometriosis-associated pain. These provide support, alongside existing pre-clinical data, for the importance of further assessment in randomised controlled trials.
BACKGROUND: Women infertility is associated with cardiovascular diseases. Life's Essential 8 (LE8), a recently updated measure of cardiovascular health (CVH), has been investigated for its association with women infertil...BACKGROUND: Women infertility is associated with cardiovascular diseases. Life's Essential 8 (LE8), a recently updated measure of cardiovascular health (CVH), has been investigated for its association with women infertility. METHODS: The study adopted a cross-sectional design with national scope, incorporating 2534 women aged 20-49 years, selected from the National Health and Nutrition Examination Survey dataset from 2013 to 2018. The LE8 metric, which varies from 0 to 100, was evaluated based on the criteria set by the American Heart Association and then classified into three levels of CVH: low level (0-49), moderate level (50-79) and high level (80-100). Infertility status was determined based on self-report. To evaluate these correlations, we employed models with multivariable logistic variables and a restricted cubic spline. For subgroup assessment in relation to the LE8 score, a stratified multivariate logistic regression model was utilised. RESULTS: Among 2534 participants (mean weighted age 34.96 years), 314 experienced infertility (weighted percentage 13.20%). Higher LE8 scores (mean 73.87) were associated with lower odds of infertility (odds ratio (OR) 0.77 per 10-point increase; 95% confidence interval (CI) 0.68-0.86), even after adjusting for confounders. Similar trends were observed for associations between health behaviour scores, health factor scores and infertility rates, with diet, sleep health, body mass index (BMI), blood glucose and blood pressure showing more pronounced influences. LE8 scores exhibited an inverse dose-response relationship with female infertility, with a significant interaction with age ( for interaction <0.001). Among women under 35 years, the association between LE8 scores and infertility was stronger (OR 0.65 per 10-point increase; 95% CI 0.56-0.74). CONCLUSIONS: Our study demonstrates that increased LE8 scores are associated with reduced infertility risk, providing an effective strategy for female infertility prevention.
BACKGROUND: Care experiences of women with obesity are often shaped by weight stigma, negatively affecting health outcomes. Research on this issue within Brazilian healthcare remains limited. This study explored how over...BACKGROUND: Care experiences of women with obesity are often shaped by weight stigma, negatively affecting health outcomes. Research on this issue within Brazilian healthcare remains limited. This study explored how overweight and obese pregnant and postpartum women perceive the care provided by healthcare teams during prenatal, childbirth, and postpartum periods, with emphasis on experiences of prejudice or discrimination (fatphobia). METHODS: A qualitative, descriptive, exploratory, and inductive field study was conducted using netnography. Data was collected from the Facebook community 'Gestantes de Alto Risco - Obesas, Hipertensas e etc.' (High-Risk Pregnant Women - Obese, Hypertensive, etc.) through daily virtual immersion and an online survey between August 2021 and December 2023. Participants included pregnant or postpartum women with a body mass index (BMI) >25 kg/m. Thematic analysis was performed using the Discourse of the Collective Subject (DCS) technique. RESULTS: A total of 149 women completed the survey. Overall, 52.6% reported negative care experiences. Qualitative findings revealed recurrent themes of weight stigma, humiliation, shame, lack of empathy, dismissive attitudes, and structural barriers such as inadequate equipment. Many felt blamed for complications, often encountering judgmental or moralising language. In contrast, 47.4% described positive experiences when interactions involved respect, empathy, and individualised communication, though occasional weight-related criticism persisted. CONCLUSION: The study demonstrates a high prevalence of fatphobia among overweight and obese pregnant and postpartum women in Brazil. Findings highlight the need for more respectful, individualised, and humanised obstetric care. Enhancing professional training and institutional practices is essential to reduce stigma and improve health outcomes for this population.
