Raneen Sawaid Kaiyal, Darren J. Bryk, Shinnosuke Kuroda, Johnathan Doolittle, Neel V. Parekh, Edmund Sabanegh, Nina Desai, Scott D. Lundy, Sarah C. Vij
IntroductionMicrosurgical testicular sperm extraction (microTESE) is crucial for treating non‐obstructive azoospermia (NOA), offering both ‘fresh’ and ‘frozen’ options. This study evaluates the impact of fresh versus frozen microTESE on the progression to intra‐cytoplasmic sperm injection (ICSI) cycles, focusing on sperm motility.Materials and MethodsWe conducted a retrospective analysis of microTESE procedures at a major medical centre from 2007 to 2021, excluding cases of obstructive azoospermia and cryptozoospermia. Patients were divided into two groups: fresh microTESE (Group FR) and frozen microTESE (Group FZ). Sperm motility was assessed, and ICSI outcomes were compared between groups.ResultsOut of 128 microTESE procedures on 113 NOA patients, 31 were fresh and 97 were frozen. Sperm was found in 67.7% of fresh cases and 45.3% of frozen cases. In fresh cases, 85.7% had motile sperm for ICSI, whereas in frozen cases, 81.8% had motile sperm initially, but only 52.7% retained motility post‐thaw.ConclusionsOur findings indicate a significant drop in motile sperm availability for ICSI in frozen microTESE cases compared to fresh ones. This suggests a potential advantage of fresh microTESE for certain couples, despite the logistical challenges, highlighting the need for careful patient selection and counselling.
{"title":"Comparative motility assessment of sperm retrieved from micro‐testicular sperm extraction: A single‐centre study comparing fresh and frozen–thawed sperm","authors":"Raneen Sawaid Kaiyal, Darren J. Bryk, Shinnosuke Kuroda, Johnathan Doolittle, Neel V. Parekh, Edmund Sabanegh, Nina Desai, Scott D. Lundy, Sarah C. Vij","doi":"10.1111/ajo.13880","DOIUrl":"https://doi.org/10.1111/ajo.13880","url":null,"abstract":"IntroductionMicrosurgical testicular sperm extraction (microTESE) is crucial for treating non‐obstructive azoospermia (NOA), offering both ‘fresh’ and ‘frozen’ options. This study evaluates the impact of fresh versus frozen microTESE on the progression to intra‐cytoplasmic sperm injection (ICSI) cycles, focusing on sperm motility.Materials and MethodsWe conducted a retrospective analysis of microTESE procedures at a major medical centre from 2007 to 2021, excluding cases of obstructive azoospermia and cryptozoospermia. Patients were divided into two groups: fresh microTESE (Group FR) and frozen microTESE (Group FZ). Sperm motility was assessed, and ICSI outcomes were compared between groups.ResultsOut of 128 microTESE procedures on 113 NOA patients, 31 were fresh and 97 were frozen. Sperm was found in 67.7% of fresh cases and 45.3% of frozen cases. In fresh cases, 85.7% had motile sperm for ICSI, whereas in frozen cases, 81.8% had motile sperm initially, but only 52.7% retained motility post‐thaw.ConclusionsOur findings indicate a significant drop in motile sperm availability for ICSI in frozen microTESE cases compared to fresh ones. This suggests a potential advantage of fresh microTESE for certain couples, despite the logistical challenges, highlighting the need for careful patient selection and counselling.","PeriodicalId":8599,"journal":{"name":"Australian and New Zealand Journal of Obstetrics and Gynaecology","volume":"13 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142256687","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Lisa Hui, Pema Hayman, Ali Buckland, Michael C Fahey, David A Mackey, Andrew J Mallett, Daniel R Schweitzer, Clare P Stuart, Wai Yan Yau, John Christodoulou
Mitochondrial donation to reduce the risk of primary mitochondrial disease transmission from mother to child is now permitted under Australian law as part of a clinical trial. The energy demands of pregnancy have the potential to worsen mitochondrial disease symptoms and severity in affected women. We conducted a systematic literature review on mitochondrial disease in pregnancy; five cohort studies and 19 case reports were included. For many women with mitochondrial disease, pregnancy does not have a negative effect on health status. However, serious adverse outcomes may occur. We provide suggested guidelines for preconception counselling and antenatal care.
