Australian & New Zealand Journal of Obstetrics & Gynaecology最新文献

{"title":"The first International Association of Diabetes and Pregnancy Study Groups summit on the diagnosis of gestational diabetes in early pregnancy: TOBOGM Summit Report.","authors":"Arianne Sweeting, Freya MacMillan, David Simmons","doi":"10.1111/ajo.13823","DOIUrl":"https://doi.org/10.1111/ajo.13823","url":null,"abstract":"<p><p>The first International Association of Diabetes and Pregnancy Study Groups Summit on the diagnosis of gestational diabetes in early pregnancy (Treatment of Booking Gestational Diabetes Mellitus (TOBOGM) Summit) was held on the 17 November 2022 in Sydney, Australia. It sought to use the TOBOGM trial findings to scope the issues involved with early screening, to inform future discussions over possible approaches for diagnosing gestational diabetes mellitus (GDM) in early pregnancy. Most delegates supported testing for early GDM using a one-step 75 g oral glucose tolerance test approach with Canadian Diabetes Association criteria preferred, but highlighted the importance of considering resources, cost, consumer perspectives and equity in translating TOBOGM results into a clinical approach to screening for, and diagnosing, early GDM.</p>","PeriodicalId":55429,"journal":{"name":"Australian & New Zealand Journal of Obstetrics & Gynaecology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140856765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply to perinatal outcomes after regional analgesia during labour","authors":"Kara Thompson,&nbsp;Nisha Khot","doi":"10.1111/ajo.13811","DOIUrl":"10.1111/ajo.13811","url":null,"abstract":"","PeriodicalId":55429,"journal":{"name":"Australian & New Zealand Journal of Obstetrics & Gynaecology","volume":"64 4","pages":"416"},"PeriodicalIF":1.4,"publicationDate":"2024-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140609719","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editor-in-chief's introduction to ANZJOG 64(2)","authors":"Scott W. WHITE","doi":"10.1111/ajo.13818","DOIUrl":"https://doi.org/10.1111/ajo.13818","url":null,"abstract":"&lt;p&gt;Welcome to the April 2024 issue of &lt;i&gt;ANZJOG&lt;/i&gt;. Thank you to the many contributors to &lt;i&gt;ANZJOG&lt;/i&gt; who have submitted manuscripts and contributed to the peer review process as this maintains the journal as a source of robust clinical science for clinicians and researchers in Australia and New Zealand and further afield.&lt;/p&gt;&lt;p&gt;This issue begins with two stimulating articles about severe maternal morbidity. Most of us are fortunate to live and work in locations with historically low rates of maternal mortality, although there remain lessons to be learned and improvements to be made from the rare but tragic maternal deaths that still occur. Although there are robust and well-resourced processes for review of maternal mortality, the recognition, review and reporting of severe maternal morbidity are much less systematic, resulting in missed opportunities for the detection and improvement of system-level weaknesses which underlie preventable severe adverse maternal outcomes. The review by Frost et al. provides an excellent overview of the current situation of maternal morbidity review in Australia. The authors conclude by outlining a number of key steps towards implementing a systematic maternal morbidity review jurisdictionally and nationally.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; In their editorial, MacDonald et al. go further, calling upon us, clinicians and researchers, to make the case for progress in this area and to drive it.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; Major change will require policy and resource attention from government, but we can take valuable action prior to that: to demonstrate why this is important, our willingness to work towards improvements in maternal and related health outcomes and to spur policymakers into action.&lt;/p&gt;&lt;p&gt;This issue also includes reports of two randomised controlled trials. Fahy et al. present their trial of placental cord drainage at caesarean section.&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt; This practice has been shown to reduce the duration of the third stage of labour at vaginal birth although without a clinically significant reduction in blood loss. The authors compared placental cord drainage to delayed cord clamping at planned caesarean section, finding no significant differences between the two groups, and concluded that this study supports the routine use of delayed cord clamping.&lt;/p&gt;&lt;p&gt;The second trial compared sonographer-performed ultrasound-guided embryo transfer versus standard embryo transfer, including rates of intrauterine air bubble visualisation, clinical pregnancy and live birth as outcomes.