BACKGROUND: The relationship between dietary antioxidants and pelvic inflammatory disease (PID) remains poorly understood. This study aimed to investigate this association in US women using both observational data and Me...BACKGROUND: The relationship between dietary antioxidants and pelvic inflammatory disease (PID) remains poorly understood. This study aimed to investigate this association in US women using both observational data and Mendelian randomisation (MR) to assess causality. METHODS: We conducted a cross-sectional analysis of 4,003 women aged ≥20 from the National Health and Nutrition Examination Survey (2013-2018). The Composite Dietary Antioxidant Index (CDAI) was calculated from six dietary antioxidants. PID was self-reported. Multivariable logistic regression was used to assess the association between the CDAI and PID, with subgroup analyses to test robustness. Subsequently, a two-sample MR analysis using the inverse-variance weighted (IVW) method was performed to evaluate a potential causal link. RESULTS: The prevalence of PID was 5.6% (224/4,003). In the fully adjusted logistic regression model, a higher CDAI was associated with lower odds of PID (Odds Ratio [OR] 0.95, 95% Confidence Interval [CI] 0.92-0.99). Among individual components, higher zinc intake was also inversely associated with PID (OR 0.96, 95% CI 0.93-0.99, = 0.037). The inverse association between the CDAI and PID was consistent across all subgroups. However, the MR analysis did not find a significant causal relationship between antioxidant levels and PID risk. CONCLUSIONS: A higher dietary antioxidant intake, as measured by the CDAI, is associated with a lower prevalence of PID in US women. However, our MR findings do not support a causal role for individual antioxidants in the development of PID. Further longitudinal studies are warranted to enhance our understanding of the interactions between antioxidants and PID.
Prospective parallel genetic testing of both germline and tumour DNA in ovarian cancer patients (OC) is the recommended model in several different countries across the globe and the UK. The high (∼67%) chance of identify...Prospective parallel genetic testing of both germline and tumour DNA in ovarian cancer patients (OC) is the recommended model in several different countries across the globe and the UK. The high (∼67%) chance of identifying germline PVs in patients with tumour PVs has led to a discourse surrounding the need for consent for tumour genetic testing in OC. We discussed with OC patients during focus group workshops, physicians, and charity representatives about consent options for tumour testing in OC patients: verbal consent prior to testing (Option 1) and reflex testing (Option 2). Most patients (97%; 33/34) did not feel that consent was required and were happy with reflex testing (Option 2). Physician consensus was that reflex testing was preferred and most charity representatives (4/5; 80%) agreed. All groups wanted an opt-out option and a patient information sheet about tumour testing. This can inform new recommendations in the UK and foster further discussions regarding consent for OC tumour testing.
Getter S, Erridge S, Warner-Levy J
… +14 more, Clarke E, McLachlan K, Coomber R, Barnes S, Darweish Medniuk A, Guru R, Holden W, Sajad M, Searle R, Usmani A, Varma S, Rucker JJ, Platt M, Sodergren MH
Aust N Z J Obstet Gynaecol
· 2026 Feb · PMID 41305963
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BACKGROUND: Although there is growing evidence supporting the use of cannabis-based medicinal products (CBMPs) for the management of chronic pain, there is a paucity of data on their effect on endometriosis-associated ch...BACKGROUND: Although there is growing evidence supporting the use of cannabis-based medicinal products (CBMPs) for the management of chronic pain, there is a paucity of data on their effect on endometriosis-associated chronic pain. AIMS: This study aimed to perform an analysis of pain-specific and general health-related quality of life (HRQoL) outcomes for patients with endometriosis-associated chronic pain treated with CBMPs. MATERIALS AND METHODS: Primary outcomes included changes in patient-reported outcome measures (PrOMs) from baseline to 1, 3, 6, 12 and 18 months. A repeated measures ANOVA was applied to assess changes in PrOMs at 1 to 18 months from baseline. Secondary outcomes included incidence and frequency of adverse events (AEs). RESULTS: Sixty-three patients met inclusion criteria. Initiation of CBMPs was associated with improvements in all pain-specific PrOMs from baseline to 18 months (p < 0.050). EQ-5D-5L index value showed improvements between baseline and all months (p < 0.050). Anxiety and sleep quality PrOMs showed improvements from baseline to 18 months (p < 0.050). Minimal clinically significant differences (11%-37%), moderately important improvements (5%-22%) and substantial improvements (0%-11%) were observed in the Brief Pain Inventory (BPI) and pain severity visual analogue scale. Sixty-two adverse events were reported by 16 (25.40%) participants. CONCLUSIONS: This study observed an association between CBMP treatment and improvements in pain and HRQoL in patients with endometriosis. Causality cannot be inferred due to the nature of this observational study; however, these findings provide complementary evidence for the development of randomised controlled trials to assess the efficacy of CBMPs for endometriosis-associated chronic pain.
