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Biomedical subjects

B McElhinney

Publications and source records attributed to B McElhinney.

4 recordsLinked to original sources

False positive Kleihauer tests and unnecessary administration of anti-D immunoglobulin.

This obstetric case shows two false negative Kleihauer tests and two persistently positive Kleihauer tests leading to unnecessary administration of anti-D immunoglobulin. A diagnosis of hereditary persistence foetal haemoglobin (HPFH) was only confirmed by access to flow cytometry making use of both anti-HbF and anti-D labels. The case highlights the importance of a high index of clinical suspicion for HPFH and the importance of access to flow cytometry estimation of minor RhD red cell populations postnatally in RhD-negative mothers.

Adult↗

Ovarian hyperstimulation syndrome.

Ovarian hyperstimulation syndrome is an iatrogenic complication of assisted reproduction. In its most severe form, it is potentially fatal. The major clinical components are marked ovarian enlargement and increased capillary permeability leading to ascites, hydrothorax and pericardial effusion. Severe cases are associated with thromboembolic phenomena, respiratory distress and renal failure. The definitive pathophysiology is unknown. The available evidence would support a central role for inflammatory cytokines and angiogenic growth factors. Ultrasound examination and serum oestradiol values are currently used to predict patients at risk. The ideal treatment is prevention, but there has been only limited success. The main aims of treatment are to correct fluid imbalance, maintain renal perfusion and support the patient until the condition resolves. Drug therapy has a limited role, although anticytokine agents may prove useful.

Chorionic Gonadotropin↗

Transabdominal cervicoisthmic cerclage: initial experience.

Pregnancy outcome before and after insertion of transabdominal cervical cerclage is evaluated. The series also reports on the first cases of second pregnancies with the original suture left in situ. It is our view that transabdominal cervical cerclage should only be performed in units that have specialists in Perinatal Medicine.

Cervix Uteri↗