Stress urinary incontinence is a common problem among women of all ages but may resolve with pelvic floor reeducation in many cases. Compliance to a regimen of pelvic floor muscle exercises is poor and many devices have been produced to make exercising these muscles more effective and interesting. This article describes a study in which two such devices - vaginal cones and pressure biofeedback - were compared with pelvic floor exercises alone. The results show that there is no statistically significant difference between the three modalities; all treatments produced significant improvement in symptoms and quality of life scores.

Mid-urethral sling has become the standard SUI procedure being performed in Australia since its introduction in 1999. SUI operations have increased each year for patients aged over 65, with the greatest increase seen in patients aged over 84 - indicating expanded eligibility for SUI surgery in older women. However, since 2010, there has been a fall in SUI operations to below the pre-MUS baseline.

This retrospective study was conducted to identify the incidence and characteristics associated with readmissions for surgical site infections following caesarean section in a tertiary hospital from 2012 to 2015. Of 6334 patients who underwent caesarean section, 165 (2.6%) were readmitted, most commonly for surgical site infection (25.5%, n = 42). Thirty-seven of these patients (88%) had an emergency caesarean compared to five (12%) following an elective caesarean section. Of the women with surgical site infections, 69% were overweight and 14% had diabetes. Emergency caesarean sections were responsible for the majority of readmissions, particularly in women with co-morbidities that predisposed them to infection.

BackgroundObstetric anal sphincter injuries (OASIS) can complicate up to 6% of births and are a major contributor to preventable maternal morbidity. Asian women have a risk of third and fourth degree perineal tears up to four times greater than women of other ethnicities in the same community, but the lack of differentiation of Asian women into regional groups has limited insight into the reasons behind their increased risk.AimsTo investigate risk of OASIS associated with country of birth.MethodsThis was a retrospective cohort study of all women with a singleton, nulliparous pregnancy who delivered vaginally by spontaneous vaginal birth or an instrumental delivery between 1 January 2009 and 31 December 2015. The demographics of women who experienced OASIS were compared with those women who had minor perineal trauma.ResultsFrom January 2009 to December 2015 there were 10 750 singleton, nulliparous and natural vaginal birth (NVB), forceps or vacuum deliveries. Of these deliveries, 581 (5.4%) werehad third degree tears and 36 (0.3%) fourth degree tears. Women born in South Asia were at a much higher risk of OASIS than other groups, including women born in other Asian countries, compared to the Australian/New Zealand cohort. One in every 10 nulliparous South Asian women having a singleton vaginal or instrumental delivery will sustain an OASIS.ConclusionsOur study further confirms the role of Asian ethnicity in the risk of OASIS, and is the second to confirm that South Asian women are at a dramatically increased risk.

Background: Maternal obesity is a key risk factor for morbidity in pregnancy.Accurate data on trends in obesity are required in high-risk populations such as in western Sydney to implement effective policy.Results: There were 112 308 pregnant women included. Between 1997 and 2006, mean booking-in BMI climbed from 24.9 (median 23.9) to peak at 26.2 (24.9). It then fell to 25.3 (24.1) in 2012 before rising to 25.6 (24.4) in 2016. Rates of hypertensive disorders changed little over the period, with a small fall in pre-eclampsia.In contrast, there was a progressive upward trend in the prevalence of GDM, accelerating considerably after 2010. These trends were associated with a shifting ethnic profile with proportions of Australia/New Zealand-born women falling from 56.9% to 36.8%, while those from South Asia increased from 4.5% to 26.3%. Conclusions:Western Sydney booking-in BMI fluctuated between 1997 and 2016, reaching its peak in 2006. Despite this, rates of GDM progressively rose, with one in six mothers in western Sydney now diagnosed with some form of the condition.Both patterns are associated with a notable shift in the ethnic profile of patients booking-in to antenatal care in the region. K E Y W O R D Sepidemiology, gestational diabetes, hypertensive disorders, obesity, pre-eclampsia, pregnancyAustralian-born women). In our study, GDM now affects almost one in four South Asian women in western Sydney. In comparison, epidemiological studies in India and other SouthAsian countries demonstrate prevalence of GDM of up to 17.8% of women. 23 The greater frequency in our findings may be accounted for by compounding this inherent risk with the western lifestyle.South Asian cultural attitudes to diet and activity in pregnancy can limit the effectiveness of interventions to reduce GDM. 24,25 Since South Asian women are at high risk of developing type 2 diabetes long-term 26 identifying culturally appropriate approaches to reduce GDM may prevent long-term morbidity for both women and their offspring. 27 Ethnicity and gestational hypertensionOur stable rates of hypertensive disorders contrast with other Australian studies showing a decline over the same period, which those authors speculate may be due to elective delivery prior to the due date, and the use of interventions such low-dose aspirin and calcium supplementation. 28,29 There were no changes in local policy regarding the diagnosis or treatment of hypertensive conditions during the study period.Our lack of a decline is despite the reported protective nature of Asian ethnicity 30 and may reflect the fact that, in our study, country of birth showed no correlation with rates of chronic and gestational hypertension, and pre-eclampsia. Changes in GDM criteria during the study periodIt is important to note that GDM diagnostic criteria did not change across the three sites during the study period, despite domestic and global changes in standards. On a national level, the 'new' ADIPS criteria 31 replaced the 'old' ADIPS criteria in late 2014 following the lead of Interna...