Australian & New Zealand Journal of Obstetrics & Gynaecology最新文献_第3页

Verbal Information From Parents About Stillbirth: The VIPS Study (Phase One) 父母关于死产的口头信息：VIPS研究（第一阶段）。

IF 1.7 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Australian & New Zealand Journal of Obstetrics & Gynaecology

Pub Date : 2025-04-11 DOI: 10.1111/ajo.70018

Azriel Gan Lin Lo, Lauren J. Breen, Zoe Bradfield, Scott White, Sonya Criddle, Georgia Griffin, Bligh Berry, Jane Warland

Background

In many countries, a baby's cause of death (COD) following stillbirth is informed only by case notes and pathology investigations. However, parents' understanding of their baby's COD may inform or even change the COD diagnosis. We aimed to produce a standardised co-designed interview schedule to enable parents to contribute information to improve overall understanding of the causes of stillbirth.

Materials and Methods

Consensus for the interview schedule was sought via a two-round modified Delphi study. We recruited internationally for panel membership comprising bereaved parents, clinicians, and researchers. In Round 1, each panellist provided up to five questions to ask bereaved parents. After collation into categories, Round 2 asked panellists to rate the importance of each question category on a four-point scale.

Results

Panellists (n = 126 Round 1, n = 75 Round 2) were mainly bereaved parents. In Round 1, 553 potential interview questions were generated. These were grouped into categories which were pregnancy experience, antenatal care, fetal wellbeing, maternal wellbeing, days Prior to stillbirth and perceived COD. These proposed questions and question categories were then put to panel members in Round 2. All categories achieved consensus for inclusion in the final interview schedule with positive consensus percentage scores ranging from 83% to 98%.

Conclusions

Panel membership comprising mainly bereaved parents provided a clear mandate for questions parents want to be asked. The interview schedule will soon be trialled with recently bereaved parents at a tertiary-referral maternity health service. Findings from the study will inform future research on how to include parents' voices in COD determination.

背景：在许多国家，死产后婴儿的死因（COD）只能通过病例记录和病理调查来确定。然而，父母对婴儿COD的了解可能会影响甚至改变COD的诊断。我们的目标是制定一个标准化的共同设计的访谈时间表，使父母能够提供信息，以提高对死产原因的全面了解。材料和方法：通过两轮改进的德尔菲研究寻求访谈时间表的共识。我们在国际上招募了包括丧亲父母、临床医生和研究人员在内的小组成员。在第一轮中，每个小组成员向失去亲人的父母提出最多5个问题。在分类后，第二轮要求小组成员以4分制对每个问题类别的重要性进行评分。结果：小组成员（n = 126第1轮，n = 75第2轮）主要是丧亲父母。在第15轮中，产生了553个潜在的面试问题。这些数据被分为怀孕经历、产前护理、胎儿健康、产妇健康、死产前天数和感知到的COD。这些提出的问题和问题类别随后被提交给第二轮的小组成员。所有类别都达成了共识，包括在最终的面试时间表中，正面共识百分比得分从83%到98%不等。结论：小组成员主要由丧亲父母组成，对父母想要问的问题提供了明确的授权。面谈时间表将很快在一家三级转诊的产妇保健服务机构试用。这项研究的结果将为未来如何将父母的声音纳入COD测定的研究提供信息。

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引用次数: 0

Knowledge and Awareness of Cardiovascular Risk Factors Among Women With a History of Pregnancy Complications in Australia: A World Heart Federation Cross-Sectional Study 澳大利亚有妊娠并发症史的妇女对心血管危险因素的了解和认识：世界心脏联合会的一项横断面研究

IF 1.7 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Australian & New Zealand Journal of Obstetrics & Gynaecology

Pub Date : 2025-04-01 DOI: 10.1111/ajo.70026

Farnoosh Asghar Vahedi, Leila Gholizadeh, Marjan Khajehei

Background

Cardiovascular disease (CVD) is the leading cause of death worldwide, and women who experience complications during pregnancy, such as pregnancy loss (miscarriage and stillbirth), hypertensive disorders of pregnancy and gestational diabetes, have a significantly higher risk of future CVD. Increasing awareness of CVD risk among these women is crucial for effective engagement in risk reduction programs.

