• Mode of delivery according to birthweight in spontaneous and induced singleton cephalic nulliparous lanbors

      Walsh, J; Hehir, M; Barrett, N; Robson, M (American Journal of Obstetrics and Gyaecology, 2012-01)
    • Mode of delivery at term and adverse neonatal outcomes.

      Walsh, Colin A; Robson, Michael; McAuliffe, Fionnuala M; National Maternity Hospital and UCD Obstetrics and Gynaecology, School of Medicine and Medical Science, University College Dublin, National Maternity Hospital, Dublin, Ireland. colwalsh@hotmail.com (2013-01)
      To determine the relationship between mode of delivery and serious adverse neonatal outcomes in term, singleton, cephalic neonates.
    • The molecular mechanisms of offspring effects from obese pregnancy.

      Dowling, Daniel; McAuliffe, Fionnuala M; UCD Obstetrics & Gynaecology, School of Medicine and Medical Science, University College Dublin, National Maternity Hospital, Dublin, Ireland. (2013)
      The incidence of obesity, increased weight gain and the popularity of high-fat / high-sugar diets are seriously impacting upon the global population. Billions of individuals are affected, and although diet and lifestyle are of paramount importance to the development of adult obesity, compelling evidence is emerging which suggests that maternal obesity and related disorders may be passed on to the next generation by non-genetic means. The processes acting within the uteri of obese mothers may permanently predispose offspring to a diverse plethora of diseases ranging from obesity and diabetes to psychiatric disorders. This review aims to summarise some of the molecular mechanisms and active processes currently known about maternal obesity and its effect on foetal and neonatal physiology and metabolism. Complex and multifactorial networks of molecules are intertwined and culminate in a pathologically synergistic manner to cause disruption and disorganisation of foetal physiology. This altered phenotype may potentiate the cycle of intergenerational transmission of obesity and related disorders.
    • Multiple pregnancies - A 25 year review in a tertiary referral centre

      Kennelly, M; O'Mahoney, R; Foley, M (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
    • National Maternity Hospital : Clinical report for the year 1997

      Boylan, Peter (National Maternity Hospital (NMH), 1997)
      The trend of previous years continued with a further increase in deliveries compared to 1996. There were 7682 babies delivered during the year. There has been a 46% increase in primigravidae and an 8% increase in multiparous women delivering at the hospital over the past 7 years. Most of this increase has taken place in the last 3 years. The increase in primigravidae is reflected in their changed portion of the total hospital population . Primjgravidae now make-up 45% of all women delivering at the hospital where as in 1991 they made-up 38%. The changing proportions of primigravidae are partly responsible for the increased incidence of Caesarean Section, from 9% in 1991 to 10.8% in 1997. The other major change in hospital practice has been the increase of epidural anaesthesia which grew from 18% of a1l women in 1991 to 49% in 1997. These changes in practice have strained hospital resources to the limit.
    • National Maternity Hospital annual report 2013

      National Maternity Hospital Holles St (National Maternity Hospital Holles St, 2014-07)
    • National Maternity Hospital Dublin Clinical report 1991

      Boylan, Peter (National Maternity Hospital (NMH), 1991)
      1991 was another busy year with a marginal increase in the number of mothers delivered, but a very substantial increase in gynaecological activity. A total of 7,077 mothers were delivered during 1991 , an increase of 0.2% compared to 1990. The number of primigravidae delivered was 2,322, an increase of 3.1% over the previous year. A total of 6,277 infants weighing 500 grams or more were delivered by 6,178 mothers. Eight hundred and seventy seven mothers miscarried before 24 weeks gestation. There were 4 molar pregnancies and 18 ectopic pregnancies. Two mothers died during the course of pregnancy. The first was a 31 year old from Libya who died from overwhelming infection associated with a spontaneous miscarriage at 18 weeks gestation. She died after a prolonged stay in the intensive care unit of a general hospital. The second mother was also from Libya and she died approximately four weeks following caesarean delivery for eclampsia, also following a prolonged stay in the intensive care unit of a general hospital. Both these tragic deaths occurred despite the full panoply of modern intensive care.
    • National Maternity Hospital Dublin clinical report for the year 1993

