EDITOR’S NOTE

We are delighted to present the eighth edition of the Australasian Medical Journal (AMJ) for 2025

Hysteroscopy in a Secondary Maternity Hospital: Indications, Outcomes, and Complications

Background: Hysteroscopy is a cornerstone for diagnosing and treating intrauterine pathologies, yet data from secondary maternity settings are limited. Objective: To describe the indications, findings, interventions, and complications of diagnostic and operative hysteroscopy in a secondary maternity hospital. Methods: A retrospective study of 332 women undergoing hysteroscopy at Menzel Temim Regional Hospital (level IIB) from January 2018 to December 2020. Data on demographics, indications, imaging, hysteroscopic findings, interventions, and complications were extracted from medical records. Descriptive statistics summarized outcomes. Results: Mean age was 46.9 ± 9.8 years; 48.6% were premenopausal. Abnormal uterine bleeding (AUB) was the primary indication (48.2%), followed by pelvic pain (27.5%) and infertility (12.7%). Diagnostic hysteroscopy (90.4%) identified endometrial hypertrophy (20.2%), polyps (18.4%), and fibroids (7.8%); 12.6% were normal or inconclusive. Operative hysteroscopy (27.4%) included polypectomy (10.9%), myomectomy (4.8%), and adhesiolysis (3.0%). Complications occurred in 4%, including uterine perforation (1.5%) and hemorrhage (0.6%). General anesthesia was used in 84.6%, and saline irrigation in 89.8%. No TURP syndrome was reported. Conclusion: Hysteroscopy effectively diagnosed and managed intrauterine pathologies in a secondary setting, with AUB driving most procedures and low complication rates. Integrating ultrasound guidance and local anesthesia could enhance outcomes

Postpartum Hematoma of the Labia Majora: A Rare Case Report and Review of Recommendations

Introduction: Postpartum vulvar hematomas are rare but potentially severe complications that can occur without evident risk factors, impacting maternal prognosis. Methods: We report the case of a 35-year-old multiparous woman (P7G7) who presented on the 5th day postpartum with a painful hematoma of the labia majora following an unassisted vaginal delivery at home without instrumentation or episiotomy. Clinical examination and perineal ultrasound confirmed a moderate-sized encapsulated hematoma, managed conservatively with symptomatic treatment, prophylactic antibiotics, and close monitoring. Results: The hematoma resolved nearly completely by the 15th day postpartum, with the patient resuming normal activities without complications. Discussion: This case highlights the importance of rapid diagnosis and individualized management to minimize complications. We discuss pathophysiology, therapeutic options—which remain non-consensual—and recommendations based on current literature. Conclusion: Early diagnosis and conservative management are key for moderate vulvar hematomas, emphasizing the need for structured postpartum follow-up

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It is with great pleasure that I present to you the latest issue of the Australasian Medical Journal (AMJ) for the year 2025

Short Umbilical Cord Diagnosed at 12 Weeks of Amenorrhea : Case Report

Introduction The umbilical cord plays a critical role in fetal development, facilitating nutrient, oxygen, and waste exchange. Deviations from normal length, particularly a short umbilical cord (less than 35 cm at term), are associated with adverse perinatal outcomes, including restricted fetal movement, intrauterine growth restriction (IUGR), and preterm birth. Although typically detected later in pregnancy or postpartum, advancements in ultrasonography enable earlier diagnosis. This report presents a case of a short umbilical cord identified at 12 weeks of gestation through routine prenatal ultrasonography, emphasizing the significance of early detection for clinical decision-making and maternal-fetal outcomes. Methods A 29-year-old gravida 2, para 1 woman underwent routine prenatal ultrasonography at 12 weeks of gestation. A high-resolution transabdominal ultrasound and three-dimensional imaging confirmed an umbilical cord measuring 8 cm, significantly shorter than expected. Doppler studies showed normal umbilical artery blood flow. Amniotic fluid volume, fetal movements, and structural development were assessed, revealing no additional anomalies. Following multidisciplinary counseling, the pregnancy was terminated at 12 weeks of gestation. Post-procedure fetopathologic examination verified the findings. Results The umbilical cord's short length was confirmed via fetopathologic examination (8 cm), with normal placenta morphology and no fetal structural abnormalities. This early diagnosis allowed for informed counseling and management, prioritizing maternal well-being given the uncertain fetal prognosis. The case underscores the role of advanced imaging in early anomaly detection and the subsequent impact on care planning. Discussion Short umbilical cord is a rare anomaly with significant implications for fetal and maternal outcomes. Early detection using advanced ultrasonography, as demonstrated in this case, facilitates timely counseling and management. The decision to terminate the pregnancy was made to mitigate maternal risks and address the uncertain prognosis. This case underscores the importance of a personalized approach to rare prenatal anomalies. Further research is needed to elucidate the etiology, optimize diagnostic protocols, and establish evidence-based guidelines for management. Conclusion This case highlights the utility of advanced ultrasonography in detecting rare prenatal anomalies, such as a short umbilical cord, as early as the first trimester. Early diagnosis and multidisciplinary counseling enable tailored care, optimizing outcomes for both mother and fetus. Further studies are essential to refine diagnostic and management strategies for this rare conditio

EDITOR’S NOTE

We are delighted to present the tenth edition of the Australasian Medical Journal (AMJ) for 2025