• Early pregnancy maternal urinary metabolomic profile to predict fetal adiposity and macrosomia

      Walsh, J; Wallace, M; Brennan, L; Mahony, R; Foley, M; McAuliffe, F (American Journal of Obstetrics and Gynaecology, 2012-01)
    • Early pregnancy ultrasound and management – effect of a multifaceted training on physician knowledge

      O’Leary, B; Khalid, A; Higgins, M (2016-02)
      Vaginal bleeding is a common event in early pregnancy, with 20-40% of pregnancies affected. Prompt diagnosis and management of bleeding is important, both to reduce morbidity and to avoid excessive emotional distress. This was a prospective study of an educational programme aimed at Obstetrics and Gynaecology BST trainees in the National Maternity Hospital, Dublin. The educational programme consisted of didactic lectures, and simulation and practical sessions. A questionnaire reviewing early pregnancy complications was used to assess participant knowledge. Six trainees participated in the programme, with five (83%) answering the questionnaire. The pre-education questionnaire showed a generally poor level of knowledge of early pregnancy complications with 8/50 (16%) questions answered correctly. Following the educational intervention there was a statistically significant increase in participant knowledge with 45/50 (90%) questions answered correctly. A significant increase in participant knowledge of early pregnancy complications followed our multifaceted educational programme. Study limitations exist, however we have shown the potential value of our educational programme.
    • ECSSIT - Elective caesarean section Syntocinon infusion trial a multi-centre randomized controlled trial oxytocin Syntocinon % iu bolus and placebo infusion versus oxtocin 5 iu bolus and 40 iu infusion for the control of blood loss at elective caesarean section

      Sheehan, S; Montgormery, AA; Carey, M; McAuliffe, F; Eogan, M; Gleeson, R; Geary, M; Murphy, DJ; ECSSIT Study Group (Irish Journal of Medical Science, 2011-02)
      Institute of Obstetricians & Gynaecologists, RCPI Four Provinces Meeting, Junior Obstetrics & Gynaecology Society Annual Scientific Meeting, Royal Academy of Medicine in Ireland Dublin Maternity Hospitals Reports Meeting, Nov 2010
    • The effect of antenatal corticosteroid treatment on the incidence of respiratory distress syndrome in twin pregnancy

      Campbell, Sarah; Geary, Michael; Breathnach, Fionnuala; McAuliffe, Fionnuala; Daly, Sean; Higgins, John; Dornan, James; Morrison, John; Burke, Gerald; Higgins, Shane; et al. (American Journal of Obstetrics and Gynaecology, 2012-01)
    • Effect of injury on S1 dorsal root ganglia in an experimental model of neuropathic faecal incontinence.

      Peirce, C; O'Herlihy, C; O'Connell, P R; Jones, J F X; School of Medicine and Medical Science, University College Dublin, Belfield, Dublin, Ireland. (The British journal of surgery, 2011-08)
      An experimental model of neuropathic faecal incontinence has recently been established. This study aimed to quantify and compare the effect of crush and compression injury on first-order sensory neurones of the inferior rectal nerve (IRN) using a nuclear marker of axonal injury, activating transcription factor (ATF) 3.
    • The effect of the term breech trial on vaginal breech delivery 8 years on

      Fitzpatrick, C; Robson, M; Hehir, M; O'Connor, H; Coulter-Smith, S; Malone, F (Am J Obstet Gynecol, 2011-01)
      Society for Maternal-Fetal Medicine. The Pregnancy Meeting Feb 2011
    • The effects of the term breech trial on vaginal breech delivery 8 years on

      Hehir, MP; O'Connor, HD; Butt, H; Robson, M; Fitzpatrick, C; Coulter-Smith, S; Malone, F (Irish Journal of Medical Science, 2011-02)
      Institute of Obstetricians & Gynaecologists, RCPI Four Provinces Meeting, Junior Obstetrics & Gynaecology Society Annual Scientific Meeting, Royal Academy of Medicine in Ireland Dublin Maternity Hospitals Reports Meeting, Nov 2011
    • Efficacy and safety of intravenous Ig and alterations in haematological parameters of infants with isoimmune haemolytic disease.

      Freyne, B; O'Hare, F M; Molloy, E J (Archives of disease in childhood. Fetal and neonatal edition, 2012-01)
    • Endometrial aspiration biopsy: a non-invasive method of obtaining functional lymphoid progenitor cells and mature natural killer cells.

