• Delayed villous maturation of the placenta - a quantitative analysis

      Treacy, A; Higgins, M; McAuliffe, F; Mooney, E (American Journal of Obstetrics and Gynaecology, 2012-01)
    • Delayed villous maturation of the placenta: quantitative assessment in different cohorts.

      Treacy, Ann; Higgins, Mary; Kearney, John M; McAuliffe, Fionnuala; Mooney, Eoghan E; Department of Pathology, National Maternity Hospital, Dublin, Ireland. anntreacy@mac.com (2013)
      Placental villous maturation is maximal in the 3rd trimester, with an abundance of terminal villi. Delayed villous maturation (DVM) of the placenta is associated with chromosomal abnormalities, gestational diabetes, and an adverse outcome. This study compares quantitative assessment of vasculo-syncytial membranes (VSM) in cases of liveborn infants, perinatal deaths, and controls. Cases were selected as follows: (1) liveborn infants with a qualitative diagnosis of DVM (n  =  15); (2) controls matched for gestational age whose placentas did not have DVM (n  =  15); (3) stillbirths (SB)/neonatal deaths (NND) showing DVM (n  =  13); and (4) SB from autopsies in which DVM was felt to be the cause of death (COD) (n  =  12). Vasculo-syncytial membranes were counted in 10 terminal villi in each of 10 consecutive high-power fields on 3 slides. Data analysis was carried out using SPSS. Liveborn cases with DVM showed statistically significantly less VSM than controls (mean 1.01 vs 2.42, P < 0.0001). The SB/NND group also showed significantly less VSM than the control group (mean 0.46 vs 2.42, P < 0.0001) and less than the liveborn DVM group (mean 0.46 vs 1.01, P  =  0.001). The COD group was significantly different from the control group (mean 0.42 vs 2.42, P < 0.0001) and the liveborn DVM group (mean 0.42 vs 1.01, P < 0.0001) but not significantly different from the SB/NND group. There is a quantitative reduction in VSM in cases of DVM compared to controls.
    • Development of the National Maternity Hospital.

      National Maternity Hospital (NMH) (National Maternity Hospital (NMH), 2003-11)
      The need for the development of the National Maternity Hospital is well documented. Following extensive consultations with the Department of Health and Children, through the late 1990's, the establishment of a Project Team to advance the development of the hospital was approved and the Project was included in the National Development Plan. The first task of the Project Team was to examine the future role and accommodation needs of the hospital within its designated catchment area, having regard to its relationship with other service providers. In this context a Development Brief was prepared and was finalised during the summer of 200I. The Brief was informed to a large extent by a comprehensive needs assessment exercise commissioned by the Eastern Regional Health Authority.
    • Diagnostic and therapeutic dilemma associated with atypical glandular cells on liquid-based cervical cytology.

      Chummun, K; Fitzpatrick, M; Lenehan, P; Boylan, P; Mooney, E; Flannelly, G; National Maternity Hospital, Dublin, Ireland. (2012-12)
      In 2008, the management of women in Ireland with atypical glandular cells changed to immediate referral to colposcopy. The optimal management of these women is unclear. A balance between the detection of occult disease and overtreatment is required.
    • Dietary iodine intake in pregnancy: an update.

      Smyth, P; O'Herlihy, C (Irish Medical Journal (IMJ), 2012-01)
    • Doctors Today

      Murphy, JFA (Irish Medical Journal, 2012-03)
      Doctors’ relationship with patients and their role in society is changing. Until the 1960s doctors concentrated on the welfare of patients with less emphasis placed on patients’ rights1. Over recent decades there has been increasing empowerment of the individual across all facets of society including health care. Doctors continue to be perceived as having expertise and authority over medical science. Patients, however, now hold sway over questions of values or preferences. We all must be aware of this change in the doctor- patient interaction. We need to be more aware of the outcomes that patients view as important. The concept of shared decision-making with the patient is now widely appreciated. The process involves a change in mind set particularly for doctors who trained in an earlier era.
    • Does performing fetal ultrasound assessment once versus twice in the third trimester in low risk women alter the stillbirth rate?

      Mone, F; Meti, S; Ong, S (Irish Medical Journal, 2014-06)
      The aim of this retrospective observational study was to evaluate if performing fetal growth scans once or twice in the third trimester impacts on stillbirth rates in low risk pregnancies. The study was performed in a tertiary centre with 6,000 deliveries per annum. Data on all deliveries was collected via the National Maternity System Database and high risk pregnancies were excluded to calculate the stillbirth rate before and after 2011 when ultrasound assessment was performed twice and once in the third trimester. Between 2009-2012 there were 18,856 low risk-pregnancy deliveries with 45 stillbirths, (average stillbirth rate 0.26%). The stillbirth rate in 2009/2010 was 54/9423 (0.25%). The stillbirth rate in 2012 was 13/5615 (0.27%). [ p= 0.897; chi square= 0.017; df =1]. There was no statistical difference in the stillbirth rate when low risk women were scanned once or twice in the third trimester.
    • Does total parenteral nutrition raise serum vitamin D level ion preterm infants

      Onwuneme, C; Martin, F; McCarthy, R; Kilbane, M; McKenna, MJ; Murphy, N; Molloy, EJ (Archives of Disease in Childhood, 2012-10)
    • Does ultrasonic alteration of estimated date of delivery increase perinatal mortality

      Moore, R; Foley, ME (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
    • Doolin Lecture 2011: Emily O’Reilly, Ombudsman. ‘Health Care in Ireland- An Ombudsman Perspective’

      Murphy, JFA (Irish Medical Journal, 2011-11)
      Emily O’Reilly, Ombudsman, delivered the 47th Doolin lecture on 3rd Dec 2011. Ms O’Reilly is a former journalist and broadcaster. She is the author of books on Mary Robinson, Veronica Guerin and Masterminds of the Right about Catholic fundamentalism in Ireland. First appointed as Ombudsman in 2003, she in her second term of office. She has a clear vision of her role and the importance of the Office. She feels that public access to information under FOI is excessively curtailed in order to protect sectional interests. During her lecture she demonstrated how she applies her Ombudsman skills when acting as an advocate for disadvantaged patients in the face of a complex and currently constrained health service. Her address was both compelling and memorable. It gave an insight into how patients struggle to access the services that they require
    • The dual influences of age and obstetric history on fecal continence in parous women.

      Eogan, Maeve; O'Brien, Conor; Daly, Leslie; Behan, Michael; O'Connell, P Ronan; O'Herlihy, Colm; Department of Obstetrics and Gynaecology, University College Dublin, National Maternity Hospital, Dublin, Ireland. (2011-02)
      To assess whether women who underwent forceps delivery were more likely than those who delivered either normally (spontaneous vaginal delivery [SVD]) or by cesarean to experience deterioration in fecal continence as they aged.
    • 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