Methods

A descriptive cross-sectional survey using a non-probability sampling method was adopted to explore the CVD knowledge and awareness of women with a history of complications of pregnancy. Distribution occurred from February to December 2021 via two tertiary hospitals in Australia and various groups in social media.

Results

Of 364 survey responses received, a sample of 299 completed responses were considered for final analysis. The participants' mean knowledge score regarding CVD risk factors was 14.5 (SD ± 4.6; range 0–25). Among them, 50.2% had poor knowledge, 25.1% had moderate knowledge, and only 24.7% had good knowledge of CVD and its risk factors in women. Statistically significant differences in knowledge scores were observed based on ethnicity (p = 0.009) and education level (p = 0.007).

Conclusion

This study revealed a significant gap in CVD knowledge among women with pregnancy complications, highlighting the need for targeted educational programs. Improving health literacy, particularly among high-risk and lower socioeconomic groups, is crucial for reducing CVD incidence.

背景：心血管疾病（CVD）是导致全球死亡的主要原因，而在妊娠期间出现并发症（如妊娠失败（流产和死胎）、妊娠高血压疾病和妊娠糖尿病）的妇女未来患心血管疾病的风险要高得多。提高这些妇女对心血管疾病风险的认识对于有效参与降低风险计划至关重要：采用非概率抽样方法进行描述性横断面调查，以了解有妊娠并发症病史的妇女对心血管疾病的了解和认识。调查于 2021 年 2 月至 12 月期间通过澳大利亚的两家三级医院和社交媒体上的各种团体进行发放：在收到的 364 份调查回复中，299 份完成回复的样本被纳入最终分析。参与者对心血管疾病风险因素的平均了解程度为 14.5 分（SD ± 4.6；范围 0-25）。其中，50.2%的人对女性心血管疾病及其危险因素的了解较少，25.1%的人了解一般，只有 24.7%的人了解较多。根据种族（P = 0.009）和教育水平（P = 0.007）的不同，知识得分存在统计学差异：这项研究表明，患有妊娠并发症的妇女在心血管疾病知识方面存在很大差距，这突出表明有必要开展有针对性的教育计划。提高健康知识水平，尤其是高风险人群和社会经济地位较低人群的健康知识水平，对于降低心血管疾病的发病率至关重要。

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引用次数: 0

Consequences for Australian Recipients of Cross Border Oocyte Donation in South Africa: Double Embryo Transfer and Donor Anonymity 对南非跨境卵母细胞捐赠的澳大利亚接受者的后果：双胚胎移植和捐赠者匿名。

IF 1.7 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Australian & New Zealand Journal of Obstetrics & Gynaecology

Pub Date : 2025-03-30 DOI: 10.1111/ajo.70027

Cal Volks, Karin Hammarberg, Andrea Whittaker

Background

Due to the shortage of oocyte donors in Australia, Australian women increasingly travel overseas for oocyte donation. South Africa is a recognised ‘repro-hub’ due to the accessibility of relatively affordable, high-quality assisted reproductive technology services and the availability of donors. In contrast to Australia, where only known and identity release altruistic gamete donation is permitted, in South Africa, oocyte donors are anonymous and receive fixed compensation.

Aims

To explore the consequences for Australian recipients of cross-border oocyte donation (CBOD) in South Africa.

Materials and Methods

Semi-structured interviews were conducted with 12 Australian recipients who had at least one live birth after oocyte donation in South Africa between 2012 and 2020. Interviews were transcribed and transcripts analysed thematically.