      McMenamin, Moya; Lysakova-Devine, Tatyana; Wingfield, Mary; O'Herlihy, Colm; O'Farrelly, Cliona; UCD School of Medicine and Medical Science, Obstetrics and Gynaecology, University College Dublin, National Maternity Hospital, Dublin 2, Ireland. moyamcmenamin@gmail.com (2012-09)
      The aim of this study was to compare the efficacy of endometrial aspiration biopsy (EAB) with the more traditional dilatation and curettage (D&C) for the procurement of lymphoid progenitor cells and uterine natural killer (NK) populations in endometrial tissue. This prospective observational study conducted in a tertiary referral university hospital examined endometrium obtained from 32 women admitted for laparoscopic gynaecological procedures. Each participant had endometrium sampled using both EAB and D&C. Both methods were assessed as a source of uterine NK and lymphoid progenitor cells. Similar proportions of mature CD45+CD56+ NK cells (range 25.4-36.2%) and CD45+CD34+ lymphoid progenitors (range 1.2-2.0%) were found in tissue obtained using both EAB and D&C. These cells were adequate for flow cytometric analysis, magnetic bead separation and culture. Colony formation by the CD34+ population demonstrated maturational potential. Tissues obtained via endometrial biopsy and D&C are equivalent, by analysis of uterine NK and lymphoid progenitor cells. The aim of this study was to compare two methods of endometrial sampling - endometrial aspiration biopsy and traditional dilatation and curettage - for the procurement of haematopoietic stem cells and uterine natural killer (NK) populations in endometrial tissue. Thirty-two women who had gynaecological procedures in a tertiary referral hospital participated in this study and had endometrial tissue collected via both methods. Similar populations of mature NK cells and haematopoietic stem cells were found in tissue obtained using both endometrial aspiration biopsy and dilatation and curettage. Tissue obtained via endometrial aspiration biopsy was adequate for the culture and growth of haematopoietic stem cells. We conclude that tissue obtained via endometrial biopsy and dilatation and curettage is equivalent, by analysis of uterine NK and haematopoietic stem cells using flow cytometry. This has implications for further more extensive study of endometrial haematopoietic stem cell populations, as these samples can be collected in a clinical setting without a requirement for general anaesthesia.
    • Erasures and suspensions from the General Medical Council

      Murphy, JFA (Irish Medical Journal, 2012-02)
      The patterns of erasure and suspension in the UK (GMC) have recently been analysed 1. The findings are of interest to all practising doctors. It would appear that certain groups of doctors are more likely to be subject to the Councilâ s scrutiny than others. A total of 790 doctors (0.35%) are either erased or suspended. In terms of gender 86% are men and 14% are women, men are 4 times more likely to be affected. Hospital specialists are only half as likely to be brought before the GMC when compared with GPs. Non-UK graduates have rates twice that of UK-graduates. Another important demographic finding is the length of time since qualification, the longer the time the greater the likelihood. The proportion with suspension or erasure for those qualified before 1985 is 0.4%, for those qualified 1995-2005 it is 0.23% and for those qualified after 2005 it is 0.09%. Doctors are 4 times more likely to face disciplinary problems after being qualified over 25 years. This may reflect increased levels of responsibility, large patient workloads, less time for their own professional development and failure to keep up to date.
    • Ethnic variation between white European women in labour outcomes in a setting in which the management of labour is standardised-a healthy migrant effect?

      Walsh, J; Mahony, R; Armstrong, F; Ryan, G; O'Herlihy, C; Foley, M; UCD School of Medicine and Medical Science, University College Dublin, Dublin, Ireland. jennifer.walsh@ucd.ie (BJOG : an international journal of obstetrics and gynaecology, 2011-05)
      To test the hypothesis that women from Eastern European countries have lower caesarean delivery rates and higher spontaneous labour rates relative to Irish women in a setting in which the management of labour is standardised.
    • Etiology and outcome of Hydrops fetalis - a ten year experience

      O' Sullivan, C; Walsh, J; Mahony, R; Hudson, A (American Journal of Obstetrics and Gynecology, 2011-01)
      Society for Maternal-Fetal Medicine. The Pregnancy Meeting
    • The evolving patient population at Europe's busiest maternity unit

      Heir, MP; Butt, H; Robson, M; Higgins, S (Irish Journal of Medical Science, 2011-02)
      Institute of Obstetricians & Gynaecologists, RCPI Four Provinces Meeting Junior Obstetrics & Gynecology Society Annual Scientific Meeting, Royal Academy of Medicine in Ireland Dublin Matenity Hospitals Report Meeting Friday 26th Nov 2010
    • The evolving patient population at one of Europe's busiest maternity units.

      Hehir, Mark P; Higgins, Shane; National Maternity Hospital, Holles St, Dublin 2, Ireland. markhehir23@gmail.com (2012-09)
    • Exercise in pregnancy - should we do more?

