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pregnancy

The following articles have the tag pregnancy

ADHD linked to antidepressants in pregnancy

ADHD linked to antidepressants in pregnancy

CHILDREN born to women who took antidepressants during pregnancy are more likely to develop attention deficit hyperactivity disorder (ADHD), US research suggests.

Asthma and allergies

Asthma and allergies

Research on early life influences on asthma is a slow slog toward the holy grail of primary prevention of the disease.

Finding new ways to improve care for GDM

Finding new ways to improve care for GDM

A study under way in the Northern Territory may improve care for pregnant women with diabetes.

Delivering a team service for women

Delivering a team service for women

Are there distinct roles for GPs and midwives when it comes to remote area antenatal, perinatal and postnatal care?

Simplicity: key to e-health?

Simplicity: key to e-health?

Most GPs are still waiting for a functional e-health records system, so what lessons can be learned from early failures?

New trisomy tests have limitations: study

RESEARCH has highlighted the limitations of new non-invasive blood tests that detect major trisomies through analysis of cell-free fetal DNA.

Senator defends statement on breast cancer link to abortion

Senator defends statement on breast cancer link to abortion

CABINET minister Eric Abetz says his views on a link between abortion and breast cancer have been misrepresented in media reports, and he was cut off during a Thursday night TV interview.

Prenatal antibiotics safe

THE USE of antibiotics during pregnancy has been associated with asthma in children but the antibiotics themselves may not be the cause, research suggests.

GPs divided on HIV home testing

GPs are divided on the acceptability of home testing for HIV but the majority share the concern that patients will not receive appropriate counselling about results, according to an MO poll.

Pills needed before ‘morning after’?

Pills needed before ‘morning after’?

Question: Would more unplanned pregnancies be prevented if emergency contraception (EC) was available before ‘the morning after’?

Child death rates three times higher in NT

CHILDREN in the Northern Territory are more than three times more likely to die before they turn five than in the southern suburbs of Melbourne, a study shows.

Gaps in good birth control

Gaps in good birth control

Contraceptive use varies by age and culture. Here is an update on women’s choices in Australia.

Morning after pill okay regardless of weight

Morning after pill okay regardless of weight

EMERGENCY contraceptives can continue to be used to prevent unintended pregnancy in women of any weight or BMI, a European Medicines Agency review has concluded.

Cancer drug effective fertility treatment

A DRUG used to treat breast cancer in postmenopausal women may be a more effective fertility treatment for women with polycystic ovary syndrome than clomiphene, a study suggests.

New mothers missing out on diabetes testing

New mothers missing out on diabetes testing

WOMEN with a history of gestational diabetes may be missing out on appropriate testing for type 2 diabetes after they have given birth, according to researchers from Deakin University.

Coroner calls for prostaglandin gel review after death of baby

A CORONER has called for clinical guidelines to state the risk of using prostaglandin gel to induce birth in women who have had a previous uterine perforation, after the death of a baby in South Australia.

Some GPs not recommending flu vax to pregnant patients

Some GPs not recommending flu vax to pregnant patients

ONE-third of GPs do not consider influenza during pregnancy to pose a serious risk to the mother or her baby, an Australian study has found.

Many GPs not recommending flu vax to pregnant patients

Many GPs not recommending flu vax to pregnant patients

ONE-third of GPs do not consider influenza during pregnancy to pose a serious risk to the mother or her baby, an Australian study has found.

Pertussis vax in late pregnancy

QUEENSLAND GPs will be able to offer pregnant women free pertussis vaccination in their third trimester from late July, with at least one other state actively considering the same strategy.

Girl 'cured of HIV' has virus again

AN AMERICAN girl who was thought to have been cleared of HIV has seen her infection return, US scientists say.

Mother of 12 loses discrimination claim against hospital

A VICTORIAN health authority has survived a challenge to its publicly funded home-birth pilot program after a couple sued for discrimination based on the mother’s age and multiparity.

Free pertussis vax for pregnant women

PREGNANT women in Queensland will become the first in Australia to be offered free pertussis vaccinations later this month.

Protecting future fertility

Protecting future fertility

Tough conversations about fertility need to take place with young men diagnosed with cancer.

It takes a village to birth a child

It takes a village to birth a child

The National Review of Maternity Services in 2008 signalled the start of significant reforms and changes for Australian maternity care.

Babies started on antiretrovirals after birth declared HIV-free

THREE HIV-infected babies started on combination antiretroviral therapy (cART) within 24 hours of birth have been declared HIV-free and a fourth has very low levels of the virus, according to the results of a trial to be presented at the AIDS 2014 conference in Melbourne later this month.

Antiepileptic meds safe in breastfeeding

BABIES exposed to antiepileptic medications via breast milk show no signs of developmental delays in childhood, a US study has found.

Curious case of contraception

Curious case of contraception

Long-acting reversible contraceptives have many advantages, so why isn’t uptake higher in Australia?

Better birth outcomes with new GDM international guides

Better birth outcomes with new GDM international guides

NEW international guidelines lowering the diagnostic threshold for gestational diabetes improve pregnancy and birth outcomes and are more cost-effective than traditional criteria, a study has found.

Women need better access to contraception in PNG

Improving access to long-acting reversible contraception (LARC) may enable women in Papua New Guinea to space their babies and reduce maternal mortality, researchers say.

GPs rank meningococcal B vax top priority

GPs rank meningococcal B vax top priority

DESPITE rarely being encountered in clinical practice, many GPs think vaccinating children against meningococcal B should be a high priority but cost and socioeconomic status are significant barriers to initiating discussions about the vaccine with parents.

GPs rank meningococcal B vax top priority

GPs rank meningococcal B vax top priority

DESPITE rarely being encountered in clinical practice, many GPs think vaccinating children against meningococcal B should be a high priority but cost and socioeconomic status are significant barriers to initiating discussions about the vaccine with parents.

Asperger's syndrome

Asperger's syndrome

THIS Update explores the complex clinical presentation of Asperger’s syndrome, using the structure outlined in DSM-5.

Liver enzyme linked to gestational diabetes

A liver enzyme associated with an increased risk of type 2 diabetes also increases the risk of gestational diabetes (GDM) twofold, data show.

Diabetes criteria disparity could confuse

DEBATE on the criteria for diagnosing gestational diabetes (GDM) has re-emerged following the release of new RACGP guidelines for managing type 2 diabetes.

Shorter inter-pregnancy interval linked to preterm birth

SMALLER intervals between pregnancies are associated with increased rates of preterm births and shorter pregnancy durations, a US study has found.

Women putting too much faith in IVF

FERTILITY experts have warned that many Australian women are delaying pregnancy because of a false sense of security about IVF success in their 40s.

One in four pregnancies end in abortion: report

One in four pregnancies end in abortion: report

UNPLANNED pregnancies and contraception are still major issues across Australia with a new report estimating an abortion rate of almost one in four pregnancies.

Breaking out – New role for GPs in acne prescribing?

Breaking out – New role for GPs in acne prescribing?

ISOTRETINOIN is often in the headlines for all the wrong reasons – is it an appropriate drug for GPs to prescribe?

First 12 months not the most likely time for maternal depression

First 12 months not the most likely time for maternal depression

MATERNAL depression is more common at four years postpartum than at any time in the first 12 months, Australian research has found.

Understanding syphilis tests

Understanding syphilis tests

A DIAGNOSIS of syphilis depends on interpretation of a series of test results as well as patient history.

Conjoined twins amaze Australian doctors

Conjoined twins amaze Australian doctors

AUSTRALIAN conjoined twins born with the extremely rare condition diprosopus have amazed doctors after managing to breathe on their own.

Weight may diminish efficacy

Weight may diminish efficacy

QUESTION: Is levonorgestrel efficacy affected by body weight?

Is metformin a safe alternative for GDM?

