1
|
Zeki R, Li Z, Wang AY, Homer CS, Oats JJ, Marshall D, Sullivan EA. Obstetric anal sphincter injuries among women with gestational diabetes and women without gestational diabetes: A
NSW
population‐based cohort study. Aust N Z J Obstet Gynaecol 2019; 59:662-669. [DOI: 10.1111/ajo.12950] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2018] [Accepted: 12/02/2018] [Indexed: 11/27/2022]
Affiliation(s)
- Reem Zeki
- The Australian Centre for Public and Population Health ResearchFaculty of HealthUniversity of Technology Sydney Sydney Australia
| | - Zhuoyang Li
- The Australian Centre for Public and Population Health ResearchFaculty of HealthUniversity of Technology Sydney Sydney Australia
| | - Alex Y. Wang
- The Australian Centre for Public and Population Health ResearchFaculty of HealthUniversity of Technology Sydney Sydney Australia
| | - Caroline S.E. Homer
- Centre for Midwifery, Child and Family HealthFaculty of HealthUniversity of Technology Sydney Sydney Australia
| | - Jeremy J.N. Oats
- Melbourne School of Population and Global HealthUniversity of Melbourne Melbourne Australia
| | | | - Elizabeth A. Sullivan
- The Australian Centre for Public and Population Health ResearchFaculty of HealthUniversity of Technology Sydney Sydney Australia
| |
Collapse
|
2
|
McIntyre HD, Metzger BE, Coustan DR, Dyer AR, Hadden DR, Hod M, Lowe LP, Oats JJ, Persson B. Counterpoint: Establishing consensus in the diagnosis of GDM following the HAPO study. Curr Diab Rep 2014; 14:497. [PMID: 24777652 PMCID: PMC4039030 DOI: 10.1007/s11892-014-0497-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
The International Association of Diabetes in Pregnancy Study Groups (IADPSG) recommended a new protocol of 1-step testing with a 75 g oral glucose tolerance test for gestational diabetes in 2010. Since that time, these recommendations have been carefully scrutinized and accepted by a variety of organizations, but challenged or rejected by others. In the current review, we present more details regarding the background to the development of the IADPSG recommendations and seek to place them in context with the available epidemiologic and randomized controlled trial data. In this "counterpoint," we also provide specific rebuttal for errors of fact and disputed contentions provided by Long and Cundy in their 2013 article in Current Diabetes Reports.
Collapse
Affiliation(s)
- H. David McIntyre
- University of Queensland, Mater Medical Research Institute Level 3, Aubigny Place, South Brisbane, Queensland, 4101 Australia, Ph: 61-7-3163-6358, Fax: 61-7-3163-2510,
| | - Boyd E. Metzger
- Northwestern University Feinberg School of Medicine, Chicago, IL, 303 East Chicago Avenue, Tarry 12-703, Chicago, IL 60611, Ph: 312-503-7979, Fax 312-503-0037,
| | - Donald R. Coustan
- Warren Alpert Medical School of Brown University, Women and Infant’s Hospital of Rhode Island, 101 Dudley Street, Providence, RI,02905-2401, Ph: 401 274-1122 Ext 7452, Fax 401 543-7622,
| | - Alan R. Dyer
- Northwestern University Feinberg School of Medicine, 680 N Lake Shore Dr., #1400, Chicago, IL, 60611, Ph: 312-908-7919, Fax: 312-503-2707,
| | - David R. Hadden
- Royal Victoria Hospital, Belfast, BT12 6BA UK, Ph/Fax: 0044 2890 667110.
