http://hdl.handle.net/11434/2340 Sun, 05 Jul 2026 16:19:54 GMT 2026-07-05T16:19:54Z http://hdl.handle.net/11434/2397 Title: Pregnancy outcomes of 512 laparoscopic transabdominal cerclages: The Australian cohort. Epworth Authors: Ades, Alex; Mor, Omer Abstract: Study objective: Cervical insufficiency is recognized as an important cause of obstetric morbidity and mortality, leading to midtrimester loss and preterm birth. Laparoscopic transabdominal cerclage is one of the proposed interventions to manage this condition. The study reports on a large series of pregnancies with laparoscopic transabdominal cerclage to assess its effectiveness. Design: This study evaluates laparoscopic transabdominal cerclage as a procedure to improve obstetric outcomes in patients diagnosed with cervical insufficiency. It is a retrospective observational study of consecutive patients who underwent laparoscopic transabdominal cerclage between August 2007 and July 2024. Setting: The research was conducted in Melbourne, Australia, in several public and private healthcare facilities. Patients: Eligible patients had a diagnosis of cervical insufficiency based on previous obstetric history and were referred for a laparoscopic transabdominal cerclage. The indications for a transabdominal cerclage were a previous failed vaginal procedure, previous oncologic surgery that removed large portions of the cervix, and multiple midtrimester pregnancy losses because of cervical insufficiency. All patients were entered on a database and were prospectively followed up during subsequent pregnancies. The primary outcome was neonatal survival, and the secondary outcome was delivery of an infant at ≥34 weeks' gestation. Interventions: Surgical laparoscopic transabdominal cerclage. Measurement and main results: During the period of the study, 512 patients underwent a laparoscopic transabdominal cerclage following a clinical diagnosis or concerns of cervical insufficiency. We present the outcomes of 524 pregnancy reports among 414 patients to date. Neonatal survival was 96.4%, with 85.7% of neonates delivered at >34 weeks gestation. Less than 0.5% of the laparoscopic transabdominal cerclage surgeries had surgical complications or documented morbidity. Conclusions: Laparoscopic transabdominal cerclage is a successful management option for patients with concerns of cervical insufficiency and complex obstetric and gynecological histories. This large cohort study shows positive neonatal outcomes and low surgical morbidity. Wed, 01 Oct 2025 00:00:00 GMT http://hdl.handle.net/11434/2397 2025-10-01T00:00:00Z http://hdl.handle.net/11434/2342 Title: ENDometriosis and CArdioMetabolic disease risk (ENDCAM): Are doctors and patients aware of the risks? Epworth Authors: Taylor, Cassandra; Holdsworth-Carson, Sarah; Samaranayake, Dilshara; Lucky, Tarana; Whale, Rhiannon; Tyson, Kate Abstract: There is growing evidence to support that endometriosis increases a person’s risk of cardiometabolic disease. Two systematic reviews/meta-analyses published in 2023 have confirmed the association with cardiovascular disease, whilst other cohort studies have shown an association with metabolic syndrome, hypercholesterolaemia and stroke, amongst others. Explanations for this include chronic inflammation caused by endometriosis and/or common treatments for endometriosis (eg. hormonal therapy, hysterectomy). There is an urgent need for improved understanding of the burden and implications of cardiometabolic disease and endometriosis, particularly in young women. Our aim is to assess the current history-taking practices and knowledge of clinicians involved in caring for clients with endometriosis and/or cardiometabolic disease. Fri, 01 Aug 2025 00:00:00 GMT http://hdl.handle.net/11434/2342 2025-08-01T00:00:00Z http://hdl.handle.net/11434/2339 Title: Consumer use, experience and satisfaction of care coordination: Conex Study - the protocol. Epworth Authors: Holdsworth-Carson, Sarah; Tyson, Kate; Mooney, Samantha; Whale, Rhiannon; Hutchinson, Ana Abstract: Internationally, multidisciplinary team care for people with endometriosis is advocated for, and promisingly, recent ESHRE guidelines recommend shared decision-making and multidisciplinary care for endometriosis-associated pain. In the UK, a nurse-led pathway for patients with endometriosis and pain was proposed in the British Journal of Pain. “The initial lengthy [nurse] consultation starts the process of moving the patient from thinking about endometriosis associated pain syndrome as being a lesion that can be removed to regarding it as a chronic disease process that is recognised and managed, and shifts the patient’s orientation to the problem of ongoing pain”. There is an unmet need for research into multidisciplinary care models for people with endometriosis, in particular, patient-centred evidence is lacking in Australia. Support for nurse-led chronic pain clinics exist, yet evidence is limited for endometriosis. We recently established a nurse-led model of care (NLMOC), which has provided and coordinated personalised care plans for over 620 individuals with endometriosis. Anecdotally, our centre receives positive feedback about the NLMOC. We have designed this protocol to objectively measure the patient experience of the NLMOC for endometriosis care. Fri, 01 Aug 2025 00:00:00 GMT http://hdl.handle.net/11434/2339 2025-08-01T00:00:00Z http://hdl.handle.net/11434/2272 Title: A molecular staging model for accurately dating the endometrial biopsy. Epworth Authors: Holdsworth-Carson, Sarah Abstract: Natural variability in menstrual cycle length, coupled with rapid changes in endometrial gene expression, makes it difficult to accurately define and compare different stages of the endometrial cycle. Here we develop and validate a method for precisely determining endometrial cycle stage based on global gene expression. Our 'molecular staging model' reveals significant and remarkably synchronised daily changes in expression for over 3400 endometrial genes throughout the cycle, with the most dramatic changes occurring during the secretory phase. Our study significantly extends existing data on the endometrial transcriptome, and for the first time enables identification of differentially expressed endometrial genes with increasing age and different ethnicities. It also allows reinterpretation of all endometrial RNA-seq and array data that has been published to date. Our molecular staging model will significantly advance understanding of endometrial-related disorders that affect nearly all women at some stage of their lives, such as heavy menstrual bleeding, endometriosis, adenomyosis, and recurrent implantation failure. Sun, 01 Oct 2023 00:00:00 GMT http://hdl.handle.net/11434/2272 2023-10-01T00:00:00Z