• Laboratory assessment of iron status in pregnancy.

      Walsh, Thomas; O'Broin, Sean D; Cooley, Sharon; Donnelly, Jennifer; Kennedy, John; Harrison, Robert F; McMahon, Corinna; Geary, Michael; Rotunda Hospital, Dublin, Ireland. (2012-02-01)
      BACKGROUND: Efforts to improve maternal nutrition during pregnancy prompted an observational study of the occurrence of maternal iron deficiency and its laboratory diagnosis in almost 500 pregnancies. METHODS: In this longitudinal study, the biochemical and haematological iron indices of women (n=492) attending a prenatal clinic in a Dublin maternity hospital were assessed at first booking (mean 15.9 weeks), and after 24 weeks, and 36 weeks of gestation. Full blood counts were measured. Serum ferritin (SF), zinc protoporphyrin (ZPP), and transferrin receptor (sTfR) concentrations were assayed and transferrin receptor index (sTfR-Index) was calculated. The occurrence of low values and their diagnostic values were considered. RESULTS: A high occurrence iron deficiency (ID) at first booking (SF<12 mug/L) had increased over six-fold by 24 weeks, and all biochemical iron indices reflected progressive iron depletion right up to term. The WHO recommended anaemia "cut-off" (Hb<110 g/L) was insensitive to biochemical iron deficiency at booking, missing over 90% of the low SF values (SF<12 mug/L) which were mostly associated with much higher Hb levels. CONCLUSIONS: This study stresses the importance of including a biochemical index of iron status in prenatal screening and supports SF as the best indicator of biochemical ID overall. sTfR was insensitive to iron deficiency in early pregnancy, whereas the sTfR-Index, as a ratio, has the potential to distinguish between ID and physiological anaemia, and may offer stability in the assessment of iron stores from early pregnancy to full term. A policy of early screening of both Hb and SF concentrations is recommended as the minimum requirement for surveillance of maternal iron status in pregnancy.
    • Laboratory assessment of iron status in pregnancy.

      Walsh, Thomas; O'Broin, Sean D; Cooley, Sharon; Donnelly, Jennifer; Kennedy, John; Harrison, Robert F; McMahon, Corinna; Geary, Michael; Rotunda Hospital, Dublin, Ireland. (2011-07)
      Efforts to improve maternal nutrition during pregnancy prompted an observational study of the occurrence of maternal iron deficiency and its laboratory diagnosis in almost 500 pregnancies.
    • Lack of awareness of risk factors for primary toxoplasmosis in pregnancy.

      Ferguson, W; Mayne, P D; Cafferkey, M; Butler, K; Department of Paediatrics, The Rotunda Hospital, Parnell Square, Dublin 1, Ireland. wferguson@rotunda.ie (2011-12)
      The overall seroprevalence of toxoplasma antibodies in women of childbearing age in Ireland is 25% [1]. Hence, 75% of women remain susceptible to primary toxoplasma infection during pregnancy, which if transmitted to the foetus can cause ocular, neurological and other sequelae. Toxoplasma exposure during pregnancy can be avoided if there is an awareness of the potential sources of infection, mainly contaminated food, water, soil and cat faeces.
    • Length of latency with preterm premature rupture of membranes before 32 weeks' gestation.

      Peaceman, Alan M; Lai, Yinglei; Rouse, Dwight J; Spong, Catherine Y; Mercer, Brian M; Varner, Michael W; Thorp, John M; Ramin, Susan M; Malone, Fergal D; O'Sullivan, Mary J; et al. (2015-01)
      The objective of the article is to describe latency for patients with preterm premature membrane rupture (PPROM) between 24(0/7) and 31(6/7) weeks' gestation.
    • Ligation of the patent ductus arteriosus in preterm infants: understanding the physiology.

      El-Khuffash, Afif F; Jain, Amish; McNamara, Patrick J; Department of Pediatrics, The Rotunda Hospital, Dublin, Ireland. (2013-06)
    • The management of reduced fetal movements in an uncomplicated pregnancy at term: results from an anonymous national online survey in the Republic of Ireland.

      Unterscheider, J; Horgan, R P; Greene, R A; Higgins, J R; The Anu Research Centre, Department of Obstetrics and Gynaecology, University College Cork, Cork University Maternity Hospital, Wilton, Cork, Ireland. julia_unterscheider@hotmail.com (2010)
      There is currently inconsistent evidence and clinical guidance on how to best manage a pregnancy complicated by reduced fetal movements. This novel, web-based, anonymous questionnaire evaluated 96 assessment and management approaches from doctors working in obstetrics in the Republic of Ireland who were presented with a clinical scenario of a primigravida concerned about reduced fetal movements at 39+3 weeks' gestation. This study identified a lack of clinical practice guidelines available in maternity hospitals in the Republic of Ireland. We demonstrated that almost all clinicians applied more than one assessment method and that most incorporated a cardiotocograph into their assessment. There was a low uptake of simple symphysio-fundal height measurement and high usage of kickcharts. The minority of clinicians admitted or induced their patients. This survey identified the need for national and international guidelines to ensure safe antepartum care and delivery.
    • Management of the tiny infant: how can we improve?

      Clarke, T Prof.; Rotunda Hospital (Arab Neonatal Forum, 2009-05)
    • Managing the emerging clinical risk of cutaneous bullae and decubitus ulcers in obstetric patients.

      Corcoran, Siobhan; Donnelly, Jennifer C; Breathnach, Fionnuala; Department of Obstetrics and Gynecology, Rotunda Hospital, Dublin, Ireland. siobhan.corcoran@yahoo.com (2013-03)
    • Maternal 25-hydroxyvitamin d and preterm birth in twin gestations.

