Browsing Coombe Women & Infants University Hospital by Authors
Maternal Obesity and Neck CircumferenceAnglim, B; O’Higgins, A; Daly, N; Farren, M; Turner, MJ (Irish Medical Journal, 2015-06)Obese women are more likely to require general anaesthesia for an obstetric intervention than non-obese. Difficult tracheal intubation and oxygen desaturation is more common in pregnancy. Failed tracheal intubation has been associated with an increase in neck circumference (NC). We studied the relationship between maternal obesity and NC as pregnancy advanced in women attending a standard antenatal clinic. Of the 96 women recruited, 13.5% were obese. The mean NC was 36.8cm (SD 1.9) in the obese women compared with 31.5cm (SD 1.6) in women with a normal BMI (p<0.001) at 18-22 weeks gestation. In the obese women it increased on average by 1.5cm by 36-40 weeks compared with an increase of 1.6 cm in women with a normal BMI. The antenatal measurement of NC is a simple, inexpensive tool that is potentially useful for screening obese women who may benefit from an antenatal anaesthetic assessment.
A rare case of cryptogenic stroke with an incidental finding of patent foramen ovale.Anglim, B; Maher, N; Cunningham, O; Mulcahy, D; Harbison, J; O'Connell, M (Irish Medical Journal, 2015-03)Patent foramen ovale (PFO) occurs in 25-30% of the general population. Stroke in the puerperium is a rare phenomenon, 34 per 100,000 women. A 32 year old lady, Para3+2 presented eight days postnatally with symptoms of a transient episode of left sided facial and limb parathesia and dysphasia. She had a CT brain which was normal, however a subsequent MRI brain showed a small right parietal lobe infarct. An echocardiogram was performed which showed a small PFO, with an ejection fraction of 60-65%. A bubble study was performed which was positive with valsalva. She was started on aspirin 300mg once daily for 2 weeks, and shall remain on life-long aspirin 75mg.