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  • 1
    Online Resource
    Online Resource
    Use of the Robson Ten Group Classification System to categorise operative vaginal delivery
    Wiley ; 2020
    In:  Australian and New Zealand Journal of Obstetrics and Gynaecology Vol. 60, No. 6 ( 2020-12), p. 858-864
    Details
    In: Australian and New Zealand Journal of Obstetrics and Gynaecology, Wiley, Vol. 60, No. 6 ( 2020-12), p. 858-864
    Abstract: Operative vaginal delivery (OVD), either vacuum or forceps, can be used to expedite vaginal delivery. While rates of OVD have been reducing worldwide, rates in Ireland remain high. The Robson Ten Group Classification System (TGCS) was originally created to compare rates of caesarean delivery between healthcare units, although no similar system exists for the analysis of OVD. Aims We sought to examine rates of OVD using the TGCS in an effort to understand which patient groups make significant contributions to the overall rate of OVD. Materials and Methods This is a retrospective cohort study of all women delivering in a tertiary‐level university institution in Dublin, Ireland, from 2007 to 2016. Mode of delivery for all patients was extracted from contemporaneously recorded hospital records. Rates of OVD were analysed according to the TGCS, and the contribution of each group to the overall hospital population was calculated. Results There were 86 191 deliveries of women in our institution, of which 19.3% (16 673/86 191) had an OVD. Women in Group 1 (singleton, cephalic, nulliparous women at term in spontaneous labour) contributed the most to the overall rate of OVD, accounting for almost half of all OVDs (46.1% (7679/16 673)). Nulliparous women with a singleton, cephalic fetus at term who were induced (Group 2) were more likely to have an OVD than similar patients who laboured spontaneously (Group 1). Conclusion OVD accounts for almost one in five deliveries in our population and is predominately performed in nulliparous women. These groups may be the subject of interventions to lower rates of OVD. The Robson TGCS is a freely available tool to hospitals and birthing centres to facilitate comparison of rates of OVD on local and national levels.
    Type of Medium: Online Resource
    ISSN: 0004-8666 , 1479-828X
    URL: Issue
    URL: Article
    DOI: 10.1111/ajo.v60.6
    DOI: 10.1111/ajo.13169
    Language: English
    Publisher: Wiley
    Publication Date: 2020
    detail.hit.zdb_id: 2100324-5
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  • 2
    Online Resource
    Online Resource
    Single prior caesarean section and risk of anal sphincter injury
    Springer Science and Business Media LLC ; 2019
    In:  International Urogynecology Journal Vol. 30, No. 6 ( 2019-6), p. 959-964
    Details
    In: International Urogynecology Journal, Springer Science and Business Media LLC, Vol. 30, No. 6 ( 2019-6), p. 959-964
    Type of Medium: Online Resource
    ISSN: 0937-3462 , 1433-3023
    URL: Article
    DOI: 10.1007/s00192-018-3797-x
    RVK:
    XA 50350
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2019
    detail.hit.zdb_id: 1481561-8
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  • 3
    Online Resource
    Online Resource
    The prevalence of positive urine dipstick testing and urine culture in the asymptomatic pregnant woman: A cross-sectional study
    Elsevier BV ; 2020
    In:  European Journal of Obstetrics & Gynecology and Reproductive Biology Vol. 253 ( 2020-10), p. 103-107
    Details
    In: European Journal of Obstetrics & Gynecology and Reproductive Biology, Elsevier BV, Vol. 253 ( 2020-10), p. 103-107
    Type of Medium: Online Resource
    ISSN: 0301-2115
    URL: Article
    DOI: 10.1016/j.ejogrb.2020.08.004
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2020
    detail.hit.zdb_id: 2005196-7
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  • 4
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    Online Resource
    The efficacy and complications of retropubic tension‐free vaginal tapes after 20 years: A prospective observational study
    Wiley ; 2023
    In:  BJOG: An International Journal of Obstetrics & Gynaecology Vol. 130, No. 1 ( 2023-01), p. 107-113
    Details
    In: BJOG: An International Journal of Obstetrics & Gynaecology, Wiley, Vol. 130, No. 1 ( 2023-01), p. 107-113