      Boylan, Peter (National Maternity Hospital (NMH), 2012-11-21)
      1993 saw another increase in the number of infants delivered at the hospital Gynaecological activity remained extremely busy with an increase in the number of new gynaecological referrals of 7%. A total of 7,105 mothers were delivered during 1993. A total of 6,378 infants weighing 500 grams or more were delivered by 6,277 mothers. These figures represent an increase of 85 more infants born during the year compared to 1992. The number of primigravida delivered was 2,564, an increase of 139 over 1992. Seven hundred and eighty one mothers miscarried before 24 weeks gestation. There were 10 molar pregnancies and 37 ectopic pregnancies, both an increase on 1992. No mother died during the course of pregnancy or in the puerperium. There were 75 perinatal deaths and this number includes all dead born babies weighing 500 grams or more, together with all liveborn babies who did not survive the first 28 days of life. The total perinatal mortality rate was 11.7 per thousand, compared with 11.2 in 1992. An autopsy was performed on 64 occasions (85%). This figure is a great tribute to the Department of Pathology. A lethal congenital anomaly was responsible for 31 of the perinatal deaths (40%). There were three deaths from a neural tube defect. The perinatal mortality rate in normally formed infants was 6.9 per thousand. There were 24 deaths which occurred before the onset of labour in normally formed babies. In 10 of these cases, there was an obstetrical factor, of which the commonest was abruptio placentae. There were 14 antepartum deaths where no cause was found despite careful autopsy examination. There were 7 intrapartum deaths. Thirteen liveborn infants died within the first 28 days of life. Two neonatal deaths occurred in babies after 37 weeks gestation. Five deaths occurred in infants born between 28 and 37 weeks, and six occurred in infants born less than 28 weeks gestation. Total gynaecological activity saw a small decrease on the previous year due to a major renovation project of the operating theatres which was undertaken at the end of the year. Gynaecological cancer was diagnosed and treated in 68 women. Many of these women are referred from outside centres and the continued high rate of referral from around the country is a tribute to both the medical and nursing care these women receive. The rate of Caearean section was 9.8% compared with 8.5% in 1992, a significant increase. The rate in primigravidae was 12.1 %. It is unlikely that the rate will continue to increase and it is anticipated that the rate for 1994 will be significantly lower. The reasons for the increase appeared to relate mainly in primigravidae to the diagnosis of suspected fetal distress while in multiparous women there was an increase in the numbers presenting with a previous Caesarean section. Clearly an increasing rate in primigravidae leaves a legacy for the future. The operative vaginal delivery rate was 7%, remarkably low when one takes into account the continued increase in the incidence of epidural anaesthesia. The continued high rate of spontaneus delivery is a tribute to the very high standards of midwifery care practiced m the hospital. . . . . During the year 3.014 mothers and infants were seen outside medical hours as emergencies. This number continues to increase and places a strain on hospital resources outside normal working hours. . A concerted effort was made to increase breast feeding rates among mothers attending the hospital. A new policy, instigated by the midwives , has been most successful and 58% of mothers were breast feeding at the time of discharge.
    • National Maternity Hospital Dublin clinical report for the year 2003

      Keane, Declan (National Maternity Hospital (NMH), 2003)
      2003 with continuing rise in the birth rate in the hospital. 82,55 mothers give birth to 8378 infants. This was the busiest year since 1983 and was a 3% Increase on births compared to the previous year. Forty five per cent of the mothers were primigravidae, which was a slight decrease on the previous year. The Caesarean section rate for the year was 16%. a slight increase on the previous year. A full analysis of the Caesarean section can be found in the appropriate chapter. The most significant reason for the increase with a risk in the section in both spontaneously labouring and. in particular. in induced primagr.wid patients. The perinatal mortality rate for the hospital "The congenital anomalies. was 7.4 per 1.000 - a rate consistent with previous years. The continuing rise in perinatal mortality rate among non-national was a concern to the hospital and the number of non-national patients attending the hospital increased to 20.7%. There were no maternal mortalities for the year which was welcome considering the busy workload and the complexity of cases seen. With regard 10 gynaecology the hospital remained busy with over 9,300 women seen at seven gynaecological clinics during the year. Se chapters for Gynaecological Oncology. Urogynaecology and Reproductive Medicine further indicate the sub-specialisution within the fields. There was a slight increase in gynaecological major options in 2003 comfirmed 10 the previous year. The further increase in Caesarean Section rates puts an even greatcr pressure on the gynaecological themes. It is, therefore envisaged that the hospital will have its third theatre dedicated 10 obstetrical activity with its new interim development
    • National Maternity Hospital Dublin Clinical report: Centenary year 1994