| | - Moshe Hod
- Rabin Medical Center, Tel-Aviv University, Petah-Tiqva, 49100 Israel, Tel: +972 3 937 7400, Fax: +972 3 937 7402, Cell: +972 52 8888899,
| | - Lynn P. Lowe
- Northwestern University Feinberg School of Medicine, 680 N Lake Shore Dr., #1400 Chicago, IL, 60611, Ph: 312-503-7217, Fax: 312-503-2707,
| | - Jeremy J.N. Oats
- Royal Women’s Hospital & University of Melbourne, PO Box 5266, Burnley, Victoria, Australia, 3121, Ph: 0407-68-5532
| | - Bengt Persson
- Karolinska Institute, Stockholm, Sweden, Mailing address: Logbacken 2, 13150, Saltsjö-Duvnä, Sweden, Ph: 46-8-7169590,
| |
Collapse
|
3
|
Schultz R, Lockey R, Oats JJ. Birthing in the Barkly: births to Barkly women in 2010. Rural Remote Health 2013; 13:2396. [PMID: 24047202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023] Open
Abstract
INTRODUCTION A 2007 review of maternity services in Australia's Northern Territory (NT) noted the dissatisfaction of women in the Barkly region where the birthing service closed in 2006. The review recommended improved integration of maternity services, a consumer focus, and a pilot study of birthing in Tennant Creek Hospital (TCH) in the Barkly region. Barkly region is sparsely populated, with 5700 people in 320,000 km². The town of Tennant Creek with 3100 population is the only centre of more than 1000 people. In the Barkly region, 64% of the population and 74% of birthing women are Aboriginal. Current NT Department of Health (NT DoH) policy requires all women to give birth in a town with facilities for operative delivery. For most Barkly women this means travelling 500 km to Alice Springs with limited support for travel and accommodation. Emergency air evacuation is arranged for all women who enter labour or give birth while in the Barkly region, whether at TCH or elsewhere. This project was a collaboration between Anyinginyi Health Aboriginal Corporation and NT DoH to examine clinical data to inform a discussion of re-introducing birthing to TCH. METHODS Women who were resident in the Barkly region and gave birth in NT in 2010 were identified from the NT Midwives Data Collection. Women who gave birth in Central Australia were managed at Alice Springs Hospital (ASH), either for the birth or afterwards. Antenatal, birthing, postnatal and neonatal data were extracted from ASH records. RESULTS In total 99 women were identified as residents in the Barkly region from all those who gave birth in 2010. Of these, 83 gave birth in Central Australia, and their records were reviewed for this study, showing that 69 (83%) were Aboriginal; 42 were resident in Tennant Creek; and 29% were aged under 20 years with one under 16 years. Regarding delivery, 53 (64%) women had an unassisted vaginal birth; of 18 women who had had a previous caesarean section, 5 (28%) had a vaginal birth; of the 25 women who had had a normal vaginal birth previously and had no indications for obstetric consultation at the time of labour, three underwent emergency caesarean section. There were 86 infants, all liveborn; 16% were preterm; 21% were of low birth weight; and 6% weighed more than 4.5 kg. Six women gave birth in the Barkly region, two at TCH and four in health centres in remote townships. These mothers and babies were evacuated immediately following birth to ASH, irrespective of indications for referral. Eleven women were evacuated to ASH in labour and six of these were preterm. CONCLUSION Opportunities exist to improve maternity care through improved collaboration, even when women cannot give birth in or near their home community due to the absence of birthing services. The remote location of the Barkly region presents challenges to providing maternity care that addresses medical, cultural, psychological and social needs of the childbearing population. Because of this, every opportunity should be taken to optimise maternity care by improvements in continuity of care and carer, improved communication between service providers, and the use of evidence-based guidelines.
