Biomedical subjects
Publications and source records attributed to G Stirrat.
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A survey to assess the effect of changes introduced to antenatal care services provided by a Bristol teaching hospital was carried out immediately before and three years after the changes were implemented (1983 and 1986). Some 751 women resident in a neighbouring health district who gave birth during March and April 1983, were compared with 794 of their counterparts who gave birth during March and April 1986. Aspects studied included the number of antenatal hospital appointments (increased), the number of different doctors seen during the visits (unchanged), and time spent waiting to be seen at the hospital (decreased) significantly. More women had alpha-feto protein tests for spina bifida and ultrasound scans, but many less were anxious about having the test.
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The biparietal diameter of 20 fetuses with spina bifida was measured during pregnancy by ultrasound scanning, mainly in the second trimester. The mean result was 0.83 cm smaller than the value based on 186 unaffected pregnancies at the same gestational ages (P less than 0.001), suggesting that spina bifida fetuses are growth retarded. The practical consequence of this finding is that the routine use of ultrasound in pregnancy will increase the sensitivity of AFP screening for open spina bifida at 16 to 18 weeks gestation from 79 per cent as estimated by the UK Collaborative AFP Study to about 90 per cent or more.
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Maternal serum alpha-fetoprotein (AFP) levels were higher in six triplet pregnancies and three quadruplet pregnancies than in control singleton pregnancies matched for maternal age, parity and time of gestation at which the serum sample was taken. Between 12 and 23 weeks of pregnancy, the average AFP levels among the triplet pregnancies was three times that found in the singleton pregnancies, and the level in the quadruplet pregnancies was even higher. Maternal serum AFP levels appear to be associated with the number of fetuses in utero.