Tran CT, Wang M, Plymoth M
… +2 more, Chen J, McGee TM
Aust N Z J Obstet Gynaecol
· 2026 Feb · PMID 41305950
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BACKGROUND: Pregnancy provides a special opportunity to improve cervical screening test (CST) uptake and reduce cervical cancer. Screening in Australia is free for Medicare-eligible women ≥ 25 years if performed 5-yearly...BACKGROUND: Pregnancy provides a special opportunity to improve cervical screening test (CST) uptake and reduce cervical cancer. Screening in Australia is free for Medicare-eligible women ≥ 25 years if performed 5-yearly, but not sooner. Either women's self-reported last CST date or the National Cancer Screening Register (NCSR) can inform screening needs. However, accessing the NCSR is relatively difficult in public antenatal care. AIMS: To assess if pregnant women's self-reported last CST year is reliable in determining whether to offer CST in pregnancy or not. METHODS: A retrospective Australian hospital study compared the self-reported last CST recorded in the maternity database to NCSR records for all Medicare-eligible women ≥ 25 years booked-in for public antenatal care between 1 June and 30 November 2023. RESULTS: The cohort (n = 1772) had median age 33 years (interquartile range 29-36). Nearly half (n = 862; 49%) were CST-overdue/never-screened. Self-reported last CST dates were concordant with the NCSR for 80% (n = 1420) of participants in terms of needing (35%) or not needing (45%) a CST. However, 244 (14%) over-reported being CST-current when they were actually overdue/never-screened, while 108 (6%) under-reported their CST-currency. Of the 862 women due for a CST, over-reporting represented 28%. If clinicians relied solely on self-reporting, these women would miss out on needed CST screening. CONCLUSION: Measures to improve the reliability of Australian women's self-reported last CST are needed. This includes clinicians ensuring a woman always knows if a CST has been collected, the NCSR sending CST results to women (not just their practitioners) and promoting easier NCSR database accessibility for women.
Dowthwaite S, Quinton A, Thomas S
… +1 more, Clarke J
Aust N Z J Obstet Gynaecol
· 2026 Feb · PMID 41271252
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BACKGROUND: Surgical management of pregnancy loss with retained products of conception (RPOC), may result in uterine perforation, incomplete evacuation, heavy blood loss, infection or cervical trauma. Ultrasound guidance...BACKGROUND: Surgical management of pregnancy loss with retained products of conception (RPOC), may result in uterine perforation, incomplete evacuation, heavy blood loss, infection or cervical trauma. Ultrasound guidance could reduce complications. AIMS: To review studies on uterine curettage for RPOC comparing real-time ultrasound and blinded guidance and perform a meta-analysis to determine whether ultrasound reduces complications. MATERIALS AND METHODS: A systematic literature review was performed to identify studies on 24 August 2023 with further reference mining occurring up until 29 February 2024. Six studies with 1491 participants provided data on 585 participants assigned to ultrasound guidance and 906 assigned to blinded guidance. The measures of treatment effect for dichotomous outcomes-uterine perforation, RPOC, blood loss, infection and cervical trauma-were analysed and compared between the ultrasound and blinded group. A meta-analysis was performed for each outcome using inverse-variance and calculated I to test heterogeneity. Estimated relative risk (95% CIs), odds ratio (OR, 95% CIs), absolute risk reduction and number needed to treat were calculated. Risk of bias was assessed using the Downs and Black tool and GRADE for certainty. RESULTS: Five studies including 1218 women provided data for persistent RPOC. Compared to blinded guidance, ultrasound-guided women had a decreased chance of persistent RPOC (OR, 0.19, 95% CI 0.08-0.43, I 0%, high-certainty evidence). The association between ultrasound guidance and uterine perforation, blood loss, infection and cervical trauma was not significant, with serious concern for imprecision or inconsistency. CONCLUSION: Ultrasound reduces the risk of persistent RPOC with a high certainty of evidence. TRIAL REGISTRATION: Prospective register of systematic reviews (PROSPERO): CRD42023447614 (1st August 2023).
