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Biomedical subjects

R W Beard

Publications and source records attributed to R W Beard.

At least 109 records · Page 6Linked to original sources
PubMed1986

Assessment of an on-line computerized perinatal data collection and information system.

An on-line maternity data collection system has been designed to provide the information required for perinatal audit and to allow many of the letters and forms required for effective communication in pregnancy to be produced automatically. The system meets the requirements of the Korner Committee on Health Services Information and has been approved by the Computer Policy Committee. Pregnancy is followed prospectively from the first antenatal clinic visit until the file is closed 28 days after delivery. Data are entered by midwives and secretaries onto a network of microcomputers placed at convenient points in the maternity unit. The system has been fully operational with no significant problems since the beginning of 1984 and has led to improved communication between hospital and the community. Analysis of 253 consecutive case notes showed a high level of accuracy of the data recorded on computer. Reports and clinical audit are readily available both from the system locally, from standard programmes on the regional mainframe computer and via a mainframe computer at London University.

Computer Systems↗
PubMed1986

Low energy diets in the treatment of gestational diabetes.

A randomised prospective study of treatment with dietary restriction alone or insulin therapy with dietary advice was performed in 15 women with glucose intolerance diagnosed early in the third trimester of pregnancy. Twenty-four hour profiles of plasma glucose and 3-hydroxybutyrate were performed before and four weeks after commencing treatment. The effect on neonatal outcome was assessed. The case history of one of the patients in the study was sent to British physicians with a special interest in diabetes to obtain their opinion about the appropriate initial treatment of women with gestational diabetes.

3-Hydroxybutyric Acid↗
PubMed1986

The UK diabetic pregnancy survey.

A prospective, national survey of the UK which examined the management and outcome of pregnancy complicated by maternal diabetes is described. The perinatal mortality rate was 3.7 and 1.5 times greater than the overall UK rate and the malformation rate 6.4% and 1.9% in pregnancies where the mother had insulin-dependent and gestational diabetes respectively. In 57% of cases no blood glucose measurement was recorded in the first trimester of pregnancy. Significantly fewer malformed infants resulted from pregnancies where a first trimester blood glucose was recorded, irrespective of the value. Second and third trimester blood glucose values did not predict malformation but correlated inversely with gestational age at delivery and this was the major factor predicting the outcome of pregnancy.

Congenital Abnormalities↗
PubMed1985

Controlled trial of treatment of recurrent spontaneous abortion by immunisation with paternal cells.

In a paired sequential double-blind trial of immunological treatment of recurrent spontaneous abortion successful outcome of the next pregnancy was significantly more common in women injected with purified lymphocytes prepared from their husbands' blood than in those injected with their own lymphocytes. 17 of 22 women given paternal cells had successful pregnancies, compared with 10 of 27 given their own cells.

Abortion, Habitual↗
PubMed1985

The effect of oxytocin infusion on uterine activity levels in slow labour.

Uterine activity was studied in 31 women who were progressing slowly in spontaneous labour. In 75%, levels of uterine activity were below the tenth centile for normal spontaneous labour (mean uterine activity integral, UAI, 593 kPas/15 min; SD 296). Following oxytocin infusion, there was a significant increase in uterine activity to a mean of 1124 kPas/15 min (SD 276), which was the same as in normal spontaneous labour. The response to oxytocin was dependent upon the pre-existing level of uterine activity, and sensitivity to oxytocin, rather than the dose rate; 84% responded to infusion rates of less than 8 mU/min. The response to oxytocin was best expressed in terms of active contraction area (uterine activity integral, UAI) or Montevideo units, rather than the frequency or active pressure of contractions. The rate of cervical dilatation following oxytocin augmentation could not be predicted either by the increase in uterine activity or by the actual level of activity achieved.

Adult↗
PubMed1985

The effect of diet and insulin on metabolic profiles of women with gestational diabetes mellitus.

