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Biomedical subjects

Sara Paterson-Brown

Publications and source records attributed to Sara Paterson-Brown.

7 recordsLinked to original sources
PubMed2005

Non-invasive intrapartum fetal ECG: preliminary report.

OBJECTIVES: To obtain fetal heart rate, detailed fetal electrocardiography (fECG) signals and uterine contractions during labour using a single device. DESIGN: Prospective observational study. SETTING: Delivery suite at a tertiary referral hospital, London, UK. POPULATION: Fifteen patients at median gestation of 39 weeks (range 24-41) were recruited at median cervical dilatation of 4.0 cm (range 0-10) of whom 8/15 (53%) had intact amniotic membranes. METHODS: Using 12 abdominally sited electrodes, we recorded the composite abdominal signal in pregnancies intrapartum. The recorded data were analysed off-line using a blind signal separation technique. MAIN OUTCOME MEASURES: Success of signal separation and fECG time intervals. RESULTS: Successful fECG signal acquisition was achieved in 12/15 (80%) patients and an averaged fECG waveform acquired. In these patients, P and QRS waves were seen in all cases, and T waves in 11/12 (92%). True beat-to-beat heart rate (HR) was displayed and measures of its variability obtained. The mother's ECG and uterine electrical activity, shown to match tocographically recorded uterine contractions, were also separated and displayed. Failure to acquire fECG in three cases was attributed to excessive abdominal muscular activity and electrical interference. CONCLUSIONS: This study demonstrates a non-invasive technique that displays detailed intrapartum fECG waveforms, HR variability, maternal ECG and uterine contractions simultaneously, all in a single device and which avoids the potential risks of invasive monitoring with a fetal scalp electrode.

Cardiotocography↗
PubMed2002

Can we improve on the diagnosis of third degree tears?

OBJECTIVES: To assess if the clinical diagnosis of third degree tears could be improved by increased vigilance in perineal assessment. STUDY DESIGN: A prospective observational study of all nulliparous vaginal deliveries sustaining perineal trauma (483) over a 6-month period at Queen Charlotte's Hospital. RESULTS: A total of 121 women were independently assessed and compared to a control group (362). Both groups were similar for gestation at delivery, mode of onset of labour, analgesia used, duration of labour, mode of delivery, birthweight and head circumference. The overall rate of detected third degree tears increased from 2.5 (rate for 6 months prior to the study) to 9.3% during the study, P<0.001. There were significantly more third degree tears detected in the assessed group compared to the control group (14.9% versus 7.5%), P=0.01. CONCLUSIONS: With increased vigilance, it is possible to improve on the clinical diagnosis of third degree tears. This study highlights the need for improvements in training of midwives and trainee doctors in perineal anatomy and recognition of severe trauma. Improvements in diagnosis allow appropriate repair which may lead to improvements in long-term outcome.

Analgesia, Obstetrical↗
PubMed2002

Temporal and geographical variation in UK obstetricians' personal preference regarding mode of delivery.

OBJECTIVE: To assess UK obstetricians' preferences about mode of delivery for themselves or their partners and determine whether these changed since 1995. STUDY DESIGN: All 313 registered obstetricians in London and one in five (279) sample of those outside London were sent a structured anonymous postal questionnaire. RESULTS: The response rate was 54%. In a hypothetical uncomplicated first singleton pregnancy with a cephalic presentation at term, 15% chose elective caesarean section (CS) (17% in London versus 13% outside London). The overall rate for London has not changed since 1995 (17 versus 17%), although the difference between women and men was less (31 versus 8% in 1995 and 21 versus 14% in 1999, respectively). The number choosing elective CS increased with estimated foetal weight > 4.0kg (40%) and > 4.5kg (65%) and with breech presentation both in a first pregnancy (69%) and after a previous vaginal delivery (49%). CONCLUSION: The overall attitude of London obstetricians to mode of delivery for themselves or their partners has not changed since 1995 and is similar to those of UK obstetricians elsewhere.

Breech Presentation↗
PubMed2002

How do fathers feel after accompanying their partners in labour and delivery?

This study aims to investigate fathers' experiences of labour and delivery and compare their emotions from different types of delivery. One hundred and twenty-one couples were given questionnaires following the delivery of their babies after labour before discharge from the hospital where they were required to rate their feelings on a visual analogue scale. Generally, fathers were keen to accompany their partners during labour, with 81% giving a score of 9 or above. Most of them found the experience rewarding and enjoyable, but they found operative delivery more traumatic compared to normal vaginal delivery (P=0.003 for caesarean section and P=0.032 for instrumental delivery) and expressed increased anxiety at caesarean sections in labour (P=0.005). Women underestimated their partners' positive experiences during labour and found them more helpful than their partners had felt. Both partners felt their relationships with each other had improved following their shared experiences irrespective of mode of delivery.

Adult↗