Dear Editor, We read with great interest a most engaging and pragmatic clinical guideline for decreased fetal movements (DFM).1 Between 30– 55% of women who experience a stillbirth retrospectively noted DFM in the preceding week.2 This presumed negative clinical incident has long been perceived as opportunity for intervention. The AFFIRM study, recently published (November, 2018), was to be the first randomised trial involving 409 175 pregnancies that used a similar intervention package as in Norway (subjective perception of DFM by a patient in a contemporaneous setting) and was expected to deliver a 30% reduction in the rate of stillbirths.2 The results of the AFFIRM study have been disappointing to the supporters of intervention for reduced fetal movements. There was no statistically significant reduction in the stillbirth rate but rather an increase in induction and caesarean section rates, and average neonatal length of stay in neonatal intensive care.2 Also, in the intervention group there was a higher rate of post neonatal deaths. In our exuberance to prevent stillbirths, have we violated the principle of nonmaleficence? Alternatively, as suggested by Walker and Thornton, it might be safer to retain our current approach but rather place limits on awareness campaigns to gestations greater than 37 weeks.3 Reflecting upon the negative or null findings of the AFFIRM study, should the local guideline have an immediate addendum to clarify that there is no robust scientific approach to reduced fetal movements while awaiting further evidence?
{"title":"Sleep in multiple pregnancy: Obstructive sleep apnoea and beyond","authors":"Y. Bin, J. Ford, P. Cistulli","doi":"10.1111/ajo.12985","DOIUrl":"https://doi.org/10.1111/ajo.12985","url":null,"abstract":"Dear Editor, We read with great interest a most engaging and pragmatic clinical guideline for decreased fetal movements (DFM).1 Between 30– 55% of women who experience a stillbirth retrospectively noted DFM in the preceding week.2 This presumed negative clinical incident has long been perceived as opportunity for intervention. The AFFIRM study, recently published (November, 2018), was to be the first randomised trial involving 409 175 pregnancies that used a similar intervention package as in Norway (subjective perception of DFM by a patient in a contemporaneous setting) and was expected to deliver a 30% reduction in the rate of stillbirths.2 The results of the AFFIRM study have been disappointing to the supporters of intervention for reduced fetal movements. There was no statistically significant reduction in the stillbirth rate but rather an increase in induction and caesarean section rates, and average neonatal length of stay in neonatal intensive care.2 Also, in the intervention group there was a higher rate of post neonatal deaths. In our exuberance to prevent stillbirths, have we violated the principle of nonmaleficence? Alternatively, as suggested by Walker and Thornton, it might be safer to retain our current approach but rather place limits on awareness campaigns to gestations greater than 37 weeks.3 Reflecting upon the negative or null findings of the AFFIRM study, should the local guideline have an immediate addendum to clarify that there is no robust scientific approach to reduced fetal movements while awaiting further evidence?","PeriodicalId":8599,"journal":{"name":"Australian and New Zealand Journal of Obstetrics and Gynaecology","volume":"23 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86006746","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}
Dear Editor, We read with great interest a most engaging and pragmatic clinical guideline for decreased fetal movements (DFM).1 Between 30– 55% of women who experience a stillbirth retrospectively noted DFM in the preceding week.2 This presumed negative clinical incident has long been perceived as opportunity for intervention. The AFFIRM study, recently published (November, 2018), was to be the first randomised trial involving 409 175 pregnancies that used a similar intervention package as in Norway (subjective perception of DFM by a patient in a contemporaneous setting) and was expected to deliver a 30% reduction in the rate of stillbirths.2 The results of the AFFIRM study have been disappointing to the supporters of intervention for reduced fetal movements. There was no statistically significant reduction in the stillbirth rate but rather an increase in induction and caesarean section rates, and average neonatal length of stay in neonatal intensive care.2 Also, in the intervention group there was a higher rate of post neonatal deaths. In our exuberance to prevent stillbirths, have we violated the principle of nonmaleficence? Alternatively, as suggested by Walker and Thornton, it might be safer to retain our current approach but rather place limits on awareness campaigns to gestations greater than 37 weeks.3 Reflecting upon the negative or null findings of the AFFIRM study, should the local guideline have an immediate addendum to clarify that there is no robust scientific approach to reduced fetal movements while awaiting further evidence?