&lt;span&gt;&lt;sup&gt;4&lt;/sup&gt;&lt;/span&gt; Of these, only air bubble visualisation was significantly different between the groups, with sonographer-performed ultrasound proving beneficial. Given the resource implications of sonographer assistance and the lack of impact on clinical outcomes, this study does not provide compelling evidence to change standard practice in routine cases.&lt;/p&gt;&lt;p&gt;Two groups present systematic reviews of gynaecological interes","PeriodicalId":55429,"journal":{"name":"Australian & New Zealand Journal of Obstetrics & Gynaecology","volume":"64 2","pages":"83-84"},"PeriodicalIF":1.7,"publicationDate":"2024-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajo.13818","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140559546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A study protocol for live and deceased donor uterus transplantation as a treatment for women with uterine factor infertility","authors":"Jana Pittman,&nbsp;Mats Brännström,&nbsp;Neill Keily,&nbsp;Brigitte Gerstl,&nbsp;Elena Cavazzoni,&nbsp;Henry Pleass,&nbsp;Mianna Lotz,&nbsp;Natasha Rogers,&nbsp;Germaine Wong,&nbsp;Wayne Hsueh,&nbsp;Ashraf Hanafy,&nbsp;Jason A. Abbott,&nbsp;Rebecca Deans","doi":"10.1111/ajo.13810","DOIUrl":"10.1111/ajo.13810","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Uterus transplantation (UTx) is an emerging treatment option for women with uterine factor infertility (UFI) or the absence of a functional uterus. This is the study protocol for the first human UTx clinical trial in Australia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>This protocol outlines the approved training program used to plan, diagnose, screen, and treat patients who may be eligible for UTx using living and deceased donors. This multi-site clinical research study includes three tertiary hospital sites within New South Wales (NSW), Australia – Prince of Wales, Royal Hospital for Women and Westmead Hospitals. Our UTx protocol is based on that used by our collaborative partner, the inaugural UTx team in Gothenburg, Sweden. The Swedish UTx team provides ongoing preceptorship for the Australian UTx team. Ethics approval for six UTx procedures using living or deceased donors (Western Sydney Local Health District Human Research Ethics Committee: 2019/ETH138038) was granted in 2020.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Results from surgeries and live births will be published. Data will be prospectively entered into the registry of the International Society of Uterus Transplantation (ISUTx), a sub-section of The Transplantation Society (TTS). Trial Id: ACTRN12622000917730.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>A multidisciplinary research team has been formed between three tertiary hospitals in Sydney – The Royal Hospital for Women, Prince of Wales and Westmead Hospitals; and with the Swedish UTx, University of Gothenburg. The Swedish team pioneered animal and human UTx studies since 1998, including publishing the first live birth after UTx. (1) This Australian trial commenced in January 2023.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Uterus transplantation gives women with UFI the opportunity to be gestational and genetic mothers. It is a complex procedure for both the donor and recipient, with medical and surgical risks. An extensive multidisciplinary approach is required to optimise patient safety and graft outcomes. This protocol outlines our Australian UTx team strategy for screening, recruitment, surgical approach, and clinical management of UTx recipients and donors.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55429,"journal":{"name":"Australian & New Zealand Journal of Obstetrics & Gynaecology","volume":"64 4","pages":"399-406"},"PeriodicalIF":1.4,"publicationDate":"2024-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajo.13810","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140319894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Severe maternal morbidity – we need more action to prevent harm","authors":"Evelyn Jane MacDonald,&nbsp;Beverley Lawton,&nbsp;Francesca Storey,&nbsp;Kendall Stevenson,&nbsp;John David Tait,&nbsp;Peter Stone","doi":"10.1111/ajo.13813","DOIUrl":"10.1111/ajo.13813","url":null,"abstract":"&lt;p&gt;Reviewing severe maternal morbidity (SMM) is considered a marker of the quality of maternity care, as in high income countries (HIC) maternal mortality is thankfully now rare.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; SMM disrupts maternal (and wider family) wellbeing, causing considerable personal and public cost. SMM preventability review has the potential to reduce this and the associated harm. To do this, we must identify its occurrence, review these cases, and analyse findings to develop appropriate system improvements.