Optic nerve sonography and ophthalmic artery Doppler velocimetry in healthy pregnant women: an Australian cohort study.

Purpose: Maternal ocular sonography offers a window into cerebrovascular and intracranial pressure changes in pregnancy. This study aimed to determine the Doppler velocimetric variables of the ophthalmic artery, and the mean diameter of the optic nerve sheath (ONSD), in an Australian cohort of healthy pregnant women.

Methods: A prospective observational cohort study of healthy women with uncomplicated singleton pregnancies in the third trimester was undertaken in a tertiary maternity service.

Outcomes following antenatal identification of hydrops fetalis: a single-centre experience from 2001 to 2012.

Objective: To describe the aetiologies and outcomes of pregnancies complicated by hydrops fetalis (HF).

Study Design: Case series of all pregnancies complicated by HF managed at The Royal Women's Hospital (RWH), Melbourne, Australia, between 2001 and 2012. Multiple pregnancies, and cases where antenatal care was not provided at RWH were excluded.

Non-Invasive Prenatal Testing for Sex Chromosome Aneuploidy in Routine Clinical Practice.

Objectives: To assess the accuracy of non-invasive prenatal testing (NIPT) for sex chromosome aneuploidy (SCA) in routine clinical practice and to review counselling and sonographic issues arising in SCA cases.

Methods: Three specialist Australian obstetric ultrasound and prenatal diagnosis practices offering NIPT after 10 weeks' gestation participated in this study. NIPT was reported for chromosomes 21, 18, 13, X, and Y.

Chorionic villus sampling in the cell-free DNA aneuploidy screening era: careful selection criteria can maximise the clinical utility of screening and invasive testing.

Objectives: To quantify the impact of cell-free DNA (cfDNA) screening on chorionic villus sampling (CVS) test indications and outcomes in a tertiary maternity service.

Methods: Retrospective cohort study of all CVS procedures performed for any indication on singleton pregnancies at The Royal Women's Hospital, Melbourne, and at Women's Ultrasound Melbourne, Australia, between August 2008 and February 2015. Karyotypes were classified according to pathogenicity and detectability by standard cfDNA screening panels.

Women's opinions on being weighed at routine antenatal visits.

Objective: To assess the opinions of pregnant women regarding their weight gain and to assess the level of satisfaction and anxiety provoked by being weighed in clinic.

Design: Questionnaires were given to women participating in a randomised controlled trial comparing routine weighing in the antenatal clinic with standard care.

Setting: A tertiary hospital antenatal clinic in Melbourne, Australia.

Routine weighing to reduce excessive antenatal weight gain: a randomised controlled trial.

Objective: To assess whether routinely weighing women at each antenatal visit leads to a difference in gestational weight gain and weight gain within the Institute of Medicine (IOM) recommendation.

Design: A randomised controlled trial.

Setting: Antenatal clinics in a tertiary obstetric hospital in Melbourne, Australia.

The effect of iodine supplementation in pregnancy on early childhood neurodevelopment and clinical outcomes: results of an aborted randomised placebo-controlled trial.

Background: Concern that mild iodine deficiency in pregnancy may adversely affect neurodevelopment of offspring has led to recommendations for iodine supplementation in the absence of evidence from randomised controlled trials. The primary objective of the study was to investigate the effect of iodine supplementation during pregnancy on childhood neurodevelopment. Secondary outcomes included pregnancy outcomes, maternal thyroid function and general health.

Contemporary clinical management of the cerebral complications of preeclampsia.

The neurological complications of preeclampsia and eclampsia are responsible for a major proportion of the morbidity and mortality arising from these conditions, for women and their infants alike. This paper outlines the evidence base for contemporary management principles pertaining to the neurological sequelae of preeclampsia, primarily from the maternal perspective, but with consideration of fetal and neonatal aspects as well. It concludes with a discussion regarding future directions in the management of this potentially lethal condition.

Antenatal immunoglobulin for fetal red blood cell alloimmunization.

Background: Red blood cell alloimmunization in pregnancy can lead to fetal anaemia with potentially disastrous consequences. Traditional management involves the use of intrauterine transfusion, which is associated with significant procedure-related risks. An alternative treatment that has been trialled is the use of immunoglobulin administered intravenously to the mother.

Transferring responsibility and accountability in maternity care: clinicians defining their boundaries of practice in relation to clinical handover.

Objective: This exploratory study reports on maternity clinicians' perceptions of transfer of their responsibility and accountability for patients in relation to clinical handover with particular focus transfers of care in birth suite.

Design: A qualitative study of semistructured interviews and focus groups of maternity clinicians was undertaken in 2007. De-indentified data were transcribed and coded using the constant comparative method.

Patients' perceptions of safety and quality of maternity clinical handover.

Background: Maternity clinical handover serves to address the gaps in knowledge existing when transitions between individuals or groups of clinicians occur throughout the antenatal, intra-partum and postnatal period. There are limited published studies on maternity handover and a paucity of information about patients' perceptions of the same. This paper reports postnatal patients' perceptions of how maternity handover contributes to the quality and safety of maternity care.

Managing back pain in pregnancy using a support garment: a randomised trial.