{"title":"Pregnancy in women with mitochondrial disease—A literature review and suggested guidance for preconception and pregnancy care","authors":"Lisa Hui, Pema Hayman, Ali Buckland, Michael C Fahey, David A Mackey, Andrew J Mallett, Daniel R Schweitzer, Clare P Stuart, Wai Yan Yau, John Christodoulou","doi":"10.1111/ajo.13874","DOIUrl":"https://doi.org/10.1111/ajo.13874","url":null,"abstract":"Mitochondrial donation to reduce the risk of primary mitochondrial disease transmission from mother to child is now permitted under Australian law as part of a clinical trial. The energy demands of pregnancy have the potential to worsen mitochondrial disease symptoms and severity in affected women. We conducted a systematic literature review on mitochondrial disease in pregnancy; five cohort studies and 19 case reports were included. For many women with mitochondrial disease, pregnancy does not have a negative effect on health status. However, serious adverse outcomes may occur. We provide suggested guidelines for preconception counselling and antenatal care.","PeriodicalId":8599,"journal":{"name":"Australian and New Zealand Journal of Obstetrics and Gynaecology","volume":"3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142222794","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Correction to the abstracts of Annual Scientific Meeting of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG), 28 October – 1 November 2023","authors":"","doi":"10.1111/ajo.13829","DOIUrl":"https://doi.org/10.1111/ajo.13829","url":null,"abstract":"","PeriodicalId":8599,"journal":{"name":"Australian and New Zealand Journal of Obstetrics and Gynaecology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140842360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Brydie Willburger, Zhuoran Chen, Kylie J. Mansfield
BackgroundMany women are embarrassed to discuss pelvic floor exercises with health professionals during pregnancy; instead they search the internet for information on pelvic floor exercises.AimsThis project investigated the quality and health literacy demand in terms of readability, understandability and actionability of information available on the internet relating to pelvic floor exercises.Materials and MethodsAn analysis was conducted on 150 websites and 43 videos obtained from three consecutive Google searches relating to pelvic floor exercises. Websites were assessed for Health on the Net certification. Readability was assessed using a readability calculator, and understandability/actionability of website and video information was assessed using the Patient Education Materials Assessment Tool (PEMAT) for Print or Audiovisual Materials.ResultsLess than one‐third (24%) of the websites were certified for quality. The median readability score for the websites was grade 9 and the websites and videos both rated highly for understandability and actionability. The median understandability score for the website information was 87%, and the median actionability score was 71%. The median understandability score of the video information was 95.5% and the median actionability score was 100%. The understandability and actionability of video information was also significantly greater than that for website information (P < 0.01).ConclusionClinicians could consider directing patients to video‐based resources when advising online pelvic floor exercise resources for women during pregnancy, especially those with lower health literacy.
{"title":"Investigation of the quality and health literacy demand of online information on pelvic floor exercises to reduce stress urinary incontinence","authors":"Brydie Willburger, Zhuoran Chen, Kylie J. Mansfield","doi":"10.1111/ajo.13830","DOIUrl":"https://doi.org/10.1111/ajo.13830","url":null,"abstract":"BackgroundMany women are embarrassed to discuss pelvic floor exercises with health professionals during pregnancy; instead they search the internet for information on pelvic floor exercises.AimsThis project investigated the quality and health literacy demand in terms of readability, understandability and actionability of information available on the internet relating to pelvic floor exercises.Materials and MethodsAn analysis was conducted on 150 websites and 43 videos obtained from three consecutive Google searches relating to pelvic floor exercises. Websites were assessed for Health on the Net certification. Readability was assessed using a readability calculator, and understandability/actionability of website and video information was assessed using the Patient Education Materials Assessment Tool (PEMAT) for Print or Audiovisual Materials.ResultsLess than one‐third (24%) of the websites were certified for quality. The median readability score for the websites was grade 9 and the websites and videos both rated highly for understandability and actionability. The median understandability score for the website information was 87%, and the median actionability score was 71%. The median understandability score of the video information was 95.5% and the median actionability score was 100%. The understandability and actionability of video information was also significantly greater than that for website information (<jats:italic>P</jats:italic> < 0.01).ConclusionClinicians could consider directing patients to video‐based resources when advising online pelvic floor exercise resources for women during pregnancy, especially those with lower health literacy.","PeriodicalId":8599,"journal":{"name":"Australian and New Zealand Journal of Obstetrics and Gynaecology","volume":"76 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140831543","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Oestrogen is considered by many to be a major cause of breast cancer, and yet hormonal contraception and menopausal hormonal therapy have a paradoxically small effect on breast cancer risk. Also, in the oestrogen‐only arm of the Women's Health Initiative, subjects given oestrogen had a reduced risk of breast cancer compared to controls. Initiation of breast cancer likely begins early in life, in the long‐lived ER−PR− breast stem cell. The main mitogen of ER+PR+ breast cancers is oestrogen derived from local breast fat and the tumour itself, rather than circulating oestrogens. Progesterone is relatively breast neutral, but progestins in the laboratory have been shown to expand malignant breast stem cell number.