&lt;/p&gt;&lt;p&gt;As Joanne Frost and her colleagues in this current &lt;i&gt;Australian and New Zealand Journal of Obstetrics and Gynaecology&lt;/i&gt; state, there is currently no national consensus or agreement in Australia on terms to use, definitions to follow and therefore no ability to compare inter-state data on the rates and causes of SMM. There is also no defined process to assess preventability in Australia and without this at the outset it is difficult to see how change would be effected. While in Aotearoa (New Zealand), our Health Research Council has previously funded research to enable national SMM preventability reviews, across both countries there appears to be no will by our respective governments to provide ongoing funding to enable routine SMM preventability reviews to take place.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; No funding is currently available at regional, state, or national levels, and there is no apparent plan for these reviews to become ‘business as usual’. This is regrettable, as opportunities are being missed to improve poor maternal and baby outcomes.&lt;/p&gt;&lt;p&gt;There is no global agreement on how to define and implement SMM or maternal near-miss (MNM) reviews. There is not even agreement on what to call it. Professor Marion Knight stated four years ago in an editorial for another equally high-quality journal, – ‘As we publish yet more studies (re)defining severe maternal morbidity, should we be questioning whether it is time to draw a line on this research waste and instead initiate a truly international consensus process?’&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;And ‘ay, there is the rub’.&lt;span&gt;&lt;sup&gt;4&lt;/sup&gt;&lt;/span&gt; How do we initiate a ‘truly international consensus process’? A systematic review of global practices in monitoring of MNM/SMM showed inconsistencies in monitoring with low /middle income countries (LIC/MIC) using predominantly the World Health Organization (WHO) definition of MNM and tools, and high-income countries (HIC) using the SMM definition tools such as the Geller tool for reviewing preventability. The authors concluded that global standardising was ‘not feasible at this time’.&lt;span&gt;&lt;sup&gt;5&lt;/sup&gt;&lt;/span&gt; Even a good news recent systemic review and meta-analysis of the WHO MNM criteria uptake in LIC showed that despite good uptake in these countries enabling some intercountry comparisons, there was still the need in individual countries for contextual adaptations.&lt;span&gt;&lt;sup&gt;6&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;Surely the conversation needs to change. A se","PeriodicalId":55429,"journal":{"name":"Australian & New Zealand Journal of Obstetrics & Gynaecology","volume":"64 2","pages":"85-87"},"PeriodicalIF":1.7,"publicationDate":"2024-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajo.13813","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140319895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health needs, treatment decisions and experience of traditional complementary and integrative medicine use by women with diminished ovarian reserve: A cross-sectional survey","authors":"Alison Maunder,&nbsp;Susan Arentz,&nbsp;Mike Armour,&nbsp;Michael F Costello,&nbsp;Carolyn Ee","doi":"10.1111/ajo.13805","DOIUrl":"10.1111/ajo.13805","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Women with diminished ovarian reserve (DOR) have fewer eggs than would be expected at their age. It is estimated that 10% of women seeking fertility treatment are diagnosed with DOR. However, the success rate of medically assisted reproduction (MAR) is significantly lower in women with DOR, thus many seek additional approaches.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To explore the health needs of women with DOR, treatment options and experience of treatment including traditional complementary integrative medicine (TCIM).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Anyone with a diagnosis of DOR, living in Australia or New Zealand, aged over 18 were invited to complete an online survey distributed via fertility support networks and social media platforms from April to December 2021.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Data from 67 respondents were included. The main aspects of health that were impacted by DOR were fertility (91.0%) and mental health (52.2%). The main treatment recommended was MAR with most women either currently using MAR (38.8%) or having previously used MAR (37.3%). TCIM was widely used with 88.1% of women utilising supplements, 74.6% consulting with TCIM practitioners, and 65.7% adopting self-care practices. The main reasons for using TCIM were to improve fertility or support pregnancy, and to support general health and well-being.