Objectives Ultrasound‐based screening is widely employed for the detection of congenital malformations in utero including congenital heart disease (CHD), but there is widespread variability in the efficacy of screening programs. We aimed to evaluate current antenatal detection rates of selected congenital heart defects in Victoria. Methods Data were collected from the Victorian Perinatal Data Collection Unit and Birth Defects Registry. There were 631 209 births in Victoria (1993–2002), of which 4897 cases had CHD. Cases included live births, stillbirths and termination of pregnancies because of CHD. We reviewed all cases from 1999 to 2002 with atrioventricular septal defect, simple coarctation of the aorta, double‐inlet or ‐outlet ventricle, hypoplastic left heart syndrome, simple transposition of the great arteries (TGA), tetralogy of Fallot and truncus arteriosus. Outcome measures were antenatal diagnosis, pregnancy outcome and associated malformations. Results The overall birth prevalence of CHD from 1993 to 2002 in Victoria was 7.8/1000. The antenatal detection rate for the seven selected defects from 1999 to 2002 was 52.8%. All but 4.8% of the cases had an ultrasound examination at > 13 weeks' gestation. Antenatal detection was highest for hypoplastic left heart syndrome (84.6%) and lowest for simple TGA (17.0%). Conclusions This study shows wide variation in the antenatal detection rate of CHD in Victoria. The low antenatal detection rate of TGA, a defect that should be detected easily, demonstrates suboptimal routine obstetric anomaly scanning. Copyright © 2007 ISUOG. Published by John Wiley & Sons, Ltd.

Objective Higher risks of uterine rupture have been reported among women attempting vaginal birth after caesarean (VBAC) particularly following induction with prostaglandins, compared with women who do not labour. This study aimed to estimate these risks as well as that associated with oxytocin use.Design Population-based retrospective cohort study involving all women who had their first births by caesarean. In their second birth, risks of uterine rupture among women without labour and women who had labour augmented or induced were compared with women who gave birth after spontaneous labour.Setting Four Australian states in 1998-2000.Population Women on pregnancy outcome databases with a second birth after a prior caesarean for their first birth.Methods From 29 008 women identified from the databases, those with uterine rupture were identified and validated using hospital case records.Main outcome measure Uterine rupture.Results The risk of complete uterine rupture among women without labour was 0.01%. The risk in spontaneous labour without augmentation was 0.15%, considerably higher when there was augmentation with oxytocin (1.91%). The risk with induction of labour was 0.54% for oxytocin alone, 0.68% for prostaglandin alone, 0.63% without either and 0.88% when they were combined. Compared with spontaneous labour, risks were increased three-to five-fold for any induction, six-fold for prostaglandin combined with oxytocin and 14-fold for augmentation with oxytocin.Conclusions Careful consideration should be given to the use of oxytocin for augmentation of labour or induction by any method for women with a previous caesarean in view of increased risks of uterine rupture.Keywords Uterine rupture, vaginal birth after caesarean.Please cite this paper as: Dekker G, Chan A, Luke C, Priest K, Riley M, Halliday J, King J, Gee V, O'Neill M, Snell M, Cull V, Cornes S. Risk of uterine rupture in Australian women attempting vaginal birth after one prior caesarean section: a retrospective population-based cohort study.

The data do not suggest large differences in total prevalence of HPE among the studied populations that would be useful to generate etiological hypotheses.

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This paper describes methods used and results obtained from a study that measured the accuracy of a routinely collected population-based data set. Data on a random sample of births were extracted from the 2003 Victorian Perinatal Data Collection (VPDC) and compared with information in the original medical record. Accuracy was calculated for 111 items related to diverse aspects of maternity and neonatal health and care. Sensitivity, specificity, positive predictive value and negative predictive value were calculated for dichotomous items. Seventynine items were accurate in at least 97% of cases, 45 of them in at least 99% of cases, and accuracy was below 90% for five items. Very high specificities demonstrate that conditions were rarely reported in error. Lower sensitivities indicate that some events that occurred went unreported on the perinatal form. The excellent results for specifi city indicated that the dataset is appropriate for a conservative analysis of relationships between factors. The lower sensitivities could result in true relationships between factors remaining unidentified. Reasons for discrepancies between the VPDC and the original medical record are described.