Results

Most participants had failed assisted reproductive treatment in Australia before travelling to South Africa. Inability to secure an Australian donor led to CBOD. Ten recipients had at least one double embryo transfer (DET). Of the 15 pregnancies, participants reported one third were twin pregnancies. Some had more than one double embryo transfer cycle. Donors were anonymous, creating disparity around access to genetic information between children conceived with an Australian donor and those conceived with a South African donor. Some Australian recipients used sleuthing methods to locate donor siblings whose recipient parents had used the same donor.

Conclusions

Double embryo transfers increase the possibility of multiple pregnancy and its associated risks of poorer obstetric outcomes, and donor anonymity prevents donor conceived children's ability to officially access information about the donor through donor registers. Strategies to address the shortage of Australian oocyte donors could alleviate the need for CBOD. Education about the consequences of DET and donor anonymity is needed.

背景：由于澳大利亚的卵母细胞供体短缺，越来越多的澳大利亚妇女到海外捐献卵母细胞。南非是一个公认的“生殖中心”，因为可以获得相对负担得起的高质量辅助生殖技术服务，并且可以获得捐助者。在澳大利亚，只有已知和身份释放的利他配子捐赠才被允许，而在南非，卵母细胞捐赠者是匿名的，并接受固定的补偿。目的：探讨在南非接受跨境卵母细胞捐赠（CBOD）的澳大利亚人的后果。材料和方法：对2012年至2020年期间在南非捐赠卵母细胞后至少有一个活产的12名澳大利亚受赠人进行了半结构化访谈。采访记录下来，并按主题分析笔录。结果：大多数参与者在前往南非之前在澳大利亚接受辅助生殖治疗失败。由于无法找到澳大利亚捐赠者，导致了慢性阻塞性肺病。10例受者至少进行了一次双胚胎移植（DET）。在15次怀孕中，参与者报告三分之一是双胞胎怀孕。有些人有一个以上的双胚胎移植周期。捐赠者是匿名的，这就造成了澳大利亚捐赠者和南非捐赠者在获取基因信息方面的差异。一些澳大利亚的受赠者使用了侦查方法来寻找受赠者父母使用过同一供体的兄弟姐妹。结论：双胚胎移植增加了多胎妊娠的可能性及其相关的不良产科结局风险，并且捐赠者匿名阻止了捐赠者怀孕的孩子通过捐赠者登记正式获取捐赠者信息的能力。解决澳大利亚卵母细胞供体短缺的战略可以减轻对CBOD的需求。需要对DET和捐赠者匿名的后果进行教育。

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引用次数: 0

Patient Satisfaction With Rapid Access Hysteroscopy Clinics for Postmenopausal Bleeding—A Single Centre Observational Study 快速宫腔镜治疗绝经后出血患者满意度：单中心观察性研究

IF 1.7 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Australian & New Zealand Journal of Obstetrics & Gynaecology

Pub Date : 2025-03-29 DOI: 10.1111/ajo.70025

Sanskruti Patel, Charlotte Oyston, Katherine Sowden, Julia Coffey, Catherine Askew

Background

Endometrial cancer (EC) is the leading gynaecological cancer and is increasing in incidence. The Counties Manukau area has higher rates of EC than the rest of New Zealand. Hysteroscopy is the gold standard for the investigation of those with risk factors for EC. To reduce time to diagnosis, our service developed a rapid access clinic (RAC) where hysteroscopy occurs at the first specialist clinic (FSA) visit.

Aim

To describe patient experience and satisfaction with the RAC.

Methods

Postmenopausal patients referred to the RAC were invited to participate in a survey about their experience. Survey responses were summarised, with patient satisfaction, acceptability of FSA and procedure in the same appointment, and pain scores considered as primary outcomes.

Results

The RAC had 194 attendances over 6 months and 74/112 approached patients consented to participate in the survey (approached response rate 66%). All patients surveyed reported high satisfaction with their care, and all were comfortable having the FSA and procedure in the same appointment. 57% described pain of hysteroscopy equal to or less than a menstrual period.

