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Biomedical subjects

Peter Soothill

Publications and source records attributed to Peter Soothill.

9 recordsLinked to original sources
PubMed2005

Is zygosity or chorionicity the main determinant of fetal outcome in twin pregnancies?

OBJECTIVE: The purpose of this study was to examine whether fetal outcome in twin pregnancies is dependent on zygosity or chorionicity. STUDY DESIGN: This was a prospective observational study comprised of women with twin pregnancies who attended the fetal medicine unit at St Michael's Hospital, Bristol, Ireland, during the years 1998 to 2000 and who were delivered in hospitals in south west England. After delivery, zygosity was determined with umbilical cord blood with the use of microsatellite markers that were amplified by polymerase chain reaction. Placentae were examined histologically for chorionic type. The perinatal outcomes of 3 groups of monozygotic monochorionic, monozygotic dichorionic, and dizygotic pregnancies were compared with the use of the Mann-Whitney U test and the Fisher's exact test. RESULTS: All 92 dizygotic and 15 monozygotic dichorionic pregnancies resulted in live births. In 7 of the 39 cases in the monozygotic monochorionic group, either both twins were not live born or delivery occurred <24 weeks of gestation. The gestational age at delivery and birth weight were significantly lower, and there were a greater number of cases with birth weight discordancy of >25% in the monochorionic pregnancies compared with the other 2 groups (P < .05). There were no significant differences in any of the study parameters between the monozygotic dichorionic and dizygotic groups. CONCLUSION: Fetal outcome in twin pregnancies is related to chorionicity rather than zygosity.

Chorion↗
PubMed2004

Median sternotomy as an exit procedure in a child with massive pericardial tumor.

Fetuses can survive with complete airway obstruction caused by placental gas exchange until birth when full ventilatory function is required. The authors present a case in which prenatal scans suggested that adequate ventilation would not be achievable because of the presence of an intrathoracic tumor. An EXIT procedure (exutero intrapartum treatment) was therefore performed, which permitted sufficient lung expansion for adequate ventilation.

Adult↗
PubMed2004

Management of fetal growth restriction.

When fetuses are growth restricted as a result of inadequate placental function, there is an increased risk of poor perinatal outcome compared with fetuses where small dimensions are constitutional and associated with normal placental function. The management of reduced fetal size should therefore focus on the identification of the fetus at risk due to placental dysfunction, and longitudinal assessment to reduce the morbidity and mortality associated with this pathology by ideal timing of delivery. The aim of this review is to rationalize the best way to assess fetuses affected in this way and how to improve their outcome by appropriately timed intervention.

Delivery, Obstetric↗
PubMed2004

Responses to the 35% CO challenge in postpartum women.

Lactation has been associated with suppression of some components of the neuroendocrine stress response. In humans, suppression of the hypothalamo-pituitary-adrenal (HPA) axis has been demonstrated in response to both a psychological and an exercise challenge, but appears to be limited to a short period of time following suckling. Information regarding other components of the stress response and to other challenges in humans is limited. We have evaluated the endocrine, autonomic and psychological response to a single breath of 35% CO(2) during lactation. The 35% CO(2) challenge is a safe and simple test that has been shown to stimulate the HPA axis, produce autonomic activation and emotional arousal. Eight breastfeeding and six bottle-feeding mothers, 6 weeks' postpartum, and eight control women were studied. Twenty minutes following the cessation of feeding, plasma cortisol levels were significantly reduced in the breastfeeding women (P = 0.002 compared with control and P = 0.003 compared with bottle-feeders). Despite this, cortisol, blood pressure, heart rate and psychological responses to the challenge were no different in the breastfeeding group compared to either the control or bottle feeding groups. These results confirm that suckling is associated with short-term suppression of cortisol, but this has no effect on the ability of the mother to mount a normal hormonal, autonomic and psychological response to the 35% CO(2) challenge.

Adult↗
PubMed2002

Outcomes of pregnancies diagnosed with Klinefelter syndrome: the possible influence of health professionals.

OBJECTIVE: To describe the association between the outcomes of pregnancies diagnosed with Klinefelter syndrome (KS) and the specialty of the health professional providing pre- and post-diagnostic counselling. METHOD: Data were extracted from the case notes of the 111 cases of KS diagnosed prenatally between 1986 and 1997 in eight geographical regions in five European countries. The data extracted included: outcome of pregnancy, maternal age, social class, parity, gestational age at diagnosis, year of diagnosis and specialties of the health professionals conducting pre- and post-diagnosis consultations. RESULTS: The overall termination rate was 44% (49/111: 95% confidence interval: 35 to 54). Using multivariable logistic regression analysis, the only significant predictor of continuation of the pregnancy was the specialties of the health professionals conducting post-diagnosis counselling: the affected pregnancy was more likely to continue when post-diagnosis counselling involved only a genetics specialist (relative risk: 2.42 (1.14 to 5.92)). CONCLUSION: There is an association between whether or not a woman terminates a pregnancy affected by an unfamiliar fetal anomaly and the professional background of the health professional providing post-diagnostic counselling. The causal nature of this association remains to be determined.

Abortion, Eugenic↗