Background To determine the prevalence and outcomes of intrahepatic cholestasis of pregnancy. Methods A review comparing intrahepatic cholestasis of pregnancy pregnancies to all other pregnancies in three tertiary care Australian hospitals over a 36-month period. Results There were 43,876 pregnancies. The prevalence of intrahepatic cholestasis of pregnancies ( n = 319) was 0.7%. There were differences between intrahepatic cholestasis of pregnancy and non-intrahepatic cholestasis of pregnancy mothers including higher prevalence of South Asian (22.6% versus 3.1%, p < 0.001), Indigenous Australian (3.8% versus 1.8%, p < 0.05), and Asian ethnicity (8.4% versus 5.7%, p < 0.05), mothers with a body mass index >35 kg/m2 (10.6% versus 5.5%, p < 0.001), those with diabetes mellitus (25.7% versus 9.8%, p < 0.001), and those with twin births (8.7% versus 2.2%, p < 0.001). The primary clinical outcomes of intrahepatic cholestasis of pregnancy included a median gestational age at delivery of 36.4 (SE 0.09) weeks compared to 38.6 (SE 0.01) weeks (p < 0.001), a lower birth weight (3.12 (SE 0.03) versus 3.31 kg (SE 0.03), p < 0.001), and an increase in special care nursery admissions (44.5% versus 15.3%, p < 0.001). Conclusion Treated intrahepatic cholestasis of pregnancy in the population described here had similar mortality outcomes although increased special care nursery admission as compared to the general population.

We report on a rare case of dicavitary twin pregnancy in a woman with a uterine didelphys. Delivery was performed by elective caesarean section, where live female and male infants were born. Twin pregnancies, in women with uterine anomalies, are high risk and require close surveillance in a specialist centre to monitor for complications such as preterm birth and fetal growth restriction.

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Background Limited access to obstetrics and gynaecology (O&G) services in rural and remote Australia is believed to contribute to suboptimal birth outcomes. Aims To describe the characteristics of pregnancy aeromedical transfers, in‐hospital outcomes, and patient access to O&G services, as compared to whole of Australia data. Materials and methods We conducted a cohort study of women who required aeromedical retrieval for pregnancy‐related issues between the 1 January 2015 and 31 December 2017. Results Hospital outcome data were collected on 2171 (65.2%) mothers and 2438 (100.0%) babies. The leading retrieval reason was threatened preterm labour and delivery (n = 883; 40.7%). Most patients were retrieved from rural and remote areas (n = 2224; 93.0%). Retrieved patients were significantly younger (28.0 vs 30.0 years, 95% CI 27.7–28.3), more likely to be overweight or obese (52.2% vs 45.1%, 95% CI 47.5–56.9) and to have smoked during their pregnancy (14.0% vs 9.9%, 95% CI 12.5–15.5) compared to Australian pregnant women overall. Over one‐third of transferred women gave birth by Caesarean section (n = 812; 37.4%); the median gestational age at birth was 33.0 (95% CI 32.7–33.3) weeks. Early gestation is associated with low birth weights (median = 2579.5 g; 95% CI 2536.1–2622.9), neonatal resuscitation (35.4%, 95% CI 33.5–37.3), and special care nursery admission (41.2%, 95% CI 39.3–43.2). There were 42 (1.7%, 95% CI 1.2–2.2) stillbirths, which was significantly higher than seen Australia‐wide (n = 6441; 0.7%). Conclusion This study found that pregnant women retrieved by the Royal Flying Doctor Service were younger, with higher rates of obesity and smoking.

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