雌激素被许多人认为是导致乳腺癌的主要原因，然而激素避孕和更年期激素治疗对乳腺癌风险的影响却很小。此外，在 "妇女健康倡议"（Women's Health Initiative）的纯雌激素治疗组中，与对照组相比，服用雌激素的受试者患乳腺癌的风险更低。乳腺癌的发病可能始于生命早期，即寿命较长的ER-PR-乳腺干细胞。ER+PR+乳腺癌的主要有丝分裂原是来自局部乳房脂肪和肿瘤本身的雌激素，而不是循环中的雌激素。孕激素对乳腺癌的影响相对较小，但实验室研究表明，孕激素会增加恶性乳腺干细胞的数量。
{"title":"Why does hormonal contraception and menopausal hormonal treatment have such a small effect on breast cancer risk?","authors":"John A. Eden","doi":"10.1111/ajo.13825","DOIUrl":"https://doi.org/10.1111/ajo.13825","url":null,"abstract":"Oestrogen is considered by many to be a major cause of breast cancer, and yet hormonal contraception and menopausal hormonal therapy have a paradoxically small effect on breast cancer risk. Also, in the oestrogen‐only arm of the Women's Health Initiative, subjects given oestrogen had a reduced risk of breast cancer compared to controls. Initiation of breast cancer likely begins early in life, in the long‐lived ER<jats:sup>−</jats:sup>PR<jats:sup>−</jats:sup> breast stem cell. The main mitogen of ER<jats:sup>+</jats:sup>PR<jats:sup>+</jats:sup> breast cancers is oestrogen derived from local breast fat and the tumour itself, rather than circulating oestrogens. Progesterone is relatively breast neutral, but progestins in the laboratory have been shown to expand malignant breast stem cell number.","PeriodicalId":8599,"journal":{"name":"Australian and New Zealand Journal of Obstetrics and Gynaecology","volume":"88 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140831545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Annabel S. Jones, Jessica Deitch, Christopher Yates, Peter Shane Hamblin, Glyn Teale, Dev Kevat, I‐Lynn Lee
BackgroundPacific Islander (PI) women in Australia have an increased risk of gestational diabetes (GDM); however, their perinatal outcomes are poorly understood.AimThe aim was to determine the maternal characteristics and perinatal outcomes of PI women with and without GDM compared to Australian/European (AE)–born women.MethodsA retrospective analysis of perinatal outcomes of singleton deliveries >20 weeks’ gestation between 1 January 2011 and 31 December 2020 was conducted at a tertiary provider (Melbourne, Australia). Antenatal details and birth outcomes were extracted from the Birth Outcome Systems database. t‐Tests and χ2, univariate and multivariable logistic regression analyses assessed the relationship between ethnicity and outcomes.ResultsOf 52,795 consecutive births, 24,860 AE women (13.3% with GDM) and 1207 PI‐born women (20.1% with GDM) were compared. PI women had significantly greater pre‐pregnancy body mass index (BMI) and significantly lower rates of smoking and nulliparity. PI women with GDM had higher rates of pre‐eclampsia (P < 0.001), large‐for‐gestational age (LGA) neonates (P = 0.037) and neonatal hypoglycaemia (P = 0.017) but lower rates of small‐for‐gestational age neonates (P = 0.034). Neonatal intensive care unit (NICU)/special care nursery requirements did not increase. After having adjusted for covariates, PI women's risk of LGA neonates (adjusted odds ratio (aOR): 1.06, 95% confidence interval (CI): 0.86–1.31) was attenuated; however, risk of pre‐eclampsia (aOR: 1.49, 95% CI: 1.01–2.21) and neonatal hypoglycaemia (aOR: 1.40, 95% CI: 1.01–1.96) still increased. They were less likely to require a primary caesarean section (aOR: 0.86, 95% CI: 0.73–0.99).ConclusionPI women have higher BMI and GDM rates, contributing to an increased likelihood of adverse perinatal outcomes. BMI is a modifiable risk factor that could be addressed prenatally.