Collapse
Affiliation(s)
- R Schultz
- Clinical Services, Anyinginyi Health Aboriginal Corporation, Tennant Creek, Northern Territory, Australia.
| | | | | |
Collapse
|
4
|
Catalano PM, McIntyre HD, Cruickshank JK, McCance DR, Dyer AR, Metzger BE, Lowe LP, Trimble ER, Coustan DR, Hadden DR, Persson B, Hod M, Oats JJ. The hyperglycemia and adverse pregnancy outcome study: associations of GDM and obesity with pregnancy outcomes. Diabetes Care 2012; 35:780-6. [PMID: 22357187 PMCID: PMC3308300 DOI: 10.2337/dc11-1790] [Citation(s) in RCA: 636] [Impact Index Per Article: 53.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2011] [Accepted: 01/04/2012] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To determine associations of gestational diabetes mellitus (GDM) and obesity with adverse pregnancy outcomes in the Hyperglycemia and Adverse Pregnancy Outcome (HAPO) Study. RESEARCH DESIGN AND METHODS Participants underwent a 75-g oral glucose tolerance test (OGTT) between 24 and 32 weeks. GDM was diagnosed post hoc using International Association of Diabetes and Pregnancy Study Groups criteria. Neonatal anthropometrics and cord serum C-peptide were measured. Adverse pregnancy outcomes included birth weight, newborn percent body fat, and cord C-peptide >90th percentiles, primary cesarean delivery, preeclampsia, and shoulder dystocia/birth injury. BMI was determined at the OGTT. Multiple logistic regression was used to examine associations of GDM and obesity with outcomes. RESULTS Mean maternal BMI was 27.7, 13.7% were obese (BMI ≥33.0 kg/m(2)), and GDM was diagnosed in 16.1%. Relative to non-GDM and nonobese women, odds ratio for birth weight >90th percentile for GDM alone was 2.19 (1.93-2.47), for obesity alone 1.73 (1.50-2.00), and for both GDM and obesity 3.62 (3.04-4.32). Results for primary cesarean delivery and preeclampsia and for cord C-peptide and newborn percent body fat >90th percentiles were similar. Odds for birth weight >90th percentile were progressively greater with both higher OGTT glucose and higher maternal BMI. There was a 339-g difference in birth weight for babies of obese GDM women, compared with babies of normal/underweight women (64.2% of all women) with normal glucose based on a composite OGTT measure of fasting plasma glucose and 1- and 2-h plasma glucose values (61.8% of all women). CONCLUSIONS Both maternal GDM and obesity are independently associated with adverse pregnancy outcomes. Their combination has a greater impact than either one alone.
Collapse
Affiliation(s)
- Patrick M. Catalano
- Reproductive Biology, Case Western Reserve University at MetroHealth Medical Center, Cleveland, Ohio
| | - H. David McIntyre
- Endocrinology and Obstetric Medicine, Mater Medical Research Institute, University of Queensland, Brisbane, Australia
| | - J. Kennedy Cruickshank
- Diabetes and Clinical Endocrinology, University of Manchester and Royal Infirmary, Manchester, U.K
| | - David R. McCance
- Regional Centre for Endocrinology and Diabetes, Royal Victoria Hospital, Belfast, Northern Ireland, U.K
| | - Alan R. Dyer
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Boyd E. Metzger
- Division of Endocrinology, Metabolism and Molecular Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Lynn P. Lowe
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Elisabeth R. Trimble
- Department of Clinical Biochemistry, Queen’s University Belfast, Belfast, Northern Ireland, U.K
| | - Donald R. Coustan
- Division of Maternal Fetal Medicine, Women & Infants’ Hospital of Rhode Island, Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - David R. Hadden
- Regional Centre for Endocrinology and Diabetes, Royal Victoria Hospital, Belfast, Northern Ireland, U.K
| | - Bengt Persson
- Department of Pediatrics, Karolinska Institute, Stockholm, Sweden
| | - Moshe Hod
- Department of Obstetrics and Gynecology, Helen Schneider Hospital for Women, Rabin Medical Center-Sackler Faculty of Medicine, Tel-Aviv University, Petah-Tiqva, Israel
