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Biomedical subjects

B Peat

Publications and source records attributed to B Peat.

16 recordsLinked to original sources
PubMed1998

Cystic fibrosis and pregnancy.

The case records of 11 patients with cystic fibrosis (CF) who had 13 completed pregnancies between 1975 and 1995 were retrospectively reviewed to assess: (1) the changes in spirometry and body mass index (BMI) during pregnancy; and (2) maternal and neonatal complications and outcomes. Prepregnancy the mean age of the group was 24 (range 17-27) years. Two patients were exsmokers, 7 had pancreatic insufficiency and 7 had chest X-ray evidence of bronchiectasis. None of the patients had diabetes mellitus but 3 developed gestational diabetes. The mean +/- SEM (% predicted) forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC) prepregnancy were 2.3 +/- 1.0 (83%) litres and 3.0 +/- 0.9 (85%) litres respectively. Five patients had normal spirometry (FEV1 and FVC >80% predicted) prior to 6 pregnancies. The mean body mass index (kg/height(m)2) for the group was 20.5 +/- 2.0. There was a significant decline in spirometry during pregnancy (FEV1 15.5 +/- 6.6% p<0.01; FVC 14.0 +/- 8.3% p<0.5). However, FVC but not FEV1 recovered to prepregnancy values by 12 months postpartum. There was a significant increase in both weight (7.1 kg) and BMI (2.6 kg/height(m)2) at the time of delivery compared with prepregnancy (p=0.0004). However, postpregnancy both weight and BMI had returned to their prepregnancy values (p<0.2). Mothers with an FEV1>80% had less decline in FEV1 related to pregnancy, better outcomes, fewer operative and instrumental deliveries, fewer preterm infants and fewer neonatal complications. Suggestions for the planning and management of pregnancy in women with CF are discussed.

Adolescent↗
PubMed1996

Pregnancy and argininosuccinic aciduria.

We present the outcome of a pregnancy in a woman with mild argininosuccinic lyase deficiency to add to the collective experience of the maternal and fetal effects of urea cycle defects. In females affected with argininosuccinic lyase deficiency, careful clinical and biochemical monitoring of pregnancy will minimize the risk of metabolic decompensation in the perinatal period. Furthermore, it would appear that argininosuccinate is not teratogenic to the development of the human fetus.

Adult↗
PubMed1995

Maternal and neonatal outcome of patients classified according to the Australasian Society for the Study of Hypertension in Pregnancy Consensus Statement.

OBJECTIVE: To outline the maternal and perinatal features and outcome of patients referred to a tertiary referral obstetric hospital for management of their hypertension. SETTING AND PATIENTS: 205 consecutive public patients admitted for assessment of hypertension (either full admission or day-stay) to King George V Hospital's Hypertension in Pregnancy Unit, between February 1993 and January 1994. DESIGN: A prospective study in which patients were classified according to the Australasian Society for the Study of Hypertension in Pregnancy (ASSHP) Consensus Statement classification. RESULTS: Of the 205 patients, 25% did not meet the criteria for pre-eclampsia or chronic hypertension, 33% had mild pre-eclampsia, 34% had severe pre-eclampsia and the remainder had chronic hypertension. The mean gestation at delivery for those with mild pre-eclampsia was 38.3 weeks and for severe pre-eclampsia 35.3 weeks. For the mild and severe groups respectively, the rate of elective delivery for raised blood pressure was 56% and 53%; for caesarean section, 17% and 61%; and for perinatal death, 2% and 4%. In the severe group, 49% had fetal problems and 25% required intravenous antihypertensives. CONCLUSIONS: The multisystem nature of pre-eclampsia makes comparison of management protocols difficult. Ongoing audit is needed of maternal and perinatal outcomes and features of disease in patients with hypertension in pregnancy under a universal classification. The ASSHP classification system successfully identifies patients who require more intensive management and intervention.

Chronic Disease↗
PubMed1993

Pregnancy complicated by maternal phenylketonuria.

Pregnant women who have elevated levels of serum phenylalanine are more likely to have a spontaneous abortion or to give birth to an infant with congenital cardiac anomalies, symmetrical growth retardation, microcephaly and mental retardation than pregnant women with normal levels of this amino acid (1). Nine pregnancies in 7 women were managed in conjunction with the staff of the Children's Hospital, Sydney. In 6 patients, satisfactory serum levels of phenylalanine were attained and 6 offspring are all normal at follow-up, ranging from 15 years to 1 year. The 2 children of the poorly controlled mother were of low birth-weight and both had microcephaly at birth. The poor control of serum phenylalanine was due to poor compliance with the strict dietary regimen. It is concluded that dietary control of serum phenylalanine levels below 600 umol/l in pregnant women with PKU is possible and desirable and may improve perinatal and long-term outcome. This requires close co-operation between paediatrician, dietician, obstetrician and patient. Further data are required to confirm these findings in larger numbers and to provide long-term neurological follow-up.

Female↗
PubMed1992

Laparoscopic salpingostomy with electrocautery in the management of tubal pregnancy.

