Checkup Medical Column for Oct 27

First-time mothers on an epidural who lie down in the later stages of labour are more likely to have a spontaneous vaginal delivery, a study has found.

A weekly round-up of news affecting your health.

HEART

Research has revealed many Australians have poor understanding of the risk factors for heart disease.

A study by researchers at the Baker Heart and Diabetes Institute, based on a survey of 8000 adults, found three-quarters of participants did not know heart disease was a leading cause of death in women and only half knew it was the No.1 cause of death for men.

Study co-author Professor Garry Jennings, of the Heart Foundation, says most people could identify poor diet, smoking and sedentary lifestyle as risk factors for heart disease.

Only six per cent recognised high blood pressure and one in 10 identified high cholesterol as clinical risk factors, Professor Jennings said.

"Also of great concern was the lack of awareness of clinical risk factors among people taking medications for heart disease and those who had a history of heart attack or angina," he said.

The study also found people mistakenly believed breast cancer was the leading cause of death for women.

"We advise all adults aged 45 and over to have regular heart health checks with their health professionals and to be aware of their blood pressure and cholesterol levels," Prof Jennings said.

He said more campaigns were needed to improve the public's understanding of heart disease and its risk factors.

LABOUR

First-time mothers on an epidural who lie down in later stages of labour are more likely to have a spontaneous vaginal delivery, a study has found.

Evidence has previously shown painkillers administered via epidural leads to a prolonged second stage of labour and an increased risk of a instrumental vaginal delivery; that is, involving the use tools such as forceps or a vacuum device.

It's been suggested the mother's position during labour might affect the risk of instrumental vaginal delivery.

To investigate this, a randomised control trial involving more than 3000 pregnant UK women who gave birth between October 2010 and January 2014 showed significantly fewer spontaneous vaginal births - a birth that does not require the aid of tools - occurred in women in the upright group, 35 per cent versus 41 per cent.

The authors of the study, published in the journal BMJ, said this result was unchanged when adjusting for age, ethnicity, diagnosis of delay and the nature of the onset of labour.

"Evidence from this randomised controlled trial indicates that a policy of adopting a lying-down position in the second stage of labour in women having their first baby with epidural analgesia increases the chances of a spontaneous vaginal birth. No disadvantages were apparent to short or longer-term outcomes for mother or baby," the authors said.

POLYCYSTIC OVARY SYNDROME

Lifestyle interventions and herbal medicines are an effective treatment of polycystic ovary syndrome (PCOS), Australian scientists say.

THe hormonal disorder affects one in five young Australian women and one in four Australian indigenous women. Its symptoms can range from weight gain to an irregular menstrual cycle and infertility.

A study by researchers at the National Institute of Complementary Medicine and Western Sydney University investigated the impact of herbal medicine on 122 women aged 18-44 years with a confirmed medical diagnosis of PCOS.

"Lifestyle modification is the current first line-intervention. However, as many as seven in 10 women with PCOS use additional complementary medicine and approximately two out of five use herbal medicine. Hence, we sought to test the most commonly used herbal interventions," lead author and NICM adjunct research fellow Dr Susan Arentz said.

The three-month trial compared the clinical effect of combining a herbal medicine treatment with a lifestyle intervention, compared with lifestyle alone for improved menstrual regularity in overweight women with PCOS, Dr Arentz said.

The findings, presented at the Fertility Society of Australia Annual Conference 2017 in Adelaide this week, showed 32.9 per cent more women in the group receiving both interventions reported greater improvement in menstrual regularity.

The average menstrual cycle length was 43 days shorter in the combination group compared with those in the lifestyle-only study group.

Those to receive herbal medicine also reported improved pregnancy rates, glucose metabolism, blood pressure and reductions in depression, anxiety and stress.

University of NSW Associate Professor Jason Abbott, gynaecologist and trial co-supervisor, says the trial has demonstrated this combination non-pharmaceutical approach might improve gynaecological outcomes for women with PCOS.

"Many women do not want to take medications or may have considerable side effects from medications and a scientific approach that utilises lifestyle changes and effective complementary and alternative medications is more suited to the changing needs of a woman with PCOS," Prof Abbott said.

However, he said more research was needed to confirm the findings.

Source AAP

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