Conclusion

The results indicate that the RAC is well received by our postmenopausal patients, including higher risk ethnicities, and aligns with existing literature. These findings support the continuation of the outpatient hysteroscopy service and can aid in providing accurate counselling, patient expectations and reproduction of similar service models across other gynaecology units.

背景：子宫内膜癌（EC）是妇科主要肿瘤，发病率呈上升趋势。曼努考郡的EC率高于新西兰其他地区。宫腔镜是调查有危险因素的子宫癌患者的金标准。为了缩短诊断时间，我们的服务开发了一个快速访问诊所（RAC），在第一次专科诊所（FSA）就诊时进行宫腔镜检查。目的：描述患者对RAC的体验和满意度。方法：绝经后的RAC患者被邀请参加一项关于他们的经历的调查。对调查结果进行总结，包括患者满意度、FSA的可接受性和同一预约的程序，以及疼痛评分作为主要结果。结果：RAC在6个月内有194名患者参加，112名患者中有74名同意参加调查（接近应答率66%）。所有接受调查的患者都对他们的护理非常满意，并且在同一预约中接受FSA和手术都很舒服。57%的人描述宫腔镜疼痛等于或小于月经期。结论：结果表明RAC在绝经后患者中得到了很好的接受，包括高危种族，并且与现有文献一致。这些发现支持门诊宫腔镜服务的继续，可以帮助提供准确的咨询，病人的期望和复制类似的服务模式在其他妇科单位。

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引用次数: 0

The Patient Is Dying of Drug Poisoning—Let's Increase the Dosage! 病人快死于药物中毒了，加大剂量吧！

IF 1.7 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Australian & New Zealand Journal of Obstetrics & Gynaecology

Pub Date : 2025-03-25 DOI: 10.1111/ajo.13898

Hans Peter Dietz, Susanne Langer, Ka Lai Shek, John Pardey

The recently completed Select Committee of the NSW Upper House into Birth Trauma has caused consternation amongst colleagues and triggered a controversial response from the NSW Government. It is high time that our college started to fight back.

新南威尔士州上议院最近成立的 "出生创伤 "特别委员会引起了同事们的震惊，并引发了新南威尔士州政府的争议性回应。现在是我们学院开始反击的时候了。

引用次数: 0

Maternal Deaths in Australia, 1964–2020. A Review 澳大利亚产妇死亡，1964-2020年。复习一下。

IF 1.7 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Australian & New Zealand Journal of Obstetrics & Gynaecology

Pub Date : 2025-03-25 DOI: 10.1111/ajo.70011

Gerald Wightman Lawson

Background

The overall number of maternal deaths in Australia has significantly declined over the last six decades. However, there has not been a decline in certain types of maternal deaths.

Aims

The aim is to highlight the types of maternal death where the decline has not occurred.

Materials and Methods

Data was analysed from the 19 Australian maternal mortality reports that covered the years 1964–2020. Further information was obtained from searches in the medical literature on the Australian experience of maternal mortality.

Results and Conclusions

The previous ‘traditional’ causes of maternal death—haemorrhage, hypertension, pulmonary emboli and sepsis—are very much reduced. However, deaths following psychiatric and medical causes persist, often beyond the standard postnatal definition of 42 days.