From August, 1990 to May, 1991, all cases of tubal pregnancy presenting to King George V Hospital for Mothers and Infants were considered for laparoscopic salpingostomy. This procedure involved opening the affected Fallopian tube with diathermy, removal of ectopic tissue via the laparoscope, achieving haemostasis and leaving the tubal incision to heal by secondary intention. The procedure was undertaken in 35 patients and was successfully performed in 31 patients with an average operating time of 66.4 minutes (+/- 20.1 minutes). Average hospital stay was 2.1 days (+/- 1.3). This paper examines the technique and results of the initial learning curve for laparoscopic salpingostomy and finds that with knowledge of potential hazards and care in surgery, this operation can be safely carried out in a selected group of patients.

Adolescent↗
PubMed1991

Second trimester abortion by extra-amniotic PGF2 alpha infusion: experience of 178 cases.

There is a continuing need for second trimester induced abortions, most recently due to the increase in the use of antenatal diagnostic procedures, amniocentesis, high resolution ultrasound and cordocentesis. To evaluate the efficacy and safety of extraamniotic infusion of PGF2 alpha for this purpose a retrospective review of 178 procedures was undertaken. There were 4 failures of the technique and the major complication rate was 5.6%. This rate was independent of gestational age. The mean induction to abortion interval was 29.6 (+/- 16.3) hours. The conclusion reached after comparison with other published data is that extraamniotic PGF2 alpha infusion is a slow and painful but safe and effective technique, but that at gestational ages less than 17 weeks, a comparative trial of Dilatation and Evacuation versus extraamniotic PGF2 alpha infusion would be justified.

Abortion, Induced↗
PubMed1989

Experience with silastic slings for female urinary incontinence.

Between September 1, 1985 and December 31, 1987, 54 patients with stress urinary incontinence were treated with a reinforced silastic sling using an abdominovaginal approach; 42 patients were cured, two improved and nine were the same or worse. Five patients who are continent required periodic intermittent self-catheterization. Eight patients developed detrusor instability postoperatively. One patient had to have the sling removed due to a persistent sinus. Fifteen patients had to have the sling adjusted.

Adult↗
PubMed1987

Perinatal factors and the development of chronic lung disease in preterm infants: a case control study.

A case control study of neonates was performed to determine those factors contributing to the development of chronic lung disease (CLD). During the 5 years 1981-84 there were 487 neonatal survivors at gestations of 25-32 weeks; 391 of these developed respiratory failure (oxygen therapy required for more than 6 h). Fifty-six of the latter developed CLD (oxygen therapy required for more than 28 days and a coarse reticular pattern on chest X-ray). These neonates were predominantly of the shortest gestational ages, regardless of the initial chest X-ray diagnosis. Forty-three of these infants with CLD were matched for gestation and initial chest X-ray appearance (respiratory distress syndrome, n = 20; normal, n = 15; non-specific, n = 8) with 42 control infants. The mean duration of oxygen therapy (P less than 0.001), maximum FiO2 (P less than 0.001), incidence (P less than 0.01) and duration of intermittent positive pressure respiration (IPPR; P less than 0.05) and peak IPPR (P less than 0.05) were significantly greater in the CLD group. Mean birthweight (P less than 0.001), arterial cord pH (P less than 0.05) and base excess (P less than 0.05) were significantly lower in the CLD group. Factors that were not statistically significant in the development of CLD included antenatal fetal heart rate abnormality, hypertensive disease of pregnancy, acute intrauterine infection (chorioamnionitis or umbilical vasculitis), administration of antenatal steroids, sex, patent ductus arteriosus and pneumothorax. The association between CLD and ventilator/oxygen therapy is confirmed. Contrary to other reports, male sex, clinical patent ductus arteriosus and pneumothorax were not associated with CLD.

Birth Weight↗
PubMed1986

Vascular and neural changes in the rat optic nerve following induction of diabetes with streptozotocin.

This study was undertaken to determine whether or not changes occur in blood vessels, axons or glia of the optic nerve as the result of streptozotocin-induced diabetes. Diabetes was induced in 4 weeks old Sprague-Dawley rats. At 12 and 16 weeks of age, the rats were killed and the optic nerves prepared for examination. The number and density of blood vessels was found to be significantly increased in the diabetic rats. No alteration in the structure of the blood vessels was noted. A decrease in the percentage volume of axons and an increase in the percentage volume of glial elements accompanied the increase in blood vessels in the diabetic rats. No difference was found in the spectrum of fibre diameters.

Animals↗
PubMedDate not supplied

Nasal symmetry: a 10-year comparison between the Pigott and McComb nasal correction.

The objective assessment of the symmetry of the cleft lip nose has not been properly evaluated. A simple technique using enlarged photographs and area assessment is described. Two different techniques were assessed, the Pigott "alar leapfrog" technique and the McComb alar lift technique. The children were assessed at 10 years of age. The results show no differences in the linear measurements or when the symmetry is assessed in the frontal view. In the worm's eye view, the Pigott correction was shown to produce a more asymmetric nose when compared with the McComb technique. Both corrections produce significant asymmetry when compared with a control group.

Abnormalities, Multiple↗