Is metformin a safe alternative for GDM?

AUSTRALIAN research suggests concern about metformin in pregnancy may be unfounded.

Antipsychotics in pregnancy up postnatal risks

MOOD stabilisers and high doses of antipsychotics taken during pregnancy increase the likelihood of babies requiring specialist care following delivery, an Australian study has found.

Antidepressants linked to preterm birth

USING antidepressants during pregnancy increases the risk of preterm birth, particularly when taken in the third trimester when the risk is almost doubled, a meta-analysis shows.

Antenatal exposure and autism

Antenatal exposure and autism

THE pathogenesis of autism remains unknown, but will new data provide fresh impetus to look for an environmental trigger?

Avoid sushi, soft cheese — and TV

Avoid sushi, soft cheese — and TV

PREGNANT women who watch television while they are eating may, unwittingly, be putting their unborn child at risk of future obesity.

Perinatal anxiety and depression

Perinatal anxiety and depression

THIS Update discusses the common, and often underdiagnosed and undertreated, perinatal mental health disorders of anxiety and depression.

Finding relief from fibroids

Finding relief from fibroids

SYMPTOMATIC relief from fibroids can often be achieved with minimally invasive treatments.

Low-level drinking harm in pregnancy not clear

GUIDELINES on drinking during pregnancy overemphasise the dangers of low-level alcohol consumption, according to a letter to the Medical Journal of Australia.

Is magnesium mandated for cramps?

Is magnesium mandated for cramps?

QUESTION: Does the evidence support using magnesium for leg cramps?

Coffee to fix your health?

Coffee to fix your health?

RESEARCH on the effects of caffeine can appear contradictory, so what is the best advice for health?

Obesity giving rise to pregnancy hypertension

AN INCREASING number of women will suffer the complications of chronic hypertension in pregnancy as conception continues to be delayed and the obesity epidemic worsens, a study has warned.

GP sued for failing to detect pregnancy

A WOMAN who was 48 when she gave birth to a boy with Down syndrome has successfully sued her GP for not detecting her pregnancy.

Acellular pertussis vax wanes drastically

Acellular pertussis vax wanes drastically

THE acellular pertussis vaccine effectively protects children against severe forms of whooping cough but its effectiveness rapidly declines from two years after the last dose, Queensland research has confirmed.

Indigenous 5-year-old girl diagnosed with type 2 diabetes

A FIVE-year-old Indigenous girl from a remote community in Far North Queensland has been diagnosed with type 2 diabetes, according to a case report in The Lancet.

Preconception aspirin increases live birth rates

Preconception aspirin increases live birth rates

A DAILY low dose of aspirin started before conception does not appear to prevent pregnancy loss in women who experienced one or two previous pregnancy losses.

Losing baby weight within a year is optimal: study

Losing baby weight within a year is optimal: study

WOMEN who gain weight in the year after childbirth develop an adverse cardiometabolic profile compared to those who shed even a small amount of their excess ‘baby weight’, a study shows.

Pertussis vax reach: cocooning touted

Pertussis vax reach: cocooning touted

PERTUSSIS vaccination should be federally funded for pregnant women, fathers, grandparents and siblings as part of an immunisation strategy overhaul to prevent whooping cough epidemics in newborns.

Iron deficiency anaemia

Iron deficiency anaemia

IN THIS Update we discuss the common and potentially underdiagnosed condition of iron deficiency anaemia (IDA). The diagnostic pathway for IDA is discussed and the medications available in Australia to treat this condition are listed.

Pertussis vax overhaul to fund cocooning touted

Pertussis vax overhaul to fund cocooning touted

PERTUSSIS vaccination should be federally funded for pregnant women, fathers, grandparents and siblings as part of an immunisation strategy overhaul to prevent whooping cough epidemics in newborns, a conference has been told.

Increased iodine awareness needed in pregnancy

DOCTORS may need to take a more proactive role in raising awareness of the need for increased iodine in pregnancy, Australian researchers say.

Women being left out of antenatal decisions

Women being left out of antenatal decisions

ONE in 10 women who deliver their baby by caesarean section say they are not consulted about the risks and benefits of the surgery and 60% say they are not informed of the risks and benefits of a vaginal examination during pregnancy and labour, Queensland research has found.

Bronchiolitis risk increased by folic acid supplements

Bronchiolitis risk increased by folic acid supplements

FOLIC acid supplementation during pregnancy may increase the risk of offspring developing viral bronchiolitis, researchers say.

Exercise bike improves glucose levels in GDM

HOME-based exercise bike training for women with GDM reduces postprandial glucose levels, an Australian study shows.

Exposure risk

Exposure risk

TIPS for a timely primary care response when a patient needs post-exposure prophylaxis.

GDM risk linked to low sex hormones

LOWER levels of sex hormone-binding globulin (SHBG) before pregnancy have been associated with an increased risk of gestational diabetes mellitus (GDM), a study has shown.

New DNA test may become primary trisomy screen tool

New DNA test may become primary trisomy screen tool

TESTING of cell-free fetal DNA in maternal plasma is likely to become the primary screen for chromosomal abnormalities, according to the UK Royal College of Obstetricians and Gynaecologists (RCOG).

Perinatal practicalities for new mums

Perinatal practicalities for new mums

BEING pregnant and then having a newborn baby is an unbelievably special time – but it can also be quite overwhelming.

Travel health for GPs

Travel health for GPs

THIS Update outlines a stepwise plan to assist GPs with the evaluation of patients planning to travel and will guide the GP through the evaluation and referral process.

Baby HIV free after immediate treatment

A BABY treated for HIV within hours of birth is free of the virus nearly a year later, in the second case that has raised hopes about early treatment, doctors say.

Preterm delivery more likely on Western diet

Preterm delivery more likely on Western diet

EATING healthy foods during pregnancy may be more important than steering clear of junk food when it comes to the risk of preterm delivery, researchers from Norway have found.

Class action touted over combined oral contraceptives

MORE than 800 women have registered their interest in taking part in a class action against Bayer over combined oral contraceptives Yaz and Yasmin (drospirenone/ethinyloestradiol).

Reproduction under supervision

Reproduction under supervision

RESEARCH is under way to determine a link between assisted reproductive therapies and birth defects.

Tackling obesity on a genetic level could be key to reducing weight

ADDRESSING social inequality and modifying behaviours that may influence gene activity could have a greater effect on reducing obesity than diet and lifestyle interventions alone.

Paracetamol in pregnancy linked to ADHD

Paracetamol in pregnancy linked to ADHD

PREGNANT women who take paracetamol may increase the risk of their children developing ADHD, a study of Danish mothers has suggested.

Nuchal translucency still valid for Down’s

Nuchal translucency still valid for Down’s

AUSTRALIAN experts have warned that a new non-invasive blood test for detecting aneuploidy should not replace nuchal translucency (NT) screening for women with low-risk pregnancies.

Fertility – No quick fix for ageing

Fertility – No quick fix for ageing

PATIENTS' knowledge about the negative impact of age on fertility and pregnancy health is inadequate.

Study finds chubby bubby fat forever

BABIES with a hearty appetite may, unwittingly, be on the path to adult obesity, a twin study from the UK has found.

Quitting for a better life

Quitting for a better life

CONQUERING the nuances involved in smoking cessation contributes to a healthier community.

Pregnant Australian women sending blood abroad for Down's test

Pregnant Australian women sending blood abroad for Down's test

AN INCREASING number of pregnant Australian women are asking their doctors to send their blood samples overseas for the latest Down syndrome test.

Big-appetite babies could become obese adults

Big-appetite babies could become obese adults

BABIES with a hearty appetite may, unwittingly, be on the path to adult obesity, a twin study from the UK has found.