背景：在过去六十年中，澳大利亚孕产妇死亡总人数显著下降。然而，某些类型的产妇死亡并没有减少。目的：目的是突出显示未出现下降的产妇死亡类型。材料和方法：分析了1964年至2020年期间19份澳大利亚孕产妇死亡率报告的数据。对澳大利亚产妇死亡率经验的医学文献检索获得了进一步的资料。结果和结论：以前造成产妇死亡的“传统”原因——出血、高血压、肺栓塞和败血症——大大减少了。然而，由于精神和医疗原因导致的死亡仍然存在，往往超过了产后42天的标准定义。

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引用次数: 0

A 2-Min Cytomegalovirus (CMV) Awareness Video Improves Pregnant Women's Knowledge and Planned Adherence to Hygiene Precautions 两分钟的巨细胞病毒 (CMV) 知识视频可提高孕妇对卫生预防措施的了解和计划性遵守。

IF 1.7 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Australian & New Zealand Journal of Obstetrics & Gynaecology

Pub Date : 2025-03-25 DOI: 10.1111/ajo.70016

Tanya Tripathi, Jotara Watson, Hayley Smithers-Sheedy, Kath Swinburn, Natalia Rode, Emma Waight, Annabel Webb, Natasha E. Holmes, Hanako Stump, Antonia Shand, Lisa Hui

Introduction

Congenital cytomegalovirus (cCMV) is a leading infectious cause of life-long neurodevelopmental disabilities, but public awareness of CMV is low. This study evaluated a short educational video on cCMV for its acceptability and impact on pregnant women's knowledge and planned hygiene adherence.

Materials and Methods

Participants were pregnant women recruited from an Australian tertiary maternity hospital clinic and social media (May 2023 to May 2024). Participants completed online surveys: before the video (T1), immediately after (T2), and 8 weeks later (T3). Linear mixed effects models assessed changes in knowledge and intended adherence to CMV precautions, adjusting for previous CMV education, and parity.

Results

A total of n = 296 eligible pregnant women were recruited, n = 270 completed the T1 survey and watched the video. Participants (n = 270) had a median age of 33 years (range: 18–43 years), 21% were multiparous and 30% had received previous CMV education. Of the 270 participants who completed the T1 survey and viewed the video, 202 (75%) and 109 (40%) completed surveys at T2 and T3 respectively. Adjusted total mean CMV knowledge scores increased significantly between T1 and T2 (+2.38; p < 0.001) and remained higher at T3 (+2.14; p < 0.001). Self-reported adherence to hygiene precautions improved from T1 to T2 (p < 0.001) and were maintained for four out of five key behaviours at T3. Participants (99%) found the content valuable, and 91% agreed that CMV precautions were “easy” to follow.

Conclusion

A CMV education video is a simple, effective method to improve pregnant women's knowledge and planned adherence to hygiene precautions.

先天性巨细胞病毒（cCMV）是导致终身神经发育障碍的主要感染性疾病，但公众对CMV的认识较低。本研究评估了cCMV教育短片的可接受性及其对孕妇知识和计划卫生依从性的影响。材料和方法：参与者是从澳大利亚三级妇产医院诊所和社交媒体招募的孕妇（2023年5月至2024年5月）。参与者完成了在线调查：视频播放前（T1），视频播放后（T2）和8周后（T3）。线性混合效应模型评估了知识的变化和CMV预防措施的预期依从性，调整了先前的CMV教育和平等。结果：共招募到n = 296名符合条件的孕妇，其中n = 270人完成了T1调查并观看了视频。参与者（n = 270）的中位年龄为33岁（范围：18-43岁），21%为多产，30%曾接受过CMV教育。在270名完成T1调查并观看视频的参与者中，202名（75%）和109名（40%）分别在T2和T3完成了调查。调整后总平均CMV知识得分在T1和T2之间显著增加(+2.38；结论：制作巨细胞病毒教育视频是一种简单、有效的方法，可以提高孕妇的知识和有计划地遵守卫生注意事项。

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引用次数: 0

The PreGen Research Program: Implementing Prenatal Genomic Testing in Australia—A Commentary PreGen研究计划：在澳大利亚实施产前基因组检测-评论。

IF 1.7 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Australian & New Zealand Journal of Obstetrics & Gynaecology

