Day 2 | Session 4 | Concurrent | Gynaecology - Free Communications

How the change to primary HPV screening affected referrals and detection of high-grade abnormalities in colposcopy clinics in Canterbury, Aotearoa / New Zealand

Background: In June 2023, the New Zealand Cervical Screening Programme guidelines1 changed from cytology-based cervical screening to primary HPV screening.

Objective: To assess the impact of the guideline change on the number of new colposcopy referrals, time to colposcopy, and number of high-grade abnormalities in people referred to the Christchurch colposcopy service.



Dr Brigitte King
O&G Registrar, FRANZCOG Trainee
Canterbury

Dr Brigitte King is a 4th year RANZCOG trainee currently completing a six-month gynae-oncology registrar run at Christchurch Women’s hospital. Outside of the hospital Brigitte enjoys skiing, surfing or hiking around Ōtautahi, Canterbury.


Mapping health professional perspectives of epistemic (in)justices in gynaecological care: developing a shared understanding

Clinical epistemic injustice occurs when a healthcare professional prejudicially discredits a person’s knowledge or lived experience, resulting in epistemic harm. This impacts healthcare by increasing missed diagnosis, disease burden and morbidity, and reducing trust. 

People seeking gynaecological care are particularly at risk of experiencing epistemic harms as gynaecology consultations are the site of complex, sensitive and time-constrained communication interactions. 

Gynaecological care in Aotearoa New Zealand is situated within a broader sociopolitical context in which gynaecological health occupies a marginal position within medical hierarchies. This is reflected in comparatively limited access to specialised resources and constraints within undergraduate medical education, such as the proposed removal of women’s health as a mandatory component of final-year medical training at the University of Otago (2020). 

To contribute to a holistic understanding of the impacts of epistemic (in)justice in gynaecology settings, conversations with 20 nationally representative gynaecological health professionals were conducted. 


Liz Jonas
Medical Student
University of Otago
Wellington

Liz Jonas is a PhD candidate at the University of Otago, Wellington, studying epistemic injustice in clinical gynaecological interactions.

Measuring outcomes and monitoring performance: the Australasian Pelvic Floor Procedure Registry (APFPR) is coming to New Zealand

Background: Following an Australian Senate enquiry into outcomes from pelvic mesh, mesh products for pelvic floor disorders were deregistered, except for mid-urethral slings for SUI and mesh for transvaginal POP procedures. The APFPR was established in 2019 to monitor outcomes from mesh for these procedures.

Objective: To report on the current activities of the APFPR and the development of the New Zealand (NZ) module of the APFPR.


Professor Susannah Ahern
Clinical Outcomes Data Research and Reporting Unit
Monash University

Professor Ahern is a medical administrator and academic in health services research. As the Head, Clinical Outcomes Reporting and Research Program, she is the Monash University Academic Lead for four national clinical quality registries, including Chair of the Australasian Pelvic Floor Procedure Registry. She is the recipient of many grants for registry-related research and improvement projects and has published over 100 academic papers and forty registry reports. She is a member of national and international registry committees and collaborations.

Mate Whenua – Follow-up after early medical abortion in Aotearoa New Zealand: a randomised controlled trial

Background: Early medical abortion (EMA) accounts for >60% of all abortions in Aotearoa New Zealand (NZ).(1)  Follow up is important to ensure no live ongoing pregnancy and includes comparative serial serum βHCG or low sensitivity urine pregnancy test (UPT)(2). The NZ abortion care guideline suggests either method, citing an evidence gap precluding an evidence-based recommendation.(3)

Objective: To evaluate self-assessment with low sensitivity UPT versus comparative serum βHCG in women having EMA. Primary outcome was complete follow-up (able to discuss follow-up test results within six weeks). Secondary outcomes included successful abortion.


Jane Macdonald
Senior Research Fellow
Te Tātai Hauora o Hine, Victoria University of Wellington 

Jane trained in O&G in Scotland and Aotearoa New Zealand before switching to sexual health medicine. She is a sexual health physician, abortion provider (retired) and current senior research fellow with Te Tātai Hauora o Hine – The National Centre for Women’s Health Research, Te Herenga Waka- Victora University of Wellington. 

Her current research interests include maternal and neonatal preventable morbidity, abortion medicine, congenital syphilis, PoCT in rural primary care, HPV self-testing, and HPV vaccination.