Your Latest Updates in 2022….
We are delighted to roll out our next newsletter for 2022.
We also hope that 2022 is the year that we genuinely find equilibrium in ‘living with COVID’! Already, COVID has thrown up some things that were unpredictable, and some things not. The ‘predictable’ is the wave of pregnant women testing positive for COVID seeking our help. Well done to those here in SA, including OSC GPs, who have faced up to the challenge so selflessly, putting pathways into place to look after our pregnant women and their families and supporting them in their recovery. There is some hope now that numbers are droppi
The ‘unpredictable’ is impact on children, with their schooling, vaccination and RAT testing!
This newsletter aims to keep you updated on the latest news, changes, updates, special announcements and more. We hope you enjoy the read!
Stay tuned as we announce our education activities for 2022.
Talking COVID 2022 In Pregnancy – GP Obstetric Shared Care Q&A Webinar
Please see below the link to the recent GP Obstetric Shared Care Program Webinar, held on Wednesday 16th February 2022. We hope you enjoyed it!
Special thanks to our excellent Presenters, Dr Rob Carey, Dr Jenni Goold, Dr Liz Beare, Dr Caroline Phegan and Dr Jenny Biggins.
Useful Links
Management of COVID-19 in Pregnancy in South Australia | V7.2
Infographic | Key Information on COVID-19 in Pregnancy
Statewide COVID-19 Maternity Pathway
Statewide Regional COVID-19 Positive Maternity Pathway
This review is an interesting contribution from a Monash team and looks at whether diet and exercise actually impacts on weight gain and pregnancy outcomes.
Obesity is now the most common medical condition worldwide and is projected to affect 21% of women globally by 2025. Previous large-scale meta-analyses have shown that gestational weight gain that exceeds international recommendations affects ~50% of pregnancies and is an independent risk factor for adverse maternal and neonatal pregnancy outcomes.
This systematic review aimed to evaluate the impact of different antenatal diet and physical activity-based interventions on gestational weight gain and maternal and neonatal outcomes.
Mean gestational weight gain (GWG) was the primary outcome. Secondary outcomes included gestational diabetes, hypertensive disorders of pregnancy, caesarean section, preterm delivery, large or small for gestational age neonates, neonatal intensive care unit admission, and fetal death.
117 RCTs (34, 546 women) of antenatal lifestyle interventions were analysed. The interventions were:
- Structured diet alone (dietary targets with or without monitoring)
- Structured physical activity alone (specific activity programs in controlled environments such as a gym or self-led activity programs with targets and equipment supplied)
- Diet with physical activity (one structured component but not both)
- Mixed interventions (unstructured lifestyle support, written information with weight monitoring, or behavioural support alone).
Compared with routine care, any lifestyle intervention resulted in reduced GWG (−1.15 kg; 95% CI, −1.40 to −0.91) and a reduced risk of gestational diabetes by 21% (odds ratio [OR], 0.79; 95% CI, 0.70-0.89) and total adverse maternal outcomes by 11% (OR, 0.89; 95% CI, 0.84-0.94).
Compared with routine care, structured diet alone was associated with less GWG (−2.63 kg; 95% CI, −3.87 to −1.40) than physical activity (−1.04 kg; 95% CI, −1.33 to −0.74) or mixed interventions (−0.74 kg; 95% CI, −1.06 to −0.43) and a reduced risk of:
- gestational diabetes (OR, 0.61; 95% CI, 0.45-0.82)
- preterm delivery (OR, 0.43; 95% CI, 0.22-0.84)
- large for gestational age neonate (OR, 0.19; 95% CI, 0.08-0.47)
- neonatal intensive care admission (OR, 0.68; 95% CI, 0.48-0.95)
- total adverse maternal (OR, 0.75; 95% CI, 0.61-0.92) and neonatal outcomes (OR, 0.44; 95% CI, 0.26-0.72).
Structured diet alone had no impact on risk of hypertensive disorders, caesarean section, fetal death or having a small for gestational age infant.
Structured physical activity alone was associated with less GWG (−1.04kg; 95%CI −1.33 to −0.74) and reduced risk of:
- gestational diabetes (OR, 0.60; 95% CI, 0.47-0.75)
- hypertensive disorders (OR, 0.66; 95% CI, 0.48-0.90)
- caesarean section (OR, 0.85; 95% CI, 0.75-0.95)
- total adverse maternal outcomes (OR, 0.78; 95% CI, 0.71-0.86)
Structured physical activity alone had no impact on risk of preterm birth, NICU admission or birth of a small or large for gestational age infant.
Diet with physical activity (one structured component) was associated with less GWG (−1.35 kg; 95% CI, −1.95 to −0.75) and reduced risk of:
- gestational diabetes (OR, 0.72; 95% CI, 0.54-0.96)
- total adverse maternal outcomes (OR, 0.81; 95% CI, 0.69-0.95).
Diet with physical activity had no impact on risk of hypertensive disorders, preterm birth, caesarean delivery, NICU admission or birth of a large or small for gestational age infant.
Mixed interventions were associated with reduced GWG only.
Overall, diet interventions had the greatest impact on GWG and were the only intervention to affect neonatal outcomes. The study concluded that there is strong evidence that antenatal structured diet and physical activity-based interventions are associated with reduced weight gain and lower risk of adverse maternal and neonatal outcomes. Widespread implementation of these interventions should be considered in antenatal care, with greatest support for diet-based interventions.
With thanks Mercy Perinatal
IUGA International Symposium on Birth and Beyond: Management, Assessment,and Prevention of Pelvic Floor Dysfunction
Antenatal prevention of pelvic floor dysfunction is one of the themes of this year’s IUGA Virtual International Symposium, Birth and Beyond. How do you find time within a busy appointment to discuss reducing trauma? How do you manage pelvic organ prolapse in pregnancy?
Pregnant Women – COVID-19 Maternity Care at
Women’s and Children’s Hospital
Pregnant Women – COVID-19 Maternity Care at
Flinders Medical Centre
For information, please see:
- FMC COVID-19 Maternity Care fact sheet (PDF 357KB)
- Birthing while COVID-19 positive fact sheet (PDF 264KB)
- Pregnant women at FMC fact sheet (PDF 117KB)
SA Paediatrics and Newborns
New Paediatric Specialist Practice in North Adelaide!
A new group of 10 Paediatric Specialists and 8 Allied Health Professionals from three major Paediatric Hospitals (WCH, FMC, LMH) have come together to offer some unique services.
Take a look at their website!
- Located at:
- 149B Ward Street
- North Adelaide SA 5006
- Telephone: (08) 7081 9819
- Email: reception@sapan.health
‘Prevalence of rectus diastasis (abdominal separation) in Australian women from pregnancy until 1 year after birth’
Rectus diastasis is the separation of the rectus abdominis muscles caused by the hormonal and mechanical influences of pregnancy. Normally, it resolves after birth, however, in some women it persists, leaving them at risk of back pain, urinary incontinence and reduced quality of life. Rectus diastasis is a poorly understood and often overlooked medical condition potentially affecting millions of Australian mothers. Data on the prevalence, natural history, and risk factors of rectus diastasis is lacking.
Siobhan Fitzpatrick is investigating the prevalence of rectus diastasis in a population of Australian primiparous women from pregnancy until one-year post-partum. Using a longitudinal design, she will examine the quality of life, back pain and urinary incontinence of women with patient reported outcome measures (the SF-36, ODI, ICIQ-UI SF, respectively), and correlate these with inter-rectus distances as measured on bedside ultrasound.
To recruit such significant numbers of participants, we need your help! If you could please refer any suitable patients to the study.