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Women with DOR have additional health needs apart from infertility, most notably mental health support. The main form of treatment utilised is MAR, despite DOR being challenging for fertility clinicians. TCIM was widely used, and respondents perceived benefits related to improving fertility, supporting pregnancy, or improving well-being through use of acupuncture, meditation, naturopathy, massage, yoga.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55429,"journal":{"name":"Australian & New Zealand Journal of Obstetrics & Gynaecology","volume":"64 4","pages":"390-398"},"PeriodicalIF":1.4,"publicationDate":"2024-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajo.13805","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140186393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving accuracy of outcome prediction for infants born extremely preterm using a digital tool: Translating ‘NIC-PREDICT’ into clinical practice, the first steps","authors":"Rosemarie A. Boland,&nbsp;Jeanie L.Y. Cheong,&nbsp;Michael J. Stewart,&nbsp;Stefan C. Kane,&nbsp;Lex W. Doyle","doi":"10.1111/ajo.13808","DOIUrl":"10.1111/ajo.13808","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Many clinicians overestimate mortality and disability rates in infants born extremely preterm. We developed a digital tool (‘NIC-PREDICT’) that predicts infant mortality and survival with and without major disability in infants born 23–27 weeks' gestation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>To determine if clinicians could use NIC-PREDICT accurately, and if their perceptions of infant outcomes improved after its release in 2021.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>Midwives, nurses, obstetricians, neonatologists and paediatricians working in tertiary and non-tertiary hospitals in Victoria were asked to use NIC-PREDICT to estimate three mutually exclusive outcomes: (i) mortality; (ii) survival free of major disability; and (iii) survival with major disability for six different scenarios where a liveborn infant was offered survival-focused care after birth. The proportions who completed the survey (responded to all six scenarios) and the proportions able to provide 100% accurate results for all scenarios were determined. Estimates of the three outcomes were compared with true rates.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 85 clinicians responded: 70 (82%) completed the survey, with an overall accuracy of 76%. Overall, predictions of mortality were accurate (mean difference from true value 0.7% (95% confidence interval (CI) −0.7, 2.1) <i>P</i> = 0.33), as were predictions of survival without major disability (mean difference − 0.7 (95% CI –3.0, 1.7) <i>P</i> = 0.58). However, survival with major disability was overestimated by 4.9% ((95% CI 1.7, 8.0) <i>P</i> = 0.003).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Most perinatal clinicians who responded used NIC-PREDICT correctly to estimate expected outcomes in infants born extremely preterm who are offered intensive care. Undue pessimism about survival with major disability remains an ongoing concern.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55429,"journal":{"name":"Australian & New Zealand Journal of Obstetrics & Gynaecology","volume":"64 4","pages":"383-389"},"PeriodicalIF":1.4,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajo.13808","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140001404","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Colposcopy performance in the new primary HPV screening in Australia: How to determine colposcopy competency?","authors":"Jeffrey H.J. Tan,&nbsp;Deborah Neesham,&nbsp;Rebecca A. Szabo,&nbsp;Natalia Khomko,&nbsp;Desiree Yap,&nbsp;C. David H. Wrede","doi":"10.1111/ajo.13807","DOIUrl":"10.1111/ajo.13807","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>To assess colposcopic performance and determine indicators for competency within the new Australian primary human papillomavirus (HPV) cervical screening program.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and methods</h3>\u0000 \u0000 <p>A retrospective observational study of 4542 women seen at The Royal Women's Hospital Colposcopy Clinic in Melbourne, from 1 December 2017 to 31 July 2020 after a higher-risk cervical screening test (CST) result.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Histological CIN2+ was detected in 25.1% up to two years from first colposcopy visit (FCV). The majority (86.7%) of CIN2+ was detected early within the first six months of presentation. Biopsy rate overall was 96.1% with abnormal colposcopic impression. Of four colposcopists with a lower biopsy rate, only one was able to achieve this early detection rate. Biopsy was also taken in over 30% of cases with negative reflex cytology and normal colposcopy, with CIN2+ detected in 5.0% among positive HPV16/18 and 3.8% with non-16/18 HPV. Positive predictive value of high-grade colposcopic impression at FCV averaged 66.4% (range: 54.9–81.6% among our colposcopists) and is poorly correlated with early detection rate of CIN2+. Overall accuracy of colposcopy is 84.5% (range: 78.7–90.3%), buoyed by high true negative colposcopic predictions secondary to high rates of negative reflex cytology referral with the new screening algorithm and is also unlikely to be a useful colposcopy indicator.