Vaginal delivery: An argument against requiring consent.

Birth by vaginal delivery is an evolutionary process refined over millennia to create a sustainable and safe method of human reproduction. A key argument against requiring consent for vaginal birth acknowledges that from an evolutionary point of view, vaginal delivery has successfully accompanied human development and remains the natural and default form of human birth. Concern has been raised by the Montgomery court case in the United Kingdom; however, the ruling does not mean consent is required for normal birth.

Australian Fathers' Study: What Influences Paternal Engagement With Antenatal Care?

This mixed-methods study explores factors associated with and levels of engagement of fathers in antenatal care. One hundred expectant fathers were recruited from antenatal clinics and community settings in Western Australia. They completed validated questionnaires.

Attitudes of pregnant women towards personally controlled electronic, hospital-held, and patient-held medical record systems: a survey study.

Background: On July 1, 2012 the Australian Government launched the personally controlled electronic health record (PCEHR). This article surveys obstetric patients about their medical record preferences and identifies barriers to adoption of the PCEHR.

Materials And Methods: A survey study was conducted of antenatal patients attending a large Australian metropolitan hospital.

What Factors Impact upon a Woman's Decision to Undertake Genetic Cancer Testing?

Introduction: The advent of human genome project has lead to genetic tests that identify high-risk states for certain cancers. Many are privately marketed on the Internet. Despite the availability of tests, limited data has evaluated factors that lead to test uptake.

Barriers to the 4-h rule: what causes delays for gynaecology patients in the emergency department?

Objectives: To explore factors that led to noncompliance with the 4-h rule for gynaecology patients in a general emergency department.

Methods: A cross-sectional cohort study was performed at a general emergency department. The files of all female patients aged from birth to 100 years presenting from 1 January 2009 to 31 December 2010 were screened.

Prevalence and associations of domestic violence at an Australian colposcopy clinic.

Objective: Domestic violence is associated with significant mortality and morbidity including gynecological morbidity. We report the prevalence and associations of domestic violence in an Australian colposcopy service.

Materials And Methods: A prospective study was performed from consecutive patients attending colposcopy clinics at a major metropolitan hospital in Australia.

The impact of molar pregnancy on the male partner.

Background: Molar pregnancy is a complication of 1 in 200-2000 pregnancies whereby abnormal placental tissue proliferates in the absence of a fetus and may lead to metastases. The disease origin lies in dispermy or dual fertilisation of the egg. The aim of this study was to explore the impact of molar pregnancy upon the male partner.

Human papillomavirus genotype detection from archival papanicolaou-stained cervical tests.

Background: Archival Papanicolaou (Pap)-stained cervical cytology tests may be the only source of a clinical sample for the evaluation of previous human papillomavirus (HPV) infection. Pap tests are ideal because the majority of women in countries with comprehensive screening programs would have had several collected and stored.

Methods: In the current study, HPV detection and genotyping were compared in samples collected from a conventionally fixed Pap test with those collected using an endocervical brush and collected in PreservCyt (liquid-based) in 87 women undergoing management for a high-grade Pap test abnormality.

Pandemic (H1N1) 2009 influenza vaccine uptake in pregnant women entering the 2010 influenza season in Western Australia.

Objective: To audit the uptake of pandemic (H1N1) 2009 influenza vaccine in pregnant women entering the 2010 influenza season in Western Australia, and to identify why some women did not receive the vaccine.

Design, Setting And Participants: Cross-sectional study of consecutive patients attending the Joondalup Health Campus public antenatal clinics in WA in January 2010.

Intervention: Audit of uptake of the H1N1-specific vaccine.

Selecting medical students for academic and attitudinal outcomes in a Catholic medical school.

Objectives: To evaluate whether the four criteria used by the University of Notre Dame Australia (UNDA) to select medical students are successful in selecting for graduates with the desired outcomes of academic excellence and Catholic "mission fit".

Design, Setting And Participants: Prospective cohort study of medical students selected for 2008 and 2009 entry to UNDA in Sydney, New South Wales.

Main Outcome Measures: The statistical association between the two academic selection criteria of the Graduate Australian Medical School Admissions Test (GAMSAT) and grade point average (GPA) compared with the outcome of medical school examination performance, and the two mission selection criteria of a portfolio score and interview score compared with the outcome of a positive attitude towards serving underserved communities as measured using the Medical Student Attitudes Toward the Underserved (MSATU) test.