      National Maternity Hospital (NMH) (National Maternity Hospital (NMH), 1994)
      On March 17th, 1894 the National Maternity Hospital was opened. During its first year of operation, 308 women were admitted. There were 230 women delivered, 87 first births and 143 multiparous women; 46 women were admitted to the gynaecological wards . An additional 208 women were attended on the district. One woman was recorded as suffering from smallpox, there were no Caesarean deliveries and the forceps rate was recorded as 10%. A typical complicated labour was described as the woman spending eleven hours in the first stage and eight and a half hours in the second stage of labour. There is no record in the first year of the number of maternal deaths, but, at the time, the maternal mortality rate in Dublin was of the order of 350 per 100,000 deliveries. The main causes of maternal mortality at the time wife puerperal fever, hypertensive disorders, and haemorrhage associated with miscarriage, placental separation, and postpartum. There were about 10,000 babies born in the Dublin area each year in the 1890's and so there would have been approximately 35 maternal deaths in anyone year at that time.
    • National Maternity Hospital Dublin. Clinical Report for the year 1996

      National Maternity Hospital Holles Street (National Maternity Hospital (NMH), 1996)
    • National Maternity Hospital Dublin: clinical report 2002

      National Maternity Hospital Holles Street; Keane, Declan; National Maternity Hospital Holles Street (National Maternity Hospital Holles St, 2003)
      2002 saw continuing rise in the birth rate in the hospital. 8022 mothers gave birth to 8162 infants. This was the busiest year since 1983. It was a 4% increase on births compared to 2001. The number of first time mothers delivering in the hospital continued also to increase and the figure for the year was 47.5%. If current trends continue the number of first time mothers will exceed multiparous parents in the ensuing years. The Caesarean section rate for the year was 15.5%. This is a 1% increase on the previous year. A full analysis of the Caesarean section rate can be found in the appropriate chapter. The increase probably represents a rise across all ten groups although it is worth noting that the rise in women who had a previous Caesarean seclion was certainly one of the factors.
    • National Maternity Hospital Holles Street annual report 2008

      National Maternity Hospital Holles Street (National Maternity Hospital Holles Street, 2009)
    • National Maternity Hospital, Holles Street annual report 1999

      National Maternity Hospital (NMH) (National Maternity Hospital (NMH), 2000)
      I have pleasure in presenting the report on the hospital for the twelve months ended 31st December 1999. This report outlines the main activities of the hospital during a year where the hospital had to decline routine obstetrical bookings from areas outside of our traditional catchment areas which includes the greater Dublin area, Wicklow, North Kildare and parts of Meath. This action was necessary as the infrastructure of the hospital makes it very difficult to deliver a satisfactory service in line with the expectations of our patients when the level of deliveries exceed 7,500 per annum. However, tertiary referrals continued to be accommodated. The number of mothers delivered in 1999 was 7,537, a decrease of 3.58% over 1998. The hospitals budgetary performance during 1999 is set out in detail in the Report of the Finance & General Purposes Committee. The accumulated deficit carried into the year was £661k and this was reduced to £16k by 31st December 1999 despite an actual decrease in actual patient income of £68,431 over 1998. During the year discussions continued with the Department of Health & Children in regard to the need to develop the hospital to provide a satisfactory and safe environment in which we deliver services to patients. These discussions advanced satisfactorily and verbal assurances were received by year end that a Project Team would be established in the first quarter of 2000 to oversee a major hospital development, the cost of which is included in the National Development Plan
    • National Maternity Hospital, Holles Street, annual report 1997

      National Maternity Hospital (NMH) (National Maternity Hospital, 1998)
      The year marked the end of Dr. Peter Boylan's Mastership and I would like to thank him for his leadership over the past seven years during which time the hospital experienced a significant increase in activity. The Executive Committee express their appreciation of his input and many achievements including the appointment of the current Matron and Secretary / Manager, the development of the Merrion Wing and his focus on communication and openness. During the year the three Dublin Maternity Hospitals engaged Mr. David Kennedy to prepare a Strategic Review Report which addresses the role of the hospitals in the organisation and the delivery of services in the Dublin region. The report, presented to the Department of Health in December, is primarily concerned with the totality of the services provided by the three hospitals in the greater Dublin area including their national tertiary care responsibilities . Its focus is on the development of these services tor the future in a coherent and planned manner and, in particular, on the implications of the establishment of the new Eastern Regional Health Authority with consequent changes in the funding arrangements for public patients.
    • National Maternity Hospital, Holles Street, annual report 1998

