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Biomedical subjects

R S Settatree

Publications and source records attributed to R S Settatree.

8 recordsLinked to original sources
PubMed2002

[Comparability of obstetric and perinatal data from England and Germany using standard-primip-groups - maternal and neonatal outcome].

OBJECTIVE: Aim of the study was to assess whether different birth management of an english and german department can influence the maternal and neonatal outcome. MATERIAL AND METHODS: The database consisted of routinely published data from 1986-95 for two clinical units in Solihull (England) and Ibbenbueren (Germany) comprising 34 820 and 9 053 deliveries respectively. In order to standardise the obstetric risk profiles the heterogeneous primary groups were subdivided into "standard primip groups". A statistical comparison using the "binomial confidence interval method" was carried out. RESULTS: In the standardised comparison induction of labour, duration of labour 1-6 hours, vaginal delivery from cephalic presentation, elective caesarean section, both for cephalic and breech presentation, transfer to the childrens hospital were less frequent in Solihull. On the other hand, Solihull showed more frequent oxytocin administration, fetal blood analysis, epidural anaesthesia, episiotomies, duration of labour > 13 hours, forceps, ventouse and emergency caesarean section deliveries from cephalic presentation, vaginal deliveries or emergency caesarean sections from breech presentation, resuscitation of the newborn using mask and/or drugs, maternal blood loss > 1 000 ml as well as abnormalities of placental separation. Despite the different management of the departments being compared no significant differences in the incidence of perinatal hypoxia as determined by Apgar scores at 5 minutes nor in the fetal mortality rate between the units could be identified. CONCLUSION: Using standardised data the quality of obstetric and perinatal care in England and Germany can be reliably compared. Different birth management does not significantly influence the neonatal outcome.

Breech Presentation↗
PubMed1993

Classifying perinatal death: experience from a regional survey.

OBJECTIVE: To examine problems encountered in classifying perinatal death using the systems proposed by Hey et al. (1986) and Cole et al. (1986). SUBJECTS: 451 deaths from a regional perinatal mortality survey of which 293 had a post mortem examination. METHODS: Documents from each death were reviewed by four assessors, one from each discipline, selected randomly from a pool of obstetricians, paediatricians, general practitioners and midwives. Each assessor classified the cause of death blind to the others. The degree of agreement between assessors was calculated for the full and shortened obstetric and fetal-neonatal classifications using the kappa statistic for inter-rater agreement. RESULTS: The kappa statistic, which is a measure of the proportion of agreement above chance, gave a value of 0.55 for the full obstetric classification and 0.58 for the full fetal and neonatal classification when all four assessors made an assignment. An assignment was omitted in 6.2%, but the kappa value of zero for these omissions suggested that this was a nonsystematic result due to random protocol violations. The grouped (shortened) classifications generated a higher kappa value of 0.62 for the nine point obstetric system and 0.67 for the six point fetal and neonatal (New Wigglesworth) system. Post mortem had little effect on agreement. The best agreement levels observed were for congenital anomaly. CONCLUSION: This survey highlighted the complexity of the 22 and 24 point classifications, the uneven distribution of deaths within their categories, and the variable levels of agreement between professionals classifying deaths, thus questioning the validity of individual maternity units of health districts generating local data in this degree of detail for comparative purposes in regional and national statistics. Grouping the original categories led to greater agreement particularly for the New Wigglesworth classification. The role of post mortems in clarifying the cause of fetal and neonatal death needs further investigation.

Cause of Death↗
PubMed1980

Analysis of ethnic differences in perinatal statistics.

The 3996 mothers delivered at Dudley Road Hospital, Birmingham, in 1979 were analysed for their ethnic origins. Social classes IV and V predominated in all groups. A high proportion of Indian mothers fell into the low-risk group based on age and parity but had the highest stillbirth and perinatal mortality rates (15.1 and 27.5/1000 respectively) and infants of low mean birth weight (2986 g). Elderly and multiparous mothers were characteristic of the Pakistani and Bangladeshi groups. Young, primiparous mothers were more common among the West Indians and Europeans, in whom the stillbirth and perinatal mortality rates were low; infants in the European group had a mean birth weight higher than in any other group (3231 g). From these findings ethnic origin of the mother is apparently an important factor in perinatal mortality.

Bangladesh↗
PubMed1977

Comparison between linear array real time ultrasonic scanning and conventional compound scanning in the measurement of the fetal biparietal diameter.

Ultrasonic measurements of fetal biparietal diameter (BPD) obtained by the Real Time scanning (Dynamic Section Scan) and conventional compound scanning (Static Section Scan) in twenty patients were compared. A comparison between two operators, one of whom was relatively inexperienced, was also made, both measuring the same BPDs. The mean variance of 20 groups-of-four 'blind' measurements was reduced using dynamic scanning, particularly for the less experienced operator. A significant difference was observed between operators using conventional scanning but not when using dynamic scanning. Both operators were able to obtain results in a shorter time with dynamic scanning, the faster operator averaging less than one minute for each observation. Apparent advantages of dynamic scanning are discussed. The terms 'Dynamic Section Scan' and 'Static Section Scan' are suggested to emphasize the difference between the two imaging systems.

Anthropometry↗