      Bodnar, Lisa M; Rouse, Dwight J; Momirova, Valerija; Peaceman, Alan M; Sciscione, Anthony; Spong, Catherine Y; Varner, Michael W; Malone, Fergal D; Iams, Jay D; Mercer, Brian M; et al. (2013-07)
      To assess whether there was an independent association between maternal 25-hydroxyvitamin D concentrations at 24-28 weeks of gestation and preterm birth in a multicenter U.S. cohort of twin pregnancies.
    • Maternal hyperinsulinism and glycaemic status in the first trimester of pregnancy are associated with the development of pregnancy-induced hypertension and gestational diabetes.

      Kayemba-Kay's, Simon; Peters, Catherine; Geary, Michael P P; Hill, Nathan R; Mathews, David R; Hindmarsh, Peter C; Developmental Endocrinology Research Group, Clinical and Molecular Genetics Unit, Institute of Child Health, University College London, 30 Guilford Street, London WC1N 1EH, UK. (2013-03)
      To evaluate the relationships across a range of glucose and insulin measures at 12 weeks of gestation with the development of pregnancy-induced hypertension (PIH), gestational diabetes mellitus (GDM) and birth size.
    • Maternal insulin-like growth factors 1 and 2 (IGF-1, IGF-2) and IGF BP-3 and the hypertensive disorders of pregnancy.

      Cooley, Sharon M; Donnelly, Jennifer C; Geary, Michael P; Rodeck, Charles H; Hindmarsh, Peter C; Rotunda Hospital, Parnell Street, Dublin 1, Ireland. smcooley@hotmail.com (2012-02-01)
      OBJECTIVE: To investigate the relationship between levels of insulin-like growth factors 1 and 2 (IGF-1, IGF-2) and insulin-like growth factor binding protein 3 (IGFBP-3) in antenatal maternal serum and gestational hypertension and pre-eclampsia (PET). METHODS: Prospective cohort study of 1650 low-risk Caucasian women in a University teaching hospital in London. Statistical analysis was performed using commercial software (SPSS for Windows, version 6.1, SPSS, Chicago, IL), with P < 0.05 as significant. Maternal IGF 1, IGF 2 and IGF BP-3 were assessed on maternal blood at booking. Blood pressure was checked at each visit in conjunction with urine analysis. The Davey & MacGillivray 1988 classification system was used in making the diagnosis of PET. RESULTS: There was no significant correlation between maternal IGF-1 or IGFBP-3 levels and gestational hypertension or PET. However, a significant positive correlation does exist between maternal IGF-2 levels and PET. CONCLUSIONS: Maternal IGF-2 has a significant positive correlation with PET.
    • Maternal insulin-like growth factors 1 and 2 (IGF-1, IGF-2) and IGF BP-3 and the hypertensive disorders of pregnancy.

      Cooley, Sharon M; Donnelly, Jennifer C; Geary, Michael P; Rodeck, Charles H; Hindmarsh, Peter C; Rotunda Hospital, Parnell Street, Dublin 1, Ireland. smcooley@hotmail.com (2010-07)
      To investigate the relationship between levels of insulin-like growth factors 1 and 2 (IGF-1, IGF-2) and insulin-like growth factor binding protein 3 (IGFBP-3) in antenatal maternal serum and gestational hypertension and pre-eclampsia (PET).
    • Maternal Mortality in Women with Epilepsy

      Holohan, M (Irish Medical Journal, 2016-10)
      It is estimated that, in Ireland, there are 10,000 women with epilepsy of childbearing potential1. In this paper the maternal mortality rate for women with epilepsy attending the Rotunda Hospital Epilepsy Clinic 2004 - 2013 was determined. There were 3 maternal deaths in women with epilepsy during this time, which represents a mortality rate of 0.8%. In those women who died, there were concerns in relation to risks to the foetus by taking Anti-Epileptic Drugs (AED) and also issues with access to neurology services before pregnancy, acceptance of specialist support and lack of consistency in advice from health care professionals outside of Ireland. Implementing the nationally agreed care plan for women with epilepsy will improve the quality of care given and potentially we will see a reduction in maternal mortality in these women.
    • Methadone and perinatal outcomes: a prospective cohort study.

      Cleary, Brian J; Eogan, Maeve; O'Connell, Michael P; Fahey, Tom; Gallagher, Paul J; Clarke, Tom; White, Martin J; McDermott, Christine; O'Sullivan, Anne; Carmody, Deirdre; et al. (2012-08)
        Methadone use in pregnancy has been associated with adverse perinatal outcomes and neonatal abstinence syndrome (NAS). This study aimed to examine perinatal outcomes and NAS in relation to (i) concomitant drug use and (ii) methadone dose.
    • Methadone dosing and prescribed medication use in a prospective cohort of opioid-dependent pregnant women

      Cleary, Brian J.; Reynolds, Kieran; Eogan, Maeve; O'Connell, Michael P.; Fahey, Tom; Gallagher, Paul J.; Clarke, Tom; White, Martin J.; McDermott, Christine; O'Sullivan, Anne; et al. (Society for the study of Addiction, 2013-02-20)
    • Micro-sampling in the preterm: comparing gold standard laboratory tests to blood gas analyzer

      Iskandar, D; Halling, C; Gallagher, P; Wortly, A; Foran A; Rotunda Hospital (2009)
    • Middle cerebral artery Doppler: Doppler masterclass

      Breathnach FM; Rotunda Hospital (Perinatal Ireland Research Consortium, 2009)