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R S Cartmill

Publications and source records attributed to R S Cartmill.

6 recordsLinked to original sources
PubMed1992

Effect of presentation of partogram information on obstetric decision-making.

The way in which medical information is presented may affect doctors' decision-making. We have assessed whether changing the appearance of the same information on the partogram affects clinical decisions during labour. Sixteen junior obstetricians were asked about how they would manage six hypothetical cases of difficult labour. Information was given by partogram, in which we varied either the relative scales of the x and y axes or whether the latent phase of labour had been included. Doctors were more likely to intervene and to intervene more actively if the progress of labour curve appeared flat and if the latent phase was included. The shape and point of origin of the partogram probably influence intervention rates in practice and may partly explain the low rates of caesarean section in some hospitals.

Decision Making↗
PubMed1991

Fetal movements; factors affecting their perception.

We prospectively recorded placental site, maternal weight and parity in 182 patients reporting decreased fetal movements and compared these with controls. Reports of decreased fetal movements were 2.10 times (95% CI 1.51-2.92) as likely in association with an anterior placenta and 1.81 times (95% CI 1.20-2.93) and 2.61 times (95% CI 1.26-5.40) as likely in mothers weighing over 80 and 90 kg, respectively, but there was no association with parity. Decreased perception of fetal movements is more likely to have serious implications in thin women with a posterior placenta. Our findings also suggest that the sensation of fetal movements arises from pressure against body wall structures rather than the uterus or peritoneum.

Body Weight↗
PubMed1991

Clinical experience with the triple test for Down's syndrome screening.

The introduction of maternal serological screening for chromosome disorders in pregnancy in women aged over 30 years at the estimated date of delivery was monitored in two hospitals. The test used involved measurement of three substances in maternal serum combined with maternal age (the triple test). This is the first report of such screening applied to an unselected antenatal clinic population. Test uptake was high but there was no overall increase in amniocentesis numbers because the increase in younger mothers was compensated for by a decrease in older women who previously, without serological testing, might have gone directly to amniocentesis. It is anticipated that widespread introduction of such testing will lead to improved detection of Down's syndrome as predicted from retrospective studies.

Adult↗