Premature labour and birth

Full term for pregnancy is defined as 37 – 42 weeks from the beginning of the last menstrual period. Premature birth is a very important condition, being the leading cause of death and disability of babies.

Despite many advances in obstetric and neonatal care, premature birth still occurs in approximately 10% of pregnancies and significantly premature babies are far more likely to die or become disabled than babies born at full term. Read more

New cover arrangements

You will no doubt be aware that I practice by myself and I have avoided the increasingly popular trend whereby obstetricians practice in groups of up to six with any of the doctors being “on call” for births at any particular time.

This has meant that I have literally personally delivered more than 99% of my own patients’ babies when many other obstetricians expect to deliver approximately 85% of their own babies. In fact since February 2008 I have not missed one birth. Read more

Nausea and vomiting in early pregnancy

Nausea and Vomiting (N and V) are common symptoms of early pregnancy affecting 60 to 70 percent of all pregnant women. They usually settle down by 12 weeks gestation.

While most women are not unduly troubled by N and V (although vomiting is never pleasant) about one third of all women have to alter their daily activities and at least 25 percent lose time from their paid work or household tasks. A small proportion of women (around 3 percent) suffer severe N and V characterised by a number of features: Read more

Leg cramps in pregnancy

Many women – almost half, in fact – suffer from leg cramps in pregnancy. These involuntary spasms usually begin to cause trouble at night during the second half of pregnancy.

The cramps mostly affect the calves. Some women find it difficult to sleep because of the pain from these leg cramps.

Considering leg cramps are so common in pregnancy you would expect there to be a well studied effective treatment. In fact there is surprisingly little research into this common problem. However the strongest evidence for any particular treatment relates to magnesium supplements. A Swedish study reported in 1995 found that magnesium tablets taken twice a day for three weeks were more effective than no treatment in reducing the frequency and severity of leg cramps. Women who had suffered from cramps every second night only got them once or twice a week after taking magnesium. Read more

GP information

Making a referral

Please write me a referral and either give it to your patient or send it to me at:

Suite 26
Level 7
Prince of Wales Private Hospital
Barker St
Locked Bag 2
Randwick NSW 2031

Or fax it to:
(02) 9650 4898

Or email me at rbuist@gmail.com Read more

Caffeine intake during pregnancy

Caffeine is pretty much my favourite substance in the whole world. I try to start every day with a long black and after two double shot coffees I tend to move on to tea for the rest of the day.

The issue of caffeine use in pregnancy has been around for a while and many authorities advise women to reduce their caffeine intake or eliminate its use altogether. The scientific literature is a little conflicting on this topic however so I am a little more circumspect. Read more

Air travel during pregnancy

Travelling by air during pregnancy is a very important issue and one that generates many questions from pregnant women.

Travelling by air is very important during pregnancy because it is very hard to go to Port Douglas, Fiji or Noumea shortly after your baby (? babies) is (are) born.

The complication we wish to prevent is that of formation of blood clots in the veins of the legs (Deep Vein Thrombosis, or DVT) and movement of such clots to the lungs (Pulmonary Embolus, or PE). Because doctors love acronyms, we call DVTs and PEs VTE – Venous Thrombo-Embolism. Read more

Pregnancy Information Sheet

Congratulations on your pregnancy. The following information is provided as a guide to help you to plan the next few months.
Antenatal care
Your first visit will usually be between 6 and 12 weeks of pregnancy.

At this visit I will take a medical history and perform an examination. We will discuss arrangements for your antenatal care and the birth. I look after women at the Royal Hospital for Women and the Prince of Wales Private Hospital.

Subsequent visits are monthly until 28 weeks, fortnightly to 36 weeks, then weekly until the birth. If your pregnancy is complicated in any way I am likely to see you more frequently. If you would like me to share your antenatal care with your GP I am happy to do so. I’d be delighted if your partner or any other family members attended your visits. Read more

Infant male circumcision – to snip or not to snip?

Head to head: Is infant male circumcision an abuse of the rights of the child?

Hinchley G (Yes) and Patrick K (No). British Medical Journal 8^th December 2007. Volume 335, page 1180.

Conclusion: Er, none.

Comment: Male circumcision attracts strongly held views from all parts of society as to the appropriateness or otherwise of this procedure. The operation’s advocates and critics can produce reams of scientific evidence that provide “conclusive” evidence of the operations health benefits and harms respectively. With the possible exception of the reduction transmission of HIV in sub Saharan Africa, many reputable medical authorities have produced statements to the effect that male circumcision confers no health benefits to the individual. Read more

Caesarean Section – Game Over?

Reference: Maternal and neonatal individual risks and benefits associated with caesarean delivery:
multicentre prospective study. Villar et al. British Medical Journal 17^th November 2007. Volume 335, page 1025.

Conclusions:
“Caesarean delivery independently reduces overall risk in breech (bottom – first) presentations and risk of intrapartum (during labour) fetal death in cephalic (head – first) presentations but increases the risk of severe maternal and neonatal morbidity (harm) and mortality (death) in cephalic presentations.” Read more