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Biomedical subjects

C A Michael

Publications and source records attributed to C A Michael.

7 recordsLinked to original sources
PubMed1990

Subspecialisation in obstetrics and gynaecology--whither (or wither) the generalist.

In 1987, Council of the Royal Australian College of Obstetricians and Gynaecologists (RACOG) established its subspecialisation committee who identified subspecialty groups. It was the belief of the subspecialty committee that specialty training was necessary if haphazard evolution of the subspecialties and fragmentation within the discipline of obstetrics and gynaecology was to be avoided. The major issues of such training are manpower considerations and the time committed to the subspecialty, its effect on research and whether the generalist obstetrician and gynaecologist has been disadvantaged by such an initiative. Research initiatives must not suffer and the subspecialist should be prominent in the respective fields informing colleagues of important clinical and research advances. Undoubtedly the workload of the generalist will be eroded but their importance in the practice of obstetrics and gynaecology must be strengthened. The generalist should be encouraged to assist in the management of the patient in association with the subspecialist and referral should be on a tertiary basis. The limits of subspecialisation must be clearly defined and the availability and distribution of subspecialists determined. The numbers should be carefully monitored and training and accreditation and certification of subspecialists should remain within a central body such as the RACOG.

Gynecology↗
PubMed1979

Genetic screening in Western Australia.

The wider application of genetic screening is described in four Western Australian populations. Counselling with prenatal diagnosis of Down's syndrome was offered to 57 women over the age of 35 years and less than 16 weeks' gestation who attended an antenatal outpatients department. Forty-four women consented to amniocentesis and two affected fetuses were found. Both public and private patients can be screened to detect fetuses with Down's syndrome. In a population of 200 pregnant girls whose infants were intended for adoption, a specially designed family history form aided identification of genetic disorders in 32 families. Counselling was offered to the biological parents, to the adoptive parents, and, prospectively, to the child in later years. The effectiveness of the family history as a screening device is illustrated in this adoption sample. Counselling of parents of 20 decreased malformed infants initiated the genetic counselling clinic in Western Australia and led to subsequent referral of 92 similar cases by the family doctors. It was found that parents who gave birth to malformed infants welcome information and risk figures. Diagnostic screening in a population of 6000 intellectually handicapped individuals yielded 1372 cases (23%) with Mendelian, multifactorial, or chromosomal modes of inheritance. This screening enabled patients with inherited causes for their intellectual handicap to be identified and placed on a register for health planning.

Abortion, Induced↗
PubMed1979

Prolonged labour.

Although prolonged labour may be a decreasing obstetrical problem, the importance of its implications should not be overlooked. This article discusses the causes of arrested labour, its complications and their management.

Female↗
PubMed1979

Use of labetalol in the treatment of severe hypertension during pregnancy.

1 Labetalol, a hypotensive agent combining alpha- and beta-adrenoceptor antagonist properties, was used to treat severe hypertensive disease complicating pregnancy. 2 Effective reduction in BP was achieved in all but 3 of the 25 patients treated. Careful monitoring of feto-placental function was undertaken to ensure the maintenance of fetal well-being. Maternal and fetal side-effects were minimal and it was not necessary to discontinue the drug in any patient. 3 Labetalol was estimated in the cord blood of the fetus at delivery as well as in the breast milk of mothers on day 3 post partum. There were no adverse effects of the drug on the infants and significant hypotension did not occur. 4 The reults suggest that labetalol has a direct action on fetal lung maturation and this, together with its effective hypotensive effect, contributes to the low perinatal mortality (3.5%) observed. 5 Oculotoxicity due to the labetalol was not observed in the infants delivered. 6 It is concluded that the efficient hypotensive action of labetalol, together with apparent freedom from maternal and fetal side-effects, and consequent improved perinatal mortality, suggest that it is a suitable drug for use in pregnancy complicated by hypertension.

Adolescent↗
PubMed1978

The treatment of hypertension in pregnancy.

Hypertensive disease in pregnancy remains a major cause of maternal and perinatal morbidity and mortality. Control of maternal hypertension with antihypertensive therapy improves maternal and foetal outcome. If the blood pressure is elevated in early pregnancy, complications are more likely to occur to both mother and foetus, and the outcome may not be favourable. In labour the threat of severe pre-eclampsia or eclampsia is a constant hazard.

Adolescent↗
PubMed1975

Ultrasonic "B" scanning as a pregnancy test after less than six weeks amenorrhoea.

Sixty patients with less than six weeks amenorrhoea were examined by ultrasonic "B" scanning for the detection of pregnancy. The results were compared with those obtained by histological examination of the aspirate after the patient had undergone menstrual regulation by vacuum aspiration of the uterine contents. The overall accuracy was 79 per cent with 15 per cent false positives. The accuracy after 39 days amenorrhoea was 95 per cent. The technique was compared with an immunological pregnancy test.

Abortion, Induced↗