Pub Date : 2025-03-24 DOI: 10.1111/ajo.13936

Sarah Long, Deborah Schofield, Josh Kraindler, Rebecca Vink, Kate Ross, Natalie Hart, Holly Evans, Alyssa Wilson, Jon Hyett, Claire E. Wakefield, Lauren Kelada, Hamish Scott, Sebastian Lunke, Meaghan Wall, Michael F. Buckley, Gemma Fernihough, George McGillivray, Tony Roscioli

Prenatal genomic sequencing, which can provide a significantly increased diagnostic rate for fetal structural anomaly (FSA) compared with karyotype and microarray, is not available uniformly across Australia. PreGen, a 5-year translational research program, has identified significant barriers to implementation including access to funding, the availability of genomic testing, access to termination of pregnancy services and the availability of specialist genomic centres. A federal item number for prenatal genomic testing would increase equitable test availability and reduce delays to diagnoses by making them in pregnancy whilst removing the need for low-yield diagnostic interventions and enabling personalised patient management and family support.

与核型和芯片相比，产前基因组测序可以显著提高胎儿结构异常（FSA）的诊断率，但在澳大利亚并不统一。PreGen是一项为期5年的转化研究计划，它已经确定了实施的重大障碍，包括获得资金、获得基因组检测、获得终止妊娠服务和获得专业基因组中心。产前基因组检测的联邦项目编号将增加公平的检测可用性，并通过在怀孕期间进行检测来减少诊断延误，同时消除对低产量诊断干预的需求，并实现个性化的患者管理和家庭支持。

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引用次数: 0

Postprandial Hyperglycaemia Screening and Pregnancy Outcomes-Lessons From COVID -19 餐后高血糖筛查和妊娠结局——来自COVID -19的教训。

IF 1.7 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Australian & New Zealand Journal of Obstetrics & Gynaecology

Pub Date : 2025-03-24 DOI: 10.1111/ajo.70014

Beenu Bastian, Lisa Gaye Smithers, Ansar Kunjunju, Alexia Pape, Monique Francois

Background

During COVID-19, the diagnosis and treatment of GDM differed from conventional criteria. In Australia, during the alternative testing period, women with fasting glucose < 4.7 mmol/L were not diagnosed with GDM.

Aim

To describe the maternal and neonatal outcomes of pregnant women with fasting blood glucose < 4.7 mmol/L for whom the diagnosis and treatment pathways differed before and during COVID-19.

Materials and Methods

An Australian population-based data linkage study involving 3891 women with fasting blood glucose < 4.7 mmol/L between 24 and 32 weeks of gestation categorised into three groups: women diagnosed with GDM by postprandial hyperglycaemia (PPGDM; n = 226); normal glucose tolerance group (NGT; n = 3125) and women not tested for postprandial hyperglycaemia, mostly during COVID-19 (LFBG; n = 540). Perinatal outcomes were compared using generalised linear models.

Results

There were no differences between PPGDM and NGT groups in the risk of large for gestational age infants (RR 0.98, 95% CI: 0.63–1.52) although the mean birth weight (MD −103.43, 95% CI: −175.46 to −31.40)) was lower in the PPGDM group. The maternal and neonatal outcomes in the LFBG group were mostly comparable to the NGT group.

Conclusion

In our study, the Australian COVID-19 GDM screening protocol, which includes initial fasting glucose testing, reduced the need for an OGTT in 67% of pregnant women. Diagnosis and treatment for postprandial hyperglycaemia in women with lower FBG should consider the benefits, as well as the financial, logistical and psychological costs involved.

