O Magazine&G Vol 18 No 1 Autumn 2016 Making headlines The Royal Australian and New Zealand College of Obstetricians and Gynaecologists Confi dence that lasts* * Approved for up to 5 years’ continuous use with over 99% contraceptive effi cacy1 Start a conversation... MIRENA® Minimum Product Information Mirena®, levonorgestrel 52 mg, intrauterine drug delivery system. Indications: Contraception, idiopathic menorrhagia and prevention of endometrial hyperplasia during oestrogen replacement therapy. Contraindications: Known/suspected pregnancy; current or recurrent pelvic infl ammatory disease; lower genital tract infection; postpartum endometritis; infected abortion during the past three months; cervicitis; cervical dysplasia; uterine or cervical malignancy; progestogen-dependent tumours; undiagnosed abnormal uterine bleeding; congenital or acquired uterine anomaly including fi broids if they distort the uterine cavity; conditions associated with increased infection susceptibility; acute liver disease/ tumour; hypersensitivity to the constituents. Precautions: migraine; exceptionally severe headache; jaundice; marked increase in blood pressure; severe arterial disease; young nulligravid women; post-menopausal women with advanced uterine atrophy; thrombosis; breast cancer; congenital or valvular heart disease; diabetes; pelvic infections; expulsion; uterine perforation; ectopic pregnancy; sexually transmitted diseases; lost threads; delayed follicular atresia. Adverse effects: headache; abdominal/pelvic pain; changes in menstrual bleeding; vulvovaginitis; genital discharge; depressed mood; depression; nervousness; decreased libido; migraine; nausea; acne; hirsutism; back pain; upper genital tract infection; ovarian cyst; dysmenorrhoea; breast tenderness/pain; intrauterine contraceptive device expelled (partial and complete); weight increased; uterine perforation. Breast cancer; hypersensitivity including rash, urticaria and angioedema; procedural pain and/or bleeding; insertion related vasovagal reaction with dizziness or syncope; sepsis have been reported. Others: refer to full Product Information. Interactions: CYP450 inducers e.g. anticonvulsants & anti-infectives. Dosage & administration: Initial release rate 20 microgram levonorgestrel per 24 hours. Mirena should be removed after 5 years. Inserted into the uterine cavity by trained healthcare professional. Date of most recent amendment: 20 March 2014. Reference: 1. Mirena Approved Product Information. PLEASE REVIEW FULL PRODUCT INFORMATION BEFORE PRESCRIBING. Full Product Information is available on request from Bayer Australia Ltd, or can be accessed from www.ebs.tga.gov.au. Bayer Australia Ltd. ABN 22 000 138 714, 875 Pacific Highway, Pymble NSW 2073. ® Registered Trademark of Bayer AG, Germany. L.AU.WH.05.2014.0473. May 2014. PBS Information: Restricted Benefit. Contraception. Idiopathic menorrhagia where oral therapies are ineffective or contraindicated. BA2753 Mirena Ad Update (O&G).indd 1 11/02/2016 10:51 am BEHINDBEHIND TMA In the diagnosis of postpartum TMA, the first 48 hours can be decisive 1 • Both HELLP syndrome and pregnancy-related atypical Haemolytic Uraemic Syndrome (P-aHUS) can have similar clinical presentations 2 • The onset of postpartum HELLP syndrome is usually within 48 hours of birth 1 • In contrast, P-aHUS can occur at any time in the 4 months following birth 2 • Prompt, accurate diagnosis is essential as there is a high (62%) risk of the development of End Stage Renal Disease (ESRD) within the first month of aHUS manifestation 2 It is recommended that any patient suspected of having aHUS be referred to a nephrologist For more information please call 1800 788 189 or visit PREGNANCYRELATEDAHUS.COM.AU HELLP = Haemolytic Anaemia, Elevated Liver Enzymes, and Low Platelets. References 1. Cakmak B, et al. Journal of Clinical and Diagnostic Research. 2013;7(12):2998-2999. 2. Fakhouri F, et al. J Am Soc Nephrol. 2010;21:859-867. 3. Laurence J. Clin Adv Hematol Oncol. 2012;10(suppl 17):1-12. © 2016 Alexion Pharmaceuticals Australasia Pty Limited. All rights reserved. ACN 132 343 036. Suite 401, Level 4, Building A, 20 Rodborough Rd, Frenchs Forest NSW 2086 Australia. Feb 2016 AU/UNB-aHUS/16/0002 Contents Making headlines 10 Editorial: there’s no such thing as ‘off the record’ OMagazine& G Julia Serafin O&G Magazine Advisory Group 13 Editorial: dog bites man Dr Gillian Gibson Fellows Rep, New Zealand Stephen Robson A/Prof Stephen Robson Fellows Rep, ACT Dr Enzo Lombardi Fellows Rep, SA 15 Thalidomide: a byword for tragedy Dr John Schibeci Diplomates Rep, NSW Dr Brett Daniels Young Fellows Rep, TAS Debra Kennedy Dr Alexa Bendall Trainees Rep, QLD 18 Standing up to the Grim Reaper: the early days of AIDS O&G Magazine Editors