      NiGhabhann, S; Walsh, J; McGowan, C; Mahony, R; Foley, M; McAuliffe, F (Irish Journal of Medical Science, 2011-02)
      Institute of Obstetricians & Gynaecologists, RCPI Four Provinces Meeting, Junior Obstetrics & Gynaecology Society Annual Scientific Meeting, Royal Academy of Medicine in Ireland Dublin Maternity Hospitals Reports Meeting, Nov 2010
    • An exploration of the experiences of mothers as they suppress lactation following late miscarriage, stillbirth or neonatal death

      McGuinness, D; Coghlan, B; Butler, Michelle; National Maternity Hospital, Holles St. UCD School of Nursing Midwifery and Health Systems,The University of British Columbia. (Royal College of Midwives, 2014)
      Objective. To explore the experiences of bereaved mothers as they suppress lactation following late miscarriage (>20 weeks), stillbirth or neonatal death. Method. A qualitative, focused ethnographic approach was used involving in-depth interviews with 15 bereaved mothers, who attended a maternity hospital in Dublin. Data were collected from January to August 2012. Findings. Three key themes were identified: (1) suppression of lactation following the loss of a baby: silent tears; (2) mothering; (3) supportive care needs and the bereaved mother’s experience. This paper focuses on the first global theme. The majority of bereaved mothers found engorgement and leaking milk particularly challenging both physically and emotionally following the loss of their baby; especially as their baby’s funeral or wake took place during this period. The study highlights a number of areas where women could be better prepared for this experience. Conclusion. The findings highlight that the majority of bereaved mothers will require improved guidance and support with their breast care needs following the loss of their baby with awareness and sensitivity to their shortened motherhood.
    • Fallout of the enterocolitis, autism, MMR vaccine paper.

      Murphy, J F A (Irish Medical Journal, 2011-02)
      On the 28th Feb 1998 The Lancet published a paper by Andrew Wakefield 1 that proposed a new condition of enterocolitis, regressive autism and an association with MMR vaccine as the apparent precipitating event. At a press conference describing the 12 children case series he urged the use of single vaccines instead of MMR. The study generated immediate alarm and controversy. After its publication the findings had far reaching consequences. The implication that the MMR vaccine could precipitate Crohnâ s disease and Autism was widely disseminated by the media. Attempts by the health authorities to reassure and calm fears were ineffective. Parents became extremely alarmed. Public confidence in the MMR vaccine was undermined and immunisation rates fell sharply below the critical 92% required for herd immunity. There was a rapid resurgence in the numbers of children affected with measles. Dublin was particularly badly affected. A paper published in 2003 describing the Irish experience of measles reappearance received worldwide attention 2 . It graphically illustrated the damage that can be caused when a vaccination programme is impaired. A total of 355 children attended Temple Street A&E with Measles and 111 were admitted with either pneumonitis or dehydration. Seven children required ventilation and 3 children died. The allegations against the MMR vaccine were difficult to refute and the restoration of confidence in the vaccine was painfully slow. An IMJ commentary in 2000 stated that the current large number of children developing Measles was due to the significant reduction in the proportion being administered MMR vaccination 3 . Vaccination rates were as low as 75% in some parts of the country. The Dept. of Health had become very concerned. The then Minister for Health and Children Michael Martin launched â A Vaccination Awareness Campaignâ to highlight the problem. Despite everybodyâ s best efforts the problem of low vaccine uptake rumbled on. This is not surprising. Allegations of vaccine risk are difficult to defend. In relation to vaccination, todayâ s allegation is remembered long after tomorrowâ s explanation is forgotten.
    • Fatigue and the delivery of medical care

      Murphy, JFA (Irish medical Journal, 2011-01)
      Lack of sleep has well established effects on physiological, cognitive and behavioural functionality. Sleep deprivation can adversely affect clinical performance as severely as alcohol according to some sources. Sleep deficiency may be due to loss of one night’s sleep or repeated interruptions of sleep. Chronic sleep degrades the ability to recognise one’s ability to recognise the impairments induced by sleep loss. The problem of sleep deprivation has vexed acute medical practice for decades. Improvement has been painfully slow. The problem is that all 168 hours throughout every week of every year have to be covered and there are a finite number of doctors to shoulder the burden. There are many strongly held views about how best to provide night-time and week-end care. Constructive innovations are thin on the ground. The biggest gap is between administration and doctors with financial considerations being the limiting factor. It is, however, generally accepted on all sides that sleep loss and fatigue can have adverse effects on both patients and doctors.
    • Fetal and maternal leptin in pre-gestational diabetic pregnancy.

      Higgins, Mary F; Russell, Noirin M; Brazil, Derek P; Firth, Richard G; McAuliffe, Fionnuala M; UCD Obstetrics and Gynecology, School of Medicine and Medical Science, University College Dublin, National Maternity Hospital, Dublin, Ireland. (2013-02)
      To compare maternal and fetal leptin among women without diabetes, women with type 1 diabetes, and women with type 2 diabetes.