| | - Jeremy J.N. Oats
- Obstetric Medicine, Mater Misericordiae Mothers’ Hospital-University of Queensland, Brisbane, Australia
| | - for the HAPO Study Cooperative Research Group
- Reproductive Biology, Case Western Reserve University at MetroHealth Medical Center, Cleveland, Ohio
- Endocrinology and Obstetric Medicine, Mater Medical Research Institute, University of Queensland, Brisbane, Australia
- Diabetes and Clinical Endocrinology, University of Manchester and Royal Infirmary, Manchester, U.K
- Regional Centre for Endocrinology and Diabetes, Royal Victoria Hospital, Belfast, Northern Ireland, U.K
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
- Division of Endocrinology, Metabolism and Molecular Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
- Department of Clinical Biochemistry, Queen’s University Belfast, Belfast, Northern Ireland, U.K
- Division of Maternal Fetal Medicine, Women & Infants’ Hospital of Rhode Island, Warren Alpert Medical School of Brown University, Providence, Rhode Island
- Department of Pediatrics, Karolinska Institute, Stockholm, Sweden
- Department of Obstetrics and Gynecology, Helen Schneider Hospital for Women, Rabin Medical Center-Sackler Faculty of Medicine, Tel-Aviv University, Petah-Tiqva, Israel
- Obstetric Medicine, Mater Misericordiae Mothers’ Hospital-University of Queensland, Brisbane, Australia
| |
Collapse
|
5
|
Wong SF, Chan FY, Cincotta RB, Oats JJ, McIntyre HD. Sonographic estimation of fetal weight in macrosomic fetuses: diabetic versus non-diabetic pregnancies. Aust N Z J Obstet Gynaecol 2001; 41:429-32. [PMID: 11787919 DOI: 10.1111/j.1479-828x.2001.tb01323.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The objective of this study is to compare the accuracy of sonographic estimation of fetal weight of macrosomic babies in diabetic vs non-diabetic pregnancies. All babies weighing 4,000 g or more at birth, and who had ultrasound scans performed within one week of delivery were included in this retrospective study Pregnancies with diabetes mellitus were compared to those without diabetes mellitus. The mean simple error (actual birthweight--estimated fetal weight); mean standardised absolute error (absolute value of simple error (g)/actual birthweight (kg)); and the percentage of estimated birthweight falling within 15% of the actual birthweight between the two groups were compared. There were 9,516 deliveries during the study period. Of this total 1,211 (12.7%) babies weighed 4,000 g or more. A total of 56 non-diabetic pregnancies and 19 diabetic pregnancies were compared. The average sonographic estimation of fetal weight in diabetic pregnancies was 8% less than the actual birthweight, compared to 0.2% in the non-diabetic group (p < 0.01). The estimated fetal weight was within 15% of the birthweight in 74% of the diabetic pregnancies, compared to 93% of the non-diabetic pregnancies (p < 0.05). In the diabetic group, 26.3 % of the birthweights were underestimated by more than 15 %, compared to 5.4% in the non-diabetic group (p < 0.05). In conclusion, the prediction accuracy of fetal weight estimation using standard formulae in macrosomic fetuses is significantly worse in diabetic pregnancies compared to non-diabetic pregnancies. When sonographic fetal weight estimation is used to influence the mode of delivery for diabetic women, a more conservative cut-off needs to be considered.
Collapse
Affiliation(s)
- S F Wong
- Department of Maternal Fetal Medicine, Mater Mothers' Hospital, South Brisbane, Queensland, Australia
| | | | | | | | | |
Collapse
|
6
|
|
7
|
Oats JJ. Fourth International Workshop-Conference on Gestational Diabetes Mellitus. Overview and commentary on first session. Diabetes Care 1998; 21 Suppl 2:B58-9. [PMID: 9704228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- J J Oats
- Department of Obstetrics and Gynaecology, Mater Misericordiae Mothers' Hospital, South Brisbane, Queensland, Australia.
