Biomedical subjects

T Macharper

Publications and source records attributed to T Macharper.

8 recordsLinked to original sources

PubMed1991

Pregnancy outcomes in primigravid women aged 35 years and over in South Australia, 1986-1988.

The South Australian perinatal data collection for 1986-1988 was used to compare the characteristics and outcomes of singleton pregnancies in 515 primigravid women aged 35 years and over with those in 4175 younger primigravid women aged 20-29 years. Notable differences observed were a higher prevalence of medical, obstetric and labour complications and assisted deliveries in the older group. Breech presentations were almost twice as common in the older women, as were caesarean sections. Only 27% achieved a spontaneous vaginal delivery. The mean duration of hospital stay for the older women was longer for both vaginal and caesarean deliveries. However, although their babies were more likely to be premature or of low birthweight, the perinatal mortality rate was not significantly increased and the great majority of older primigravid women managed by modern obstetric methods can expect a good pregnancy outcome.

Adult↗

PubMed1990

Pregnancy and perinatal factors associated with persistently low Apgar scores: an analysis of the birth records of infants born in South Australia.

This study included all newborns with Apgar scores below seven at one minute after birth who were born in 1986 and whose births were notified to the South Australian Perinatal Statistics Collection. Univariate comparisons were made of the demographic, obstetric and pregnancy outcome characteristics of the 301 newborns whose Apgar scores remained below seven at five minutes and the 3165 whose scores recovered to seven or more. The results provide a general risk profile of the 301 newborn infants who perform poorly at birth, as indicated by a low Apgar score at both one and five minutes. Adverse risk factors identified in this study were similar to those for intellectual disability (mental retardation) and cerebral palsy in South Australia. It is suggested that persisting low Apgar scores, when combined with the other risk factors demonstrated in this and previous studies, would provide more reliable prognostic information than would Apgar scores alone. The study also shows that the majority of infants with low Apgar scores at one minute scored seven or better at five minutes. This demonstrates, that although a low one minute Apgar score has value in identifying newborns in need of immediate attention, it must be supplemented by the five minute score's stronger association with perinatal morbidity.

Apgar Score↗

PubMed1990

Surveillance and sentinel systems.

The research committee of the RACGP has urged authorities in each State to introduce sentinel practice schemes in order to provide information on selected conditions not normally notifiable to public health agencies. To date not all States have taken up the request. In this article the history and role of such schemes are examined. Special attention is paid to the sentinel system that has operated in South Australia since 1983.

Data Collection↗

PubMed1989

Pregnancy and birth risk factors for intellectual disability in South Australia.

It is generally accepted that developmental handicaps can often be minimized through early detection and intervention. For this reason, it is normal practice in many hospitals to follow-up and screen infants who present at birth with established risk factors. Clinical judgement will always be important when selecting children for follow-up. However, as hospital data systems improve, automated systems could be developed for listing children potentially "at risk". Where initial clinical decisions not to follow-up individual children prove to be at odds with this automated output, the individual child could be re-assessed clinically. This process could increase the level of quality control. An initial risk-factor model for intellectual disability has been developed, based on the South Australian Perinatal Statistics Collection, for use in this context.

Australia↗

PubMed1989

A South Australian study of pregnancy and birth risk factors associated with cerebral palsy.

Using the Perinatal Statistics Collection compiled by the Pregnancy Outcome Unit of the South Australian Health Commission, a profile of statistically significant risk factors for cerebral palsy has been established for a South Australian population. Logistic regression analysis revealed that these factors included threatened miscarriage, ante-partum haemorrhage, maternal age of under 20 years, shortened gestational age, low birthweight, low Apgar score at 5 minutes, foetal distress, delay in establishing spontaneous regular respiration, presence of a congenital abnormality and prolonged hospital stay. In addition, pregnancy hypertension, reduced number of antenatal visits, breech presentation, resuscitation of the neonate by intubation and intermittent positive pressure ventilation, and the need for specialised nursery care were found to be significant in univariate analyses. These data point to the risk factors which may help identify infants who require closer monitoring for early signs of cerebral palsy.

Adult↗

PubMed1988

Obstetric profiles of immigrant women from non-English speaking countries in South Australia, 1981-1983.

Obstetric profiles of non-English speaking immigrant women in South Australia are presented to assist in planning for health services. They were derived from perinatal data routinely collected by midwives and neonatal nurses. The characteristics of 5,675 immigrant women were compared with those of a random sample of approximately 5% of Australian-born women who delivered babies in 1981-1983 in South Australia. This study demonstrates that immigrant women tended to be urban dwellers and to deliver their babies in large metropolitan hospitals. They were less often from unemployed families but more often from those of low occupational status. They were older, with fewer teenagers and single women among them. They were of higher parity, and tended to commence antenatal care later. They had lower incidences of pregnancy hypertension and induced labour, but were more likely to have anaemia, antepartum haemorrhage and a Caesarean section. There were also important differences between the 7 largest immigrant groups. For example, the very high Caesarean section rate (36%) in Filipino women is of concern. Also, the mean birth-weight of babies of Vietnamese women was 263g lower than that of babies of Australian-born women. Support services need to be logistically located and address the findings of this study in a culturally acceptable way.

Adult↗

PubMed1987

Induced abortion trends in South Australia, 1970-84.

Following legislative amendments extending the grounds for abortion in South Australia the abortion rate rose from 6.0/1000 in 1970, to 9.9/1000 in 1971, to 13.2/1000 in 1984. However, rates differ widely by marital status among young women, the age pattern varies markedly for different marital status groups, and trends over time differ for different age/marital status groups. Collection of detailed age and marital status data on every live birth and abortion is recommended in order to provide the most informative analysis of abortion trends.

Abortion, Induced↗

PubMed1986

Clinical aspects of induced abortion in South Australia from 1970-1984.

Clinical changes, and their implication, in medically induced abortion within South Australia from 1970-1984 were assessed by analysis of legally required reports provided by operating practitioners. In the past 15 years vacuum aspiration has largely replaced dilatation and curettage for early abortions, and intrauterine chemical methods have greatly decreased the use of hysterotomy for late abortions. A marked improvement in gestational pattern has also occurred, and recorded complication rates have been halved for all gestational ages. Sterilization rates at the time of abortions increased with increasing age and with increasing gravidity, but the total rates, adjusted for age and gravidity of patients, have changed little in the past 15 years.

Abortion, Induced↗