Midwife care reduces costs, complications

Midwife care reduces costs, complications

WOMEN who see the same midwife throughout pregnancy undergo fewer interventions and cost the health system significantly less than those who receive standard antenatal care or private obstetric care, a study of patients attending the Royal Hospital for Women in Sydney has found.

Contraception: finding the right fit

Contraception: finding the right fit

THE ability to control one’s fertility, avoid unintended pregnancy and to space children, if desired, is a fundamental right.

Mobile phone use safe, investigation concludes

Mobile phone use safe, investigation concludes

MOBILE phone use poses no risk to health, an 11-year investigation has concluded.

Caseload midwifery costs less and involves fewer complications

WOMEN who see the same midwife throughout pregnancy undergo fewer interventions and cost the health system significantly less than those who receive standard shared antenatal care or private obstetric care, a study of patients attending the Royal Hospital for Women in Sydney has found.

Laws are to protect, not add risk

Laws are to protect, not add risk

THE Crimes Amendment (Zoe’s Law) Bill 2013 (No 2) passed in the lower house of the NSW parliament on 21 November 2013. It was prompted by a woman’s 36 week stillbirth when hit by a car.

Tougher genital mutilation laws

Tougher genital mutilation laws

IN THE wake of tougher penalties in NSW for female genital mutilation (FGM), GPs and health professionals should be aware of their duty to report such crimes, a law expert has warned.

Tougher genital mutilation laws

IN THE wake of tougher penalties in NSW for female genital mutilation (FGM), GPs and health professionals should be aware of their duty to report such crimes, a law expert has warned.

New gender-specific guidelines target stroke prevention in women

LOW-DOSE aspirin or calcium supplement therapy should be considered for women with a history of high blood pressure before pregnancy to reduce the risk of pre-eclampsia, according to the first gender-specific guidelines for preventing stroke in women.

High rates of risky drinking in pregnancy: study

FEWER than one in five women abstain from alcohol when they become pregnant, and most women (46%) continue with risky drinking, an Australian study suggests.

Premature birth ‘hikes asthma risk’

Premature birth ‘hikes asthma risk’

BEING born prematurely may triple a baby's risk of developing childhood asthma, research has shown.

Experts claim IVF used too early

Experts claim IVF used too early

TOO many couples are being offered early non-evidence-based access to IVF for unexplained infertility, a group of experts has warned.

Experts claim IVF used too early

Experts claim IVF used too early

TOO many couples are being offered early non-evidence based access to IVF for unexplained infertility, a group of experts has warned.

Most pregnant women continue drinking: study

Most pregnant women continue drinking: study

FEWER than one in five women completely abstain from alcohol when they become pregnant, and most women (46%) continue with risky drinking, an Australian study suggests.

Premature birth 'hikes asthma risk'

Premature birth 'hikes asthma risk'

BEING born prematurely can triple a baby's risk of developing childhood asthma, research has shown.

Maternal stress link to child autism, ADHD

PRE- and postnatal maternal stress does not increase the risk of major psychological outcomes but may be linked to ADHD and autism spectrum disorders (ASD) in children, research shows.

New Down syndrome test could improve detection and reduce invasive procedures

A NEW, non-invasive test for Down syndrome in unborn babies could significantly increase detection rates if it was available to all expectant mothers, according to a new study.

Women’s abortion rights will not be reduced: Vic govt

THE Victorian government has ruled out supporting any legislation likely to reduce women’s abortion rights, following controversy over doctors’ ability to exercise conscientious objections to the procedure.

A healthy change

A healthy change

THE summer break is often a time of reflection and resolutions. For these GPs, making the move to a regional hub has proved a boon to family and work.

Diabetes risk higher in women with PCOS

Diabetes risk higher in women with PCOS

IMPROVED diagnosis of polycystic ovary syndrome important to reduce type 2 diabetes.

Obesity, age linked to delayed lactation

Obesity, age linked to delayed lactation

PRE-PREGNANCY obesity and older maternal age are among the risk factors for delayed lactation in women with gestational diabetes, a US study has suggested.

Miscarriage higher in women with diabetes

ABOUT 20% of pregnancies in patients with diabetes end in spontaneous loss, which is much higher than the rates in women without diabetes, a UK general practice study shows.

GPs still needed during pregnancy

GPs still needed during pregnancy

IN MANY countries the role of GPs in obstetrics has been taken over by specialists and midwives.

Abortion choice for all, doctors too

Abortion choice for all, doctors too

AS A general practitioner and mentor for many years, I have always supported the right of a doctor to be guided by his or her own conscience in terms of the services offered to patients.

Examining the young infant – Part one

Examining the young infant – Part one

THIS Update is the first in a two-part series and focuses on general examination and the head.

A load of hot air or do e-cigs have merit?

A load of hot air or do e-cigs have merit?

ARE e-cigarettes a useful method to boost smoking quit rates or a clever marketing ploy?

Experts back greater use of IUDs, implants

FAMILY planning experts are calling for increased prescribing of long-acting reversible contraceptives (LARCs) to cut unintended pregnancy and abortion rates.

Gestational weight gain may increase risk of autism

Gestational weight gain may increase risk of autism

AUTISM spectrum disorder (ASD) in children has been linked to maternal weight gain in pregnancy in a case-control study.

Gestational weight gain may increase risk of autism

AUTISM spectrum disorder (ASD) in children has been linked to maternal weight gain in pregnancy in a case-control study.

Investigating developmental delay

Investigating developmental delay

ASTUTELY investigating any sign of developmental delay may help parents access assistance.

I’ll face deregistration and follow my conscience: GP

I’ll face deregistration and follow my conscience: GP

THE Melbourne GP under investigation for refusing to refer a woman requesting an abortion at 19 weeks due to the fetus’s gender is prepared to be deregistered over his right to follow his conscience.

Use long-acting contraception first: expert

Use long-acting contraception first: expert

LONG-ACTING reversible contraceptives (LARCs) improve long-term continuation rates, research shows, and should be recommended to all women regardless of age, according to an expert.

Women need to protect their hearts

Women need to protect their hearts

DOUBLE jeopardy: Women underestimate heart risk and doctors may miss an atypical presentation.

Another pregnant asylum seeker sent to Nauru

Another pregnant asylum seeker sent to Nauru

A SECOND pregnant asylum seeker, who is expecting twins, has been sent by the federal government to Nauru’s immigration detention centre, the United Nation's refugee agency has said.

GP may be struck off after objecting to abortion

A MELBOURNE GP may be stripped of his medical licence after he refused to give a couple an abortion because they only wanted to have a boy.

PID: Difficulties in diagnosis

PID: Difficulties in diagnosis

FIVE things to know about identifying and managing pelvic inflammatory disease.

Female urinary incontinence

Female urinary incontinence

THIS Update looks at the aetiology, assessment and management of urinary incontinence.

GPs advise antenatal flu shots

GPs advise antenatal flu shots

WOMEN receiving antenatal care from a GP are more than twice as likely to receive the influenza vaccine during pregnancy compared to those cared for in a public hospital, a study has shown.

Pregnant woman develops sertraline-induced hepatitis

Pregnant woman develops sertraline-induced hepatitis

A RARE case of sertraline-induced hepatitis has been reported by specialists at Monash Medical Centre.

Asthma in pregnancy concern

Asthma in pregnancy concern

REGULAR monitoring of pregnant women with asthma dramatically reduces the risk of bronchiolitis in their babies, research from the Hunter Medical Research Institute has found.

D&C may increase risk of preterms

D&C may increase risk of preterms

PREVIOUS pregnancy loss managed by dilation and curettage (D&C) increases the risk of preterm birth compared with medical management, new data suggests.

Sperm tales: Infertility issues

Sperm tales: Infertility issues

WHAT to look for when ordering semen analysis for the man with infertility issues.

Asthma control in pregnancy reduces bronchiolitis risk

Asthma control in pregnancy reduces bronchiolitis risk

REGULAR monitoring of pregnant women with asthma dramatically reduces the risk of bronchiolitis in their babies, research from the Hunter Medical Research Institute has found.

