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Biomedical subjects

M Holohan

Publications and source records attributed to M Holohan.

8 recordsLinked to original sources
PubMed2006

Management of women with major placenta praevia without haemorrhage: a questionnaire-based survey of Irish obstetricians.

Our aim was to determine individual management of women with major placenta praevia without antepartum haemorrhage (APH) using a questionnaire-based study. Placenta praevia complicates one in 200 pregnancies. It is associated with maternal mortality of 0.03%. The maternal, fetal and neonatal morbidity and mortality are due to the complications of haemorrhage and prematurity. APH due to placenta praevia is unpredictable and this may explain the traditional inpatient approach to management. This approach may be justified in those with bleeding, it is questionable in those who have not bled. A total of 121 obstetricians replied (63%), to 192 questionnaires sent out. Of these, 48 obstetricians would admit all women with major placenta praevia without APH, while 69 would manage them on an outpatient basis. When asked whether or not they agreed with outpatient management, 21 agreed strongly, 51 tended to agree, 23 tended to disagree and 13 disagreed strongly. Over half of the obstetricians adopt an outpatient management approach.

Attitude of Health Personnel↗
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↗
PubMed1996

Maternal and neonatal hyponatraemia: a comparison of Hartmanns solution with 5% dextrose for the delivery of oxytocin in labour.

We performed a randomised controlled trial to compare the effect on neonatal and maternal serum sodium of using oxytocin in Hartmanns solution compared to the standard 5% Dextrose regimen for induction or augmentation in labour. We found significantly decreased maternal and neonatal serum sodium concentrations in the 5% Dextrose group compared to the Hartmanns group.

Adult↗
PubMed1992

Intrapartum asphyxia in term and post term infants.

Many attempts have been made to identify infants at risk of suffering asphyxial brain damage. In a retrospective review of records at the Rotunda Hospital over a five year period all infants who died or suffered seizures, presumed secondary to asphyxia, were compared with the general hospital population. Out of 28,655 deliveries reviewed, there were 13 deaths in infants at or after term associated with perinatal asphyxia, and 32 surviving infants had asphyxial seizures. Seizures were regarded as asphyxial in origin if they occurred in the first forty eight hours of life and were associated with other clinical evidence of asphyxia. The incidence of abnormal presentations, assisted breech deliveries, instrumental deliveries and emergency caesarean sections was all increased in the asphyxial categories compared to the control population. Referral to the fetal assessment unit was associated with a seizure rate of 0.16/1000 live births compared with a rate of 1.4/1000 in the remaining non referred hospital population. Nineteen percent of the infants who seized subsequently developed cerebral palsy. It would appear from our data that referral to the fetal assessment unit and the consequent assignment to "high risk" status is associated with low risk in terms of asphyxial outcome.

Asphyxia Neonatorum↗
PubMed1989

Analysis of endometrial carcinoma.

Between 1980/86 there were 58 cases of uterine cancer reviewed at the Mater Misericordiae Hospital, of which 49 (84.5%) had endometrial adenocarcinoma. The median survival in Stage I disease was 30 months and where applicable the overall five-year survival rate was 43.75%. These survival rates are less than those reported from most other centres. This reduced survival rate was not related to presentation with more advanced disease. However, patients were of an older age and had a greater number of poorly differentiated tumours than in other reported series. Comparative results with other centres in Ireland would be assisted by the establishment of a National Tumour Registry.

Adenocarcinoma↗
PubMedDate not supplied

Idiopathic mesenteric thrombosis following caesarean section.

Mesenteric venous thrombosis, "the great mimicker", is a very rare disorder in pregnancy and the puerperium, particularly when not associated with any pre-existing thrombophilia or autoimmune states. We describe a patient requiring a resection of 150 cm of gangrenous small bowel after uncomplicated elective Caesarean section. The only risk factor for thrombosis was recovery from an elective Caesarean section, a condition classified by the Royal College of Obstetricians and Gynaecologists as "low risk". Death from thromboembolism is the leading cause of maternal mortality and should always be considered with unusual post partum symptoms. Early diagnosis of mesenteric vascular occlusion is difficult and recent evidence suggests that elevated GST isoenzyme may be helpful. In all cases of MVT anti-coagulation is the basis of treatment. Patients who are not anti-coagulated after surgery have a recurrence rate of 25 per cent compared with 13 per cent of heparinised post-operative patients. As no other pre-existing cause for MVT was found, management was with warfarin for 6 months, the oral contraceptive pill was contraindicated and heparin prophylaxis was recommended for future pregnancies.

Adult↗