    Abstract: Long‐term data regarding risks associated with tension‐free vaginal tapes (TVT) are sparse, and where available are limited to small numbers. We analyse patient‐reported outcomes of TVT after 16–24 years. Design Prospective observational study. Setting Single‐centre study in a tertiary referral urogynaecology unit. Population A cohort of 350 women who had a TVT inserted between 1999 and 2004, in which 96% had urodynamically proven stress incontinence. Methods Postal questionnaire survey using the International Consultation on Incontinence Questionnaire, a visual analogue scale and a yes/no question as to whether they would have the procedure again. Main outcome measures The primary outcome was cure of stress urinary incontinence, which was assessed using the ICIQ‐FLUTS questionnaire. Secondary outcomes included overactive bladder symptoms, pain, sexual dysfunction, and patient satisfaction with the procedure. Results A total of 183/350 (52%) responses were received. The median age of women at follow up was 67 years (range 53–93 years) and the median follow up was 20 years (17–24 years). Stress urinary incontinence was denied by 39.3% of women. Urgency was reported by 42.1%. Bladder pain was reported either ‘never’ or ‘occasionally’ by 92.3% of women. The median satisfaction rate was 98/100 and 92.4% said they would have the TVT procedure again. Conclusions Tension‐free vaginal tape has high levels of satisfaction and cure up to 24 years after placement. Pain was uncommon and its impact on quality of life was low. Symptoms of urgency were prevalent but may be related to age. TVT is an effective treatment for SUI more than 20 years after initial placement.
    Type of Medium: Online Resource
    ISSN: 1470-0328 , 1471-0528
    URL: Issue
    URL: Article
    DOI: 10.1111/bjo.v130.1
    DOI: 10.1111/1471-0528.17282
    Language: English
    Publisher: Wiley
    Publication Date: 2023
    detail.hit.zdb_id: 2036469-6
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  • 5
    Online Resource
    Online Resource
    Validation of online delivery of the Australian Pelvic Floor Questionnaire in an Irish obstetric population
    Springer Science and Business Media LLC ; 2023
    In:  International Urogynecology Journal Vol. 34, No. 9 ( 2023-09), p. 2133-2139
    Details
    In: International Urogynecology Journal, Springer Science and Business Media LLC, Vol. 34, No. 9 ( 2023-09), p. 2133-2139
    Abstract: Childbirth remains an important risk factor for the development of pelvic floor disorders, regardless of the mode of delivery. To accurately assess these symptoms, accurate, woman-centric assessments are needed. Online versions of these assessments may be especially useful in the COVID-19 era. Women may potentially answer questions differently in an online format, and this study aimed to validate an online version of the paper-based self-administered Australian Pelvic Floor Questionnaire (APFQ). Methods The questionnaire was completed antenatally and at 3 months postpartum by 647 and 481 women respectively. Test– validity was assessed in subgroups of 61 and 57 women in each period, using intraclass correlation coefficients and Cohen’s kappa. Sensitivity to change was assessed by comparing responses during pregnancy to those at 3 months postpartum. Internal consistency was assessed using Cronbach’s alpha. Construct validity was assessed by comparing women with and without subjective bothersomeness. Results Intraclass correlation coefficients were above 0.9 for all domains and the overall questionnaire. Cohen’s kappa for individual questions ranged from 0.71–1.00 across the antenatal and postnatal questionnaires. Cronbach’s alpha was acceptable for all domains except the prolapse domain. The APFQ was sensitive to changes occurring between antenatal recruitment and 3 months postpartum. Effect sizes ranged from 0.83–7.99. Conclusions This online version of the APFQ is valid for assessing pelvic floor disorders in an Irish obstetric population. The APFQ is reproducible and responsive to change occurring with childbirth, and can be used to research longitudinal changes in pelvic floor disorders. As an online tool, this questionnaire may be useful in increasing response rates to clinical research.