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Early detection rate of CIN2+ within the first six months of presentation is a useful measure of colposcopy competency and we would encourage our National Cancer Screening Register to explore this with the participating colposcopists.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55429,"journal":{"name":"Australian & New Zealand Journal of Obstetrics & Gynaecology","volume":"64 4","pages":"375-382"},"PeriodicalIF":1.4,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139998378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"‘I was able to make a better decision about my health.’ Wāhine experiences of colposcopy at a marae-based health clinic: A qualitative study","authors":"Judy Ormandy,&nbsp;Simon Phillips,&nbsp;Maringikura Campbell,&nbsp;Bernie Haenga-Melvin,&nbsp;Luana Phillips-Govind,&nbsp;Sara Filoche","doi":"10.1111/ajo.13803","DOIUrl":"10.1111/ajo.13803","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Equitable access to colposcopy services is required if we are to realise the benefit of the introduction of human papilloma virus (HPV) screening in Aotearoa New Zealand. We piloted a community colposcopy clinic, co-located at an urban marae health clinic.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To describe the experiences of wāhine (women) attending the marae-based colposcopy clinic.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>An in-depth reflexive thematic analysis from 34 people's accounts was undertaken.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Five themes were identified from the experiences of wāhine attending the clinic. Three themes related to how having a local clinic supported access: everyone was welcoming and friendly, the environment was familiar and non-clinical and the clinic was accessible. The fourth theme related to how this contributed to agency. A fifth theme relates to wāhine views about informing the ongoing provision of colposcopy services. The experiences reflected the principles and values practised at the marae health clinic. Wāhine described feeling cared for as soon as they entered the clinic. As the clinic was local, and for some based at their marae, it was a known space where they knew the experience would be safe. Whānau were welcome with spaces for children to play. Being local meant there were fewer logistics to manage, all of which supported access.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Prioritising wāhine through the provision of culturally safe and accessible colposcopy is feasible. It has the potential to contribute to the elimination of cervical cancer in Aotearoa, New Zealand.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55429,"journal":{"name":"Australian & New Zealand Journal of Obstetrics & Gynaecology","volume":"64 4","pages":"368-374"},"PeriodicalIF":1.4,"publicationDate":"2024-02-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajo.13803","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139998380","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and feasibility of the RADA16 self-assembling peptide, PuraStat® for haemostasis in laparoscopic gynaecological surgery: A pilot study","authors":"Philip Hall","doi":"10.1111/ajo.13798","DOIUrl":"10.1111/ajo.13798","url":null,"abstract":"<p>Bleeding after laparoscopic gynaecological surgery remains a potential complication. We assessed RADA16 (PuraStat®), a topical self-assembling peptide haemostatic agent, in a pilot study of 46 women undergoing laparoscopic gynaecological surgery. The primary outcome was intraoperative haemostatic efficacy for resection site bleeding. Haemostasis was achieved in all intraoperative bleeding situations (40/40 participants: 100%) with no clinically significant surgical bed bleeding or complications. Mean volume and time required to achieve haemostasis were 6 mL and 14 sec, respectively. This study suggests that PuraStat® is a safe, effective haemostatic agent in laparoscopic gynaecological surgery. Randomised controlled trials are warranted to confirm these findings.</p>","PeriodicalId":55429,"journal":{"name":"Australian & New Zealand Journal of Obstetrics & Gynaecology","volume":"64 4","pages":"407-410"},"PeriodicalIF":1.4,"publicationDate":"2024-02-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139998379","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}