Costs cut with continuity of midwife care

Costs cut with continuity of midwife care

WOMEN who see the same midwife throughout pregnancy are more likely to experience an unassisted vaginal birth and cost the health system less than women in standard shared antenatal care, a study has found.

Costs cut by continuity of midwife care

Costs cut by continuity of midwife care

WOMEN who see the same midwife throughout pregnancy are more likely to experience an unassisted vaginal birth and cost the health system less than women in standard shared antenatal care, a study has found.

Milk may have long-lasting growth promoting effect

Milk may have long-lasting growth promoting effect

PREGNANT women who drink one or two glasses of milk per day are likely to have slightly longer and heavier babies who grow into taller adults, a study suggests.

Half of pregnant women lacking iodine

Half of pregnant women lacking iodine

ONLY 50% of pregnant women in Australia are aware they need to take iodine supplements during pregnancy, an expert has warned.

Aust women missing out on LARCs

Aust women missing out on LARCs

TOO many Australians are having unwanted pregnancies, says a leading gynaecologist who believes women are missing out on the benefits of long-acting reversible contraceptives (LARCs).

Mum and dad-to-be Vali and Dean

Pregnancy from grafted ovarian tissue

AUSTRALIAN doctors have achieved a world first by helping a woman become pregnant from ovarian tissue grafted into her abdomen.

Moderate topical corticosteroid use safe in pregnancy

Moderate topical corticosteroid use safe in pregnancy

WOMEN can be reassured that moderate use of topical corticosteroids in pregnancy is not associated with poor birth outcomes, UK researchers say.

Gonorrhoea and chlamydia increase risk of preterm birth

Gonorrhoea and chlamydia increase risk of preterm birth

INFECTION with chlamydia and gonorrhoea preconception or antenatally increases the risk of pregnancy complications, research shows.

Sleep disorders – A broader perspective

Sleep disorders – A broader perspective

THIS Update looks at common sleep disorders and discusses their management.

Gonorrhoea and chlamydia increase risk of preterm birth

INFECTION with chlamydia and gonorrhoea preconception or antenatally increases the risk of pregnancy complications, research shows.

Pregnancy from grafted ovarian tissue a world first

Pregnancy from grafted ovarian tissue a world first

AUSTRALIAN doctors have achieved a world first by helping a woman become pregnant from ovarian tissue grafted into her abdomen.

Breast disease risk linked to alcohol prior to pregnancy

Breast disease risk linked to alcohol prior to pregnancy

YOUNG women who drink alcohol prior to their first pregnancy may be raising their risk of breast disease, irrespective of later alcohol consumption, a study shows.

Drinking during pregnancy declines

ALCOHOL consumption during pregnancy has fallen dramatically in the past five years, an Australian study has found.

Benefits of long-acting contraceptives being ignored

TOO many Australians are getting pregnant by mistake, says a leading gynaecologist who believes women are missing out on the benefits of long-acting contraceptives.

IVF success drops dramatically after five attempts

IVF success drops dramatically after five attempts

ONE in two women aged under 35 will be rewarded with a baby if they persevere with assisted fertilisation attempts, but success rates vary widely by centre, according to a groundbreaking study.

Processed food linked to poorer mental health

Processed food linked to poorer mental health

THE shift to more high-energy, low-nutrition foods marketed by the processed food industry may be contributing to poorer mental health, an Australian researcher says.

Expert slams midwife study

Expert slams midwife study

MANY of the advantages of GP-led antenatal care have been ignored in research claiming midwife-led care leads to better outcomes for most women, according to an expert.

Heatwaves linked to preterm births

PREGNANT women are up to twice as likely to have a preterm birth if they have been exposed to heatwaves in the last weeks of pregnancy, Australian research shows.

Obstetrician reprimanded after fatal outcome of botched surgery

A COUNTRY obstetrician and gynaecologist who caused catastrophic trauma to a patient's right iliac artery and vein during laparoscopic surgery – leading to the woman’s death – has been formally reprimanded, had restrictions put on his future practice and been ordered to undertake further training.

Prenatal smoking and problematic offspring

WOMEN who smoke during pregnancy increase the risk of their children having conduct problems, an effect that is independent of the child-rearing environment, a UK study shows.

Curious parasitic worm

Curious parasitic worm

BE ALERT to variable signs of Strongyloides.

Health must be central in all govt policy: AMA

Health must be central in all govt policy: AMA

THE AMA has called for a dramatic shift in government approaches to health, saying it is linked to every aspect of life and must be included as a central feature in every policy.

Asthma in pregnancy disease link

Asthma in pregnancy disease link

NEW research shows children whose mothers had asthma during pregnancy have a high risk of several diseases, but an expert has warned that treatment should not be stopped as a result of the finding.

Pregnancy duration can vary by up to five weeks: study

Pregnancy duration can vary by up to five weeks: study

SO MUCH for nine months! Researchers have calculated the length of a healthy human pregnancy can vary naturally by as much as five weeks.

Natural conception high after ART

Natural conception high after ART

A THIRD of women who conceive using assisted reproductive technology (ART) fall pregnant again naturally within two years, Australian research has found.

Pre-pregnancy plans can help with diabetes

Pre-pregnancy plans can help with diabetes

DIABETES control in the first trimester of pregnancy is critical.

Exploring adolescent issues

Exploring adolescent issues

THIS Update discusses issues that arise in adolescence.

GDM diagnosing criteria lowered

GDM diagnosing criteria lowered

CONSENSUS on lowering the criteria for diagnosing gestational diabetes (GDM) was finally reached last week by obstetrics and endocrinology groups.

Stronger laws on sterilisation

Stronger laws on sterilisation

A SENATE committee has recommended stronger protection for people with disabilities against sterilisation without informed consent but has stopped short of an outright ban on the practice.

Stronger laws on forced sterilisation

A SENATE committee has recommended stronger protection for people with disabilities against sterilisation without informed consent but has stopped short of an outright ban on the practice.

Doctor slams AVN for inaccuracies on anti-D

Doctor slams AVN for inaccuracies on anti-D

A PAEDIATRICIAN has reported the Australian Vaccination Network to the NSW HCCC after its Facebook site posted allegedly misleading information about anti-D prophylaxis.

Soft drinks prelude to metabolic risk

ADOLESCENTS who drink more than one soft drink a day have a greater cardiometabolic risk than those who drink less soft drink, new Australian data shows.

Delivering partner therapy

Delivering partner therapy

BEYOND contact tracing: the pros and cons of scripts for partners.

Sildenafil may aid fetal growth

A GROUND-breaking clinical trial in Australia and New Zealand is set to give pregnant women sildenafil (Viagra) in a bid to enhance fetal growth.

Exclude cancer in scalp nodule

Exclude cancer in scalp nodule

ANY rapidly growing nodule in a bare scalp is a skin cancer until proven otherwise, but this one was occurring in a younger, pregnant female with a good head of hair.

Doctor slams AVN for inaccuracies on anti-D injections

Doctor slams AVN for inaccuracies on anti-D injections

A PAEDIATRICIAN has reported the Australian Vaccination Network to the NSW HCCC after its Facebook site posted misleading information about anti-D prophylaxis.

Govt to fund medical abortions

MEDICAL abortion will be funded by the government as of 1 August, Health Minister Tanya Plibersek has announced.

Overactive bladder linked to GDM

WOMEN with a history of gestational diabetes mellitus (GDM) are twice as likely to have an overactive bladder compared with women without GDM, data show.

Govt to fund medical abortion

MEDICAL abortion will be funded by the government as of 1 August, Health Minister Tanya Plibersek has announced.

Mumps spike prompts adult immunity check

Mumps spike prompts adult immunity check

A SPIKE in mumps cases in NSW has prompted a call for young adults to check their immunisation status, particularly before overseas travel.