      National Maternity Hospital (NMH) (National Maternity Hospital, 1999)
      This report outlines the main activities of the hospital during a year which saw the continuation of the sustained increase in activity in recent years. The number of mothers delivered was 7,817, an increase of 3.4% over 1997 and 25% since 1994. The hospital's budgetary performance during 1998 is set out in detail in the Report of the Finance & General Purposes Committee. The deficit carried into the year was £212K and this increased to £661K primarily due to the need to increase the number of midwives to cope with the continuing increase in activity. The extent of this deficit is a cause for concern as it will be a "first charge" against the hospital's allocation in 1999. During the year the hospital commissioned a Development Control Plan (DCP). This DCP sets out a plan in terms of the infrastructure which will be needed to cope with increasing activity levels, changes in medical practice and enhanced patient expectations. This must be a priority for the hospital in the coming years. 1998 was a very challenging and stressful year for the hospital reflecting the sustained pressure on limited resources in terms of overworked staff and overused hospital facilities. These pressures were intensified by the ever higher standards of patient care that are now demanded by all who attend the hospital. Not wishing to single out individuals for fear of seeming not to recognise the efforts of everybody in the entire organisation,
    • The National Neonatal Transport Programme (NNTP) 2004-2009

      Noone, D; Bowden, A; Twomey, A; National Maternity Hospital, Holles St (Irish Medical Journal, 2011-08)
    • The National Neonatal Transport Programme (NNTP) 2004-2009.

      Noone, D; Bowden, A; Twomey, A; Department of Neonatology, National Maternity Hospital, Holles St, Dublin 2. dgnoone@gmail.com (2011-09)
      A retrospective analysis of all National Neonatal Transport Programme (NNTP) transport data from 2004-2009 was performed. 1621 transports were conducted during this period with a yearly average of 271. The majority (96%) were ground transports. 1118 (69%) were forward transfers. Of the 446 (27.5%) retrotransfers, 411 (91%.) were to tertiary centres. When transported, 592 infants (36.5%) were <48 hours old and 770 (47.5%) were <1 week old. 902 transports (55%) involved infants <32 wks birth-gestation and 720 (44%) involved infants weighing <1500gms. Transport for management of patent ductus arteriosus accounted for 357 (22%). The average mobilisation time was 34 minutes. 54% of transports were completed after scheduled service hours. The NNTP currently transports similar numbers of critically ill infants during its 8hr service compared with neonatal transport services that operate 24hr services. Performing PDA ligations in a tertiary neonatal unit would significantly reduce the number of neonatal transports required annually.
    • Necrotising Enterocolitis and Systemic Inflammation: Placental Pathology and Haematological Markers of Mortality

      Baastad, S; McCarthy, R; Lee, R; O'Hare, F; Mooney, E; Grant, T; Molloy, E (Pediatric Research, 2011-11)
      Necrotizing enterocolitis (NEC) is a devastating disease that affects premature neonates. Associated mortality has not changed appreciably over the past several decades. The underlying aetiology of NEC remains elusive, although bacterial colonization of the gut, formula feeding, and perinatal stress have been implicated as risk factors. We aimed to characterize clinical indicators predicting mortality from NEC.
    • Neonatal brachial plexus injury: comparison of incidence and antecedents between 2 decades.

      Walsh, Jennifer M; Kandamany, Nandini; Ni Shuibhne, Niamh; Power, Helen; Murphy, John F; O'Herlihy, Colm; Department of Obstetrics and Gynaecology, School of Medicine and Medical Science, University College Dublin, Dublin, Ireland. jennifer.walsh@ucd.ie (2011-04)
      We sought to compare the incidence and antecedents of neonatal brachial plexus injury (BPI) in 2 different 5-year epochs a decade apart following the introduction of specific staff training in the management of shoulder dystocia.