Infertility, the inability to conceive after one year of unprotected intercourse, 1 affects between 8-12% of couples worldwide. 1 The assessment of tubal patency under imaging is a necessary step in the investigation and treatment of infertility. 2 This can occur under radiologic guidance, referred to as hysterosalpingography (HSG), or under ultrasound guidance called hystero-salpingo contrast sonography (HyCoSy). Although a diagnostic procedure, several studies have shown improved pregnancy rates directly following HSG and HyCoSy, suggesting a therapeutic effect. 1,3,4 In order to ascertain tubal patency and uterine cavity shape, contrast media is injected via the cervix. The contrast media typically used is iodinated water (WSCM); however, oil-soluble contrast

Background The higher burden of post‐caesarean infection in the remote Kimberley region of Australia is intimately associated with poorer social determinants of health. This results in a confluence of environmental factors such as overcrowding and limited access to clean water and host factors such as diabetes mellitus and obesity which result in heightened susceptibility and vulnerability to infection. Aim To ascertain infection rates following caesarean section in Broome Hospital, before and after the implementation of evidence‐based strategies intended to reduce bacterial load and mitigate the impact of poor underlying social determinants of health. Materials and methods This is a retrospective observational longitudinal audit study including women who underwent caesarean section in Broome Hospital between the time of 1 January 2019 and 1 May 2019 or 1 January 2021 and 1 May 2021. Files and theatre records were audited to determine demographic, surgical and post‐partum infection in women who underwent caesarean section at Broome Hospital. The main outcome measure was infection within six weeks post‐caesarean section. Results This study found a statistically significant improvement in post‐operative infection rates in women who underwent caesarean section at Broome Hospital (41.7% vs 11.6%, P = 0.002). The two groups were statistically similar in background. Conclusion The combination of various infection prevention initiatives targeted at reducing infection burden can result in clinical and statistically significant reductions in post‐caesarean infections in high‐risk populations with poor underlying social determinants of health.

Background Women with type one diabetes experience poorer obstetric outcomes than normoglycaemic women in pregnancy. Objective To investigate the cost and clinical effectiveness of continuous glucose monitoring (GCM) compared to self‐monitoring of blood glucose in improving obstetric outcomes in women with type one diabetes during pregnancy. Materials and Methods This retrospective cohort study included women with type one diabetes referred to a state‐wide tertiary obstetric centre before and after the introduction of government‐funded CGMs in Australia in March 2019. Forty‐nine women using CGMs were propensity matched on a range of clinical features with a historical group of 49 women with type one diabetes who exclusively used intermittent self‐monitoring of blood in the year prior to the introduction of funding of sensors. Medical records and administrative cost data were audited to quantify cost and clinical effectiveness. Results There were significantly lower pre‐term (95% CI 0.39–0.922; P = 0.026) and very pre‐term birth rates (95% CI 1.002–1.184; P = 0.041) in the CGM group. There was a significant reduction in the length of antenatal inpatient hospital stay (P < 0.01) and adult special care unit stay (P = 0.013) and neonatal admission to the neonatal intensive care unit (P = 0.0262) in the continuous glucose monitoring group. CGMs represented a net cost saving to the health care sector of $12 063 per pregnancy where the device was used, with an incremental cost‐effectiveness ratio of $3275 per prevented pre‐term birth. Conclusions CGM use in pregnancy is a cost‐effective intervention for reducing the risk of pre‐term birth in women with type one diabetes, resulting in a net cost benefit to the health sector.