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Biomedical subjects

M Geary

Publications and source records attributed to M Geary.

At least 19 recordsLinked to original sources
PubMed2006

Understanding operative intervention in childbirth: a patient perspective.

A study was undertaken to ascertain patients' understanding of the operative interventions in labour and to assess follow-up by the operator. A total of 200 consecutive women who had undergone caesarean section or instrumental delivery were selected. These women were questioned postoperatively. Questions were asked to ascertain the patients' understanding of the procedure and to assess follow-up by the operator. Seven patients had a forceps delivery, 64 had a ventouse delivery and 129 had a caesarean section. The majority of patients felt that the reason for the operative delivery had been explained to them at delivery and that they fully understood the need for this intervention. A total of 26 women were not seen postoperatively by the doctor who delivered them. Women who underwent forceps or ventouse delivery were less likely to be seen post-delivery, although this difference did not reach statistical significance.

Adolescent↗
PubMed2006

Pregnancy outcome in immigrant women in the Rotunda Hospital.

In recent years the numbers of immigrants attending maternity hospitals has risen. The amount of antenatal care these women receive varies widely. Analysis was performed of deliveries to immigrant women in the Rotunda Hospital in 2002. Women were sub-divided depending on antenatal care received in Ireland. Women who received no antenatal care were 'unbooked', those who attended the hospital two to 28 days before delivery were 'late bookers'. The remaining women were 'booked'. There were 1,954 deliveries to immigrant women; 1,1 73 (60%) 'booked', 391 (20%) 'late bookers' and 390 (20%) 'unbooked'. 'Unbooked' women had a higher rate of spontaneous vertex delivery (63%) (p < 0.01). 'Late bookers' had a higher rate of caesarean section (27.6%) (p < 0.01). The 'late bookers' infants were more likely to be preterm, low birth weight and had a higher rate of neonatal ICU (NICU) admissions (p < 0.01). This study has identified 'late booker' immigrants as a high-risk group.

Adolescent↗
PubMed2006

Acceptability of routine enquiry regarding domestic violence in the antenatal clinic.

Domestic Violence poses a significant health risk for the woman and her baby. We wished to determine the acceptability of routine questioning for domestic violence in the maternity hospital setting. A non-anonymised questionnaire was completed by 481 women attending for booking antenatal appointment in a maternity hospital antenatal clinic. The doctor asked four questions regarding experience of partner abuse, The acceptability of these questions was determined. 468 (99%) patients found the questions acceptable and said it would be helpful to ask all patients. Sixty-one (12.9%) women gave a history of at least one form of partner abuse. We concluded that routine enquiry about domestic violence during hospital antenatal visits is acceptable to women and perceived by them to be worthwhile.

Communication↗
PubMed2006

Smoking and alcohol in pregnancy. Survey in the immediate post-partum period.

This was a questionnaire-based study of 151 postnatal women. We found 42% of women were smokers prior to pregnancy and only 37% of these women succeeded in quitting smoking during pregnancy. Success in quitting was significantly related to the number of cigarettes smoked (p<0.05). However, 71% of pregnant smokers were aware of the associated risks. Alcohol was consumed by 89% of women and 10% admitted to binge drinking during pregnancy. Only 44% of the study group were aware of the associated risks of alcohol. We propose that we need to change our social acceptance of these behaviours before pregnancy, and provide support to those women during pregnancy.

Adolescent↗
PubMed2005

Influence of posture on the incidence of vein cannulation during epidural catheter placement.

BACKGROUND AND OBJECTIVE: Epidural vein cannulation has long been recognized as a problem in parturients due to distension of epidural veins. Epidural vein engorgement is maximal when the pregnant woman is in the supine position and minimal in the lateral position. Following an initial observation of an apparently high incidence of epidural vein cannulation in the sitting position, a randomized trial was conducted to document whether such an association existed. METHODS: A total of 209 term parturients were randomized to either the sitting or lateral position (107 left lateral, 102 sitting). Epidural catheter placement was achieved using a loss of resistance to air technique with an 18-G Tuohy needle. A data sheet was completed for each patient recording patient position, patient characteristics data, stage in labour and the incidence of epidural vein cannulation. Poor labour analgesia was defined as a visual analogue scale (VAS) > 40 mm on a 0-100 mm pain intensity VAS. RESULTS: The risk of epidural vein cannulation was significantly higher in the sitting group (16 of 102 = 15.7%) compared with the lateral position group (4 of 107 = 3.7%), P = 0.011. There was a significant association between epidural vein cannulation and poor analgesia (P = 0.006). These two variables remained independently significant on multiple regression analysis (position, P = 0.009; analgesia, P = 0.006). CONCLUSIONS: We conclude that there is a direct correlation between the incidence of epidural vein cannulation and patient posture during epidural catheter insertion in parturients.

Adult↗
PubMed2005

An audit of the use of magnesium sulphate in severe pre-eclampsia and eclampsia.

