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Biomedical subjects

M J Carty

Publications and source records attributed to M J Carty.

At least 19 recordsLinked to original sources
PubMed2000

Angiographic embolisation in the management of pelvic haemorrhage.

Haemorrhage from pelvic veins during obstetric and gynaecological surgery is a major cause of morbidity and mortality. In a recent commentary entitled The Seven Surgeons of King's: a fable by Aesop(1), surgeons from different specialties used techniques peculiar to their own practice to treat a woman with intractable haemorrhage. Could transcatheter arterial embolisation be the 'eighth surgeon'? We describe two cases where embolisation was used to control bleeding when local surgical measures had failed and discuss the use of embolisation in obstetrics and gynaecology.

Adult↗
PubMed1998

Superficial vein thrombosis: incidence in association with pregnancy and prevalence of thrombophilic defects.

Superficial venous thrombotic (SVT) events are a feature of thrombophilic abnormalities, particularly those involving the protein C pathway. We have determined the incidence of SVT associated with pregnancy and the early postpartum period in a retrospective study involving 72000 deliveries. Fourty-nine cases occurring in 47 individuals were recorded, with an overall incidence of 0.68/1000 deliveries (95% CI 0.48-0.88). None had a previous history of deep vein thrombosis or pulmonary embolism. Most events occurred in the early postpartum period (0.54/1000 deliveries). Twenty-four/fourty-seven were screened for established thrombophilic abnormalities, with only 1 abnormality detected (FV(Leiden) heterozygote). Thrombophilia may play a minor role in the aetiology of SVT associated with pregnancy, although a larger study is required to confirm this.

Adult↗
PubMed1997

Risk factors for pregnancy associated venous thromboembolism.

In an attempt to reduce the incidence of pregnancy associated venous thromboembolism (PA-VTE), some researchers have advocated screening of all women for the factor V(Leiden) mutation during early pregnancy. We have conducted a large retrospective study (over 72,000 deliveries) to determine if this would be useful. Sixty-two objectively confirmed venous thrombotic events (51 DVT, 11 PE) were recorded at two maternity units in the UK. The incidence of DVT was 0.71 per 1000 deliveries (95% CI 0.5-0.9) with 0.50 occurring in the antenatal period (95% CI 0.34-0.66) and 0.21 in the puerperium (95% CI 0.11-0.31). The incidence of PE was 0.15 per 1000 deliveries (95% CI 0.06-0.24), 0.07 antenatal (95% CI 0.01-0.13) and 0.08 in the puerperium (95% CI 0.02-0.14). Of these 62, 50 attended for follow-up and thrombophilia screening. 28% of all episodes of PA-VTE had no clinical risk factor for thrombosis or an identifiable thrombophilic abnormality. Deficiency of antithrombin was identified in 12% of individuals (95% CI 3-21) and the factor V(Leiden) mutation in 8% (95% CI 0.5-15.5). Based on estimates of the prevalence of the factor V(Leiden) mutation in the population, we estimate that the thrombotic risk for a woman during pregnancy or the puerperium with the defect is approximately 1 in 400-500. This figure would not lend support to the idea of random screening for the mutation in early pregnancy.

Adult↗
PubMed1986

Early prenatal investigation of a pregnancy at risk of adenosine deaminase deficiency using chorionic villi.

A pregnancy at risk for adenosine deaminase deficiency and severe combined immunodeficiency disease was investigated using samples of chorionic villi obtained during the eighth week of pregnancy. Adenosine deaminase levels suggested that the fetus was a probable carrier and that a diagnosis of severe combined immunodeficiency disease could be excluded. Enzyme and chromosome results were available within 24 hours of the chorionic villous sampling procedure, and were confirmed on amniotic fluid cell cultures after amniocentesis at 17 weeks' gestation and on cord blood at delivery.

Adenosine Deaminase↗
PubMed1976

Coagulation and fibrinolytic properties of peripheral venous blood in chronic ectopic pregnancy.

The coagulation and fibrinolytic properties of peripheral venous blood was studied in 10 Black patients with chronic ectopic pregnancy. There were significant elevations of plasma fibrinogen and serum fibrin-fibrinogen degradation products (FDP) and prolongation of the euglobulin lysis time. These features are believed to be compatible with chronic inflammation. No evidence of a haemostatic defect was found.

Adult↗
PubMed1976

Ambulance transport of obstetric emergencies.

Ninety-eight patient records from obstetric flying squad calls were reviewed. The reasons for call-out and the effect of transport on maternal and foetal cardiovascular parameters were analysed. The main reason for calling the flying squad is now antepartum haemorrhage. Transporting the patient to hospital has little effect on the cardiovascular state.

Adult↗
PubMed1975

An ultrastructural study of the reversibility of the effects of hypoxia on human trophoblast maintained in organ culture.

Ultrastructural changes in normal human trophoblast maintained in hypoxic organ culture are described. Marked structural changes were noted even after hypoxia for 6 hr. These changes could be partly reversed by reoxygenation after hypoxia for 18 hr or less, but no regeneration occurred when hypoxia lasted for 24 hr or longer. The significance of the vulnerability of trophoblast to hypoxia is discussed.

Carbon Dioxide↗