• Quality assurance: The 10-Group Classification System (Robson classification), induction of labor, and cesarean delivery.

      Robson, Michael; Murphy, Martina; Byrne, Fionnuala (Elsevier, 2015-10)
      Quality assurance in labor and delivery is needed. The method must be simple and consistent, and be of universal value. It needs to be clinically relevant, robust, and prospective, and must incorporate epidemiological variables. The 10-Group Classification System (TGCS) is a simple method providing a common starting point for further detailed analysis within which all perinatal events and outcomes can be measured and compared. The system is demonstrated in the present paper using data for 2013 from the National Maternity Hospital in Dublin, Ireland. Interpretation of the classification can be easily taught. The standard table can provide much insight into the philosophy of care in the population of women studied and also provide information on data quality. With standardization of audit of events and outcomes, any differences in either sizes of groups, events or outcomes can be explained only by poor data collection, significant epidemiological variables, or differences in practice. In April 2015, WHO proposed that the TGCS (also known as the Robson classification) is used as a global standard for assessing, monitoring, and comparing cesarean delivery rates within and between healthcare facilities.
    • A randomised control trial of low glycaemic index carbohydrate diet versus no dietary intervention in the prevention of recurrence of macrosomia.

      Walsh, Jennifer; Mahony, Rhona; Foley, Michael; Mc Auliffe, Fionnuala; Department of Obstetrics and Gynaecology, University College Dublin National Maternity Hospital, Dublin, Ireland. jennifer.walsh@ucd.ie (2010)
      Maternal weight and maternal weight gain during pregnancy exert a significant influence on infant birth weight and the incidence of macrosomia. Fetal macrosomia is associated with an increase in both adverse obstetric and neonatal outcome, and also confers a future risk of childhood obesity. Studies have shown that a low glycaemic diet is associated with lower birth weights, however these studies have been small and not randomised 12. Fetal macrosomia recurs in a second pregnancy in one third of women, and maternal weight influences this recurrence risk 3.
    • Randomised controlled trial comparing early home biofeedback physiotherapy with pelvic floor exercises for the treatment of third-degree tears (EBAPT Trial).

      Peirce, C; Murphy, C; Fitzpatrick, M; Cassidy, M; Daly, L; O'Connell, P R; O'Herlihy, C (2013-09)
      To compare early home biofeedback physiotherapy with pelvic floor exercises (PFEs) for the initial management of women sustaining a primary third-degree tear.
    • A randomised controlled trial using the Epidrum for labour epidurals.

      Deighan, M; Briain, D O; Shakeban, H; O'Flaherty, D; Abdulla, H; Al-Jourany, A; Ash, S; Ahmed, S; McMorrow, R (Irish Medical Journal, 2015-03)
      The aim of our study was to determine if using the Epidrum to site epidurals improves success and reduces morbidity. Three hundred parturients requesting epidural analgesia for labour were enrolled. 150 subjects had their epidural sited using Epidrum and 150 using standard technique. We recorded subject demographics, operator experience, number of attempts, Accidental Dural Puncture rate, rate of failure to site epidural catheter, rate of failure of analgesia, Post Dural Puncture Headache and Epidural Blood Patch rates. Failure rate in Epidrum group was 9/150 (6%) vs 0 (0%) in the Control group (P = 0.003). There were four (2.66%) accidental dural punctures in the Epidrum group and none in the Control group (P = 0.060), and 2 epidurals out of 150 (1.33%) in Epidrum group were re-sited, versus 3/150 (2%) in the control group (P = 1.000). The results of our study do not suggest that using Epidrum improves success or reduces morbidity.
    • A randomised crossover study of low-flow air or oxygen via nasal cannulae to prevent desaturation in preterm infants.

      Hensey, Conor C; Hayden, Eoghan; O'Donnell, Colm Patrick Finbarr; Department of Neonatology, The National Maternity Hospital, Dublin, Ireland. (2013-09)
      To compare the efficacy of low-flow oxygen, low-flow air and sham treatment given via nasal cannulae in preventing desaturation (falls in oxygen saturation (SpO2)) in preterm infants.
    • Randomised trial comparing early home biofeedback physiotherapy with pelvic floor exercises following third degree perineal tears

      Pierce, C; O'Herlihy, C; Murphy, C; Fitzpatrick, M; Cassidy, M; Daly, L; O'Connell, PR (American Journal of Obstetrics and Gynaecology, 2012-01)
    • Randomised trial of single nasal prong or face mask for respiratory support for preterm infants in delivery room

      McCarthy, LK; Molloy, EJ; Twomey, AR; Murphy, JF; O'Donnell, CPF (Archives of Disease in Childhood, 2012-10)
    • A randomized controlled trial of prongs or mask for nasal continous positive airways pressure (NCPAP) in preterm infants: The POM Trial. (ISRCTN43000169)

      Kieran, EA; Twomey, AR; Molloy, EJ; Murphy, JF; O'Donnell, CP (Pediatric Research, 2011-11)
      52nd Annual Meeting of the European Society for Paediatric Research Newcastle, UK
    • A randomized trial of exothermic mattresses for preterm newborns in polyethylene bags.

      McCarthy, Lisa K; Molloy, Eleanor J; Twomey, Anne R; Murphy, John F A; O'Donnell, Colm P F; The National Maternity Hospital, Holles Street, Dublin, Ireland. (2013-07)
      Hypothermia on admission to the NICU is associated with increased mortality in preterm infants. Many newborns are hypothermic on admission despite using polyethylene bags (PBs). Using exothermic mattresses (EMs) in addition to PBs may reduce hypothermia but increase hyperthermia. We wished to determine whether placing preterm newborns in PBs on EMs in the DR results in more infants with rectal temperature outside the range 36.5 to 37.5°C on NICU admission.
    • Randomized trial of prongs or mask for nasal continuous positive airway pressure in preterm infants.

