Australian & New Zealand Journal of Obstetrics & Gynaecology最新文献_第5页

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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引用次数: 0

ANZJOG in 2025 到2025年。

IF 1.7 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Australian & New Zealand Journal of Obstetrics & Gynaecology

Pub Date : 2025-03-14 DOI: 10.1111/ajo.70017

Scott W. White

<p>Welcome to Volume 65 of the <i>Australian and New Zealand Journal of Obstetrics and Gynaecology</i>. It is my great pleasure to lead RANZCOG's scientific publication into another year. 2024 was a busy year for the Journal, seeing an increase in submissions and published articles. I am grateful to those who contribute to the Journal's success through submission of quality manuscripts and participation in the peer review process. This support for our local publication furthers our aim of providing high-quality evidence to guide clinical care and further research.</p><p>This year will bring some changes to authors and readers of <i>ANZJOG</i>. Authors will notice a change in submission processes which aim to streamline what has previously been a cumbersome process. We aim to provide new ways for readers to interact with the Journal's content, making our articles more visible to busy clinicians and researchers in this era of information overload and benefiting authors by raising the profile of and increasing the community's engagement with their publications. Please keep an eye out for these new features via <i>ANZJOG</i> and RANZCOG channels soon.</p><p>I am very grateful to the <i>ANZJOG</i> Editorial Board for their sustained efforts and support of the Journal's activity. I am very mindful of the delays that some authors have experienced in the peer review and decision processes, and this is something I am committed to improving upon in 2025. One mechanism for this will be to expand the Editorial Board, and a call for expressions of interest will soon be made, and I encourage anyone with an interest in research and publication to reach out. A diverse Editorial Board with a broad range of clinical and research experience makes for a more efficient and responsive Journal that will benefit authors and readers alike.</p><p>This first issue of the new volume contains many valuable articles. To open, Baalman et al. [<span>1</span>] provide an overview of Prospective Structured Perinatal Audit using the Robson Ten Group Classification System. They identify a requirement for a cohesive strategy for the assessment of uniformly collected data, of outcomes relevant to clinicians, consumers, and health systems, to allow meaningful assessment of the quality of maternity care and benchmarking across jurisdictions and between models of care. Currently, there is no universally accepted consensus on maternity and newborn outcome data collection that allows such robust and insightful analysis. The authors highlight the difficulty in overcoming inertia in systematic audit and call upon health authorities and clinicians to make a strategic commitment to Prospective Structured Perinatal Audit with a view to improving outcomes for those under our care.</p><p>Readman et al. [<span>2</span>] provide a commentary on the escalating problem of long waitlists for specialist gynaecology services, specifically in Victoria, and particularly for pelvic pain as the presenting