    Type of Medium: Online Resource
    ISSN: 0937-3462 , 1433-3023
    URL: Article
    DOI: 10.1007/s00192-023-05529-x
    RVK:
    XA 50350
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2023
    detail.hit.zdb_id: 1481561-8
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  • 6
    Online Resource
    Online Resource
    The etiology of stillbirth over 30 years: A cross‐sectional study in a tertiary referral unit
    Wiley ; 2021
    In:  Acta Obstetricia et Gynecologica Scandinavica Vol. 100, No. 2 ( 2021-02), p. 314-321
    Details
    In: Acta Obstetricia et Gynecologica Scandinavica, Wiley, Vol. 100, No. 2 ( 2021-02), p. 314-321
    Abstract: Stillbirth remains an often unpredictable and devastating pregnancy outcome, and despite thorough investigation, the number of stillbirths attributable to unexplained causes remains high. Placental examination has become increasingly important where access to perinatal autopsy is limited. We aimed to examine the causes of stillbirth in normally formed infants over 30 years and whether a declining autopsy rate has affected our ability to determine a cause for stillbirths. Material and methods All cases of normally formed singleton infants weighing ≥500 g that died prior to the onset of labor from 1989 to 2018 were examined. Trends for specific causes and uptake of perinatal autopsy were analyzed individually. Results In all, 229 641 infants were delivered, with 840 stillbirths giving a rate of 3.66/1000. The rate of stillbirth declined from 4.84/1000 in 1989 to 2.51 in 2018 ( P   〈  .001). There was no difference in the rate of stillbirth between nulliparous and multiparous women (4.25 vs 3.66 per 1000, P  = .026). Deaths from placental abruption fell (1.13/1000 in 1989 to 0 in 2018, P   〈  .001) and the relative contribution of placental abruption to the incidence of stillbirth also fell, from 23.3% (7/30) in 1989 to 0.0% (0/19) in 2018 ( P   〈  .001). Stillbirth attributed to infection remained static (0.31/1000 in 1989 to 0.13 in 2018, P  = .131), while a specific causal organism was found in 79.2% (42/53) of cases. Unexplained stillbirths decreased from 2.58/1000 (16/6200) in 1989 to 0.13 (1/7581) in 2018 ( P   〈  .001) despite a fall in the uptake of perinatal autopsy (96.7% [29/30] in 1989 to 36.8% (7/19) in 2018; P   〈  .001). Placental disease emerged as a significant cause of stillbirth from 2004 onwards (89.5% [17/19] in 2018). Conclusions The present analysis is one of the largest single‐center studies on stillbirth published to date. Stillbirth rates have fallen across the study period across parity. A decrease in deaths secondary to placental abruption contributed largely to this. Infection‐related deaths are static; however, in one‐fifth of cases a causative organism was not found. Despite a decreasing autopsy rate, the number of unexplained stillbirths continues to fall as the importance of placental pathology is increasingly recognized.