{"title":"Antenatal health and perinatal outcomes of Pacific Islander women in Australia with and without gestational diabetes: A ten‐year retrospective cohort study","authors":"Annabel S. Jones, Jessica Deitch, Christopher Yates, Peter Shane Hamblin, Glyn Teale, Dev Kevat, I‐Lynn Lee","doi":"10.1111/ajo.13826","DOIUrl":"https://doi.org/10.1111/ajo.13826","url":null,"abstract":"BackgroundPacific Islander (PI) women in Australia have an increased risk of gestational diabetes (GDM); however, their perinatal outcomes are poorly understood.AimThe aim was to determine the maternal characteristics and perinatal outcomes of PI women with and without GDM compared to Australian/European (AE)–born women.MethodsA retrospective analysis of perinatal outcomes of singleton deliveries >20 weeks’ gestation between 1 January 2011 and 31 December 2020 was conducted at a tertiary provider (Melbourne, Australia). Antenatal details and birth outcomes were extracted from the Birth Outcome Systems database. <jats:italic>t</jats:italic>‐Tests and χ<jats:sup>2</jats:sup>, univariate and multivariable logistic regression analyses assessed the relationship between ethnicity and outcomes.ResultsOf 52,795 consecutive births, 24,860 AE women (13.3% with GDM) and 1207 PI‐born women (20.1% with GDM) were compared. PI women had significantly greater pre‐pregnancy body mass index (BMI) and significantly lower rates of smoking and nulliparity. PI women with GDM had higher rates of pre‐eclampsia (<jats:italic>P</jats:italic> < 0.001), large‐for‐gestational age (LGA) neonates (<jats:italic>P</jats:italic> = 0.037) and neonatal hypoglycaemia (<jats:italic>P</jats:italic> = 0.017) but lower rates of small‐for‐gestational age neonates (<jats:italic>P</jats:italic> = 0.034). Neonatal intensive care unit (NICU)/special care nursery requirements did not increase. After having adjusted for covariates, PI women's risk of LGA neonates (adjusted odds ratio (aOR): 1.06, 95% confidence interval (CI): 0.86–1.31) was attenuated; however, risk of pre‐eclampsia (aOR: 1.49, 95% CI: 1.01–2.21) and neonatal hypoglycaemia (aOR: 1.40, 95% CI: 1.01–1.96) still increased. They were less likely to require a primary caesarean section (aOR: 0.86, 95% CI: 0.73–0.99).ConclusionPI women have higher BMI and GDM rates, contributing to an increased likelihood of adverse perinatal outcomes. BMI is a modifiable risk factor that could be addressed prenatally.","PeriodicalId":8599,"journal":{"name":"Australian and New Zealand Journal of Obstetrics and Gynaecology","volume":"226 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140798065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Asvini K. Subasinghe, Kirsten I. Black, Edwina Dorney, Jacqueline A. Boyle
In 2021, the Preconception Health Network Australia co‐developed preconception health core indicators identified as critical to ensuring optimal maternal and child outcomes following conception. We conducted an audit of perinatal databases across each state and territory to identify whether preconception core indicator data were available. Seven health domains co‐developed by the Preconception Health Network were mapped against the data collected in the perinatal databases. Indicator data were lacking across all seven health domains, with data missing for social determinants of health indicators. Better data linkage and developing a national evidence‐based framework would allow ongoing monitoring of women's preconception health nationally.