Vulval rashes

Vulval rashes

This Update will discuss the presentation of vulval rashes and guidelines for management.

Pertussis vax acceptable in pregnancy

THE vast majority of Australian women (80%) would follow a recommendation to have the pertussis vaccine during pregnancy, research reveals.

Pertussis plan: give vaccine in pregnancy

Pertussis plan: give vaccine in pregnancy

THE vast majority of Australian women (80%) would follow a recommendation to have the pertussis vaccine during pregnancy, research reveals.

Fetal DNA a complementary Down’s test

Fetal DNA a complementary Down’s test

CELL-FREE fetal DNA testing to screen for Down syndrome has a lower false positive rate than existing screening, new data shows, but experts say it will complement rather than replace combined screening.

Low uptake of chlamydia screening

Low uptake of chlamydia screening

FEW obstetrics and gynaecology specialists are screening young pregnant women for chlamydia as recommended by Australian guidelines, new data shows.

Safe prescribing in pregnancy needs more evidence

Safe prescribing in pregnancy needs more evidence

NOW more than ever, data is needed on drug effects and optimum dosages in pregnant women, experts say.

Study favours pertussis vax in pregnancy

Study favours pertussis vax in pregnancy

AUSTRALIAN experts say pertussis vaccination in pregnancy is likely to be more effective than postpartum vaccination, despite a lack of real world data.

Experts warn to be alert and alarmed at risks in pregnancy

PREGNANT women have been advised to adopt a ‘safety first’ policy to minimise the harm to their unborn child from chemical exposure.

Perinatal mood disorder linked to partner violence

Perinatal mood disorder linked to partner violence

WOMEN with high levels of perinatal anxiety or depression are three times as likely as other women to have experienced partner violence during their pregnancy, researchers have found.

Which diet is best for gestational diabetes?

Which diet is best for gestational diabetes?

HOW important is a low GI diet in women with gestational diabetes?

Joint hypermobility syndrome

Joint hypermobility syndrome

THIS Update looks at how to recognise joint hypermobility syndrome and outlines an approach to management.

Neonatal abstinence syndrome

Neonatal abstinence syndrome

This Update looks at the issues surrounding withdrawal from opiates in the neonate.

Fertility reduced minimally post caesarean section

Fertility reduced minimally post caesarean section

CAESAREAN section marginally reduces fertility, researchers have found after a systematic review covering more than half a million women.

Risk of bipolar rises after exposure to maternal flu

Risk of bipolar rises after exposure to maternal flu

MATERNAL influenza confers a nearly four-fold increased risk of bipolar disorder in adult offspring, a study shows.

Risk of bipolar rises after exposure to maternal flu

Risk of bipolar rises after exposure to maternal flu

MATERNAL influenza confers a nearly four-fold increased risk of bipolar disorder in adult offspring, a study shows.

Insulin requirement not affected by low carb diet in GDM

PUTTING pregnant women with gestational diabetes mellitus (GDM) on a low carbohydrate diet doesn’t reduce their chances of needing insulin during the pregnancy, new data shows.

An irritating, recurring itch

An irritating, recurring itch

VULVAL pruritus is a common symptom resulting from infectious or noninfectious causes.

Fetal DNA testing not yet routine

Fetal DNA testing not yet routine

QUESTION: What is the clinical utility of testing for fetal DNA in maternal blood to detect Down syndrome?

A rare infertility disorder

A rare infertility disorder

ASHERMAN’S syndrome: an acquired disorder with consequences for fertility.

Pregnancy Pap smear queried

THE UK’s Royal College of Obstetricians and Gynaecologists (RCOG) has recommended women recalled for a routine Pap smear while pregnant should delay the test until after the birth.

Many women delay sex postpartum

Many women delay sex postpartum

MOST women do not resume sexual intercourse until more than six weeks following a vaginal birth, and women who had caesarean section or other interventions tend to take longer, an Australian study shows.

US rejects new international diagnostic criteria for gestational diabetes

US rejects new international diagnostic criteria for gestational diabetes

CONSENSUS in Australia on controversial new international diagnostic criteria for gestational diabetes has been further delayed after a US expert committee rejected the proposed changes.

Caffeine link to low birthweight

Caffeine link to low birthweight

CAFFEINE intake has been linked to prolonged pregnancy and low birthweight babies in a study of nearly 60,000 women.

Folate reduces autism, Asperger’s risk

NEW evidence has emerged of the benefits of folic acid supplementation early in pregnancy, with Norwegian researchers linking it to a nearly 40% reduced risk of autism.

Early folate supplementation in pregnancy linked to lower risk of autism

Early folate supplementation in pregnancy linked to lower risk of autism

RESEARCHERS have linked folic acid supplementation in early gestation to a reduced risk of autism.

Vulval itch that isn’t thrush

Vulval itch that isn’t thrush

The diagnoses and treatment of lichen sclerosus in women.

First-time mums older but caesarean rates plateau

First-time mums older but caesarean rates plateau

THE average age at which women have their first child continues to rise, but the rate of caesarean sections appears to have plateaued, according to a report from the Australian Institute of Health and Welfare (AIHW).

NSAIDs appear safe in pregnancy

ANTENATAL NSAID exposure does not appear to increase the risk of persistent pulmonary hypertension of newborns (PPHN), according to the biggest study yet to look at the issue.

Best of 2012: Top 20 apps for GPs

With tens of thousands of medical apps now available, anyone can have excellent clinical, consumer and business tools at their fingertips. Here are the top 20 most recommended for GPs.

Low rates of contraception with teratogenic drug use

Low rates of contraception with teratogenic drug use

GPs have been warned to advise women with diabetes who are of childbearing age about the risks of potentially teratogenic drugs, after a study revealed low rates of contraceptive use in patients at risk.

Study backs pertussis vax in late stage of pregnancy

Study backs pertussis vax in late stage of pregnancy

THE first study of its kind to evaluate pertussis immunisation strategies among US women backs vaccination late in pregnancy to protect infants.

Chronic health conditions and childbearing

Chronic health conditions and childbearing

Women with a chronic illness need to know the implications of their condition and treatment on their reproductive capacity.

Caution over SSRI use in infertility and pregnancy

Caution over SSRI use in infertility and pregnancy

PRESCRIBING SSRIs in pregnancy and for women struggling with infertility is fraught with risk, researchers say after a literature review.

Fertility often ignored in chronic disease

Fertility often ignored in chronic disease

Women with chronic non-communicable disease have concerns about their fertility that aren’t being addressed, according to an Australian study.

Metformin in pregnancy linked to heavier children

INTRAUTERINE metformin exposure may have long-term effects on a child’s weight, according to a study.

Metformin use in pregnancy linked to heavier children

INTRAUTERINE metformin exposure may have long-term effects on a child’s weight, according to a study.

Sex steroid hormones throughout the female lifespan

Sex steroid hormones throughout the female lifespan

Ovarian ageing in women is associated with key hormonal and clinical manifestations from menarche until late postmenopausal years.

Australia lags behind on antenatal pertussis vax

Australia lags behind on antenatal pertussis vax

A STRONG national recommendation on vaccination of pregnant women against pertussis would benefit Australia, according to experts, as the UK moves to implement a temporary program.

Pregnancy risks double in prem mums

Pregnancy risks double in prem mums

WOMEN born premature are almost twice as likely to have pregnancy complications as those born at term, a study shows.

Vegetarian diet - a fresh look

Vegetarian diet - a fresh look

The key to obtaining health benefits from a vegetarian diet is good knowledge and planning.

GDM raises risk of postpartum incontinence

WOMEN with gestational diabetes (GDM) are more likely than other women to experience urinary incontinence after they give birth, according to a longitudinal cohort study.

