Transverse position. Using rotation to aid normal birth-OUTcomes following manual rotation (the TURN-OUT trial): a randomized controlled trial.

Background: The fetal occiput transverse position in the second stage of labor is associated with adverse maternal and perinatal outcomes. Prophylactic manual rotation in the second stage of labor is considered a safe and easy to perform procedure that has been used to prevent operative deliveries.

Objective: This study aimed to determine the efficacy of prophylactic manual rotation in the management of the occiput transverse position for preventing operative delivery.

Persistent occiput posterior position outcomes following manual rotation: a randomized controlled trial.

Background: Persistent occiput posterior position in labor is associated with adverse maternal and perinatal outcomes. Prophylactic manual rotation from the occiput posterior position to the occiput anterior position in the second stage of labor is considered a safe and easy to perform procedure that in observational studies has shown promise as a method for preventing operative deliveries.

Objective: This study aimed to determine the efficacy of prophylactic manual rotation in the management of occiput posterior position for preventing operative delivery.

First-Trimester Prediction of Preterm Prelabour Rupture of Membranes.

Background: Preterm prelabour rupture of membranes (PPRoM) is commonly associated with preterm delivery and affects up to 3% of all pregnancies. It is associated with high rates of morbidity and mortality for the mother and the newborn.

Objectives: To identify risk factors for PPRoM and develop a model for first-trimester prediction of risk of PPRoM.

Prospective Validation of First-Trimester Ultrasound Characteristics as Predictive Tools for Twin-Twin Transfusion Syndrome and Selective Intrauterine Growth Restriction in Monochorionic Diamniotic Twin Pregnancies.

Objective: Monochorionic diamniotic (MCDA) twins are at increased risk of adverse outcome due to unequal placental sharing and placental vascular communications between the fetal circulations. Most centres perform ultrasound examination every 2-3 weeks to identify these complications. Identifying a high-risk cohort of MCDA twins in the first trimester would allow more efficient surveillance.

The association between induction of labour at 38 to 39 weeks pregnancy and indication for caesarean delivery: An observational study.

Background: Induction of labour is associated with a reduction in caesarean delivery, but the mechanism of action and which groups of women might benefit remain unknown.

Aims: To assess the association between induction of labour at 38-39 weeks pregnancy, and caesarean delivery: (i) overall; (ii) for slow progress in labour; and (iii) for suspected fetal compromise.

Material And Methods: Retrospective observational study in two Sydney hospitals from 2009 to 2016, among nulliparous women with induction of labour at 38 or 39 completed weeks pregnancy and a singleton, cephalic presenting fetus.

Does low dose aspirin prescribed for risk of early onset preeclampsia reduce the prevalence of preterm prelabor rupture of membranes?

Placental dysfunction, inflammation and degradation of fetal membranes has been hypothesized as a cause of preterm prelabor of rupture of membranes. To examine the effect of aspirin, an anti-inflammatory agent, on the prevalence of preterm prelabor rupture of membranes (PPRoMs). A retrospective analysis was conducted to examine the effect of aspirin on the prevalence of PPRoM.

Outcomes of induction of labour in nulliparous women at 38 to 39 weeks pregnancy by clinical indication: An observational study.

Background: Knowledge of the outcomes of induction of labour for different indications is sparse.

Aims: To describe the mode of birth and other outcomes for nulliparous women induced at 38-39 weeks gestational age by indication for induction of labour.

Material And Methods: This was a retrospective observational study in a tertiary referral hospital, and a metropolitan teaching hospital in Sydney.

Characteristics and service needs of women and babies admitted to residential parenting units in New South Wales: A mixed-methods study.

Aims And Objectives: To examine the characteristics and service needs of women and babies admitted to residential parenting services (RPS) in the first year following birth in New South Wales, Australia.

Background: In Australia, there is a tiered system to support maternal, child and family health, which includes RPS.

Design: Sequential explanatory mixed-methods design.

Effect of early use of low-dose aspirin therapy on late-onset preeclampsia.

Objective: Low-dose aspirin (LDA) therapy has been found to be effective in preventing the development of early-onset preeclampsia. However, its effect on late-onset preeclampsia has not been described. Our study was aimed at determining if LDA therapy prescribed from early in pregnancy modified the severity of late-onset preeclampsia.

All Hypertensive Disorders of Pregnancy Increase the Risk of Future Cardiovascular Disease.

Hypertensive disorders of pregnancy are associated with vascular dysfunction in the pregnancy and an increased risk of long-term cardiovascular disease (CVD) in the mother. What remains to be understood is whether the length, severity of the disease, the treatment of hypertension in pregnancy, or the subtype of hypertensive disorders of pregnancy are significant predictors of future CVD. We undertook a retrospective cohort study to review all women who gave birth at a tertiary hospital in Sydney between the years 1980 and 1989 (n=31 656).

Benchmarking the Hypertensive Disorders of Pregnancy.

Introduction: The Hypertensive Disorders of Pregnancy (HDP) affect 7-10% of pregnancies worldwide and are one of the leading causes of mortality and morbidity in the perinatal period. An accurate assessment of mortality and morbidity is essential to provide effective care and treatment and benchmarking of these issues is required to enhance outcomes and define standards.

Aim: To benchmark outcomes for women and babies following a diagnosis of hypertension between obstetric units in similar settings.

Hypertension in pregnancy and long-term cardiovascular mortality: a retrospective cohort study.

