• Adrenal function in preterm infants undergoing patent ductus arteriosus ligation.

      El-Khuffash, Afif; McNamara, Patrick J; Lapointe, Anie; Jain, Amish; Department of Paediatrics, Rotunda Hospital, Dublin, Ireland. (2013)
      Targeted milrinone treatment for low left ventricular output (LVO) reduces the incidence of acute cardiorespiratory instability following ligation of patent ductus arteriosus (PDA) in preterm infants. Despite this, some infants continue to experience postoperative deterioration. Adrenal insufficiency related to prematurity has been postulated as a possible mechanism.
    • Assessment and treatment of post patent ductus arteriosus ligation syndrome.

      El-Khuffash, Afif F; Jain, Amish; Weisz, Dany; Mertens, Luc; McNamara, Patrick J; Department of Pediatrics, The Rotunda Hospital, Dublin, Ireland. (2014-07)
      To compare differences in tissue Doppler imaging, global longitudinal strain (GLS), and cardiac troponin T (cTnT) between infants with low (<200 mL/kg/min) and high (>200 mL/kg/min) left ventricular (LV) output 1 hour after duct ligation and assess the impact of milrinone treatment on cardiac output and myocardial performance.
    • The association of cerebral palsy and death with small-for-gestational-age birthweight in preterm neonates by individualized and population-based percentiles.

      Grobman, William A; Lai, Yinglei; Rouse, Dwight J; Spong, Catherine Y; Varner, Michael W; Mercer, Brian M; Leveno, Kenneth J; Iams, Jay D; Wapner, Ronald J; Sorokin, Yoram; et al. (2013-10)
      The objective of the study was to determine whether an individualized growth standard (IS) improves the identification of preterm small-for-gestational-age (SGA) neonates at risk of developing moderate/severe cerebral palsy (CP) or death.
    • Early and late preterm delivery rates - a comparison of differing tocolytic policies in a single urban population.

      Hehir, Mark P; O'Connor, Hugh D; Kent, Etaoin M; Robson, Michael S; Keane, Declan P; Geary, Michael P; Malone, Fergal D; Rotunda Hospital , Parnell Square, Dublin 1, Ireland. markhehir23@gmail.com (2012-11)
      Preterm delivery results in neonatal morbidity and mortality. We set out to estimate the difference in rates of preterm delivery in two institutions, serving a single population, with differing policies regarding use of tocolytic drugs for the prevention of preterm delivery.
    • Evaluation of cerebral electrical activity and cardiac output after patent ductus arteriosus ligation in preterm infants.

      Leslie, A T F S; Jain, A; El-Khuffash, A; Keyzers, M; Rogerson, S; McNamara, P J; Division of Neonatology, Department of Pediatrics, Federal University of Sao Paulo, Sao Paulo, Brazil. (2013-11)
      To characterize and investigate the relationship between systemic blood flow and pre- and postoperative cerebral electrical activity in preterm neonates undergoing patent ductus arteriosus (PDA) ligation.
    • 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.
    • 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.
    • Neonatal outcomes and operative vaginal delivery versus cesarean delivery.

      Contag, Stephen A; Clifton, Rebecca G; Bloom, Steven L; Spong, Catherine Y; Varner, Michael W; Rouse, Dwight J; Ramin, Susan M; Caritis, Steve N; Peaceman, Alan M; Sorokin, Yoram; et al. (2010-06)
      We compared outcomes for neonates with forceps-assisted, vacuum-assisted, or cesarean delivery in the second stage of labor. This is a secondary analysis of a randomized trial in laboring, low-risk, nulliparous women at >or=36 weeks' gestation. Neonatal outcomes after use of forceps, vacuum, and cesarean were compared among women in the second stage of labor at station +1 or below (thirds scale) for failure of descent or nonreassuring fetal status. Nine hundred ninety women were included in this analysis: 549 (55%) with an indication for delivery of failure of descent and 441 (45%) for a nonreassuring fetal status. Umbilical cord gases were available for 87% of neonates. We found no differences in the base excess (P = 0.35 and 0.78 for failure of descent and nonreassuring fetal status) or frequencies of pH below 7.0 (P = 0.73 and 0.34 for failure of descent and nonreassuring fetal status) among the three delivery methods. Birth outcomes and umbilical cord blood gas values were similar for those neonates with a forceps-assisted, vacuum-assisted, or cesarean delivery in the second stage of labor. The occurrence of significant fetal acidemia was not different among the three delivery methods regardless of the indication.
    • Optimum timing for planned delivery of uncomplicated monochorionic and dichorionic twin pregnancies.