Over the last decade there has been an increase in the use of MgSO4 for the prevention of seizures in women with severe pre-eclampsia or eclampsia. At the Rotunda Hospital it is regularly used for this purpose. The aim of this study was to audit the use of MgSO4 at the hospital, to determine whether the drug was being used according to the hospital's protocol and to observe its effectiveness in the prevention of eclampsia in our population. A retrospective chart review over the two years from 1/1/2000 to 31/12/2001 was undertaken. Outcome measures assessed were; Patient selection, Administration of the drug - whether recommended protocols were adhered, Effectiveness of therapy for seizure prophylaxis, Maternal and neonatal outcomes. There were 12,910 deliveries at the Rotunda hospital over this period of time. Fifty of these women were treated with MgSO4 (0.4%). Patient selection was appropriate in all cases. The correct loading dose of MgSO4 was administered in all cases, however MgSO4 levels were recorded in only 30 (60%) of women. There were no seizures in the treated group. Two women presented with seizures (one was antenatal the other post-natal period), both were treated with MgSO4. There were no maternal or neonatal mortality. Seventy two percent (36) of these women were delivered by lower segment caesarean section. The mean gestation at delivery was 36 weeks (range 28-41 weeks). Thirty eight percent (13) of babies required admission to the neonatal intensive care unit. The mean birth weight at delivery was 2.54 kg (range 1.11-3.68 kg). MgSO4 use in the Rotunda hospital appears to be safe and effective for the prevention of seizures in women with severe pre-eclampsia or eclampsia. Serum MgSO4 levels were only recorded in 60% of patients and the hospital's protocol was not adhered to regarding monitoring of patients on treatment. This needs to be addressed.

Adolescent↗
PubMed2005

Birth-weight trends in primiparous women in the twentieth century.

We investigated the trend in birth-weights in the Rotunda hospital in primiparous women over the 20th century. There was a significant increase in birth-weight particularly in the latter third of the century. In light of these findings we believe that new approaches to the management of labour in primiparous mothers be developed.

Birth Weight↗
PubMed2003

The caesarean section rate in the Republic of Ireland in 1998.

The Caesarean section (CS) rate has risen dramatically in the United Kingdom and North America over the past 20 years. There are no recent data in the Republic of Ireland on CS rates. Our aim was to ascertain the national CS rate for the year 1998. In addition, we sought to determine instrumental delivery rates and epidural rates. Twenty-two of 24 units replied to a questionnaire giving a response rate of 92%. The CS rate was 17.8% (12.8-26.7%), 7.5% were elective and 10.3% were emergency. The size or type of the maternity unit did not influence the CS rate. The cause for the rise in the CS rate is multifactorial. Review of the current literature would suggest that a further rise in the CS rate in Ireland is likely.

Analgesia, Epidural↗
PubMed2001

Interactions between artificial saliva and 20 aroma compounds in water and oil model systems.

The interactions between saliva components and 20 aroma compounds in water and oil model systems were systematically evaluated as a function of saliva composition and saliva/model system ratio. Air/liquid partition coefficients of dimethyl sulfide, 1-propanol, diacetyl, 2-butanone, ethyl acetate, 1-butanol, 2-pentanol, propyl acetate, 3-methyl-1-butanol, ethyl butyrate, hexanal, butyl acetate, 1-hexanol, 2-heptanone, heptanal, alpha-pinene, 2-octanone, octanal, 2-nonanol, and 2-decanone were determined by static headspace gas chromatography. Chain length of compounds within the homologous series determined the extent of interactions with the model system or saliva. Salts in the artificial saliva hardly interacted with aroma compounds. On the other hand, saliva proteins lowered retention of highly volatile compounds and increased retention of less volatile, hydrophobic compounds. Significant differences in volatility of compounds when artificial saliva or water was added indicated that saliva could not be sufficiently replaced by water. The model system/saliva ratio influenced air/liquid partitioning of the aroma compounds significantly for both model systems. Although saliva composition affected volatility of the aroma compounds, the saliva/model system ratio was of much greater influence.

Chromatography, Gas↗
PubMed2001

Myocardial ischaemia in normal patients undergoing elective Caesarean section: a peripartum assessment.

Incidence rates of electrocardiographic changes during Caesarean section vary from 25 to 60%. To date, no investigator has identified myocardial ischaemia resulting from these changes. We investigated patients undergoing elective Caesarean section using peripartum Holter monitoring and serum analysis of cardiac troponin I (cTnI). Twenty-six patients presenting for elective Caesarean section were studied. Peroperative Holter monitoring continued for 12 h postoperatively, at which time blood samples for cTnI levels were taken. Significant ST changes were recorded in 42% of patients peroperatively and 38.5% of patients postoperatively. Forty-two per cent of patients experienced peroperative chest pain requiring opioid analgesia. Chest pain was significantly associated with abnormal electrocardiogram (ECG) findings. Ischaemic levels of cTnI were recorded in two patients. This study reports, for the first time, myocardial ischaemia (7.69% of patients) arising in conjunction with the ECG changes seen during elective Caesarean section. We also report episodes of significant postoperative ST-segment changes.

Adult↗