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Crosshouse, United Kingdom

Shields R.C.,Obstetrics and Gynaecology | Caric V.,Obstetrics and Gynaecology | Hair M.,University of West of Scotland | Jones O.,Biomedical Scientists and Consultant | And 3 more authors.
Journal of Obstetrics and Gynaecology | Year: 2011

Using laboratory reference ranges, B12 deficiency is inappropriately diagnosed and treated in pregnancy. We aim to define reference ranges for ferritin, folate, haemoglobin and B12 in a pregnant population with advancing gestation. A total of 190 women participated in a cross-sectional study, 113 in the 1st and 77 in the 3rd trimester. All variables studied except red cell folate, decreased significantly from the 1st to the 3rd trimester. A total of 34% (64/190) of women were found to have 'xlow' B 12 as defined by traditional ranges. In women with anaemia and apparent B12 deficiency, co-existing ferritin deficiency was demonstrated. All women with 'low' B12 levels were invited to attend postnatally for re-testing. A total of 28% (18/64) attended, in whom all B 12 levels spontaneously increased. The use of gestation specific reference ranges for haematological variables may reduce inappropriate diagnosis of B12 deficiency. In most women with apparent low B12 levels and anaemia, ferritin deficiency was demonstrated. Therefore iron should be the initial management therapy. © 2011 Informa UK, Ltd. Source

Jarvie E.,Ayrshire Maternity Unit | Ramsay J.E.,Ayrshire Maternity Unit
Seminars in Fetal and Neonatal Medicine | Year: 2010

Rates of obesity among the pregnant population have increased substantially and adiposity has a damaging effect on every aspect of female reproductive life. This review summarises epidemiological data concerning obesity-related complications of pregnancy. Obesity is linked to a number of adverse obstetric outcomes as well as increased maternal and neonatal morbidity and mortality. These complications include miscarriage, congenital abnormalities, pre-eclampsia, gestational diabetes mellitus, iatrogenic preterm delivery, postdates pregnancy with increased rates of induction of labour, caesarean section, postpartum haemorrhage, shoulder dystocia, infection, venous thromboembolism, and increased hospital stay. It is important to consider obese pregnant women as a high risk group with a linear increase in risk of complications associated with their degree of obesity. Their obstetric management should be consultant-led and involve a multidisciplinary team approach to improve outcome. © 2009 Elsevier Ltd. All rights reserved. Source

Phatak M.,Ayrshire Maternity Unit | Ramsay J.,Ayrshire Maternity Unit
Journal of Obstetrics and Gynaecology | Year: 2010

A maternal body mass index (BMI)≥30kg/m2 increases the risk of giving birth to a baby with an anatomical congenital anomaly. Such anomalies can be detected prior to birth using ultrasound as a screening modality. This study documents the impact of maternal obesity on image quality and service provision of the mid-trimester fetal anomaly scan. A prospective observational study of 327 pregnant women demonstrated 21 of women were obese. In this group, sub-optimal views of fetal anatomy and consequent requirement for re-appointment were all significantly greater. We conclude that obese women require information regarding reduced sensitivity of the 20-week anomaly scan. The increasing prevalence of obesity will have a significant effect on resources for maternity ultrasound departments. © 2010 Informa Healthcare USA, Inc. Source

Sardar C.M.,University of Glasgow | Kinmond S.,Ayrshire Maternity Unit | Siddique J.,Ayrshire Maternity Unit | Cooper A.,Ayrshire Maternity Unit | And 5 more authors.
Hormone Research in Paediatrics | Year: 2015

Background/Aims: Intrauterine growth restriction is an indication for growth hormone treatment. Birth length (BL) is needed to evaluate the influence of birth size on childhood short stature. However, BL is commonly measured only approximately, if at all. A single-centre study was undertaken to determine the value of measuring accurate and targeted BL and parental height (PH) for neonates with a birth weight (BW) ≤9th centile, identifying short [BL ≤-2 standard deviation scores (SDS)] and light newborns (BW ≤-2 SDS), and remeasuring short neonates at 2 years in order to detect those not showing catch-up growth. Methods: Information was collected on all live births (n = 3,798) in a single maternity unit during a 1-year period. Results: BW was ≤9th centile in 481 neonates (12.7%) of whom 47 were light but not short, 46 were short, and 60 were both light and short. Of 107 eligible infants, 57 (53%) attended the 2-year follow-up; failure of catch-up growth was identified in 6 infants (11%) of whom only 1 was already known to medical services. PH was measured in both parents of 52/153 (34%) light and/or short infants. Conclusion: Targeted and accurate BL measurement in newborns with a BW ≤9th centile is a promising alternative to the current practices. The feasibility of PH measurement after birth still requires further evaluation. © 2015 S. Karger AG, Basel. Source

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