Boon Lim

Objective: To describe clinical management of congenital uterine anomalies in Australia and New Zealand and identify areas requiring standardisation, we conducted a cross‐sectional online survey of members of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists and the Australasian Society for Ultrasound in Medicine. Methods: A 23‐item Qualtrics survey assessed clinical experience, diagnostic approaches, imaging, classification use, training and challenges among clinicians providing reproductive healthcare. Participation was voluntary and anonymous. The survey was distributed via institutional channels: ASUM at multiple time points and its 2024 annual meeting, and RANZCOG over 5 weeks (July–August 2024) with committee approval. Ethics was obtained from the Australian National University Human Research Ethics Committee (ANU HREC 2023/1238). Descriptive analyses were performed. Results: A total of 317 responses were analysed. CUAs were infrequently encountered, with septate, arcuate and bicornuate anomalies most commonly identified. Classification practices varied, with ESHRE/ESGE most frequently used, although no system was uniformly adopted. Referrals were most common for infertility care and second opinions, while surgical intervention was less frequent. Limited access to specialised imaging and subspeciality care was a key barrier, particularly outside metropolitan areas. Training and confidence varied by location, with greater limitations in remote settings. Clinicians supported standardised classification, improved imaging access and integration of CUA risk factors into national care systems. ASUM findings were consistent. Conclusion: Clinical management of CUAs in Australia and New Zealand remains variable, highlighting the need for greater standardisation, improved diagnostic access and multidisciplinary collaboration to support consistent, evidence‐based care.

There is evidence that climate change has been linked to increasing frequency of natural disasters such as flooding. Historical studies have documented significant impacts on reproductive health but more needs to be known in order to improve access to healthcare to improve reproductive health outcomes.

Environmental disasters such as wildfires and air pollution appear to be occuring more frequently. Studies have shown that they can have significant impact on pregnancy outcomes and more studies need to be conducted to fully understand the impact on reproductive health.

Objective To evaluate the Australian Capital Territory (ACT) Preterm Birth (PTB) Prevention Initiative and its effects on preterm and early term birth rates at the main tertiary hospital after 16 months of implementation. Design: A non-randomised before and after study, where the intervention was a multifaceted PTB prevention initiative. Setting: The main tertiary referral hospital in the ACT. Population: Women who birthed at the main tertiary hospital in the ACT in the pre and post intervention period. Methods: The PTB prevention initiative was implemented in 2019. Rates of early birth were assessed using run charts of bimonthly preterm and early term rates from 2014-2020. Main Outcomes measured: The main outcomes measured were rates of preterm and early term births before and after implementation of the PTB prevention initiative. Results: At the main tertiary hospital in the ACT, the rate of PTB was significantly reduced by 10% after 16 months of implementation of the initiative, corresponding to 45 averted or delayed PTBs. The number of iatrogenic early term births with no medical indication (NMI) was significantly reduced by 34.5% and resulted in 77 averted or delayed early term births. Conclusions: The multifaceted PTB prevention initiative safely lowered the rates of early birth in the ACT context. These results highlight the importance of prioritising early birth prevention, education, research and expanding the PTB Prevention Initiative nationwide.

Objective: Data published from the United States have demonstrated that the use of cervical cerclage has fallen in the period 1998–2013. This is in contrast to recommendations in Australia. We examined this trend using data from the Australian Institute of Health and Welfare (AIHW). Study design: Retrospective population-based study. Methods: Data from the Australian Institute of Health and Welfare procedural database were used to determine the total number of cervical cerclage sutures inserted during the period 2004 to 2013. Population datasets were used to calculate age-stratified incidence rates of cerclage. Findings: There was a significant increase in the rate of cervical cerclage in women aged 25 to 34 years and in the 35 years and older age group. The incidence of preterm birth was stable for gestations of 32 to 36 weeks, but slightly increased in the 20 to 27 week and 28 to 31 week gestational age groups. Further research into cervical cerclage and the use of vaginal progesterone for the prevention of preterm birth would be valuable.