Objective: Large population studies have shown that low back pain affects about 50% of pregnant women. The aim of this study was to determine whether the use of the BellyBra in pregnant women with back pain is associated with changes in assessments of pain severity, physical activity and satisfaction with life after 3 weeks of intervention compared with tubigrip, a more generic form of support.

Design: Randomised controlled trial.

Management of undifferentiated embryonal sarcoma of the liver in pregnancy.

Background: Undifferentiated embryonal sarcoma of the liver is a rare mesenchymal neoplasm with a poor prognosis. Most cases occur in children, with few cases reported in adults. Our patient was a woman whose pregnancy was complicated by the recurrence of metastatic undifferentiated embryonal sarcoma of the liver.

Autosomal recessive omodysplasia: early prenatal diagnosis and a possible clue to the gene location.

Autosomal recessive omodysplasia (ARO), a rare congenital skeletal dysplasia, is characterized by micromelia and craniofacial anomalies. Upper and lower limbs are affected in contrast to the dominant form in which the lower limbs are normal. Radiographic features include shortening and distal tapering of the humerus and femur, proximal radioulnar diastasis, and anterolateral radial head dislocation.

Cervical surveillance as an alternative to elective cervical cerclage for pregnancy management of suspected cervical incompetence.

Objective: The aim of the present study was to compare the outcome of pregnancies among patients with suspected cervical incompetence treated either by elective cervical cerclage or an alternative management program involving cervical surveillance.

Design, Setting And Methods: A prospective cohort study was performed in two groups of patients at risk of cervical incompetence with singleton gestations attending the Royal Women's Hospital, Melbourne, Australia, from 1996 to 2000. The first group was managed by their obstetric carers with an elective cerclage, while the second group was managed conservatively as part of a cervical surveillance program offered to patients attending the Department of Perinatal Medicine for pregnancy care.

Differences in learning objectives during the labour ward clinical attachment between medical students and their midwifery preceptors.

Objectives: Midwives have been actively involved in the clinical teaching of medical students for many years. However, this role has received little attention and limited research has been conducted into either its efficacy or the development of strategies to maximise the potential of such teaching opportunities. We examined medical student and midwifery preceptor attitudes towards students' learning objectives during the labour ward placement.

Analysis of intra-uterine cytokine concentration and matrix-metalloproteinase activity in women with recurrent failed embryo transfer.

Background: In all IVF programmes, some patients fail to achieve an ongoing pregnancy, even after numerous embryo transfer procedures. An unfavourable environment within the uterus might be a contributory factor to such recurrent implantation failure. This question was addressed by measuring cytokine concentrations and matrix metalloproteinase activities in fluid derived from uterine irrigation of such patients.

Medical and midwifery students: how do they view their respective roles on the labour ward?

Background: It has been suggested that much of the medical and midwifery student curricula on normal pregnancy and birth could be taught as a co-operative effort between obstetric and midwifery staff. One important element of a successful combined teaching strategy would involve a determination of the extent to which the students themselves identify common learning objectives.

Aim: The aim of the present study was to survey medical and midwifery students about how they perceived their respective learning roles on the delivery suite.

Pre-conception and antenatal screening for the fragile site on the X-chromosome.

Background: Fragile X is the most common cause of mental retardation after Down syndrome. It is the commonest inherited cause of mental retardation, and results from a dynamic mutation in a gene on the long arm of the X chromosome. Various strategies are used for prenatal screening.

Is an ultrasound assessment of gestational age at the first antenatal visit of value? A randomised clinical trial.

Objectives: To assess the efficacy of an ultrasound scan at the first antenatal visit.

Design: Randomised clinical trial.

Setting: Women's and Children's tertiary level hospital, Adelaide, Australia.

Schwangerschafts protein 1 (SP1) adds little to the age-related detection of fetal Down syndrome in the first trimester of pregnancy.

Schwangerschafts Protein 1 (SP1), being a placental protein appearing in the maternal circulation early in pregnancy, has been investigated as a potential marker for Down syndrome in the first trimester. Our study compared SP1 levels in 15 pregnancies with a Down syndrome fetus and 97 matched controls. Although the median MoM in Down syndrome pregnancies (0.

Maternal serum levels of free beta-hCG and PAPP-A in the first trimester of pregnancy are not associated with subsequent fetal growth retardation or preterm delivery.

The purpose of this case-control study was to examine the association of first-trimester concentrations of free beta-human chorionic gonadotropin (free beta-hCG) and pregnancy-associated plasma protein A (PAPP-A) in maternal serum with subsequent preterm delivery or small-for-gestational age (SGA) fetuses. We collected all the blood samples before chorionic villus sampling in the first trimester. Concentrations of free beta-hCG and PAPP-A were expressed in multiples of the median (MOM) for gestational age.

Women's opinions and the implications of first- versus second-trimester screening for fetal Down's syndrome.

Two groups of pregnant women were questioned regarding their opinions on serum screening for Down's syndrome in the first trimester of pregnancy. One group comprised 83 women attending our antenatal clinic who were questioned at the time of the existing second-trimester screening test. Seventy-six per cent of those who participated in the second-trimester screening programme would have preferred the test to have been in the first trimester, mainly because of the easier termination of pregnancy and/or the earlier reassurance provided.