{"title":"Reduced fetal movements – First do no harm","authors":"A. Saunders, C. Griffin","doi":"10.1111/ajo.12976","DOIUrl":"https://doi.org/10.1111/ajo.12976","url":null,"abstract":"Dear Editor, We read with great interest a most engaging and pragmatic clinical guideline for decreased fetal movements (DFM).1 Between 30– 55% of women who experience a stillbirth retrospectively noted DFM in the preceding week.2 This presumed negative clinical incident has long been perceived as opportunity for intervention. The AFFIRM study, recently published (November, 2018), was to be the first randomised trial involving 409 175 pregnancies that used a similar intervention package as in Norway (subjective perception of DFM by a patient in a contemporaneous setting) and was expected to deliver a 30% reduction in the rate of stillbirths.2 The results of the AFFIRM study have been disappointing to the supporters of intervention for reduced fetal movements. There was no statistically significant reduction in the stillbirth rate but rather an increase in induction and caesarean section rates, and average neonatal length of stay in neonatal intensive care.2 Also, in the intervention group there was a higher rate of post neonatal deaths. In our exuberance to prevent stillbirths, have we violated the principle of nonmaleficence? Alternatively, as suggested by Walker and Thornton, it might be safer to retain our current approach but rather place limits on awareness campaigns to gestations greater than 37 weeks.3 Reflecting upon the negative or null findings of the AFFIRM study, should the local guideline have an immediate addendum to clarify that there is no robust scientific approach to reduced fetal movements while awaiting further evidence?","PeriodicalId":8599,"journal":{"name":"Australian and New Zealand Journal of Obstetrics and Gynaecology","volume":"62 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85294294","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":"Journal Editorial Board","authors":"","doi":"10.1111/ajo.12860","DOIUrl":"https://doi.org/10.1111/ajo.12860","url":null,"abstract":"","PeriodicalId":8599,"journal":{"name":"Australian and New Zealand Journal of Obstetrics and Gynaecology","volume":"26 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74342138","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}
We thank the authors for their recent letter and agree with the observation of a striking disparity between recognition of OSA in pregnancy by hospital coding data (0.08%) in contrast with a rate of 8.3% in prospectively screened nulliparous singleton pregnancy at 21-33 weeks of gestation [1] This emphasises that OSA is likely to be greatly underestimated in usual clinical practice in Australia. We anticipate that rates are also likely to be significantly higher in women with twin or multiple pregnancy than identified by hospital coding data. The relationship between OSA and adverse pregnancy outcomes makes this a problem worthy of further study.
{"title":"A Reply to: Sleep in multiple pregnancy: Obstructive sleep apnoea and beyond","authors":"M. Rees","doi":"10.1111/ajo.13007","DOIUrl":"https://doi.org/10.1111/ajo.13007","url":null,"abstract":"We thank the authors for their recent letter and agree with the observation of a striking disparity between recognition of OSA in pregnancy by hospital coding data (0.08%) in contrast with a rate of 8.3% in prospectively screened nulliparous singleton pregnancy at 21-33 weeks of gestation [1] This emphasises that OSA is likely to be greatly underestimated in usual clinical practice in Australia. We anticipate that rates are also likely to be significantly higher in women with twin or multiple pregnancy than identified by hospital coding data. The relationship between OSA and adverse pregnancy outcomes makes this a problem worthy of further study.","PeriodicalId":8599,"journal":{"name":"Australian and New Zealand Journal of Obstetrics and Gynaecology","volume":"10 33 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80651396","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}
Raelia Lew, J. Foo, Ben Kroon, C. Boothroyd, M. Chapman
One in six Australian women and couples suffer infertility. A rising proportion relates to advanced maternal age, associated with poorer oocyte quality and in vitro fertilisation (IVF) outcomes. Internationally, oocyte cryopreservation technology applied to oocytes vitrified before 35 years provides similar live‐birth statistics compared to IVF treatment using fresh oocytes. Oocyte cryopreservation is accessible in Australasian settings and elective uptake is increasing. For women accessing treatment, oocyte cryopreservation may expand future family building options.
