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M Renwick

Publications and source records attributed to M Renwick.

6 recordsLinked to original sources

How good is ultrasound in the detection and evaluation of anterior abdominal wall defects?

The ability of routine obstetric ultrasound to detect and accurately describe fetuses with anterior abdominal wall defects has been examined in an unselected population using data from a regional abnormality survey. Examination between 16 and 22 weeks gestation detected 60% of defects with a false positive rate of 5.3%. Fetuses with gastroschisis were incorrectly assigned as exomphalos in 14.7% of cases recognized before 22 weeks gestation. The diagnosis, including description of associated detectable anomalies, was completely accurate in 71.6% of cases. Some of the problems of diagnostic accuracy need to be considered when counselling couples with a fetal anomaly. Cross-referral between obstetric ultrasound units should be encouraged to improve diagnostic accuracy. These results form the basis for audit of obstetric ultrasound in the diagnosis of fetal abnormality within a geographically defined population.

Abdominal Muscles

Northern Region Fetal Abnormality Survey results 1987.

The UK Northern Region Fetal Abnormality Survey was notified of 572 suspected fetal abnormalities in 1987. Of these, 265 (46%) had pediatric surgical implications. Because the registry traces the postnatal outcome of each notification and records congenital abnormalities diagnosed postnatally, it is possible to measure both sensitivity and selectivity of antenatal diagnosis of fetal abnormalities. Cases were divided into five groups: diaphragmatic hernia, abdominal wall defects, intestinal anomalies, neural tube defects, and urological anomalies. Each group comprised cases that were unsuspected, suspected but not confirmed, and suspected and confirmed. Sensitivity was highest in the urological group, but 30% of the notified cases were unconfirmed so selectivity was higher in the abdominal wall and neural tube groups. None of the diaphragmatic hernias and only 14.3% of the intestinal anomalies were correctly suspected. Only 13.5% of all neural tube defects were treated surgically. The Survey has improved cooperation and communication between specialists concerned with the management of fetal abnormalities and this in turn has improved patient care.

Abdominal Muscles

Quality assurance in Australian hospitals: who does it and how?

OBJECTIVE: To seek information on the type, method and extent of quality assurance being undertaken in all public and private hospitals within Australia. METHOD: Mailed questionnaire. RESULTS: There was a predominance of two types of review being undertaken. Some important deficiencies in the quality assurance process were identified. Far more private than public hospitals reviewed medical records and surveyed patient satisfaction.

Australia

Antenatal diagnosis of congenital abnormalities in the urinary tract. Results from the Northern Region Fetal Abnormality Survey.

One hundred and sixty-two cases of suspected congenital abnormalities of the urinary tract notified to the Northern Region Fetal Abnormality Survey Register between the beginning of 1984 and the end of 1986 were studied. These cases represented 14.3% of total notifications, which in turn were 0.93% of total births. There were a further 25 cases notified but not due for delivery until early 1987; 10 of these were urological. Thirty-five cases (22%) notified proved postnatally to have normal urinary tracts and 21 (13.2%) had unsuspected urinary tract abnormalities. Of the 106 cases in which a suspected urinary tract abnormality was confirmed postnatally, confirmation was obtained at perinatal death in 32 and by ultrasound, radiographic and radioisotope investigation in the remainder; 34.5% of all urological cases registered and 75% of the confirmed survivors were treated surgically. The urological abnormality most frequently missed was posterior urethral valves. Attempts to diagnose the fetal sex were seldom made but when they were the prediction was usually male and usually correct. The perinatal mortality in this group was 0.43/1000 births, a contribution of nearly 4% to overall perinatal mortality in the Northern Region.

Female