      Kieran, Emily A; Twomey, Anne R; Molloy, Eleanor J; Murphy, John F A; O'Donnell, Colm P F; The National Maternity Hospital, Dublin, Ireland. (2012-11)
      To determine whether nasal continuous positive airway pressure (NCPAP) given with nasal prongs compared with nasal mask reduces the rate of intubation and mechanical ventilation in preterm infants within 72 hours of starting therapy.
    • Real increasing incidence of hysterectomy for placenta accreta following previous caesarean section.

      Higgins, Mary F; Monteith, Cathy; Foley, Michael; O'Herlihy, Colm; Obstetrics and Gynaecology, University College Dublin, National Maternity Hospital, Ireland. Electronic address: maryhiggins@physicians.ie. (2013-11)
      Placenta accreta, morbid adherence to the uterus to the myometrium, is commonest in association with placenta previa in women previously delivered by caesarean section (CS). It has become proportionally a greater cause of major maternal morbidity and mortality as the frequency of other serious obstetric complications has declined. The aim of this study was to examine the incidence of placenta accreta in the context of a rising caesarean delivery rate.
    • Recurrent twin-twin transfusion syndrome after selective fetoscopic laser photocoagulation: a systematic review of the literature.

      Walsh, C A; McAuliffe, F M; Department of Fetal Medicine, National Maternity Hospital, Dublin, Ireland. (2012-11)
      Selective fetoscopic laser photocoagulation (SFLP) is now the treatment of choice for twin-twin transfusion syndrome (TTTS). The incidence of recurrent TTTS following SFLP has been inconsistently reported across different studies. We performed a systematic review of TTTS recurrence following SFLP.
    • Reference charts for fetal growth in twins: longitudenal data from the ESPRiT

      Dicker, P; Daly, S; Breathnach, F; Geary, M; Higgins, J; Dornan, J; Morrison, JJ; Burke, G; Higgins, S; McAuliffe, F; et al. (American Journal of Obstetrics Gynaecology, 2012-01)
      Annual Meeting - Socirty for Maternal-Fetal Medicine. The Pregnancy meeting 6 - 11 February 2012. Dallas Texas USA
    • Regionalisation and neonatal networks.

      Geoghegan, S; Foran, A; Twomey, A; Murphy, B P; Clarke, T (Irish Medical Journal, 2012-07)
    • The relationship between maternal and fetal vitamin D, insulin resistance, and fetal growth.

      Walsh, Jennifer M; McGowan, Ciara A; Kilbane, Mark; McKenna, Malachi J; McAuliffe, Fionnuala M; UCD Obstetrics and Gynaecology, School of Medicine and Medical Science, University College Dublin, National Maternity Hospital, Dublin, Ireland (2013-05)
      Evidence for a role of vitamin D in maintaining normal glucose homeostasis is inconclusive. We sought to clarify the relationship between maternal and fetal insulin resistance and vitamin D status. This is a prospective cohort study of 60 caucasian pregnant women. Concentrations of 25-hydroxyvitamin D (25-OHD), glucose, insulin, and leptin were measured in early pregnancy and at 28 weeks. Ultrasound at 34 weeks assessed fetal anthropometry including abdominal wall width, a marker of fetal adiposity. At delivery birth weight was recorded and fetal 25-OHD, glucose, C-peptide, and leptin measured in cord blood. Insulin resistance was calculated using the Homeostasis Model Assessment (HOMA) equation. We found that those with lower 25-OHD in early pregnancy had higher HOMA indices at 28 weeks, (r = -.32, P = .02). No significant relationship existed between maternal or fetal leptin and 25-OHD, or between maternal or fetal 25-OHD and fetal anthropometry or birth weight. The incidence of vitamin D deficiency was high at each time point (15%-45%). These findings lend support to routine antenatal supplementation with vitamin D in at risk populations.
    • Reproductive health outcomes in women with psoriatic arthritis.

      Murray, Kieran; Moore, Louise; McAuliffe, Fionnuala; Veale, Douglas J (2019-02-15)
    • Resuscitation of preterm infants: delivery room interventions and their effect on outcomes.

      O'Donnell, Colm P F; Schmölzer, Georg M; Department of Neonatology, The National Maternity Hospital, Holles Street, Dublin 2, Ireland. (2012-12)
      Despite advances in neonatal care, the rate of oxygen dependence at 36 weeks' postmenstrual age or bronchopulmonary dysplasia has not fallen. Neonatologists are increasingly careful to apply ventilation strategies that are gentle to the lung in the neonatal intensive care unit. However, there has not been the same emphasis applying gentle ventilation strategies immediately after birth. A lung-protective strategy should start immediately after birth to establish a functional residual capacity, reduce volutrauma and atelectotrauma, facilitate gas exchange, and improve oxygenation during neonatal transition. This article discusses techniques and equipment recommended by international resuscitation guidelines during breathing assistance in the delivery room.
    • Robust early immune function in preterm infants

      O'Hare, F; Watson, R; O'Neill, A; Donoghue, V; O'Donnell, C; Murphy, J; Twomey, A (Pediatric Research, 2011-11)
      52nd Annual Meeting of the European Society for Paediatric Research Newcastle UK Oct 2011
    • The role of cephalocentesis in the management of the severely hydrocephalic fetus

      Howse, E; Teoh, T; Kelly, E; Chitayat, D; McParland, P; Ryan, G (Ultrasound in Obstetrics and Gynecology, 2011-10)
      21st World Congress on Ultrasound in Obstetrics and Gynecology