[show abstract][hide abstract] ABSTRACT: Being born small for gestational age (SGA) confers significantly increased risks of perinatal morbidity and mortality. Accumulating evidence suggests that an SGA fetus results from a poorly perfused and abnormally developed placenta. Some of the placental features seen in SGA, such as abnormal cell turnover and impaired nutrient transport, can be reproduced by culture of placental explants in hypoxic conditions. Metabolic footprinting offers a hypothesis-generating strategy to investigate factors absorbed by and released from this tissue in vitro. Previously, metabolic footprinting of the conditioned culture media has identified differences in placental explants cultured under normoxic and hypoxic conditions and between normal pregnancies and those complicated by pre-eclampsia. In this study we aimed to examine the differences in the metabolic footprint of placental villous explants cultured at different oxygen (O(2)) tensions between women who deliver an SGA baby (n = 9) and those from normal controls (n = 8). Placental villous explants from cases and controls were cultured for 96 h in 1% (hypoxic), 6% (normoxic) and 20% (hyperoxic) O(2). Metabolic footprints were analysed by Ultra Performance Liquid Chromatography coupled to an electrospray hybrid LTQ-Orbitrap Mass Spectrometry (UPLC-MS). 574 metabolite features showed significant difference between SGA and normal at one or more of the oxygen tensions. SGA explant media cultured under hypoxic conditions was observed, on a univariate level, to exhibit the same metabolic signature as controls cultured under normoxic conditions in 49% of the metabolites of interest, suggesting that SGA tissue is acclimatised to hypoxic conditions in vivo. No such behaviour was observed under hyperoxic culture conditions. Glycerophospholipid and tryptophan metabolism were highlighted as areas of particular interest.
[show abstract][hide abstract] ABSTRACT: There is currently inconsistent evidence and clinical guidance on how to best manage a pregnancy complicated by reduced fetal movements. This novel, web-based, anonymous questionnaire evaluated 96 assessment and management approaches from doctors working in obstetrics in the Republic of Ireland who were presented with a clinical scenario of a primigravida concerned about reduced fetal movements at 39+3 weeks' gestation. This study identified a lack of clinical practice guidelines available in maternity hospitals in the Republic of Ireland. We demonstrated that almost all clinicians applied more than one assessment method and that most incorporated a cardiotocograph into their assessment. There was a low uptake of simple symphysio-fundal height measurement and high usage of kickcharts. The minority of clinicians admitted or induced their patients. This survey identified the need for national and international guidelines to ensure safe antepartum care and delivery.
Journal of obstetrics and gynaecology: the journal of the Institute of Obstetrics and Gynaecology 01/2010; 30(6):578-82. · 0.43 Impact Factor
[show abstract][hide abstract] ABSTRACT: Small for gestational age (SGA) can have lifelong consequences. Placental dysfunction is implicated in its pathophysiology. A reduced uterine perfusion pressure (RUPP) rat model can create an in vivo model of placental insufficiency. Metabolomics is the holistic study of the basic biochemistry within a biological system.The authors aimed to examine the metabolomic differences in (1) venous cord blood (VCB) plasma between SGA babies and normal controls and (2) plasma from the RUPP rat.Cord blood was collected from normally grown babies, and babies with confirmed SGA (n=7–8). Blood was also collected from RUPP, sham operated and control rats (n=7–9). All samples sets were analysed using Ultra Performance Liquid Chromatography/LTQ-Orbitrap Mass Spectrometry.In VCB, over 1700 metabolite features were detected, of which 900 (52%) showed significant difference between SGA and normally grown babies (p
Archives of Disease in Childhood-fetal and Neonatal Edition - ARCH DIS CHILD-FETAL NEONATAL. 01/2010; 95(1).
[show abstract][hide abstract] ABSTRACT: Hysterectomy is one of the most common gynaecological surgical procedures performed but there appears to be a decline in the performance of this procedure in Ireland in recent times. We set out to establish the extent of the decline of hysterectomy and to explore possible explanations. Data for hysterectomy for benign disease from Ireland was obtained from the Hospital In-Patient Enquiry Scheme (HIPE) section of the Economic and Social Research Institute for the years 1999 to 2006. The total number of hysterectomies performed for benign disease showed a consistent decline during this time. There was a 36% reduction in the number of abdominal hysterectomy procedures performed.
Irish medical journal 04/2009; 102(3):70, 72-3. · 0.51 Impact Factor