Penelope Griffiths Alex Wodak Julia Serafin Lisa Westhaven 20 How to deal with the media during a crisis Designer and Production Editor Maura Angle Lisa Westhaven 21 Hormone alert for cancer: how not to release data from your RCT Editorial Communications O&G Magazine Advisory Group, Rod Baber RANZCOG 254–260 Albert Street 26 Tales from the test tube revolution EAST MELBOURNE, VIC 3002 Australia Gab Kovaks (t) +61 3 9417 1699 (f) +61 3 9419 0672 (e) [email protected] 30 ART: fertile ground for reporters Anusch Yazdani Advertising Sales Bill Minnis Director Minnis Journals 34 Singular success: ART in Australia and New Zealand (t) +61 3 9836 2808 Robert Norman (f) +61 3 9830 4500 (e) [email protected] 37 Creation of a controversy: stem cell science Printer William Ledger Highway Press (t) +61 3 9887 1388 39 Mont Liggins: an obstetrical scientist with a lasting impact factor (f) +61 3 9800 2270 Peter Gluckman O&G Magazine authorised by Ms Alana Killen © 2016 The Royal Australian 42 Two revolutions in one lifetime: HPV and New Zealand College of Obstetricians Michelle Harris and Gynaecologists (RANZCOG). All rights reserved. No part of this publication may be 44 RU486: behind the headlines reproduced or copied in any form or by any Caroline de Costa and Michael Carrette means without the written permission of the publisher. The submission of articles, news items and letters is encouraged. 46 Celebrating more than 50 years of the Pill Margaret Sparrow For further information about contributing to O&G Magazine visit: www.ranzcog.edu.au/ publications/oandg-magazine.html 48 Victoria’s secret: chloroform and the acceptability of analgesia for birth George Skowronski The statements and opinions expressed in articles, letters and advertisements in O&G Magazine are those of the authors and, unless 50 Caesarean section in the news: plus ça change... specifically stated, are not necessarily the Paul Howat views of RANZCOG. Although all advertising material is expected Letter to the editor to conform to ethical and legal standards, acceptance does not imply endorsement by 52 ROTEM and TEG in an obstetric setting the College. Anna Dalton, Kylie Webber and Kim Osborn ISSN 1442-5319 54 William Smellie Cover: © studiostoks Shutterstock Euan M Wallace 312287618 2 O&G Magazine Contents RANZCOG Regional Committees New Zealand Dr Ian Page Chair Jane Cumming Executive Officer Level 6 Featherson Tower 23 Waring Taylor Street/ PO Box 10611 Women’s health WELLINGTON 6011, NEW ZEALAND 56 Case report: Successful pregnancy outcome after treatment for primary (t) +64 4 472 4608 (f) +64 4 472 4609 (e) [email protected] lung adenocarcinoma Michelle Englund, Stephen Robson, William Burke, Stephen Australian Capital Territory Brazenor, David Leong, Angela Rezo and John Tharion Dr Stephen Adair Chair Case report: Endometriosis in the inguinal canal New South Wales 59 Prof Gabrielle Casper Chair Philip Jeans and Stephen Robson Lee Dawson Executive Officer Suite 2, Ground Floor, 69 Christie Street ST LEONARDS, NSW 2065 64 Five years on: the PANDA Helpline (t) +61 2 9436 1688 (f) +61 2 9436 4166 (e) [email protected] Terri Smith Queensland 67 : the bullying consultant Dr Carol Breeze Chair Q&a Linda Cupitt Acting Executive Officer Sarah Tout Unit 22, Level 3, 17 Bowen Bridge Road HERSTON, QLD 4006 (t) +61 7 3252 3073 (f) +61 7 3257 2370 68 Strengthening the rights of rural women in Fiji (e) [email protected] South Australia/Northern Territory Swaran L Naidu Dr Roy Watson Chair Tania Back Executive Officer Level 1, 213 Greenhill Road Eastwood 5063 The College (t) +61 8 8274 3735 (f) +61 8 8271 5886 5 From the President (e) [email protected] Tasmania Michael Permezel Dr Emily Hooper Chair Mathew Davies Executive Officer College House 8 From the CEO 254–260 Albert Street EAST MELBOURNE, VIC 3002 Alana Killen (t) +61 3 9663 5606 (f) + 61 3 9662 3908 (e) [email protected] 72 The RANZCOG Provincial Core Training program Victoria Dr Alison Fung Chair Anthony Geraghty Mathew Davies Executive Officer College House 254–260 Albert Street 75 RANZCOG Women’s Health Award winners 2015 EAST MELBOURNE, VIC 3002 (t) +61 3 9663 5606 (f) + 61 3 9662 3908 (e) [email protected] 76 Writing award for secondary students continues to grow Western Australia Dr Robyn Leake Chair Delwyn Lawson Janet Davidson Executive Officer Level 1, 44 Kings Park Road WEST PERTH, WA 6005/PO Box 6258 78 FRANZCOG logbook online EAST PERTH, WA 6892 (t) +61 8 9322 1051 (f) +61 8 6263 4432 Kathryn Hertrick (e) [email protected] The Royal Australian 79 Staff news and New Zealand College of Obstetricians and Gynaecologists 80 Honours awards College House 254–260 Albert Street EAST MELBOURNE, VIC 3002 (t) +61 3 9417 1699 (f) +61 3 9417 0672 81 Obituary (e) [email protected] (w)