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Journal of obstetrics and gynaecology [journal]
- Evaluation of Propess outcomes for cervical ripening and induction of labour in full-term pregnancy. [JOURNAL ARTICLE]
- J Obstet Gynaecol 2013 Dec 6.
This study was to investigate the efficiency and safety of vaginal Propess as a methodology for cervical ripening and labour induction in full-term pregnant patients. Women at term with a Bishop's score of < 6 and without any contraindications, such as vaginal delivery, prostaglandin and oxytocin in induction of labour, were divided into three groups: oxytocin group (n = 59), intact membranes (Propess I group; n = 58) and natural rupture (Propess R group; n = 52) groups. The main outcome measures, including change in Bishop's score, induction to delivery interval, total delivery time, rate of vaginal delivery, fetal outcome and maternal complications during induction, were recorded. In the Propess groups, the Bishop's score and rate of vaginal delivery were significantly higher while the induction to delivery interval and total delivery time were much shorter, as compared with oxytocin patients (p < 0.01). There were no significantly differences in fetal and maternal outcome during induction between the Propess groups and oxytocin group (p > 0.05). In addition, there were no significantly differences of Bishop's score, rate of vaginal delivery, induction to delivery interval and total delivery time between the Propess I group and Propess R group (p > 0.05). Propess is an effective and safe approach to promote cervical ripening and be successfully used in induction of labour.
- Surgical treatment of late-onset amniotic fluid pulmonary embolism. [JOURNAL ARTICLE]
- J Obstet Gynaecol 2013 Dec 2.
- Impact of unilateral tubal blockage diagnosed by hysterosalpingography on the success rate of treatment with controlled ovarian stimulation and intrauterine insemination. [JOURNAL ARTICLE]
- J Obstet Gynaecol 2013 Dec 2.
The aim of this study was to evaluate the success rates of intrauterine insemination (IUI) in infertile women with unilateral proximal and distal tubal blockage. A total of 161 couples with unilateral tubal blockage and unexplained infertility were included. The primary outcome measure was the cumulative pregnancy rate (CPR). The CPRs after three cycles of IUI were 26.3% (10/38) in patients with unilateral tubal blockage, and 44.7% (55/123) in patients with unexplained infertility (p = 0.043). CPRs were similar in patients with proximal unilateral tubal blockage and unexplained infertility (38.1% vs 44.7%, respectively, p = 0.572). CPR was significantly lower in patients with distal unilateral tubal blockage than in patients with unexplained infertility (11.7% vs 44.7%, respectively, p = 0.01). In conclusion, IVF instead of IUI may be a more appropriate approach for distal unilateral tubal blockage patients.
- Body mass index and labour outcome in Egyptian women. [JOURNAL ARTICLE]
- J Obstet Gynaecol 2013 Dec 2.
We conducted a cross-sectional descriptive study to evaluate the impact of body mass index (BMI) on maternal medical disorders, progress of labour, mode of delivery and neonatal outcome in Cairo University hospital between September 2012 and March 2013. A total of 574 parturients were divided into two groups: group A with a BMI < 30 and group B with a BMI ≥ 30. A statistically significant difference was found in favour of group B, regarding medical disorders, especially gestational hypertension and pre- eclampsia (p < 0.001), caesarean deliveries (p < 0.001) and neonatal birth weight (p = 0.001). There was no difference regarding gestational age at delivery, progress of labour (cervical dilatation, cervical effacement, duration of first and second stage of labour) and neonatal outcome (Apgar score at 1 and 5 min and neonatal deaths). Our conclusion is that increased maternal BMI is associated with an increased incidence of medical disorders during pregnancy, caesarean section rate and fatal macrosomia.
- Reviewers. [Journal Article]
- Aust N Z J Obstet Gynaecol 2013 Dec; 53(6):599-602.
- Uterine necrosis after B-Lynch suture in a classical caesarean section. [Letter]
- Aust N Z J Obstet Gynaecol 2013 Dec; 53(6):595-6.
- Is Colposcopy necessary at twelve months after large loop excision of the transformation zone? A clinical audit. [Journal Article]
- Aust N Z J Obstet Gynaecol 2013 Dec; 53(6):571-3.
The purpose of this study was to review outcomes from LLETZ (large loop excision of the transformation zone) procedures carried out for high-grade cervical intraepithelial neoplasia (CIN), in particular findings at colposcopy, cytology and HR-HPV(high-risk human papilloma virus) result to assess whether colposcopy provides any additional information in the management of women at 12 months.We retrospectively analysed 252 patients who had a LLETZ procedure for a HSIL (high-grade squamous intraepithelial lesion) between January 2005 and December 2010.Eighty per cent of women who had a LLETZ procedure for HSIL were reviewed in our colposcopy clinic at 12 months after the procedure. Colposcopy at 12 months after LLETZ was documented as unsatisfactory for 30% of these women. The sensitivity of colposcopy at 12 months after LLETZ was 0.47, and the specificity was 0.95.Colposcopy examination is an insensitive tool for detection of persisting HPV-related change after excision of high-grade CIN. Its usefulness to investigate persistent or recurrent HSIL is further reduced by the high rate of unsatisfactory colposcopy examinations after a LLETZ procedure. Papanicolaou smear and HRHPV tests may be adequate follow-up at 12 months after LLETZ for women at low risk of recurrence of HSIL.
- The conundrum of eclampsia and fitness to drive. [Journal Article]
- Aust N Z J Obstet Gynaecol 2013 Dec; 53(6):540-3.
Australian Fitness to Drive guidelines suggest that anyone who has had a seizure of any kind in the context of a 'metabolic' disorder should avoid driving for a period of 6 months. The special case of eclampsia is not mentioned.In this study, we aimed to assess what advice healthcare professionals involved in the peripartum care of women provide to women who have an eclamptic seizure, what investigations they would conduct to exclude other causes of seizures and their level of awareness of whether eclampsia was addressed in the Australian Fitness to Drive guidelines.A survey of 165 healthcare professionals attending the 2012 Society of Obstetric Medicine of Australia and New Zealand annual scientific meeting. Participants included registered nurses, midwives, consultant obstetricians, consultant physicians, doctors in training and others, interested in medical disorders of pregnancy.One hundred and nine conference attendees completed the survey (response rate 66.1%). 58 respondents (53.2%) had cared for 5 or more women with peripartum seizures, and 23 respondents (21.1%) had cared for 10 or more women with peripartum seizures. 46 respondents (42.2%) had never considered the issue of driving after an eclamptic seizure. For those who had considered the issue, advice ranged from no restriction (n = 5, 4.6%), no driving for 1-2 weeks (n = 14, 12.8%), no driving for 3 months (n = 20, 18.4%) or no driving for 6 months (n = 6, 5.5%).Many healthcare professionals caring for women with peripartum seizures have not considered issues relating to fitness to drive after an eclamptic seizure. There is a wide range of advice provided. Better prospective data are required regarding the risk of subsequent seizure after eclampsia, to inform clear fitness to drive guidelines.