Cancer in pregnancy on the rise, but researchers unsure why

Cancer in pregnancy on the rise, but researchers unsure why

THE rate of pregnancy-associated cancer is rising, according to a new Australian study.

Diet quality deteriorates in overweight and obese pregnant women

Diet quality deteriorates in overweight and obese pregnant women

QUALITY of diet in overweight and obese pregnant women in Australia decreases throughout pregnancy and is maintained at a poor level in the early post-partum period, new research reveals.

Contraception for young people

Contraception for young people

A contraception request is the second most common general practice presentation for females aged 14–17 years.

Unregistered midwives need tighter controls

NO WOMAN planning a high risk home birth should be “frogmarched” to hospital, but unregistered midwives who fail to follow professional guidelines must face consequences, a senior obstetrician has warned.

Most pregnant women unprotected against flu

FEWER than one third of pregnant women countrywide are receiving the seasonal flu vaccine, according to a public health expert.

At-risk and pregnant urged to get flu vaccine

At-risk and pregnant urged to get flu vaccine

HEALTH authorities in NSW and Queensland are warning a new strain of flu will likely circulate this winter and they are urging at-risk groups to get vaccinated.

Medication information at your finger tips

iMims by MIMS Australia is set to revolutionise the way you practise medicine by providing vital information about Australian-approved medications at your fingertips.

Making healthy babies

Making healthy babies

Preconception planning can address a number of fertility factors, writes Dr Karin Hammarberg.

Counting calories benefits obese pregnant women

Counting calories benefits obese pregnant women

DIETARY interventions for overweight and obese pregnant women are safe and may have the added benefit of reducing complications such as pre-eclampsia, a meta-analysis shows.

Low birth weight linked to potent topical steroids

Low birth weight linked to potent topical steroids

PREGNANT women who use “very potent” topical corticosteroids such as Diprosone OV may be more likely to have low birth weight babies, experts warn.

Weight gain in pregnancy

Weight gain in pregnancy

What are the guidelines and antenatal risks associated with excessive gestational weight gain?

Pregnancy does not alter breast cancer survival

Pregnancy does not alter breast cancer survival

RESEARCHERS have established for the first time that it is safe for women with oestrogen receptor-positive breast cancer to become pregnant.

Pertussis vax in pregnancy may become routine

AUSTRALIAN immunisation experts are considering following the US move to recommend routine vaccination of pregnant women against pertussis.

Fetal growth affected by SSRIs in pregnancy

A STUDY of pregnant women taking SSRIs for depression has found an improvement in their depressive symptoms but reduced fetal head growth and a higher risk for preterm birth in their offspring.

Poor health for early babies

Poor health for early babies

Babies born even a few weeks before full-term may have worse health outcomes than full term babies, according to the first large scale UK research to investigate the issue.

Fetal alcohol spectrum disorder poorly tracked and understood

Fetal alcohol spectrum disorder poorly tracked and understood

CASES of fetal alcohol spectrum disorder (FASD) should be mandatorily recorded, a leading researcher says.

Low vitamin D in pregnancy leads to language impairment in children

Low vitamin D in pregnancy leads to language impairment in children

IN A finding that may spur moves toward routine screening of pregnant women for vitamin D status, Australian researchers have linked low serum 25(OH)-D levels to a two-fold higher risk of language impairment in offspring.

More older mothers as average maternal age hits 30

AUSTRALIAN women continue to delay having babies, with the average maternal age hitting 30 years in official records for the first time.

Pregnant women neglect asthma meds

Pregnant women neglect asthma meds

MANY Australian women opt to not take their asthma medication during pregnancy despite a worsening of their symptoms, a study has found.

Treating asthma in pregnancy can be daunting

Treating asthma in pregnancy can be daunting

THERE is a good understanding by GPs of asthma medication safety in pregnancy but some lack confidence in managing patients whose symptom control deteriorates, an Australian study suggests.

Exercise in PCOS

Exercise in PCOS

PCOS can be a difficult and complex disorder to manage. Lifestyle change incorporating exercise remains the first-line treatment.

A radical solution

There are moves overseas to pay addicts to be sterilised. Shades of Nazism – or just good sense?

Vaccine in pregnancy may prevent pertussis deaths

Vaccination of pregnant women against pertussis may emerge as the most effective response to the recent epidemic, says a leading immunisation expert. Professor Peter McIntyre, director of the National Centre for Immunisation Research & Surveillance (NCIRS), said more research was needed to evaluate cocooning strategies, including immunising pregnant women as recommended this year by the US Advisory Committee on Immunization Practices. “The main issue is, would pregnant women go along with it … and that usually comes down to what their obstetrician or GP recommends,” Professor McIntyre said. “The lack of success at getting women ...

Probiotics lower pre-eclampsia risk

CONSUMING probiotic milk products is associated with reduced risk of pre-eclampsia, a large observational study shows. Women enrolled in a pregnancy cohort study in Norway were questioned about dietary intake, including consumption of milk and yoghurt fortified with probiotics. Among the 33,000-plus pregnant women, 1755 (5.3%) developed pre-eclampsia. The researchers found a daily intake of at least 140 mL of probiotics was associated with a 20% reduced risk of pre-eclampsia, and there was a particularly striking protective effect for severe disease (39% reduced risk). Probiotics may target and modify the type of inflammation underlying severe pre-eclampsia, ...

Exercise and reproduction

Young women need to be encouraged to prioritise regular exercise – for reproductive and general health.

Updated warning on antipsychotics in pregnancy

WARNINGS on the use of antipsychotics during the third trimester of pregnancy are being updated on labels of all drugs in this category, the TGA says. Product information (PI) will now warn about the risk of neonatal extrapyramidal signs (EPS), such as dyskinetic movements, and withdrawal symptoms. Up to May 2011, the TGA had received 19 reports of EPS or withdrawal symptoms in neonates, with an atypical antipsychotic suspected in 18 reports, the regulator said in a Medicines Safety Update. Many cases were confounded by concomitant use of other psychotropic medication, but ...

Diabetes reminder plan ‘over the top’

THE RACGP has criticised a new reminder system for annual screening of women with a history of gestational diabetes as onerous and lacking evidence to support it. The National Gestational Diabetes Register, which came into operation on 1 July, will send a letter to GPs notifying them if their patients have been diagnosed with gestational diabetes mellitus (GDM). GPs will also be sent a reminder 12–16 weeks after the patient gives birth that it is time  to have a glucose tolerance test (GTT), and then an annual letter reminding the GP to do an annual diabetes screen. ...

Perimenopause

Perimenopausal women need advice tailored to their symptoms and situations.

Urinary incontinence: managing a serious issue

Patients can be taught ways to deal with and manage this common problem.

Obesity and reproduction

Introduction THE prevalence of obesity is increasing at alarming rates in Australia. Obesity is associated with increased risk of metabolic complications such as hypertension, dyslipidaemia and insulin resistance (IR). IR is often inextricably linked with ovarian function, leading to clinical reproductive manifestations such as subfertility and polycystic ovary syndrome (PCOS) with these presentations preceding metabolic complications of IR. Reproductive and metabolic health implications Lifestyle-related metabolic diseases are underpinned by inadequate physical activity and excess dietary intake, and often form a continuum of health consequences across the lifespan. Women who are ...

Women’s wellbeing

Women’s wellbeing

Reproductive conditions are associated with mental health issues across the lifespan.

Unplanned pregnancy common in anorexia

UNPLANNED pregnancy is surprisingly common in women with anorexia nervosa, experts say. They believe clinicians may need to explain to women the need for contraception because ovulation may be restored as their bodies respond to treatment. A population-based study has found that about half of the women with anorexia report their pregnancy was unplanned, compared to 19% of women without an eating disorder. After controlling for maternal age and infertility, women with anorexia have double the risk of unplanned pregnancy. And, in the sample of 62,000 women from a joint US-Norwegian cohort study, nearly a ...