{"title":"ANZSREI consensus statement on elective oocyte cryopreservation","authors":"Raelia Lew, J. Foo, Ben Kroon, C. Boothroyd, M. Chapman","doi":"10.1111/ajo.13028","DOIUrl":"https://doi.org/10.1111/ajo.13028","url":null,"abstract":"One in six Australian women and couples suffer infertility. A rising proportion relates to advanced maternal age, associated with poorer oocyte quality and in vitro fertilisation (IVF) outcomes. Internationally, oocyte cryopreservation technology applied to oocytes vitrified before 35 years provides similar live‐birth statistics compared to IVF treatment using fresh oocytes. Oocyte cryopreservation is accessible in Australasian settings and elective uptake is increasing. For women accessing treatment, oocyte cryopreservation may expand future family building options.","PeriodicalId":8599,"journal":{"name":"Australian and New Zealand Journal of Obstetrics and Gynaecology","volume":"14 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82374389","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}
Perinatal loss is often considered an emotionally and physically traumatic event for expectant parents. While there is strong evidence of its impact on women, limited research has independently explored men's lived experiences.
{"title":"Men's lived experiences of perinatal loss: A review of the literature","authors":"Van Nguyen, M. Temple-Smith, J. Bilardi","doi":"10.1111/ajo.13041","DOIUrl":"https://doi.org/10.1111/ajo.13041","url":null,"abstract":"Perinatal loss is often considered an emotionally and physically traumatic event for expectant parents. While there is strong evidence of its impact on women, limited research has independently explored men's lived experiences.","PeriodicalId":8599,"journal":{"name":"Australian and New Zealand Journal of Obstetrics and Gynaecology","volume":"53 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91428802","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":"Journal Editorial Board","authors":"","doi":"10.1111/ajo.12858","DOIUrl":"https://doi.org/10.1111/ajo.12858","url":null,"abstract":"","PeriodicalId":8599,"journal":{"name":"Australian and New Zealand Journal of Obstetrics and Gynaecology","volume":"102 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79076580","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":"Informed consent for vaginal birth","authors":"G. Blanchette","doi":"10.1111/ajo.13037","DOIUrl":"https://doi.org/10.1111/ajo.13037","url":null,"abstract":"","PeriodicalId":8599,"journal":{"name":"Australian and New Zealand Journal of Obstetrics and Gynaecology","volume":"27 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85222404","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}
Dear Editor, I commend the Journal for promoting a discussion on informed consent for vaginal birth, by publishing the two opinion pieces in the December 2018 issue of ANZJOG. The contrasting views of the authors are mirrored by very different styles of presentation. A/Professor Petersen offers an historical and philosophical argument about the selective advantages of natural childbirth.1 It is both off‐target and biologically incorrect. The obvious mistake occurs in the first sentence. I doubt that A/Professor Petersen could provide any evidence that the process of natural childbirth has materially changed over the course of human evolution. After all, it is one of the selection pressures that evolution applies to produce change. Human anatomy may have evolved. Human culture may have evolved. But the evolutionary function of this selection pressure remains the same as it ever was: to cull mothers and babies. Professor Dietz's main research interest is in uro‐gynaecology, he has little direct involvement in operative obstetrics. However as a scientific observer, he provides a pragmatic and elegant summary of the dilemma facing practising obstetricians.2