背景：在COVID-19期间，GDM的诊断和治疗与常规标准不同。目的：描述空腹血糖孕妇的孕产妇和新生儿结局材料和方法：澳大利亚一项基于人群的数据链接研究，涉及3891名空腹血糖妇女结果：PPGDM组和NGT组在胎龄大的婴儿的风险方面没有差异（RR 0.98, 95% CI: 0.63-1.52），尽管平均出生体重(MD -103.43, 95% CI：（-175.46 ~ -31.40）) PPGDM组较低。LFBG组的产妇和新生儿结局与NGT组基本相当。结论：在我们的研究中，澳大利亚的COVID-19 GDM筛查方案，包括初始空腹血糖检测，减少了67%的孕妇对OGTT的需求。低血糖妇女餐后高血糖的诊断和治疗应考虑其益处，以及所涉及的经济、后勤和心理成本。

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引用次数: 0

Barry Normand John Walters, FRACP, FRANZCOG ad eundem (1950–2024) 巴里·诺曼和约翰·沃尔特斯，FRACP， FRANZCOG和eundem （1950-2024）

IF 1.7 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Australian & New Zealand Journal of Obstetrics & Gynaecology

Pub Date : 2025-03-24 DOI: 10.1111/ajo.13919

Bill Hague

Barry Walters, a legend of Australian Obstetric Medicine, has died after a long incapacitating illness and a much shorter battle with the COVID-19 virus.

The elder son of jewellers, Wallace and Lucille Walters, Barry was born at St Vincent's Hospital, Melbourne: his father used to say, ‘he was born there because he wanted to be close to his mother’! Within 2 years, the family moved to Perth, which then became his home for the rest of his life. After winning a scholarship to Scotch College, he excelled in every subject and eventually became Dux of the school in 1967. He studied Medicine at the University of Western Australia (UWA) and, for most of the time, was the top student, including his final year, graduating with the AMA Gold Medal in 1974. His widow, Tamara, recalls her first memory of him at the first lecture of the year in the first year of medical school, ‘sitting with his rowdy friends right behind me, making wisecracks as I was trying to listen to the lectures. We didn't think very much of each other in those days. But the more time we spent together, the more I realized that he was the smartest man I had ever met. He was funny and made me laugh, and most of all, he was kind’.

After first thinking that he would like to do neurology, he then changed his mind to a career in paediatrics, with an initial job in neonatology at King Edward Memorial Hospital (KEMH), Subiaco. There he realised that there were many medical problems in obstetric patients that were not being well addressed, and he saw a need for a specialist obstetric physician in Perth. So he and Tamara headed over to England, where he worked first in Oxford for a year with one of the then two doyens of obstetric medicine, (the late) Chris Redman, and then for 2 years with the other, Michael de Swiet, at Queen Charlotte's Hospital in West London, home of the Institute of Obstetrics. During this time, he obtained his FRACP.

Returning to Perth, he initiated the obstetric medicine unit at KEMH, where he became Physician to the Diabetes service, although his interests were much broader than diabetes. He was available for medical advice in many obstetric crises, and many mothers (and their babies) owe their lives to his wise advice. He would drop everything to see a sick patient, often left picnics and parties, and would then not be seen for hours. Like his mentor, Chris Redman, Barry wanted to cure pre-eclampsia and had endless ideas about studies and research, writing and lecturing extensively on this, as well as other subjects. He was a founding member of the Obstetric Medicine Group of Australasia (OMGA) from its first meeting in Leonard's Mill, SA in 1992, and attended almost all the annual meetings on both sides of the Tasman. In 1998, he was appointed Clinical Associate Professor at UWA, and in 2003, was appointed Clinical Professor of Medicine at the newly opened medical school of the University of Notre Dame in Fremantle. Later, after the 2005 amalgamati

