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Articles by University Hospital Kerry

Viral meningitis in pregnancy: A case report

Published on: 13th October, 2020

OCLC Number/Unique Identifier: 8691250730

Ms X is a 34 year old para 1 woman who presented at 26+5 weeks’ gestation with fever, neurological symptoms and history of a viral illness. She was treated empirically for bacterial meningitis and transferred to a tertiary maternity hospital. Cerebrospinal fluid (CSF) polymerase chain reaction (PCR) was positive for enteroviral ribonucleic acid (RNA), confirming viral meningitis. Ms X improved clinically and was discharged after six days. A high index of suspicion is required for diagnosis of meningitis in pregnancy. Thorough history, examination and workup is vital for timely treatment. Prognosis in viral meningitis is excellent with no clear adverse fetal or neonatal outcomes.
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An audit on outpatient hysteroscopy – cervical dilatation, failure rates and patient satisfaction

Published on: 12th January, 2021

OCLC Number/Unique Identifier: 8885999148

Aims: To audit the use of cervical dilators, local anaesthetic, and failure rates in outpatient hysteroscopy over a two-year period in University Hospital Kerry. To review the experiences of women attending the outpatient hysteroscopy clinic (OHC) over a two-year period in University Hospital Kerry. Methods: Retrospective data review was carried out. Green-top Guideline No. 59: Best Practice in Outpatient Hysteroscopy, published by the Royal College of Obstetricians and Gynaecologists (RCOG), was the standard used for comparison. Results: Two hundred and twenty women were seen over a two-year period. The average age was forty-eight. The most common complaint being of menorrhagia/irregular bleeding per vaginum (PV). Local anaesthetic was used in just under one third of cases of which half required cervical dilatation. Most women reported experiencing mild to moderate levels of discomfort however most would opt for an outpatient hysteroscopic procedure again if required. Discussion/Conclusion: Outpatient hysteroscopy is a well-tolerated and safe procedure. Suitability for outpatient hysteroscopy is not predictable based on parity of menopausal status. Women would elect to undergo outpatient hysteroscopy again if required and this is likely due to several reasons including convenience and lack of requirement for general anaesthetic.
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The role of urine metabolomics among newborn infants with hypoxic ishaemic encephalopathy: a literature review

Published on: 9th November, 2021

OCLC Number/Unique Identifier: 9335770218

Background: Perinatal asphyxia (PA) which may result in hypoxic ischaemic encephalopathy (HIE) affects four million neonates worldwide and accounts for the death of one million of affected babies. The science of metabolomics has become an area of growing interest in neonatal research, with a potential role in identifying useful biomarkers that can accurately predict injury severity in perinatal asphyxia and HIE.The aim of this review is to look at the evidence of the usefulness of urine metabolomics in predicting outcome in PA/HIE. Methods: The key words used in the advanced search ‘urine metabolomics’ AND ‘perinatal asphyxia’ OR ‘hypoxic ischaemic encephalopathy’, yielded 13 articles. Results: Of the selected thirteen studies, 38% (n = 5) were human studies, 31% (n = 4) were animal studies and 31% (n = 4) were review articles. The studies confirmed the involvement of known pathways in the development of PA/HIE, primarily the Krebs cycle evidenced by accumulation of TCA cycle intermediates (citrate, α-ketoglutarate, succinate) and anaerobic pathways indicated by increased lactate. Other pathways involved include amino acid and carbohydrate pathways. Conclusion: Metabolomic studies so far are promising in highlighting potential biomarker profiles in PA/HIE. Further research is necessary to further clarify the role of identified metabolites in predicting outcome and prognosis in neonates affected by PA/HIE.
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Idiopathic ascites following caesarean section: A case report

Published on: 1st November, 2022

Ms X is a 40-year-old gravida 12, para 2+9 woman, who was admitted for an elective caesarean section at 38 weeks gestation following the previous two caesarean sections. Ms X had abdominal distension and generalised abdominal tenderness in the postoperative period. On investigation, she was found to have an elevated white cell count (WCC), C - Reactive Protein (CRP) and creatinine with free fluid in the abdomen on imaging but there was no evidence of perforation of any visceral organ. Ms X was treated conservatively for sepsis, an Acute Kidney Injury (AKI) and post-operative ileus and her symptoms gradually resolved. This is a case of idiopathic ascites post caesarean delivery with no clear cause.
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