Aust N Z J Obstet Gynaecol
· 2026 Feb · PMID 41268598
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BACKGROUND: Neonatal alloimmune thrombocytopaenia (NAIT) is a rare but potentially serious condition where maternal antibodies result in destruction of foetal and neonatal platelets. At Middlemore Hospital in south Auckl...BACKGROUND: Neonatal alloimmune thrombocytopaenia (NAIT) is a rare but potentially serious condition where maternal antibodies result in destruction of foetal and neonatal platelets. At Middlemore Hospital in south Auckland, routine cord blood platelet counts were performed over many years. AIMS: These were twofold: To determine the prevalence of severe thrombocytopaenia (TP) and severe NAIT and investigate platelet counts in siblings of infants with TP. MATERIALS AND METHODS: Cord blood was collected on all hospital births over 500 g over a 12-year period (2005-2016) and term infants with TP (< 150 × 10/L) selected. Records of infants with severe TP (< 50 × 10/L) were reviewed for potential NAIT cases. Records of siblings of infants with any degree of TP were also reviewed to examine the potential for NAIT in affected families. RESULTS: Of 68910 births, 62083 platelet counts were suitable for analysis and 641 term infants had TP (1%) with 16 having severe TP (0.025%). NAIT or potential NAIT was judged clinically to be present in half of these (0.013%). Most cases were of European ethnicity with a Maori infant and a Tongan infant also being possible cases. No serious complications were identified. 5% of siblings of infants with TP had low counts with only one infant having a likely diagnosis of severe NAIT. CONCLUSIONS: Severe TP was uncommon amongst infants born in south Auckland where mothers of Maori and Pacific Island ethnicity make up the majority of the population. Performance of routine cord platelet counts was of limited value in detecting potential cases of severe NAIT.
Aust N Z J Obstet Gynaecol
· 2026 Feb · PMID 41267665
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BACKGROUND: Installation of hyaluronic acid following hysteroscopic adhesiolysis is suggested to reduce intrauterine adhesion (IUA) reformation in women with Asherman's Syndrome (AS). We aimed to assess the impact of hya...BACKGROUND: Installation of hyaluronic acid following hysteroscopic adhesiolysis is suggested to reduce intrauterine adhesion (IUA) reformation in women with Asherman's Syndrome (AS). We aimed to assess the impact of hyaluronic acid following hysteroscopic adhesiolysis on menstrual, surgical, fertility, obstetric and neonatal outcomes. METHODS: We identified 128 women treated hysteroscopically for AS over an 11-year period and invited them to participate in a questionnaire-based study. A total of 43 women were included; 21 treated surgically with hyaluronic acid administered immediately following adhesiolysis and 22 having surgery alone. Outcomes were assessed by reviewing medical records retrospectively and using a structured questionnaire at 3 months and 4 years post procedure. RESULTS: There were no differences in the rates of repeat adhesiolysis procedures to treat recurrent IUAs between the treatment and control groups (19% vs. 18%, p = 0.94). All women in the treatment group reported resumption of menses 6 months following the procedure, with 9% in the control group reported ongoing amenorrhoea. There was no difference in the overall pregnancy rate (77% vs. 81%, p = 0.76), maternal and neonatal outcomes between the groups. CONCLUSIONS: Intrauterine application of hyaluronic acid at the time of hysteroscopic adhesiolysis for women with AS was not associated with the number of repeat surgical interventions, menstrual patterns, fertility, obstetric, or neonatal outcomes.
Aust N Z J Obstet Gynaecol
· 2026 Feb · PMID 41267643
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In many areas of the world, outpatient early medical abortion (EMA) is provided through mifepristone and misoprostol up to 10 weeks or 70 days gestation; however in Australia access is restricted to 63 days. A retrospect...In many areas of the world, outpatient early medical abortion (EMA) is provided through mifepristone and misoprostol up to 10 weeks or 70 days gestation; however in Australia access is restricted to 63 days. A retrospective cohort study using South Australian data from 2012 to 2020 compares women undergoing abortion at less than 9 weeks with women undergoing abortion at less than 10 weeks. Currently, socioeconomic disadvantage is associated with a higher rate of presenting for abortion after 9 weeks. Extending EMA access would be of particular benefit for groups with socioeconomic disadvantage.
