Biomedical subjects
Publications and source records attributed to M J O'Dowd.
The incidence of neural tube defects in a rural area of the west of Ireland from 1974 to 1985 was 2.96 per 1000. The prevalence was unchanged during the 11 years. When compared with a control group there was no increased incidence of anaemia in mothers of affected infants.
In a prospective study, 200 patients with accurate menstrual data, assessed clinically and by early ultrasound, recorded their date of quickening. Fetal movements were first noted by primigravidae at a mean gestation of 19.04 weeks (SD 1.5) and by multigravidae at 17.4 weeks (SD 1.7). Since the range in both groups was wide: 15-22 weeks for primigravidae and 14-22 weeks for multigravidae, quickening was of limited value in estimating gestational age.
Explore the source record for details and available documents.
In two separate trials, 140 cases of Pregnancy Anaemia were investigated in the University Teaching Hospital, Lusaka. The distribution of anaemia was as follows: Iron deficiency 118 (84.2%); dual deficiency 15 (19.7%); haemolytic five (35%); and megaloblastic 2 (1.4%). Anaemia with megaloblastic change was more common in the second study.
During the four year period 1973 to 1976, there were 3,182 cases of delivery by Caesarean Section (CS) in the University Teaching Hospital, (UTH) Lusaka. This constituted 4.68% of the total number of deliveries. The main indications for CS were fetal distress and cephalopelvic disproportion. 130 cases of transverse lie, in labour, were delivered by CS. The lower uterine transverse incision was the operation performed in most cases. 192 cases of ruptured uteri were treated also in the period under study.
Ketalar (Ketamine Hydrochloride) was used as the sole anaesthetic agent by a single operator in fifty cases of uterine evacuation. The procedure was easy in use, and safe. It was noted that Ketalar caused a significant increase in tone of the uterine musculature, obviating the need for oxytocic drugs. The incidence of emergence phenomena was low. The patients, and staff were well pleased with the outcome.
Cases of twin pregnancy attending the University Teaching Hospital (U.T.H.), Lusaka, are analysed. The incidence was one case per 62.8 hospital deliveries. The main problem encountered was low birth weight, which was present in 63% of cases. Fifty eight percent of the infants were breech deliveries. Medical staff were involved in only 37% of the (total) twin deliveries. The perinatal mortality was high at 63 per 1,000 live and still births.
Idiopathic Respiratory Distress Syndrome (I.R.D.S.) occurs mainly in preterm babies (Halliday and McClure, 1976). The cause of the condition is a deficiency of surfactant in the fetal lung. (Avery and Mead, 1959). The condition, if untreated, is associated with high fetal mortality. A simple test, The Bubble Stability Test, which can predict the possibility of I.R.D.S. occuring is now in use in the University Teaching Hospital, Lusaka. An analysis of the use of the Bubble Stability Test in fifty cases is presented. In our series a positive Bubble Stability Test accurately predicted fetal lung maturity.
The problem of cervical cancer in Zambia is discussed. The pathogenesis of carcinoma of the cervix is described and the benefits of cervical cytology are highlighted. The role of cervical cytology in the context of a developing country is also discussed and a plea is made for a selective mass screening programme, the objective of which will be to limit and prevent cancer of the cervix. The establishment of a Central Cytology Laboratory at the University Teaching Hospital is described in some detail. This service could be extended in stages until it is possible to screen all women over the age of 20 years, at least every 3 years.
A diagnostic cytology service was started in the Obstetric and Gynaecology Department of University Teaching Hospital, Lusaka in September, 1974. Its primary aim was to diagnose precancerous lesions or early invasive cancer of the cervix. However, the service was offered to other disciplines in the hospital who could benefit from cytology. During the two and a half period, September 1974, to 31st December 1976, 2,877 cervical smears were examined. Of these, 138 smears (4.8%) showed evidence of cellular abnormality consistent with dysplasia, carcinoma in situe, or invasive cancer. Trichomonas vaginalis was diagnosed in 464 cases (16%), Candidiasis in 89 (3.1%), and Schistosomiasis in 19 (0.7%).