Low parvovirus immunity in pregnancy raises fetal risk

UP to half of pregnant women are not immune to parvovirus which is commonly vertically transmitted following infection in pregnancy and may be fatal to the fetus, experts say. According to US researchers, human parvovirus B19 (hPV B19) – also known as ‘slapped cheek’ syndrome or fifth disease – is the most common viral agent causing rashes in children.  They said 30-50% of pregnant women are susceptible to hPV B19. While only a small percentage of those will be infected with the virus, seroconversion increases by more than 10% during epidemics. According to the authors, in ...

Pre-eclampsia: The CVD connection

Pre-eclampsia: The CVD connection

Is pre-eclampsia a one-off event or a signal for future cardiac disease for mothers and children? Leigh Parry asks if we should monitor these groups more closely in later life.

Women and weight gain

Women and weight gain

How do you prevent annual weight gain in women?

Fish oil not protective for PND

WHILE many benefits have been suggested for a diet rich in omega-3 fish oils, Australian researchers say there is no evidence that they reduce the risk of postpartum depression or boost newborns’ cognitive development. The five year double-blind randomised trial of 2399 women found n-3 oils did not reduce depression rates any more than did intake of vegetable oil capsules. They also did not improve cognition or language development in the offspring of users at 18 months of age. The study’s lead author, Maria Makrides, professor of human nutrition at ...

Thousands of women now choosing medical abortion

INCREASING numbers of women are choosing to medically terminate their pregnancies, with more than 2600 using mifepristone in 2009. According to the TGA figures, only 227 women underwent medical abortion in 2008, but now some 81 doctors around Australia are authorised to prescribe mifepristone. The growing preference for  medical abortion with mifepristone (plus misoprostol) has been revealed as a new survey confirms broad support by GPs for women’s right to abortion. The survey of 517 GPs, conducted for abortion provider Marie Stopes International Australia, found 87% felt termination services should be available to all women. ...

Gestational hypertension red flag for later CVD

WOMEN with a history of gestational hypertension are likely to be at increased risk of future cardiovascular disease due to pre-pregnancy risk factors, a study suggests. Drawing on a database of nearly 25,000 women, Norwegian researchers examined risk factors among those experiencing gestational hypertension or pre-eclampsia. They found on average these women had higher BMI, systolic and diastolic blood pressure, as well as elevated cholesterol and triglyceride levels, compared to women with no hypertension in pregnancy. However, after adjusting for pre-pregnancy measurements, the differences were halved, suggest­ing pre-pregnancy risk factors influenced post-pregnancy risk. After adjusting ...

Weight loss between pregnancies may prevent pre-eclampsia

THE RISK of a recurrence of pre-eclampsia may be reduced by weight loss between pregnancies, research suggests. A US study of 17,773 women diagnosed with pre-eclampsia during their first pregnancy found those who decreased their BMI before their second pregnancy had lower rates of pre-eclampsia (12.8%) compared to women who maintained their weight (14.8%) or gained weight (18.5%).  The authors recommended that women with pre-eclampsia should be encouraged to engage in a postpartum weight management program.  “The recommendation to lose weight for all but underweight women before conceiving the next pregnancy can be made with assurance,” ...

Pregnancy attempt safe soon after miscarriage, study says

WOMEN who have a miscarriage can be reassured they do not need to wait before trying to conceive again, new findings confirm. A Scottish study of more than 30,000 women found the best reproductive outcomes following miscarriage were in women who became pregnant again within six months.  Compared to women who conceived after a delay of 6-12 months, those who fell pregnant shortly after miscarriage were less likely to have a repeat miscarriage, a termination or an ectopic pregnancy. Women who waited two years to try again had the highest risk of adverse outcomes. “Our ...

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Iodine and folate in the diet

Just how much iodine and folate do we need, and where can we get it?

Pregnancy breath test a smoking gun?

ALL pregnant women could soon be subjected to carbon monoxide tests to encourage them to kick a smoking habit, BBC News reports. The National Institute for Health and Clinical Excellence (NICE) has called for carbon monoxide tests to be performed on all pregnant women during their first antenatal visit. However, mid­wives have criticised the move, believing the test will make women who are identified as smokers feel guilty.  Commenting on behalf of the Royal College of Midwives, London, education and research manager Sue Macdonald said the “use of the monitor has the potential to make women feel guilty and ...

Psychotropic drug risk in pregnancy

ANALYSIS of adverse drug reactions (ADRs) in very young children has raised fresh concerns about the use of psychotropic medicines in pregnancy. Among 429 psychotropic-related ADR reports over 10 years in Danish children, one in five were in children younger than two years. Reactions included convulsion, feeding disorders, neonatal priapism, apnoea and ventricular septal defects. While some were reported explicitly as “maternal drugs affecting foetus”, many other ADRs were likely also due to mothers’ use of psychotropics as the indications for use included depression and schizophrenia, the researchers said. More than half of the ADRs ...

No cancer legacy from mums’ exposure to mobile phone towers

A MAJOR British study has found no links between cancer in young children and their mothers’ exposure to mobile phone towers during pregnancy. While concerns about living close to towers have been raised due to reported cancer clusters, no systematic epidemiological investigation of prenatal exposure has ever been undertaken, the researchers said. All registered cases of cancer in children aged up to four years in Great Britain from 1999-2001 were assessed for pregnancy exposure to the nearest mobile phone base station. The researchers, from Imperial College London, examined almost 1400 cases of cancer – including leukaemia, ...

Maternal deaths: Why the rise?

Maternal deaths: Why the rise?

Are we about to turn back the clock on decades of improvements in maternal morbidity rates? Caroline Brettingham-Moore looks at a disturbing set of figures in the US and asks if we could be next.

Delivery at 37 to 39 weeks raises the risk of learning difficulties

BABIES delivered before 40 weeks have a greater risk of future learning difficulties, a study shows. While preterm delivery is a known predictor of special educational needs, new research suggests even early “term” birth – at 37 to 39 weeks – increases the risk. Scottish researchers linked school census data with birth data for more than 400,000 children, showing a “dose-dependent” relationship between gestational age at delivery and learning or developmental difficulties. Children born at 37 to 39 weeks had a 16% increased risk for schooling problems compared to those born at term, with risks increasing ...

Adverse birth outcomes linked to rise in antidepressant use

CONCERN is growing over the use of antidepressants in pregnancy, as the list of adverse birth outcomes linked to the drugs continues to lengthen.   A large Australian study has for the first time linked the SSRI citalopram to a significantly increased risk of vesico-ureteric reflux (VUR) in children.   Children born to mothers taking citalopram in the first trimester were eight times as likely to have VUR compared to controls. They were also more likely to be born prematurely, have birth length under 50cm, need resuscitation at birth and to be hospitalized in the first ...

Seatbelt benefits outweigh risks for pregnant women

PREGNANT women may worry that wearing a seatbelt could cause injury to their unborn baby in a collision, but new research suggests they are better off wearing one.  Most studies have focussed on high-impact collisions, where seat belts have been demonstrated to reduce mortality and the severity of injury to occupants, including the fetus.  Japanese researchers, including staff from Honda’s research and development arm, have for the first time examined what happens to pregnant drivers in a low-speed collision, using anthropomorphic dummies.  The tests were designed to represent as closely as possible real-world impact to a ...

Seatbelt benefits outweigh risks for pregnant women

PREGNANT women may worry that wearing a seatbelt could cause injury to their unborn baby in a collision, but new research suggests they are better off wearing one.  Most studies have focussed on high-impact collisions, where seat belts have been demonstrated to reduce mortality and the severity of injury to occupants, including the fetus.  Japanese researchers, including staff from Honda’s research and development arm, have for the first time examined what happens to pregnant drivers in a low-speed collision, using anthropomorphic dummies.  The tests were designed to represent as closely as possible real-world impact to a ...