Slifirski O, Rozen G, Medwin C
… +2 more, Nassar N, Polyakov A
Aust N Z J Obstet Gynaecol
· 2026 Feb · PMID 41251386
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BACKGROUND: Using a Gonadotrophin Releasing Hormone Agonist (GnRHa) trigger and freezing all eggs or embryos is the most effective strategy for preventing Ovarian Hyperstimulation Syndrome (OHSS) in IVF cycles. The liter...BACKGROUND: Using a Gonadotrophin Releasing Hormone Agonist (GnRHa) trigger and freezing all eggs or embryos is the most effective strategy for preventing Ovarian Hyperstimulation Syndrome (OHSS) in IVF cycles. The literature predominantly suggests that severe OHSS can virtually be eliminated using the GnRHa trigger. The aim of this study was to determine the clinical characteristics and disease severity of OHSS in patients who received a GnRHa trigger compared to standard Human Chorionic Gonadotropin (HCG) trigger. MATERIALS AND METHODS: Retrospective cohort study of patients with OHSS admitted to a single tertiary referral hospital over a five-year period, from January 2016 to December 2021. HCG and GnRHa trigger cohorts were compared with respect to baseline characteristics, IVF cycle characteristics and OHSS outcomes. RESULTS: Of 150 cases of severe OHSS requiring admission, 24 (16%) occurred after a GnRHa trigger and 126 (84%) occurred after an HCG trigger. Baseline characteristics were not significantly different. Baseline AMH and the number of oocytes retrieved were significantly higher in the GnRHa group ((69.6 versus 41.4 p < 0.0001) and (28.3 versus 21.7 p = 0.0038) respectively). There was no significant difference in most markers of clinical severity or length of hospital admission. CONCLUSIONS: Using a GnRHa trigger and freeze-all protocol reduces but does not eliminate OHSS in high-risk women. Further preventative strategies may be necessary in this population.
Chalmers KJ, Dardaneliotis J, Malik A
… +1 more, Armour M
Aust N Z J Obstet Gynaecol
· 2026 Feb · PMID 41250634
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BACKGROUND: A growing body of evidence suggests that pelvic health physiotherapy is an effective, low-risk management strategy for women with endometriosis and vulvodynia. However, to date no study has identified which i...BACKGROUND: A growing body of evidence suggests that pelvic health physiotherapy is an effective, low-risk management strategy for women with endometriosis and vulvodynia. However, to date no study has identified which interventions Australian pelvic health physiotherapists are implementing in clinical practice to treat women with endometriosis and vulvodynia. AIMS: This study aimed to identify which interventions are used to treat women with endometriosis and vulvodynia, as well as increase knowledge surrounding the professional qualifications, workplace settings and information sources of these clinicians. MATERIALS AND METHODS: A cross-sectional online survey was distributed to Australian physiotherapists. Survey questions included those on workplace characteristics, information sources and intervention selection and frequency. Data were analysed using descriptive statistics. RESULTS: 151 responses were included for analysis. Most respondents (74.2%) worked in private practice. Advice from colleagues or mentors was the most used information source when deciding how to treat women's pelvic health conditions. For both endometriosis and vulvodynia, pain or lifestyle education, pelvic floor down-training, relaxation, exercise and stretching/flexibility were the five most frequently used interventions. CONCLUSIONS: Australian physiotherapists are using a mixture of evidence-based and non-evidence-based interventions to treat women with endometriosis and vulvodynia. There is an urgent need for further high-quality studies investigating intervention efficacy and safety for physiotherapy interventions in women with endometriosis and vulvodynia.
Leverington J, Keegan A, Azmanov DN
… +1 more, Dickinson JE
Aust N Z J Obstet Gynaecol
· 2026 Feb · PMID 41250585
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A clinically robust RHD non-invasive prenatal test (RHD NIPT) was developed to predict fetal RhD status and optimise RhD Ig use for RhD-negative pregnant women in Western Australia. Using rigorous methodology and stakeho...A clinically robust RHD non-invasive prenatal test (RHD NIPT) was developed to predict fetal RhD status and optimise RhD Ig use for RhD-negative pregnant women in Western Australia. Using rigorous methodology and stakeholder engagement we created clinical guidelines and educational support tools, such as reference guides and consumer brochures, to enhance test uptake. Six months post-implementation, 90% of healthcare professionals surveyed felt confident offering the test, with 87% having ordered it. A guideline review of 50 women confirmed they all received appropriate RhD Ig use. This successful implementation of RhD NIPT screening in our tertiary obstetric centre ensured safe, targeted care for RhD-negative pregnancies.
