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Biomedical subjects

D L Byrne

Publications and source records attributed to D L Byrne.

13 recordsLinked to original sources
PubMed2000

Descriptive terms for women attending antenatal clinics: mother knows best?

OBJECTIVE: To determine the noun for 'women who attend antenatal clinics' that is most accepted by the women themselves. DESIGN: Cross sectional study. SETTING: Consultant-led antenatal clinics in Cornwall. POPULATION: All women attending consultant-led antenatal clinics over a two-month period. METHODS: The women were surveyed by written questionnaire. MAIN OUTCOME MEASURES: The first, second and third choices of descriptions offered to women attending antenatal clinics. Secondary outcome measures include the relation of maternal age, gestation, civil status, occupation and obstetric history to the individual's choice of description. RESULTS: Questionnaires were received from 446 women, constituting 13% of the antenatal population of Cornwall. Their median age was 28 years and median gestation 22 weeks; 255 (57%) had one or more children and 289 (65%) were married. The most popular choice of description was 'patient' (39% of first choices made), whereas the most accepted description was 'pregnant woman' (26% of totalled second and third choices). While women who selected 'patient' as first choice were slightly younger (mean 27.5 years) than the remaining women (mean 28.4 years), the choice of 'pregnant woman' was not related to any of the other recorded characteristics of the respondents. Commercial terms that consistently were selected least included 'client', 'consumer' and 'customer'. CONCLUSION: Some professional bodies and government organisations have criticised the use of the term 'patient' to describe antenatal women. In this, the largest study to investigate what the women themselves would choose, 'patient' is the most favoured term.

Adolescent↗
PubMed1995

First trimester amnifiltration: technical, cytogenetic and pregnancy outcome of 104 consecutive procedures.

OBJECTIVE: To investigate the technical, cytogenetic and pregnancy complications of first trimester amnifiltration for the diagnosis of fetal karyotype. DESIGN: Observational study. SETTING: The fetal medicine unit, UMDS St Thomas' Campus, London. SUBJECTS: One hundred and four women seeking prenatal diagnosis of fetal karyotype. MAIN OUTCOME MEASURES: Sampling success, culture rate, harvest time and karyotype, pregnancy outcome and complications. RESULTS: Sampling was successful in all 104 cases, but equipment failure forced the procedure to be changed to early amniocentesis in eight (7%) cases. The karyotype was normal in 101 (97%) cases, abnormal in three. The mean harvest time was 14 days (range 9-26 days; SD = 3.4), and three cultures failed (2.8%). Pregnancies resulted in 99 (95%) live births, with a mean gestation of 277 days (range 182-300 days; SD = 16). There was one termination for trisomy 21 and four spontaneous miscarriages (3.8%). Amniotic fluid leakage occurred in six cases (5%), all resulted in live births, five at term and one at 35 weeks. CONCLUSIONS: This study demonstrates that amnifiltration is technically possible in the first trimester of pregnancy, and that samples can be successfully karyotyped. The harvest time for culture is similar to early amniocentesis and chorion villus sampling. The rate of fetal loss, adjusted by the estimated natural loss, is 1.7%, which compares favourably with both chorionic villus sampling and early amniocentesis.

Adult↗
PubMed1992

The role of ultrasound in gynecological emergencies.

The expanding use of ultrasonography in gynecology puts increasing strain on the resources of ultrasound departments; any mechanism to increase the diagnostic efficiency of the scan and reduce unwarranted investigation would, therefore, be welcome. This prospective study examines the use of abdominal ultrasound examination in gynecological emergencies over a 6-month period in a London teaching hospital. The examination changed the clinical management in 33% of cases where the pregnancy test was positive, but in only 14% where it was negative. In the former group, the confirmation of viable intrauterine pregnancy reassured both patient and clinician in 84% of the cases, making the test a useful investigation in 89% of the total cases where the pregnancy test was positive. When the pregnancy test was negative, the ultrasound scan was more likely to be useful if requested by doctors with gynecological experience. In cases of incomplete spontaneous abortion, ultrasound was not found to be a useful investigation. Access to ultrasound equipment by, and basic ultrasound training of admitting junior doctors with gynecological experience would reduce referrals to the ultrasound department and reduce admissions to hospital, whilst improving appreciation of the role of ultrasound in gynecological emergencies.

Journal Article↗
PubMed1991

Amnifiltration in the first trimester: feasibility, technical aspects and cytological outcome.

An amnifiltration system has been developed which allows collection of cells from the amniotic sac in the first trimester of pregnancy whilst only removing 1 ml of amniotic fluid in total. The cells can be cultured and harvested, using the same methods as early amniocentesis, to enable prenatal diagnosis of fetal karyotype. A range of filters constructed from different materials and of differing pore sizes were examined for their ability to trap and subsequently release a maximum number of amniotic fluid cells. The best filter membrane was found to be a cellulose acetate filter of 0.8 micro m pore size. To achieve the same cytogenetic outcome as a 10 ml amniocentesis, a minimum of 20 ml amniotic fluid must be filtered and recirculated through the system.

Journal Article↗
PubMed1991

Histological differences between colposcopic-directed biopsy and loop excision of the transformation zone (LETZ): a cause for concern.

Colposcopic examination and biopsy were performed on 100 patients with abnormal cervical cytology. All were suitable for ablative therapy but were treated by loop excision of the transformation zone (LETZ) as outpatients. Histological comparison between the colposcopic biopsies and LETZ samples showed poor agreement with only 43% of cases illustrating identical degrees of dysplasia. The dysplasia was underestimated by colposcopic biopsy in 16% of cases and overestimated in 41% of cases, when compared to the LETZ specimen. Microinvasive carcinoma was diagnosed in 3 cases on the LETZ histology, having been missed by the preceding colposcopy and colposcopic biopsy. The disparity between histological findings is of great concern and would not have been detected if the patients were treated by ablative therapy. It is the authors' view that LETZ should replace ablative therapy in the treatment of localized cervical dysplasia and that it may avoid the need for pretreatment colposcopic biopsy. LETZ limits the possibility of inadequate treatment and also provides a method of audit for the colposcopist.

Adolescent↗
PubMed1989

Meconium aspiration syndrome: a 6-year retrospective study.

The incidence and outcome of babies suffering from meconium aspiration syndrome (MAS) has been analysed in a 6-year review of 38,395 births at Guy's Hospital and Queen Charlotte's Maternity Hospital. One in 533 births (0.2%) was complicated by MAS, the mortality rate for which was 1 in 12. There was also a number of babies identified as possibly suffering from 'subclinical MAS' but no deaths occurred in this group. Males were more affected than females.

Female↗