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These data provide evidence of a geographic cluster of vulvar cancer in remote Indigenous communities in northern Australia.

Background Women with rheumatic heart disease (RHD) can have a lower cardiac reserve to cope with pregnancy and labour, leading to increased obstetric and cardiac risks. The Northern Territory has been repeatedly reported to have the highest prevalence of RHD in Australia, yet evidence specific to pregnancy is scarce in the literature. Aims The primary aim of this paper is to describe the baseline characteristics and maternal outcomes of pregnant women with RHD presenting to the largest obstetrics referral hospital in the Northern Territory. The secondary aim is to evaluate the current model of care in relation to their cardiac status. Methods A retrospective observational study was conducted over a 9.5‐year period. Demographics, cardiac, obstetrics and anaesthetics data were collected for analysis. Results One hundred and twenty‐nine pregnancies were included for analysis. All women were identified as Aboriginal or Torres Strait Islander, and 85% were of a RHD priority of 2 or 3. Of all 28 patients who had an emergency caesarean section, only one patient was indicated for cardiac reasons. There was no maternal or neonatal death reported. Three preterm births were induced secondary to maternal concerns related to RHD cardiac decompensation. There were no major adverse neonatal outcomes, including neonatal death, intraventricular haemorrhage or respiratory distress syndrome. Multidisciplinary care was also evaluated. Conclusion We observed a low rate of maternal and fetal morbidity and no mortality in a cohort of women with mild to severe RHD. These favourable outcomes have occurred in a multidisciplinary centre with significant experience in managing the medical and cultural complexities of this group.

The protocol described in the present article aims to validate the GLU test, a test of midpregnancy vaginal microbiome, for PTB risk prediction in pregnant First Nations women. Preterm birth (PTB; birth before 37 completed weeks gestation) is associated with a higher risk of adverse neonatal outcomes. First Nations communities are affected by increasing PTB rates, highest in remote communities, reaching 23%. Being able to predict women at high risk of PTB is one of the greatest challenges of our time. No reliable clinical predictors of PTB risk currently exist, beyond a previous history. Spontaneous PTB (sPTB) is highly associated with microbial infection. Recently, a Western Australian research team developed an innovative mid-pregnancy vaginal microbial DNA test, the 'Gardnerella, Lactobacillus, Ureaplasma' (GLU) test, capable of predicting up to 45% of sPTB cases. However, this test has only been validated in predominantly Caucasian pregnant women. The protocol described aims to validate the GLU test in pregnant First Nations women and where applicable, make modifications to this test to improve sensitivity and specificity within this population.

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