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Biomedical subjects

P Hogston

Publications and source records attributed to P Hogston.

At least 19 recordsLinked to original sources

The factors associated with effective folic acid prophylaxis in the peri-conceptional period in women attending an ante-natal clinic.

The aim of this study was to examine whether folic acid supplements had been taken and dietary folate intake increased in 662 pregnant women attending the antenatal clinic at St Mary's Hospital, Portsmouth. An assessment was also made of the factors that influenced correct compliance with the recommendations of the Expert Advisory Group on folic acid. Thirty-seven percent (245/662) women had taken folic acid supplements and 26.4% (175/ 662) increased their dietary folate before or during early pregnancy. The majority of women who commenced folic acid supplements after conception did so after the neural tube had closed (220/247). Women were more likely to have adhered to the Expert Advisory Group's recommendations if the pregnancy was planned, the woman was primiparous, there was no past or family history of neural tube defect and the patient had the correct existing knowledge of folic acid prophylaxis. The relevance of these findings to the current Health Education Authority's folic awareness campaign is discussed.

Journal Article↗

The effects of smoking on labour after uncomplicated pregnancy: a comparison between the progress and outcome of labour in 400 smokers and 400 matched non-smokers.

A comparison was made between the progress of labour and its outcome after an uncomplicated pregnancy, in 400 smokers and 400 non-smokers. Strict selection criteria were applied to eliminate, as far as possible, the variables which might have influenced labour in both groups and to ensure that the two groups of women were matched. The duration of labour was longer in smokers, who also had a higher incidence of caesarean sections. Smokers had a higher incidence of retained placenta and postpartum haemorrhage. The neonates of smokers had a higher incidence of problems in the immediate post-delivery period.

Journal Article↗

Early discharge following major gynaecological surgery.

This prospective study was to assess the safety and acceptability to patients of early discharge after major gynaecological surgery. Selective patients who fulfilled certain criteria were offered early discharge after their operations. Forty patients were discharged within 72 hours. Fourteen of them had undergone abdominal hysterectomy, 5 with a mid-line incision; 13 had vaginal hysterectomy; 9 laparoscopy and laparotomy for ectopic pregnancy; 3 laparotomy for ovarian surgery and 1 a Manchester repair. The patients were discharged home on average 2.4 days after their operations. All were satisfied with their pain relief at home. There were 4 postdischarge complications. Two had superficial drip-site phlebitis, 1 a possible urinary tract infection and 1 a wound abscess. There was only 1 readmission 2 weeks post discharge for constipation. Thirty-one out of 40 (77.5%) of the patients had expressed that the home environment was more conducive to speedy recovery and 92.5% of the patients would choose early discharge again if given the option.

Adult↗

Total perinatal wastage. A clarification of priorities.

The pregnancy outcome of 16,971 women carrying 17,352 living fetuses after 16 weeks gestation was studied. As well as recording perinatal deaths, all losses before 28 weeks and up to one year after delivery were recorded to give a total perinatal wastage rate of 21.6 per 1000 fetuses alive at 16 weeks compared with a perinatal mortality rate (stillbirths plus early neonatal deaths) of 7.8 per 1000 births. All deaths were then classified according to pathological sub-groups. The concept of auditing perinatal care using perinatal mortality was then compared with that using total perinatal wastage.

England↗

Reference values for 75 g oral glucose tolerance test in pregnancy.

A 75 g oral glucose tolerance test was performed in 212 pregnant women with no predisposing factors suggesting glucose intolerance to establish the normal pattern of glucose metabolism in pregnancy. Reference values for the test were established for the middle of pregnancy (14-20 weeks, n = 43) and late pregnancy (28-37 weeks, n = 168). One woman was excluded because she had diabetes that required treatment with insulin. There were statistically significant differences between the two groups for samples taken both one and two hours after the glucose load. Reference ranges for the interpretation of the glucose tolerance test in pregnancy should therefore take account of the period of gestation. Arbitrary upper limits of normal (represented by the 97.5 centile) two hours after a 75 g oral glucose load are proposed at 7.5 and 9.6 mmol/l for the second and third trimesters, respectively.

Blood Glucose↗

Gonococcal and chlamydial antibodies in ectopic and intrauterine pregnancy.

Sera from 50 women with ectopic pregnancy and 50 age-matched control women with intrauterine pregnancy were tested by enzyme-linked immunosorbent assay (ELISA) using C. trachomatis and N. gonorrhoeae pili as antigens. In the ectopic pregnancy group 76% had IgG antibodies to C. trachomatis compared with 38% in the controls. The prevalence of gonococcal IgG antibody was 32% in the ectopic pregnancy group and 4% in the controls. The prevalences of IgA antibodies to the two organisms ranged from 2 to 12% and were similar in the two groups; cultures for C. trachomatis from cervical swabs from the ectopic pregnancy group were negative. Chlamydial antigen was detected (by ELISA) in exfoliated cervical cells of only one patient in this group.

Antibodies, Bacterial↗

Is a paediatrician required at caesarean section?

In a series of 460 consecutive deliveries there were 55 caesarean sections (mainly under epidural anaesthesia) without evidence of fetal distress and with a cephalic presentation. There was no statistically significant difference in the frequency of resuscitation in this group compared with 296 spontaneous vertex deliveries. It is concluded that a paediatrician is not routinely required at caesarean section under epidural provided there is no fetal distress and the presentation is cephalic.

Breech Presentation↗

Ultrasound study of ovarian cysts in pregnancy: prevalence and significance.

Previous surveys of the prevalence and natural history of ovarian cysts have been based on those ascertained by clinical examination. This study examines the fate of 137 adnexal cysts discovered during the course of 26 110 ultrasound scans in early pregnancy. Of these 10% were operated on in the first instance, and a further 2% required operation during pregnancy for painful complications. In 3% cysts were removed at caesarean section or in the puerperium. Half the removed cysts were neoplastic including one low grade carcinoma. Of the 120 cysts treated conservatively, 89% could not be detected on ultrasound examination later in pregnancy. All cysts greater than 8 cm should be removed, as should smaller cysts that are multilocular, thick-walled or semi-solid.

Adolescent↗

Investigation of women with endometrial carcinoma using serum vascular endothelial growth factor (VEGF) measurement.

This study assessed whether serum VEGF measurement in women presenting with endometrial cancer could predict advanced stage disease. Preoperative sera from 37 women undergoing laparotomy for suspected endometrial cancer were assayed for VEGF, CA125 and platelet count. Significant positive correlation was shown between VEGF and platelet levels (P = 0.003, r = 0.477). However, no correlation was demonstrated between VEGF and stage overall, and no significant difference was shown between those with early (stage 1A/1B, n = 20) compared to those with advanced (stage >1B, n = 13) or disseminated (stage >2, n = 7) disease. Serum VEGF measurement was not beneficial in the preoperative assessment of stage in patients with endometrial carcinoma. Strong correlation with platelet levels suggests that this is one of the sources of VEGF measured.

Adult↗