    Type of Medium: Online Resource
    ISSN: 0001-6349 , 1600-0412
    URL: Issue
    URL: Article
    DOI: 10.1111/aogs.v100.2
    DOI: 10.1111/aogs.13992
    RVK:
    YM 6500
    Language: English
    Publisher: Wiley
    Publication Date: 2021
    detail.hit.zdb_id: 2024554-3
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  • 7
    Online Resource
    Online Resource
    Blood transfusion after vaginal hysterectomy for pelvic organ prolapse
    Springer Science and Business Media LLC ; 2019
    In:  Irish Journal of Medical Science (1971 -) Vol. 188, No. 1 ( 2019-2), p. 265-266
    Details
    In: Irish Journal of Medical Science (1971 -), Springer Science and Business Media LLC, Vol. 188, No. 1 ( 2019-2), p. 265-266
    Type of Medium: Online Resource
    ISSN: 0021-1265 , 1863-4362
    URL: Article
    DOI: 10.1007/s11845-018-1840-z
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2019
    detail.hit.zdb_id: 2275855-0
    detail.hit.zdb_id: 2468506-9
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  • 8
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    Online Resource
    The contribution of massive fetomaternal hemorrhage to antepartum stillbirth: a 25‐year cross‐sectional study
    Wiley ; 2015
    In:  Acta Obstetricia et Gynecologica Scandinavica Vol. 94, No. 12 ( 2015-12), p. 1354-1358
    Details
    In: Acta Obstetricia et Gynecologica Scandinavica, Wiley, Vol. 94, No. 12 ( 2015-12), p. 1354-1358
    Abstract: Fatal antepartum fetomaternal hemorrhage is a relatively uncommon clinical presentation, though one that appears quickly and without warning. The pathophysiology of this disease is unclear, and the incidence does not appear to be decreasing in line with overall antepartum mortality. This study was undertaken to analyse trends in antepartum fetal death from fetomaternal hemorrhage over a 25‐year period in a single maternity hospital in Dublin, Ireland. Material and methods A cross‐sectional study of 192 132 nonanomalous infants weighing 500 g or more, delivered in a single tertiary‐referral university institution between 1987 and 2011. Data was compared using Fisher's exact test, univariate analysis, and Cuzick's test for trend. Results There was no decrease in the rate of fatal fetomaternal hemorrhage over the past 25 years ( p  =   0.29), despite a decline in overall antepartum deaths ( p  =   0.0049). Fetomaternal hemorrhage accounted for 4.1% (34/828) of antepartum stillbirths. A higher proportion of these stillbirths occurred at term gestations (74%; 25/34) compared with other causes (40%; 321/794; p  =   0.0003). Female infants were statistically more likely to be involved than males [odds ratio (OR) 2.33, 95% confidence interval (CI) 1.08–5.47, p  =   0.02). Multiple gestations were up to six times as likely to be affected as singleton pregnancies (OR 6.52, 95% CI 1.67–18.50, p  =   0.005). Conclusions Over the past 25 years there has been no reduction in rates of fatal fetomaternal hemorrhage. Female infants and multiple gestations remain at higher risk of antepartum death from fatal fetomaternal hemorrhage.
    Type of Medium: Online Resource
    ISSN: 0001-6349 , 1600-0412
    URL: Issue
    URL: Article
    DOI: 10.1111/aogs.2015.94.issue-12
    DOI: 10.1111/aogs.12762
    RVK:
    YM 6500
    Language: English
    Publisher: Wiley
    Publication Date: 2015
    detail.hit.zdb_id: 2024554-3
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  • 9
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    Online Resource
    Are women attending a midwifery-led birthing center at increased risk of anal sphincter injury?
    Springer Science and Business Media LLC ; 2020
    In:  International Urogynecology Journal Vol. 31, No. 3 ( 2020-03), p. 583-589
    Details
    In: International Urogynecology Journal, Springer Science and Business Media LLC, Vol. 31, No. 3 ( 2020-03), p. 583-589
    Type of Medium: Online Resource
    ISSN: 0937-3462 , 1433-3023
    URL: Article
    DOI: 10.1007/s00192-019-04218-y
    RVK:
    XA 50350
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2020
    detail.hit.zdb_id: 1481561-8
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  • 10
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    Online Resource
    Is the older perineum a safer perineum? Risk factors for obstetric anal sphincter injury
    Springer Science and Business Media LLC ; 2021
    In:  Irish Journal of Medical Science (1971 -) Vol. 190, No. 2 ( 2021-05), p. 693-699
    Details
    In: Irish Journal of Medical Science (1971 -), Springer Science and Business Media LLC, Vol. 190, No. 2 ( 2021-05), p. 693-699
    Type of Medium: Online Resource
    ISSN: 0021-1265 , 1863-4362
    URL: Article
    DOI: 10.1007/s11845-020-02358-5
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2021
    detail.hit.zdb_id: 2275855-0
    detail.hit.zdb_id: 2468506-9
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