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Background: Perinatal mental health disorders affect up to 20% of all women. Women of refugee background are likely to be at increased risk, yet little research has explored this. This study aimed to assess if women of refugee background are more likely to screen risk positive for depression and anxiety than non‐refugee women, using the Edinburgh Postnatal Depression Scale (EPDS); and if screening in pregnancy using the EPDS enables better detection of depression and anxiety symptoms in women of refugee background than routine care. Methods: This implementation study was conducted at an antenatal clinic in Melbourne, Australia. Women of refugee and non‐refugee backgrounds were screened for depression using English or translated versions of the EPDS and a psychosocial assessment on a digital platform. The psychosocial assessment records of 34 women of refugee background receiving routine care (no screening) were audited. Results: Overall, 274 women completed the EPDS; 43% of refugee background. A similar proportion of women of refugee and non‐refugee backgrounds had EPDS scores of ≥9 (39% vs. 40% p = 0.93). Women receiving the combined EPDS and psychosocial screening were more likely to receive a referral for further support than women receiving routine care (41% vs. 18%, p = 0.012). Conclusion: Similarly, high proportions of women of refugee and non‐refugee backgrounds were at increased risk of experiencing a current depressive disorder in early pregnancy, suggesting pregnancy care systems should acknowledge and respond to the mental health needs of these women. Screening appeared to facilitate the identification and referral of women compared to routine care. [ABSTRACT FROM AUTHOR]

Background: Fetal scalp blood sampling for lactate measurement (FBSLM) is sometimes used to assist in identification of the need for expedited birth in the presence of an abnormal cardiotocograph (CTG). However, there is no randomised controlled trial evidence to support this. Aim: To determine whether adding FBSLM reduces the risk of birth by emergency caesarean section in labours complicated by an abnormal CTG, compared with CTG without FBS. Material and Methods: Labouring women at a tertiary maternity hospital in Melbourne, Australia with a singleton, cephalic presentation, at ≥37 weeks gestation with an abnormal CTG pattern were randomised to the intervention (n = 61), with intermittent FBSLM in addition to CTG monitoring, or control (CTG without FBS, n = 62). The primary outcome was rate of birth by caesarean section. Secondary outcomes included overall operative birth and fetal and neonatal safety endpoints. Trial registration: ACTRN12611000172909. Results: The smaller than anticipated sample was unable to demonstrate an effect from adding FBSLM to CTG monitoring on birth by caesarean section vs monitoring by CTG without FBS (25/61 and 28/62 respectively, P = 0.64, risk ratio 0.91, 95% confidence intervals 0.60–1.36). One newborn infant in the CTG group met the criteria for the composite neonatal outcome of death or serious outcome, neonatal encephalopathy, five‐minute Apgar score < 4, neonatal resuscitation, admission to neonatal intensive care unit for 96 h or more. Conclusion: We were unable to provide robust evidence of the effectiveness of FBSLM to improve the specificity of the CTG in the assessment of fetal wellbeing. [ABSTRACT FROM AUTHOR]

In 2015 Nippita and colleagues developed a novel system to classify women undergoing induction of labour ( IOL), which sought to overcome the problems of indication-based classification. We explored the utility and feasibility of this new system at Monash Health in Melbourne. We found overall induction rates of 24.7% compared with the New South Wales rates of 25.4% reported by Nippita et al. The classification system was easy to apply because it uses routinely and accurately collected data. There was no misinterpretation of the classification groups. The system provides a robust means for auditing IOLs and reviewing their appropriateness. [ABSTRACT FROM AUTHOR]