| |
Collapse
|
8
|
Affiliation(s)
- L Hoffman
- Department of Diabetes and Endocrinology, Royal Hobart Hospital, Hobart, TAS
| | | | | | | | | |
Collapse
|
9
|
Oats JJ. Gestational diabetes: a diagnostic dilemma? Med J Aust 1997; 166:340-1. [PMID: 9137275 DOI: 10.5694/j.1326-5377.1997.tb123157.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
|
10
|
Broughton Pipkin F, Oats JJ, Hunter JC, Craven DJ, Symonds EM. Sequential changes in the human renin-angiotensin system following therapeutic termination of pregnancy. Br J Obstet Gynaecol 1979; 86:285-9. [PMID: 435414 DOI: 10.1111/j.1471-0528.1979.tb11257.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Plasma renin and angiotensin II levels were measured in nine patients immediately before and at half-hourly intervals in the four hours following therapeutic termination of pregnancy. There was a small fall in renin and angiotensin II levels over the first 1 to 2 hours, followed by a slight increase. The magnitude of these effects was much smaller than those previously seen following normal delivery. It is concluded that in early pregnancy maternal, rather than feto-placental, factors are controlling the renin-angiotensin system.
Collapse
|
11
|
Abstract
A total of 440 women who had low oestriol excretion in a previous pregnancy was investigated by urinary oestriol assays in one or more subsequent pregnancies. The incidence of low oestriol excretion in the subsequent pregnancy was 29.1 per cent, or more than double that in the total obstetric population (13.4 per cent; p less than 0.001). Patients with persistently low oestriol excretion had a 40.8 per cent recurrence rate in subsequent pregnancies. When oestriol excretion was low in successive pregnancies it retained a significant association with increased incidences of stillbirths, neonatal deaths and fetal growth retardation. It was concluded that low oestriol excretion in a previous pregnancy is a definite indication to test fetoplacental function in subsequent pregnancies even when the clinical findings are normal.
Collapse
|
12
|
Abstract
Plasma renin activity and concentration and angiotensin II concentration have been measured serially in six normotensive primigravidae and in four mildly hypertensive patients in the four immediately following normal delivery. In normotensive patients, both renin and angiotensin II levels fell sharply over the first two hours to levels within the non-pregnant range, with a subsequent rise to levels, similar to those found in late pregnancy. Changes in the mildly hypertensive patients were smaller, and somewhat slower. It is suggested that the initial fall represents clearance of a renin of fetoplacental origin and that the subsequent rise may be a release from feedback suppression of renal renin synthesis.
Collapse
|
13
|
Broughton Pipkin F, Oats JJ, Symonds EM. Changes in the human renin-angiotensin system in the first 4 hr after delivery [proceedings]. J Physiol 1978; 276:51P-52P. [PMID: 650478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
|
14
|
Filshie GM, Sanders RR, O'Brien PM, Overton J, Khattab T, Oats JJ. Evacuation of retained products of conception in a treatment room and without general anaesthesia. Br J Obstet Gynaecol 1977; 84:514-6. [PMID: 911708 DOI: 10.1111/j.1471-0528.1977.tb12636.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
One hundred patients with an incomplete aboriton, 14 patients with retained products of conception after a second trimester termination, 5 patients with missed abortion and 2 patients with secondary postpartum haemorrhages (making a total of 121 patients) had a uterine evacuation in a treatment room using the portable Karman curette equipment. No general anaesthesia was used but patients were given intravenous pethidine or papavaretum (Omnopon) and diazepam. Four patients found the procedure painful but only two of them would have preferred general anaesthesia. There were no immediate complications but three patients required re-evacuation of the uterus.
Collapse
|
15
|
Skinner JL, Oats JJ, Symonds EM. Familial ovarian carcinoma. J R Coll Gen Pract 1977; 27:169-70. [PMID: 859148 PMCID: PMC2158454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
|
16
|
Abstract
A study was made of 56 patients with carcinoma of thecervical stump after subtotal hysterectomy who were seen between 1946 and 1972 at the National Women's Hospital, Auckland, New Zealand. The duration of symptoms before diagnosis, stage distribution and five-year survival rates were examined and compared with those in 1459 patients with carcinoma of the cervix, and no previous subtotal hysterectomy, who presented over the same period.
Collapse
|