      Breathnach, Fionnuala M; McAuliffe, Fionnuala M; Geary, Michael; Daly, Sean; Higgins, John R; Dornan, James; Morrison, John J; Burke, Gerard; Higgins, Shane; Dicker, Patrick; et al. (2012-01)
      To determine the optimum timing for planned delivery of uncomplicated monochorionic and dichorionic twin pregnancies.
    • Ponderal index (PI) vs birth weight centiles in the low-risk primigravid population: which is the better predictor of fetal wellbeing?

      Cooley, S M; Donnelly, J C; Walsh, T; Kirkham, C; Gillan, J; Geary, M P; Rotunda Hospital, Dublin, Ireland. smcooley@hotmail.com (2012-07)
      Our objective was to compare Ponderal index (PI) with birth weight centiles as predictors of perinatal morbidity and to determine which best reflects the presence of placental disease. We prospectively recruited 1,011 low-risk primigravidas and calculated PI and birth weight centiles following delivery. Perinatal morbidity was defined as: pre-term birth (PTB); fetal acidosis; an Apgar score <7 at 5 min or neonatal resuscitation. Placental disease was defined as chronic uteroplacental insufficiency (CUPI); villous dysmaturity; infection or vascular pathology. Ponderal index was statistically reduced (25.33 vs 27.79 p =0.001) and the incidence of infant birth weight <9th centile was statistically higher (11.1% vs 5.1%; p =0.004) in cases with PTB and in CUPI (26.23 vs 27.84; p =0.001 and 28.2.1% vs 10.4%; p =0.002). Both PI and infant birth weight centile <9th centile for gestational age correlate with PTB, however overall, both are poor predictors of neonatal and placental disease.
    • Population versus customized fetal growth norms and adverse outcomes in an intrapartum cohort.

      Costantine, Maged M; Lai, Yinglei; Bloom, Steven L; Spong, Catherine Y; Varner, Michael W; Rouse, Dwight J; Ramin, Susan M; Caritis, Steve N; Peaceman, Alan M; Sorokin, Yoram; et al. (2013-04)
      To compare population versus customized fetal growth norms in identifying neonates at risk for adverse outcomes (APO) associated with small for gestational age (SGA).
    • The relationship between maternal insulin-like growth factors 1 and 2 (IGF-1, IGF-2) and IGFBP-3 to gestational age and preterm delivery.

      Cooley, Sharon M; Donnelly, Jennifer C; Collins, Claire; Geary, Michael P; Rodeck, Charles H; Hindmarsh, Peter C; Rotunda Hospital, Parnell Street, Dublin 1, Ireland. smcooley@hotmail.com (2010-05)
      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 age at delivery.
    • Second trimester cervical length and risk of preterm birth in women with twin gestations treated with 17-α hydroxyprogesterone caproate.

      Durnwald, Celeste P; Momirova, Valerija; Rouse, Dwight J; Caritis, Steve N; Peaceman, Alan M; Sciscione, Anthony; Varner, Michael W; Malone, Fergal D; Mercer, Brian M; Thorp, John M; et al. (2010-12)
      To compare rates of preterm birth before 35 weeks based on cervical length measurement at 16-20 weeks in women with twin gestations who received 17-α hydroxyprogesterone caproate (17OHPC) or placebo.