HPV genotype prevalence in women with abnormal pap smears in Melbourne, Australia.

Carcinoma of the cervix and its precursor, high-grade cervical intraepithelial neoplasia (CIN2/3), are associated with persistent oncogenic Human papillomavirus (HPV) infection, particularly HPV 16 and 18. HPV genotype distribution varies with severity of cervical disease, patient demographics such as age, as well as geographical location. In this study, HPV genotype prevalence was determined, using the Roche Linear Array genotyping test, among a cohort of 1,676 women being managed with ablative or excisional treatment following colposcopically directed biopsies, who were referred initially due to cytological abnormalities.

Prevalence of Chlamydia trachomatis in a public colposcopy clinic population.

Background: Chlamydia trachomatis is a major public health issue, with notifications of this sexually transmitted disease continuing to rise in Australia. Women attending colposcopy clinics are referred for treatment of cervical abnormalities often associated with human papilloma virus (HPV) infection. There is evidence that women who have acquired one sexually transmitted infection, such as HPV, are at higher risk of acquiring another.

Early stress predicts age at menarche and first birth, adult attachment, and expected lifespan.

Life history theory suggests that in risky and uncertain environments the optimal reproductive strategy is to reproduce early in order to maximize the probability of leaving any descendants at all. The fact that early menarche facilitates early reproduction provides an adaptationist rationale for our first two hypotheses: that women who experience more risky and uncertain environments early in life would have (1) earlier menarche and (2) earlier first births than women who experience less stress at an early age. Attachment theory and research provide the rationale for our second two hypotheses: that the subjective early experience of risky and uncertain environments (insecurity) is (3) part of an evolved mechanism for entraining alternative reproductive strategies contingent on environmental risk and uncertainty and (4) reflected in expected lifespan.

Abnormal pap smears in teenage mothers and the association with domestic violence, homelessness, and Chlamydia.

Objective: To assess the incidence of Pap smear abnormalities and cervical intraepithelial neoplasia (CIN) on cervical biopsy results in teenage mothers and to establish if there are associations with social disruption.

Patients And Methods: A prospective study of 498 pregnant teenagers was performed at three Australian hospitals. Enrolled patients had a Pap smear performed.

The impact of molar pregnancy on psychological symptomatology, sexual function, and quality of life.

Background: Molar pregnancy is an unusual complication of pregnancy whereby abnormal placental tissue proliferates in the absence of a fetus. There is usually a protracted follow-up period where pregnancy is contra-indicated. Whilst the medical outcomes of the disease have been well explored, limited data have evaluated the impact on psychological symptomatology, sexual function, and quality of life.

Psychologic changes after a gynecologic cancer.

Aim: The aim of this study was to explore the wider psychologic symptomatology experienced by women with a new diagnosis of a gynecologic cancer at the point of diagnosis and 6 weeks later.

Methods: A prospective cohort study was carried out with ethics committee approval and informed consent. Women were recruited from three tertiary hospitals in Australia over an 8-month period.

Demographic variables routinely collected at colposcopic examination do not predict who will default from conservative management of cervical intraepithelial neoplasia I.

Objective: As a result of the low incidence of progression from low grade epithelial abnormalities to cervical intraepithelial neoplasia (CIN) 3 or cervical cancer, a conservative approach to management is supported, especially in young women. Loss to follow-up is a recognised problem with a conservative approach however, with women defaulting known to experience higher rates of cancer.

Aim: To determine if any routinely collected demographic variables could predict which Australian women would subsequently default from care having initially elected to have conservative management of CIN 1 lesions.

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.

Small intestinal volvulus following laparotomy for endometrial clear cell carcinoma in a woman with a past history of total gastrectomy and Roux-en-Y anastomosis for gastric carcinoma.

Background: Small intestinal volvulus is a rare complication following Roux-en-Y anastomosis.

Case Report: A 63-year-old woman was diagnosed with small intestinal volvulus following laparotomy for clear cell carcinoma of the endometrium. Her past medical history included a total gastrectomy and antecolic Roux-en-Y anastomosis for Duke's B gastric carcinoma.

Preventing anxiety and depression in gynaecological cancer: a randomised controlled trial.

Objective: To examine the effect of counselling and relaxation intervention on psychological symptoms in patients with gynaecological cancer between the post-operative period and the six-week review.

Design: Randomised controlled trial.

Participants: Fifty-three patients with gynaecological cancer.