Twenty women with abnormal glucose tolerance, detected from a routine program of antenatal screening for gestational diabetes mellitus (GDM) at 28 wk, were admitted for 24-h metabolic profiles. They were then alternately allocated to either insulin and dietary restriction or dietary restriction alone and then retested 4 wk later while on therapy. Ten normal controls were assessed twice at similar gestations to the study group. Before treatment, the 20 gestational diabetic subjects had higher mean concentrations of plasma glucose and 3-hydroxybutyrate than the controls for most of the profile, but mean insulin values were similar. Insulin therapy was associated with a reduction in mean glucose concentrations so that the profile was similar to the controls, while in the diet-alone group the reduction was less. The 3-hydroxybutyrate concentrations rose between profiles in the normal group and also rose in those treated by diet alone, but still remained within the upper range of normal even at night. Insulin therapy resulted in a similar 3-hydroxybutyrate profile to the controls. The C-peptide response to breakfast was reduced in both groups to levels below that of the controls. Neonatal outcome indices were similar in the two treatment groups, despite the differences in maternal metabolites, but because of the size of this study, conclusions about the neonate must be tentative.

3-Hydroxybutyric Acid↗
PubMed1984

Diagnosis of pelvic varicosities in women with chronic pelvic pain.

45 women with a history of lower-abdominal pain of more than 6 months' duration for which no obvious cause had been found during laparoscopy (pelvic-pain syndrome) were investigated with transuterine pelvic venography. For comparison venography was carried out on 10 women in whom pathology was considered to be a likely cause for their pain and 8 women admitted for tubal ligation and who had no pain. Pelvic varicosities and congestion unrelated to parity or the menstrual cycle were commonly found in women with the pelvic-pain syndrome. A score for quantifying the severity of the pelvic vascular abnormalities has been devised; a value of 5 or more gave a diagnostic sensitivity of 91% and a specificity of 89% for the pelvic-pain syndrome.

Adult↗
PubMed1984

Treatment of hypertension in pregnancy by relaxation and biofeedback.

In a study of the effectiveness of systematic relaxation training alone or combined with biofeedback in the treatment of hypertension in pregnancy, 60 women were seen weekly for 6 weeks. 18 were given relaxation therapy alone (group A), 18 relaxation plus biofeedback (group B), and there were 24 controls. Whereas two-thirds of the control group had to be admitted to hospital during their pregnancies, less than a third of each experimental group had to be admitted. The experimental groups also had significantly lower systolic and diastolic blood pressure than the control group. There were no significant differences between groups A and B in hospital admission rates or blood-pressure measurements.

Adolescent↗
PubMed1984

An alternative to the diagnostic dilatation and curettage--endometrial cytology.

Endometrial aspiration cytology has been shown by multicentre prospective studies to be an acceptable and valuable method of assessing the endometrium. A retrospective study was undertaken over three years' routine use of the Isaacs cell sampler. In 86% of the cases suitable endometrium was obtained, with experience of the technique being the important factor. When compared with histological findings, all 11 cases of malignancy were confirmed, including one ovarian adenocarcinoma. Of the cytological reports of endometrial hyperplasia, 78% were confirmed by the histological findings, with the remainder showing minor degrees of cystic hyperplasia or normal endometrium. In no case was a more abnormal lesion present on histological examination than had been suggested by cytological findings. The use of progestogens in reversing hyperplasia is seen to be effective, though the long term benefit remains uncertain. It is concluded that with an experienced cytologist, Isaacs endometrial aspiration should be used routinely for the primary investigation of dysfunctional uterine bleeding and postmenopausal bleeding.

Cytodiagnosis↗
PubMed1984

Normal levels of active contraction area in spontaneous labour.

A detailed study has been made of uterine activity in a group of 21 unselected women in spontaneous labour. Measurements were made of contraction frequency, active pressure, Montevideo units and active contraction area. The level of Montevideo units were comparable with values previously reported in spontaneous labour. Active contraction area correlated better than any of the other measures with the rate of cervical dilatation in the active phase of labour (r = 0.69). The mean contraction area was 1099 (SD 333) kPas/15 min.

Adolescent↗
PubMed1983

Selection of an obstetric data base for a microcomputer and its use for on-line production of birth notification forms, discharge summaries and perinatal audit.

A microcomputer system is described which stores data for perinatal audit and produces 'on-line' the statutory birth notification form and mother and baby discharge summary. The derivation of a minimum data-base and the methods used to obtain reliable data are outlined. The results of a trial of the production of the birth notification form for 195 deliveries are reported together with those of a further trial of 86 deliveries in which the system was used to produce both the notification form and the discharge summary. A study of the accuracy of the handwritten birth notification forms revealed a high error rate which was markedly reduced by the use of the microcomputer system. The system is now in routine use and further developments are outlined.

Computers↗