Aust N Z J Obstet Gynaecol
· 2026 Feb · PMID 41249894
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BACKGROUND: Early medical abortion (EMA) can be performed by administration of mifepristone and misoprostol in an outpatient setting prior to 63 days gestation in Australia. While this is a flexible, efficacious and safe...BACKGROUND: Early medical abortion (EMA) can be performed by administration of mifepristone and misoprostol in an outpatient setting prior to 63 days gestation in Australia. While this is a flexible, efficacious and safe option for abortion, it requires early identification of pregnancy and efficient access to a clinical service. Outpatient EMA with mifepristone and misoprostol was introduced in Australia in 2012 for gestations < 49 days, and extended to 63 days in 2015. METHODS: The laws governing abortion in South Australia mandate routine data collection. A retrospective cohort study was conducted of all registered abortions in South Australia from 2012 to 2020. Women undergoing abortion before 7 weeks gestation between 2012 and 2014 and then from 2015 those undergoing abortion before 9 weeks gestation were considered EMA eligible. Demographic characteristics were then compared using multiple logistic regression. RESULTS: Women who were eligible for EMA were significantly different from those who were ineligible based on gestational age. Women who were ineligible were more likely to be teenagers, live in rural and remote areas and live in areas of socio-economic disadvantage. In multivariable logistic regression teenagers were disproportionately less likely to be EMA eligible, with rural women and socially disadvantaged teenagers having the lowest rates of and eligibility for EMA. CONCLUSION: Eligibility for EMA was affected by age, rurality and socio-economic disadvantage. Interventions to improve access should investigate and address the specific barriers facing these groups of women.
Sinclair J, Adler H, Eathorne A
… +5 more, Holtzman O, Ee C, Abbott J, Sarris J, Armour M
Aust N Z J Obstet Gynaecol
· 2026 Feb · PMID 41249881
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There is growing evidence that people with endometriosis are utilising cannabis, whether legally or illicitly procured, for management of pain and associated symptoms. As such, concerns over cannabis use as a medicine ar...There is growing evidence that people with endometriosis are utilising cannabis, whether legally or illicitly procured, for management of pain and associated symptoms. As such, concerns over cannabis use as a medicine are foremost in clinicians' minds, particularly potential adverse effects. This study, a sub-set of a larger (n = 889) international survey investigating the self-reported effectiveness, safety and pharmaceutical de-prescribing trends of cannabis use in the endometriosis population, showed that 32% experienced side-effects associated with cannabis use, similar to published literature. However, some of these reported adverse effects have potential clinical utility and may require a more nuanced interpretation.
Anderson J, Young N, Fox R
… +3 more, Davis L, Cvejic E, Mooney SS
Aust N Z J Obstet Gynaecol
· 2026 Feb · PMID 41230770
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BACKGROUND: Secondary postpartum haemorrhage (PPH) complicates approximately 1% of pregnancies and can cause significant morbidity. Understanding predisposing factors may aid its prevention and management. AIMS: To ident...BACKGROUND: Secondary postpartum haemorrhage (PPH) complicates approximately 1% of pregnancies and can cause significant morbidity. Understanding predisposing factors may aid its prevention and management. AIMS: To identify and assess risk factors for presentation to the emergency department with secondary PPH, including factors associated with increased severity and need for surgical management or inpatient care. MATERIALS AND METHODS: In this prospective observational study, patients who presented to a metropolitan Melbourne women's hospital ('Level 6' maternity referral centre) with secondary PPH between 1/7/2020 and 31/12/2021 were eligible for recruitment. Prospective clinical and demographic data was collected at time of emergency presentation; antenatal and intrapartum information were collected by review of medical records. Antenatal, birth and postpartum variables of those identified as presenting with a secondary PPH were compared with control participants who birthed at the institution in the same period. Comparisons were made using chi-square tests, independent sample t-tests and Mann-Whitney U tests as appropriate. RESULTS: 168 patients who experienced a secondary PPH were recruited and compared with 9491 controls. Factors associated with secondary PPH included younger maternal age (p = 0.004), lower parity (p = 0.013), higher plurality (p < 0.001), being born in Australia (p = 0.008), incomplete placenta and/or membranes (p < 0.001), greater blood loss at birth (p = 0.014) and infant formula feeding on discharge (p = 0.019). Some of these factors, as well as others, were also associated with increased severity of secondary PPH, surgical management or inpatient care. CONCLUSIONS: Secondary PPH is a significant problem with associated risk factors. Further research should look at preventative mechanisms for secondary PPH. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry registration number: ACTRN12622000039785.