Background: There is growing evidence that hypertensive disorders of pregnancy are associated with increased long-term cardiovascular mortality in the mother. Hypertension in pregnancy, until recently, however, has been ignored largely as a risk factor for future cardiovascular disease and mortality because the link between the 2 is not fully understood.

Objective: To determine the association between women with hypertension in pregnancy and long-term cardiovascular disease mortality.

Is there an association between sonographically determined occipito-transverse position in the second stage of labor and operative delivery?

Objective: To evaluate if ultrasound-determined occipito-transverse position early in the second stage of labor is associated with operative delivery.

Design: Retrospective review of two prospective cohort studies.

Setting: An Australian tertiary referral hospital.

Cardiovascular risk, lipids and pregnancy: preeclampsia and the risk of later life cardiovascular disease.

It has been widely thought that the effects of hypertension in pregnancy reversed after delivery and hypertension values returned to their pre-pregnancy level as it was seen as a disease of short duration in otherwise healthy young women. However, recent studies have demonstrated that the principal underlying abnormality, endothelial dysfunction, remains in women who had preeclampsia and that it is this damage that increases the risk of developing cardiovascular disease (CVD) in later life. The contributions of hypertension and dyslipidaemia before and during the pregnancy are also important and contribute to future risk.

Changes in retinal microvascular caliber precede the clinical onset of preeclampsia.

Preeclampsia is a leading cause of maternal morbidity and mortality. The degree of maternal cardiovascular dysfunction that precedes the onset of preeclampsia is largely unknown. This prospective cohort study aimed to characterize differences in vivo in retinal microvascular caliber and blood pressure throughout pregnancy in relation to preeclampsia development.

High blood pressure during pregnancy is associated with future cardiovascular disease: an observational cohort study.

Objectives: The study aimed to determine if having a hypertensive disorder of pregnancy (HDP) is a risk factor for future cardiovascular disease (CVD), independent of age and body mass index (BMI).

Design: Data were sourced from the baseline questionnaire of the 45 and Up Study, Australia, an observational cohort study.

Setting: Participants were randomly selected from the Australian Medicare Database within New South Wales.

Temporal changes in retinal microvascular caliber and blood pressure during pregnancy.

The microvasculature plays an important role in regulating cardiovascular changes in pregnancy, but changes in microvasculature have been difficult to document in vivo. This study objectively quantifies changes in the maternal retinal arteriolar and venular caliber over the course of healthy pregnancy. Healthy pregnant women (n=53) were recruited from Royal Prince Alfred Hospital, Sydney, Australia.

PP102. Hypertension in pregnancy and long term cardiovascular mortality outcomes.

Introduction: Hypertensive Disorders of Pregnancy (HDP) remain a leading cause of maternal morbidity and mortality worldwide affecting up to 10% of all pregnancies. Previous works inform that long term morbidity includes cardiovascular disease, including ischaemic heart disease, stroke and hypertension. The extent of long term mortality amongst women distant from the primary pregnancy event is not known.

PP034. Cardiovascular outcomes remote from pregnancy in women with HDP: 23-32years following delivery.

Introduction: Cardiovascular disease (CVD) is a leading cause of mortality worldwide in women aged >54years. There is a strong association between HDP and the development of hypertension in later life.

Objectives: To ascertain the current health profile of some of the women who were diagnosed with a HDP and participated in a trial during the time period of 1980-1989 and to examine the association between the two.

PP033. High blood pressure in pregnancy: an indicator of future health outcomes.

Introduction: Hypertensive disorders of pregnancy (HDP) remain a leading cause of maternal and perinatal morbidity and mortality worldwide. In Australia approximately 10% of all pregnancies are affected by HDP. There is growing evidence that endothelial damage caused by HDP remains after pregnancy and has long term consequences on maternal health.

OS016. Retinal vascular changes in hypertensive disorders of pregnancy.

Introduction: Hypertensive disorders of pregnancy (HDP) are characterised by vascular dysfunction. Retinal vascular imaging is a novel, non-invasive way to characterise early microvascular changes in pregnancy, and as a result has the potential to be used to predict the onset of HDP.

Objectives: To characterise retinal vascular changes that occur in HDP, and compare these changes to those in healthy pregnancies.

OS010. Use of retinal imaging to characterise physiological vascularchanges throughout pregnancy.

Introduction: Visualisation of the microcirculation through retinal imaging can provide information on the health of systemic vasculature. Characterisation of the retinal vasculature throughout pregnancy using retinal imaging is a novel approach to examine physiological changes to the cardiovascular system, and may be useful to predict early pathophysiological signs of adverse maternal outcomes.

Objectives: To characterise the retinal vascular and blood pressure (BP) changes that occur throughout a healthy pregnancy.

Does the anti-hypertensive drug clonidine affect the short-term variation in CTG recordings?

Background: Cardiotocographic (CTG) recordings of the fetal heart remain standard obstetric practice among hypertensive women. Changes in the short-term variation (STV) in the fetal heart are often attributed to the effect of anti-hypertensive medications, regardless of the fact that this principle has never been validated.

Aim: To assess the STV of CTG recordings pre- and post- the anti-hypertensive medication, clonidine.

Role of proteinuria in defining pre-eclampsia: clinical outcomes for women and babies.

1. The presence of proteinuria is not essential to the diagnosis of pre-eclampsia under many diagnostic consensus statements. The aim of the present study was to assess maternal and perinatal outcomes after proteinuric pre-eclampsia compared with other non-proteinuric disease presentations.