{"title":"Response to letter re: Consent for vaginal delivery","authors":"Rodney W Petersen","doi":"10.1111/ajo.13033","DOIUrl":"https://doi.org/10.1111/ajo.13033","url":null,"abstract":"Dear Editor, I commend the Journal for promoting a discussion on informed consent for vaginal birth, by publishing the two opinion pieces in the December 2018 issue of ANZJOG. The contrasting views of the authors are mirrored by very different styles of presentation. A/Professor Petersen offers an historical and philosophical argument about the selective advantages of natural childbirth.1 It is both off‐target and biologically incorrect. The obvious mistake occurs in the first sentence. I doubt that A/Professor Petersen could provide any evidence that the process of natural childbirth has materially changed over the course of human evolution. After all, it is one of the selection pressures that evolution applies to produce change. Human anatomy may have evolved. Human culture may have evolved. But the evolutionary function of this selection pressure remains the same as it ever was: to cull mothers and babies. Professor Dietz's main research interest is in uro‐gynaecology, he has little direct involvement in operative obstetrics. However as a scientific observer, he provides a pragmatic and elegant summary of the dilemma facing practising obstetricians.2","PeriodicalId":8599,"journal":{"name":"Australian and New Zealand Journal of Obstetrics and Gynaecology","volume":"17 3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89385171","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}
On the 5th of April, this year, the federal health minister announced the Australian government would invest $2.3 million over three years to establish the Australasian Pelvic Floor Procedure Registry (APFPR).1 The objective of the registry is to improve the health outcomes of the tens of thousands of women who undergo pelvic floor reconstructive procedures each year. In 2018, the Australian Senate Community Affairs Reference Committee investigating the number of women in Australia who have had transvaginal mesh implants and related matters2 reported that for many Australian women, there has been significant suffering associated with the complications and long-term effects of pelvic floor mesh. To date, there has been no systematic tracking mechanism for the outcome of these procedures in the short or long term with respect to quality, safety and relative effectiveness. The APFPR will address these systemic deficits in the collection, analysis and reporting of pelvic floor procedures, to establish early warning systems, provide feedback to clinicians, hospitals and ultimately the public regarding the status of pelvic floor interventions which have the potential to provide significant improvements in quality of life.
今年4月5日，联邦卫生部长宣布澳大利亚政府将在三年内投资230万美元建立澳大利亚盆底手术登记处(APFPR)登记的目的是改善每年成千上万接受盆底重建手术的妇女的健康状况。2018年，澳大利亚参议院社区事务参考委员会(Australian Senate Community Affairs Reference Committee)调查了澳大利亚接受经阴道网状物植入的女性人数及相关事宜2，报告称，对于许多澳大利亚女性来说，盆底网状物的并发症和长期影响给她们带来了巨大的痛苦。迄今为止，还没有对这些程序的短期或长期质量、安全性和相对有效性的结果进行系统跟踪的机制。APFPR将解决盆底手术收集、分析和报告中的系统性缺陷，建立早期预警系统，向临床医生、医院和最终公众提供关于盆底干预状态的反馈，这些干预有可能显著改善生活质量。
{"title":"The Australasian Pelvic Floor Procedure Registry: Not before time","authors":"J. O. Daly, S. Ahern, R. Herkes, H. O'Connell","doi":"10.1111/ajo.13030","DOIUrl":"https://doi.org/10.1111/ajo.13030","url":null,"abstract":"On the 5th of April, this year, the federal health minister announced the Australian government would invest $2.3 million over three years to establish the Australasian Pelvic Floor Procedure Registry (APFPR).1 The objective of the registry is to improve the health outcomes of the tens of thousands of women who undergo pelvic floor reconstructive procedures each year. In 2018, the Australian Senate Community Affairs Reference Committee investigating the number of women in Australia who have had transvaginal mesh implants and related matters2 reported that for many Australian women, there has been significant suffering associated with the complications and long-term effects of pelvic floor mesh. To date, there has been no systematic tracking mechanism for the outcome of these procedures in the short or long term with respect to quality, safety and relative effectiveness. The APFPR will address these systemic deficits in the collection, analysis and reporting of pelvic floor procedures, to establish early warning systems, provide feedback to clinicians, hospitals and ultimately the public regarding the status of pelvic floor interventions which have the potential to provide significant improvements in quality of life.","PeriodicalId":8599,"journal":{"name":"Australian and New Zealand Journal of Obstetrics and Gynaecology","volume":"28 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87332190","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}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：