2021 年，澳大利亚孕前健康网络（Preconception Health Network Australia）共同制定了孕前健康核心指标，这些指标对确保受孕后母婴获得最佳结果至关重要。我们对各州和地区的围产期数据库进行了审核，以确定是否存在孕前核心指标数据。孕前健康网络共同开发的七个健康领域与围产期数据库中收集的数据进行了比对。所有七个健康领域都缺乏指标数据，健康的社会决定因素指标也缺乏数据。加强数据联系和制定国家循证框架将有助于在全国范围内持续监测妇女的孕前健康状况。
{"title":"Assessing preconception health in Australia to support better outcomes in the first 2000 days – A critical need for building a core indicator framework","authors":"Asvini K. Subasinghe, Kirsten I. Black, Edwina Dorney, Jacqueline A. Boyle","doi":"10.1111/ajo.13815","DOIUrl":"https://doi.org/10.1111/ajo.13815","url":null,"abstract":"In 2021, the Preconception Health Network Australia co‐developed preconception health core indicators identified as critical to ensuring optimal maternal and child outcomes following conception. We conducted an audit of perinatal databases across each state and territory to identify whether preconception core indicator data were available. Seven health domains co‐developed by the Preconception Health Network were mapped against the data collected in the perinatal databases. Indicator data were lacking across all seven health domains, with data missing for social determinants of health indicators. Better data linkage and developing a national evidence‐based framework would allow ongoing monitoring of women's preconception health nationally.","PeriodicalId":8599,"journal":{"name":"Australian and New Zealand Journal of Obstetrics and Gynaecology","volume":"37 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140626625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Lynn Sadler, Robin Cronin, Erena Browne, Amanda Harvey, Meghan G Hill
BackgroundThere is anecdotal evidence of Fetal Pillow® use, but no formal local information on clinician practices and perspectives.AimsTo assess obstetrician use of the Fetal Pillow®, knowledge of relevant research, and interest in a proposed randomised controlled trial in Aotearoa New Zealand.Materials and MethodsAnonymous cross‐sectional survey of practising obstetricians and obstetric trainees in Aotearoa New Zealand distributed by the Royal Australian and New Zealand College of Obstetricians and Gynaecologists.ResultsOf 136 respondents (69% specialists and 31% trainees), 130 had heard of the Fetal Pillow® device, and 108 had used it at least once (43% more than ten times). The device was available in 17/21 units represented. The 108 users of the device reported this was most commonly on collegial advice (63%) or after personal experience of a difficult delivery (33%) and most (80%) believed it reduced maternal morbidity. Only around one‐third of the 130 respondents who had heard of the device agreed there was adequate research demonstrating its efficacy for maternal (36%) and neonatal (30%) morbidity. The majority reported they would change practice in response to a randomised trial, although they were more likely to start use (81% of current non‐users) than stop (53% of users). Most (70%) respondents agreed they would encourage patients to participate in a randomised trial.ConclusionsThe Fetal Pillow® is available in most maternity units in Aotearoa New Zealand. The majority of obstetric clinicians believe it reduces maternal morbidity, while acknowledging the lack of scientific evidence. Most would support a randomised trial.
{"title":"Obstetrician views on Fetal Pillow® device use and research in Aotearoa New Zealand: A cross‐sectional survey","authors":"Lynn Sadler, Robin Cronin, Erena Browne, Amanda Harvey, Meghan G Hill","doi":"10.1111/ajo.13824","DOIUrl":"https://doi.org/10.1111/ajo.13824","url":null,"abstract":"BackgroundThere is anecdotal evidence of Fetal Pillow® use, but no formal local information on clinician practices and perspectives.AimsTo assess obstetrician use of the Fetal Pillow®, knowledge of relevant research, and interest in a proposed randomised controlled trial in Aotearoa New Zealand.Materials and MethodsAnonymous cross‐sectional survey of practising obstetricians and obstetric trainees in Aotearoa New Zealand distributed by the Royal Australian and New Zealand College of Obstetricians and Gynaecologists.ResultsOf 136 respondents (69% specialists and 31% trainees), 130 had heard of the Fetal Pillow® device, and 108 had used it at least once (43% more than ten times). The device was available in 17/21 units represented. The 108 users of the device reported this was most commonly on collegial advice (63%) or after personal experience of a difficult delivery (33%) and most (80%) believed it reduced maternal morbidity. Only around one‐third of the 130 respondents who had heard of the device agreed there was adequate research demonstrating its efficacy for maternal (36%) and neonatal (30%) morbidity. The majority reported they would change practice in response to a randomised trial, although they were more likely to start use (81% of current non‐users) than stop (53% of users). Most (70%) respondents agreed they would encourage patients to participate in a randomised trial.ConclusionsThe Fetal Pillow® is available in most maternity units in Aotearoa New Zealand. The majority of obstetric clinicians believe it reduces maternal morbidity, while acknowledging the lack of scientific evidence. Most would support a randomised trial.","PeriodicalId":8599,"journal":{"name":"Australian and New Zealand Journal of Obstetrics and Gynaecology","volume":"125 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140626615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