Gestational diabetes cases set to double

Gestational diabetes cases set to double

GPs could soon be diagnosing and treating substantially more people with gestational diabetes (GDM), under a new proposal to lower the diagnostic thresholds. Australian experts are poised to cautiously back new international criteria,  despite the substantial strain this would place on the healthcare system.  There is potential for the number of cases to double. In March the International Association of Diabetes and Pregnancy Study Groups (IADPSG), said the fasting plasma glucose threshold for GDM should drop to 5.1 mmol/l or higher.  Current Australian and Inter-national Diabetes Federation guidelines recommend a cutpoint of 5.5 mmol/l or ...

Risk of hyperemesis may run in the family, study suggests

Risk of hyperemesis may run in the family, study suggests

WOMEN are three times more likely to experience hyperemesis gravidarum if their mother had also had the condition. Linked generational data from around one million Norwegian births revealed that daughters born after a pregnancy complicated by hyperemesis had a 3% risk of having it during their own pregnancy. This contrasted with 1.1% prevalence in the pregnancies of women whose own gestation was unaffected by hyperemesis. Daughters born in an unaffected pregnancy also had an increased risk themselves if their mother had experienced hyperemesis in a previous or subsequent pregnancy. “The observed pattern of familial clustering suggests that ...

Antenatal SSRIs linked to smaller babies

MOTHERS who take anti-depressants during pregnancy run the risk of premature delivery and of having babies with a low birth weight and size.  An Australian study showed women who took antidepressants had an eight times greater risk of having low birth-weight babies and a more than four-fold increased risk of premature birth. Researchers compared 27 women taking antidepressants with 27 controls, the majority of whom were also depressed. There was no link between maternal depression and birth outcomes. Senior author Anne Buist, professor of women’s mental health at the University of Melbourne, said women needed to ...

Education to increase iodine in pregnancy

A PUBLIC health campaign is required to highlight the need for iodine supplementation in women during pregnancy and lactation. In an article in the MJA, researchers including Professor Creswell Eastman from the International Council for the Control of Iodine Deficiency Disorders say around a third of 18 multivitamins advertised for pregnancy contain no iodine. This was despite the Australian population being officially classified as mildly iodine deficient, they said. The experts described information about iodine supplementation in Australia as ad hoc, and given the cost of supplements, it was likely that many women were not taking ...

Risk of breast cancer death higher in post-partum women

Risk of breast cancer death higher in post-partum women

WOMEN diagnosed with breast cancer in the months after giving birth are at significantly higher risk of death than those diagnosed during pregnancy, Australian research shows. Research Assistant Professor Angela Ives said the study of almost 3000 breast cancer patients in Western Australia underlined the need for suspicious lumps found in pregnancy to be promptly investigated. Professor Ives, an epidemiologist from the University of WA’s Cancer and Palliative Care Research and Evaluation Unit, said the study aimed to find out whether the timing of diagnosis in and around pregnancy affected the prognosis. They found women diagnosed with ...

Start child obesity prevention in pregnancy

THE battle against obesity may need to start during pregnancy, experts believe. Speaking last week at the inaugural Obesity Summit in Sydney, Professor Berit Heitmann of Denmark’s Copenhagen University Hospital, said very few dietary determinants had been identified that caused childhood (or adult) obesity. The few possible exceptions include sugar-sweetened beverages and milk formulas. Instead, there was “increasing evidence that … prevention of childhood obesity may have to start with the pregnant woman,” she said.   “Several studies show that the more weight mothers put on during pregnancy, the higher the risk that the child would be obese ...

IVF: are we strict enough?

IVF: are we strict enough?

Europe is considering tightening access to fertility treatment if applicants don’t make healthy lifestyle changes. Lynnette Hoffman asks if Australia should follow suit.

New gestational diabetes plan divides expert opinion

A BID to lower the thresholds for gestational diabetes mellitus (GDM) could open a “Pandora’s box” by doubling the number of women needing treatment, Australian experts have warned. If adopted, the new criteria would see almost one in five pregnant women diagnosed with GDM, according to Professor Robert Moses, director of diabetes services with the South Eastern Sydney and Illawarra Area Health Service. Intervention rates would likely rise, more babies would be born by caesarean, and healthcare costs would inevitably increase, he said. A new consensus statement from the International Association of Diabetes and Pregnancy Study ...

Early weight gain a red flag for GDM

WOMEN who rapidly put on weight in early pregnancy are more likely to develop gestational diabetes mellitus (GDM) and should be advised to monitor their weight closely, US researchers say. Those gaining more than 0.27 kg a week during the first trimester faced an 82% increased risk of GDM at 24-28 weeks, the study of more than 1000 pregnancies revealed. The link was strongest in women who were overweight or obese to begin with.“Healthcare providers should talk to their patients early in their pregnancy about the appropriate gestational weight gain, especially during the first trimester, and help ...

Hypothyroidism and pregnancy

Hypothyroidism and pregnancy

The aetiology, diagnosis and management of hypothyroidism in pregnant women.

H1N1 vigilance vital in pregnancy

NEW swine flu research has underlined the importance of prompt treatment and timely vaccination of pregnant women, experts say. A study of 211 pregnant women with H1N1 presenting to a Singapore hospital showed admission was more likely with comorbidities or breathlessness. Nine developed complications, including first trimester miscarriage and premature labour. The researchers said the study suggested that the effects of swine flu infection in the cohort were overall “relatively benign”, but they attributed this to early presentation, diagnosis and treatment. Most of these women received oseltamivir within 48 hours. However, in a study ...

Is metoclopramide safe in pregnancy?

WHILE metoclopramide is a widely used antiemetic, there have been few studies to determine if the drug is safe to use in pregnancy.  Although metoclopramide does not have an approved indication, in Israel it is often prescribed  for nausea and vomiting during pregnancy. Israeli researchers have therefore assessed its safety. Data were gathered from women who had 81,703 singleton births in a regional centre between 1998 and 2007. During this period, there were 998 terminations of pregnancy. Metoclopramide had been used by 3458 women in the first trimester of pregnancy. It had also been taken by ...

Facts on fibroids

UTERINE fibroids, leiomyomas or myomas are common benign smooth muscle tumours occurring in up to 70-80% of women by the age of 50. These tumours have a fibrous texture due to high collagen and extracellular matrix content along with myometrial cells – hence the name “fibroids”. They occur during the reproductive years and diminish in the postmenopausal years. They grow under oestrogen and progesterone stimulation but other factors such as the insulin–like growth factors (IGF-II particularly) and factors involving the retinoic acid pathway are also important. TYPES OF FIBROIDS Intramural: ...

Listeriosis warnings renewed for pregnant women

AUSTRALIA’s food regulator has ramped up a campaign to warn pregnant women of the dangers of listeriosis, after a major outbreak occurred last year. Contaminated chicken served to airline passengers last August resulted in eight pregnant women developing listeriosis and three subsequent foetal deaths, Food Standards Australia New Zealand (FSANZ) spokeswoman Lydia Buchtmann said. At the time, it was reported widely that two women went into premature labour and delivered healthy babies. However, listeriosis has a long incubation period, and an OzFoodNet investigation found that 13 passengers became ill after eating chicken wraps served on the ...

Rising rate of caesareans a global trend

WHILE Australia’s rising rate of caesarean delivery is often attributed to the ‘too posh to push’ set, a study of Asian countries has revealed the trend is going global, even in the developing world. A WHO survey of data from nine countries, including Cambodia, China, Nepal, India, Japan and the Philippines, has found that, across 122 health facilities, more than 25% of women underwent a caesarean section. C-section rates were lowest in Japan, the wealthiest nation in the survey, and were highest in China, where 46.2% of deliveries were caesarean. A quarter of the Chinese procedures occurred ...

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