欢迎阅读《澳大利亚和新西兰妇产科杂志》第65卷。我很高兴能够带领RANZCOG的科学出版物进入新的一年。2024年对《华尔街日报》来说是忙碌的一年，投稿和发表的文章都有所增加。我感谢那些通过提交高质量稿件和参与同行评审过程为《华尔街日报》的成功做出贡献的人。这种对我们本地出版物的支持进一步推动了我们为指导临床护理和进一步研究提供高质量证据的目标。今年将给ANZJOG的作者和读者带来一些变化。作者将注意到提交流程的变化，旨在简化以前繁琐的过程。我们的目标是为读者提供与《华尔街日报》内容互动的新途径，使我们的文章在这个信息过载的时代更容易被忙碌的临床医生和研究人员看到，并通过提高作者的形象和增加社区对其出版物的参与，使作者受益。请通过ANZJOG和RANZCOG频道关注这些新功能。我非常感谢《中国日报》编辑委员会对《中国日报》活动的持续努力和支持。我非常注意一些作者在同行评审和决策过程中经历的延迟，这是我致力于在2025年改进的事情。其中一个机制将是扩大编辑委员会，并很快发出表达兴趣的呼吁，我鼓励任何对研究和出版感兴趣的人与我们联系。一个具有广泛临床和研究经验的多元化编辑委员会使期刊更加高效和响应，这将使作者和读者都受益。这本新书的第一期载有许多有价值的文章。首先，Baalman等人提供了使用Robson十组分类系统的前瞻性结构化围产期审计的概述。它们确定了对统一收集的数据、与临床医生、消费者和卫生系统相关的结果进行评估的统一战略的要求，以便对孕产妇保健质量进行有意义的评估，并在不同司法管辖区和不同护理模式之间制定基准。目前，在孕产妇和新生儿结局数据收集方面没有普遍接受的共识，无法进行如此有力和深刻的分析。作者强调在克服惯性的困难，在系统审计和呼吁卫生当局和临床医生作出战略性承诺，前瞻性结构化围产期审计，以改善我们的护理下的结果。Readman et al. b[2]提供了一篇关于专家妇科服务的长时间等待名单升级问题的评论，特别是在维多利亚，特别是盆腔疼痛作为主诉。他们确定了一系列因素，包括病例日益复杂，治疗选择的扩大，以及患者对护理标准的期望提高。与医疗保健的许多其他领域一样，COVID-19大流行加剧了已有的问题，政府在医疗保健提供方面的各种挑战之间的优先事项划分也被认为是原因之一。作者试图对那些面临长时间等待专家审查的患者进行经验性激素治疗的临床试验，但发现患者不愿意被招募，理由是对激素治疗持怀疑态度，希望得到明确的诊断，而不是控制症状，以及认为全科医生的作用有限是参与的障碍。他们提出了许多解决方案，例如授权全科医生，利用子宫内膜异位症中心等专门服务，共享护理模式和生活方式干预，以缓解公共妇科服务的压力。这一期的特色是对临床指导的两项杰出贡献。首先，Bowyer等人提出了修订后的澳大利亚和新西兰产科医学协会关于妊娠败血症调查和管理的立场声明。脓毒症仍然是孕产妇死亡和严重发病率的主要原因，通常可以通过及时发现和积极管理来预防。该指南对产科环境中的临床医生来说是无价的，概述了识别和管理败血症的明确流程，这应该会改善此类病例的结果。其次，Hui等人对妊娠期线粒体疾病及其管理进行了简要回顾。这些情况很少见，但由于改变了满足妊娠代谢需求的能力，可能会对孕产妇和围产期结局产生负面影响。这为门诊宫腔镜使用甲氧基氟醚镇痛提供了依据。Kapurubandaran等人[b]研究了一名外科医生阴道辅助自然孔腔内窥镜手术子宫切除术（VANH）的早期经验。在一系列的20例病例中，作者发现VANH是可行的，但注意到一个显著的学习曲线，其中5例转为腹腔镜，大多数是早期病例。他们的结论是，在有进一步关于VANH结果的可靠数据之前，患者应该仔细咨询，并就子宫切除术的模式做出个性化的决定。我相信读者会对本期的这些文章和其他文章感兴趣。期待2025年ANZJOG又一个忙碌的一年，感谢您一直以来的支持。作者声明无利益冲突。

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引用次数: 0

Prevalence and Impact of Period and Pelvic Pain in Australian Adolescents: The PPEP Talk Schools Program 澳大利亚青少年经期和骨盆疼痛的患病率和影响：PPEP谈话学校计划。

IF 1.7 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Australian & New Zealand Journal of Obstetrics & Gynaecology

Pub Date : 2025-03-14 DOI: 10.1111/ajo.70015

Kate I. Tomsett, Amelia K. Mardon, Olivia W. Gao, Annabelle K. Simpson, Bridie C. Squire, Indigo G. Warner, Susan F. Evans

Background

In 2018 the Australian Government launched the world's first National Action Plan for Endometriosis (NAPE). Of its three priorities ‘Priority 1’ was ‘Education and Awareness’. In response, the Pelvic Pain Foundation of Australia was funded to deliver their Periods, Pain and Endometriosis Program (PPEP) Talk to a proportion of Australian schools. Since then, PPEP Talk has been delivered to over 110,000 students.

Aims

This retrospective cross-sectional study investigated students assigned female at birth (AFAB) and the prevalence and impact of period and pelvic pain, interaction with health care services and knowledge of endometriosis.

Materials and Methods

Multiple choice, pre and post PPEP Talk, paper survey responses between July 2022 and June 2023 were collected from 13,078 students AFAB.

Results

52.6% of students reported regular severe period pain. 22.9% of students reported regularly missing school or work with their period. 21.5% of students had presented to a health professional for pain, and 5.7% had presented to an Emergency Department. 5.2% of students reported pelvic pain for more than 10 days per month. The prevalence and impact of period and pelvic pain varied across demographic variables. The proportion of students who knew what endometriosis was rose from 47.8% to 95.5% after the program.

Conclusions

The NAPE's objective to enhance education and awareness of endometriosis and period/pelvic pain was met. 100% of schools who received PPEP Talk want it to return. Wide discrepancies in the prevalence of pain within different demographics were identified, providing previously unknown data to improve and direct services.