巴里·沃尔特斯（Barry Walters）是澳大利亚产科医学的传奇人物，他在长期患病和与COVID-19病毒的短暂战斗后去世。作为珠宝商华莱士和露西尔·沃尔特斯的长子，巴里出生在墨尔本的圣文森特医院。他的父亲曾经说过，“他出生在那里是因为他想和他的母亲亲近。”两年后，全家搬到了珀斯，那里成为了他余生的家。在获得苏格兰学院的奖学金后，他各科成绩优异，并最终于1967年成为学校的Dux。他在西澳大利亚大学（UWA）学习医学，在大部分时间里，他都是最优秀的学生，包括他最后一年，1974年毕业时获得了美国医学协会金奖。他的遗孀塔玛拉（Tamara）回忆起她对他的最初记忆是在医学院第一年的第一节课上，“他和他那些吵闹的朋友坐在我身后，在我努力听讲座的时候说俏皮话。”在那些日子里，我们彼此都不怎么看重对方。但我们相处的时间越长，我就越意识到他是我见过的最聪明的人。他很有趣，让我开怀大笑，最重要的是，他很善良。”起初，他想做神经病学，后来他改变了主意，选择了儿科的职业，最初在苏比亚科的爱德华国王纪念医院（King Edward Memorial Hospital， KEMH）的新生儿科工作。在那里，他意识到产科病人的许多医疗问题没有得到很好的解决，他认为珀斯需要一名专业产科医生。所以他和塔玛拉去了英国，他首先在牛津和当时的两名产科医学专家之一（已故）克里斯·雷德曼（Chris Redman）一起工作了一年，然后和另一个人迈克尔·德·斯威特（Michael de swet）在西伦敦的夏洛特女王医院工作了两年，那里是产科研究所的所在地。在此期间，他获得了FRACP。回到珀斯后，他在KEMH创办了产科医学部门，在那里他成为糖尿病服务的医生，尽管他的兴趣比糖尿病广泛得多。在许多产科危机中，他都能提供医疗咨询，许多母亲（及其婴儿）的生命都归功于他的明智建议。他会放下一切去看病人，经常离开野餐和聚会，然后几个小时不见人影。和他的导师克里斯·雷德曼（Chris Redman）一样，巴里想要治愈先兆子痫，对学习和研究有无数的想法，并就这一问题以及其他主题进行了广泛的写作和演讲。他是澳大利亚产科医学小组（OMGA）的创始成员，该小组于1992年在南澳伦纳德磨坊举行了第一次会议，并参加了塔斯曼海峡两岸几乎所有的年度会议。1998年，他被任命为西澳大学临床副教授，并于2003年被任命为弗里曼特尔圣母大学新开设的医学院临床医学教授。后来，在2005年OMGA与澳大利亚妊娠高血压研究学会（ASSHP）合并后，形成了目前的澳大利亚和新西兰产科医学学会（SOMANZ）， Barry在理事会任职，并担任2009-2010年主席。他早些时候帮助发起了国际产科医学协会（ISOM），并组织了2003年在弗里曼特尔举行的第一次“医学与怀孕”会议，包括来自北美和南非以及澳大利亚，新西兰和英国的各种国家和国际团体。2005年，他被澳大利亚和新西兰皇家妇产科学院（RANZCOG）授予奖学金，并于2017年成为SOMANZ的荣誉终身会员。巴里为医学文献做出了贡献，他发表了论文，在这些论文中，他不害怕批评和/或引起争议，并在已有的教科书中撰写了章节，包括迈克尔·德·斯威特（Michael de Swiet）的权威的《产科实践中的医学失调》（通过其四个初版）以及其他一些国际文本。他是澳大利亚第一个产科医学课程的发起人。除了对产科医学的热爱，巴里还全身心地投入到他的妻子塔玛拉（Tamara）、孩子阿瑟（Asher）、艾拉（Ella）和索菲（Sophie）以及他们的七个孙子孙女身上，他们给他带来了巨大的快乐。在他患上额颞叶痴呆的漫长岁月里，家人一直照顾着他。他也是当地犹太教堂的忠实成员。在Karrakatta墓地的犹太祈祷室里，最后的告别挤满了站着的人，拉比提醒我们，“耶和华对你们的要求是什么，只要你们行公义，爱怜悯，谦卑地与你们的神同行”（弥迦书6:8）。巴里就是一个很好的例子。告别一个伟大的人，一个好朋友。

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