AimsWe hypothesise that PTNS is a safe and effective treatment for OAB. Overactive bladder (OAB) is estimated to affect 11.8% of women worldwide, causing diminished quality of life. Lifestyle modifications, muscarinic receptor antagonist and beta‐adrenoreceptor agonist remain the mainstay of treatment but are limited by their efficacy and adverse effects. Access to third‐line therapies of intravesical botulinum toxin type A or sacral neuromodulation is limited by their invasive nature. Percutaneous tibial nerve stimulation (PTNS) has emerged as a non‐invasive treatment option for OAB.MethodsThis study was a single‐arm trial of women requesting third‐line treatment for OAB. The primary treatment outcome was patient‐reported visual analogue score (VAS) improvement of at least 50%. Secondary outcome measures were Urinary Distress Inventory Short Form (UDI‐6) score and two‐day bladder diary. Patients also provided feedback on adverse effects encountered.ResultsIn the 84 women recruited, initial treatment protocol showed a success rate of 77.2% among those who completed treatment based on VAS, with a statistically significant improvement in mean UDI‐6 score of 20.13 (P < 0.01, standard deviation: 12.52). Continued success following tapering protocol of 60.8% and a mean maintenance protocol of 14.2 months was achieved. No adverse effects were reported.ConclusionThe results from this study are in concordance with previously published literature on the effectiveness and safety of PTNS as a treatment modality for OAB. Further randomised controlled trials to evaluate the optimal treatment protocol are warranted to establish a standardised regime.
{"title":"Percutaneous tibial nerve stimulation for the overactive bladder: A single‐arm trial","authors":"Hnin Yee Kyaw, Hannah G. Krause, Judith T.W. Goh","doi":"10.1111/ajo.13822","DOIUrl":"https://doi.org/10.1111/ajo.13822","url":null,"abstract":"AimsWe hypothesise that PTNS is a safe and effective treatment for OAB. Overactive bladder (OAB) is estimated to affect 11.8% of women worldwide, causing diminished quality of life. Lifestyle modifications, muscarinic receptor antagonist and beta‐adrenoreceptor agonist remain the mainstay of treatment but are limited by their efficacy and adverse effects. Access to third‐line therapies of intravesical botulinum toxin type A or sacral neuromodulation is limited by their invasive nature. Percutaneous tibial nerve stimulation (PTNS) has emerged as a non‐invasive treatment option for OAB.MethodsThis study was a single‐arm trial of women requesting third‐line treatment for OAB. The primary treatment outcome was patient‐reported visual analogue score (VAS) improvement of at least 50%. Secondary outcome measures were Urinary Distress Inventory Short Form (UDI‐6) score and two‐day bladder diary. Patients also provided feedback on adverse effects encountered.ResultsIn the 84 women recruited, initial treatment protocol showed a success rate of 77.2% among those who completed treatment based on VAS, with a statistically significant improvement in mean UDI‐6 score of 20.13 (<jats:italic>P</jats:italic> < 0.01, standard deviation: 12.52). Continued success following tapering protocol of 60.8% and a mean maintenance protocol of 14.2 months was achieved. No adverse effects were reported.ConclusionThe results from this study are in concordance with previously published literature on the effectiveness and safety of PTNS as a treatment modality for OAB. Further randomised controlled trials to evaluate the optimal treatment protocol are warranted to establish a standardised regime.","PeriodicalId":8599,"journal":{"name":"Australian and New Zealand Journal of Obstetrics and Gynaecology","volume":"244 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140626505","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Authors response to Letter to the Editor regarding ‘Perinatal outcomes after regional analgesia during labour’","authors":"Janna Lawson, Roshan Selvaratnam","doi":"10.1111/ajo.13827","DOIUrl":"https://doi.org/10.1111/ajo.13827","url":null,"abstract":"","PeriodicalId":8599,"journal":{"name":"Australian and New Zealand Journal of Obstetrics and Gynaecology","volume":"174 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140609870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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