背景：2018年，澳大利亚政府启动了世界上第一个子宫内膜异位症国家行动计划（NAPE）。在三个优先事项中，“第一优先事项”是“教育和意识”。作为回应，澳大利亚盆腔疼痛基金会得到资助，将他们的月经、疼痛和子宫内膜异位症项目（PPEP）讲座提供给一定比例的澳大利亚学校。从那时起，PPEP讲座已经为11万多名学生提供了服务。目的：本回顾性横断面研究调查了女性出生（AFAB）的学生，月经和骨盆疼痛的患病率和影响，与卫生保健服务的相互作用以及子宫内膜异位症的知识。材料与方法：在2022年7月至2023年6月期间，从AFAB的13078名学生中收集了多项选择、PPEP演讲前后、论文调查的反馈。结果：52.6%的学生报告有规律的严重经期疼痛。22.9%的学生报告月经期间经常缺课或旷工。21.5%的学生因疼痛向健康专业人员就诊，5.7%的学生因疼痛向急诊科就诊。5.2%的学生报告骨盆疼痛每月超过10天。月经和骨盆疼痛的患病率和影响因人口统计学变量而异。了解子宫内膜异位症的学生比例从47.8%上升到95.5%。结论：NAPE旨在加强对子宫内膜异位症和经期/盆腔疼痛的教育和认识。所有接受过PPEP演讲的学校都希望它能恢复。发现了不同人口统计数据中疼痛患病率的巨大差异，为改善和指导服务提供了以前未知的数据。

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引用次数: 0

The Demographics and Outcomes of Women With Stage II Endometrial Cancer Diagnosed in Australia 2005–2007 2005-2007 年澳大利亚确诊的 II 期子宫内膜癌妇女的人口统计学特征和治疗结果》（The Demographics and Outcomes of Women With Stage II Endometrial Cancer Diagnosed in Australia 2005-2007）。

IF 1.7 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Australian & New Zealand Journal of Obstetrics & Gynaecology

Pub Date : 2025-03-03 DOI: 10.1111/ajo.70006

Jonathan Sandeford, Pearl Tong, Selvan Pather

Background

Stage II endometrial cancer comprises 5% to 10% of cases and is pathologically diverse. Retrospective data guides recommendations which suggest surgical staging with adjuvant therapy, but the role of radical surgery and lymphadenectomy is uncertain, due to conflicting outcomes. Treatment decisions are influenced by histopathology, yet a definitive standard of care is still elusive.

Objectives

To identify prognostic factors affecting stage II endometrial cancer survival and assess the 2009 FIGO staging changes using data from the Australian National Endometrial Cancer Study (ANECS).

Materials and Methods

Ninety patients were identified between July 2005 and December 2007. Survival data was analysed using Kaplan–Meier estimates and Cox regression models, with ethics approval from QIMR.

Results

Ninety patients were identified with an average age of 60 and mean body mass index (BMI) of 30. Positive cytology (HR 5.4 [CI: 1.32–22.15]) and chemotherapy alone (HR 17.3) [CI: 2.65–112.6] were identified overall survival (OS) predictors in univariate and age (HR 1.81; [CI: 1.13–2.91]) in multivariate analyses. LVSI was a significant progression free survival (PFS) predictor (HR 4.29; [CI: 1.13–16.26]). There was no significant difference in OS (p = 0.9) and PFS (p = 0.6) when cases were re-stratified into the 1988 stage IIA and IIB groups.

Conclusions

The study supports contemporary management of simple hysterectomy with lymph node assessment and the refined 2009 stage II definition. Current treatment paradigms could also be refined based upon prognostic factors like age and LVSI.

背景：II期子宫内膜癌占病例的5%至10%，病理多样。回顾性数据指导建议手术分期与辅助治疗，但根治性手术和淋巴结切除术的作用是不确定的，由于冲突的结果。治疗决定受组织病理学的影响，但一个明确的护理标准仍然难以捉摸。目的：利用澳大利亚国家子宫内膜癌研究（ANECS）的数据，确定影响II期子宫内膜癌生存的预后因素，并评估2009年FIGO分期变化。材料与方法：2005年7月至2007年12月对90例患者进行了回顾性分析。生存数据使用Kaplan-Meier估计和Cox回归模型进行分析，并获得QIMR的伦理批准。结果：90例患者平均年龄60岁，平均体重指数（BMI） 30。细胞学阳性（HR 5.4 [CI: 1.32-22.15]）和单独化疗（HR 17.3 [CI: 2.65-112.6]）被确定为单因素和年龄的总生存（OS）预测因子(HR 1.81；[CI: 1.13-2.91])。LVSI是显著的无进展生存（PFS）预测因子(HR 4.29；置信区间:1.13—-16.26)。将1988年IIA期和IIB期患者重新分层后，OS （p = 0.9）和PFS （p = 0.6）无显著差异。结论：本研究支持单纯子宫切除术的当代管理与淋巴结评估和完善的2009年II期定义。目前的治疗模式也可以根据年龄和LVSI等预后因素进行改进。

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引用次数: 0