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Article ; Online: Obstetric care for environmental migrants.

Lee, Sadhbh A / Corbett, Gillian A / McAuliffe, Fionnuala M

2023 Volume 193, Issue 2, Page(s) 797–812

Abstract: Background: Migration due to environmental factors is an international crisis affecting many nations globally. Pregnant people are a vulnerable subgroup of migrants.: Aim: This article explores the potential effects of environmental migration on ... ...

Abstract	Background: Migration due to environmental factors is an international crisis affecting many nations globally. Pregnant people are a vulnerable subgroup of migrants. Aim: This article explores the potential effects of environmental migration on pregnancy and aims to draw attention to this rising concern. Methods: Based on the study aim, a semi-structured literature review was performed. The following databases were searched: MEDLine (PubMed) and Google Scholar. The search was originally conducted on 31st January 2021 and repeated on 22nd September 2022. Results: Pregnant migrants are at increased risk of mental health disorders, congenital anomalies, preterm birth, and maternal mortality. Pregnancies exposed to natural disasters are at risk of low birth weight, preterm birth, hypertensive disorders, gestational diabetes, and mental health morbidity. Along with the health risks, there are additional complex social factors affecting healthcare engagement in this population. Conclusion: Maternity healthcare providers are likely to provide care for environmental migrants over the coming years. Environmental disasters and migration as individual factors have complex effects on perinatal health, and environmental migrants may be at risk of specific perinatal complications. Obstetricians and maternity healthcare workers should be aware of these challenges and appreciate the individualised and specialised care that these patients require.
MeSH term(s)	Pregnancy ; Humans ; Infant, Newborn ; Female ; Premature Birth/epidemiology ; Transients and Migrants ; Infant, Low Birth Weight ; Parturition
Language	English
Publishing date	2023-09-16
Publishing country	Ireland
Document type	Journal Article ; Review
ZDB-ID	390895-1
ISSN	1863-4362 ; 0021-1265
ISSN (online)	1863-4362
ISSN	0021-1265
DOI	10.1007/s11845-023-03481-9
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Article ; Online: Onset and outcomes of spontaneous labour in low risk nulliparous women.

Corbett, Gillian A / Dicker, Patrick / Daly, Sean

European journal of obstetrics, gynecology, and reproductive biology

2022 Volume 274, Page(s) 142–147

Abstract: Objectives: The objective of this study was to: 1. Establish the median gestational age of spontaneous labour for low-risk nulliparas. 2. Examine the variation in mode of delivery and short-term neonatal outcomes with gestation at onset of spontaneous ... ...

Abstract	Objectives: The objective of this study was to: 1. Establish the median gestational age of spontaneous labour for low-risk nulliparas. 2. Examine the variation in mode of delivery and short-term neonatal outcomes with gestation at onset of spontaneous labour. Study design: This is a retrospective observational cohort study conducted at a tertiary obstetric unit. The study population was 12, 323 low risk nulliparous women with singleton pregnancies who experienced spontaneous onset of labour. The study period was over seven years, from Jan 1st 2011 to 31st Dec 2017. Exclusion criteria were multiparity, multi-fetal pregnancy, booking after 14 weeks gestation, antepartum or intrapartum death, or any obstetric or fetal indication for delivery with the exception of post-maturity. Gestation of onset of spontaneous labour, demographic variables and maternal and neonatal outcomes were collected. The primary outcome was median gestational age at onset of spontaneous labour and its distribution at term. Secondary outcomes were mode of delivery and neonatal outcomes including low-apgar score and NICU admission. Results: 12, 323 patients were eligible for inclusion. Median gestation for onset of labour was 40.1 weeks gestation, with 80.5% of spontaneous labour occurs by 41 + 0 weeks gestation. The risk of assisted delivery (RR 1.32, 95% CI 1.23 - 1.42), caesarean section (RR 2.17, 95% CI 1.88-2.51) and low-apgar scores (RR 3.13 95% CI 1.50-6.55) increased significantly with spontaneous labour after 41 weeks' gestation. Conclusions: Nulliparous women with low-risk pregnancies are most likely to experience spontaneous labour between 40 + 0 and 40 + 6. 80.5% of spontaneous labour occurred by 41 + 0 weeks gestation. Assisted vaginal delivery, caesarean section and low-apgar scores were significantly more likely with spontaneous labour after 41 weeks' gestation.
MeSH term(s)	Cesarean Section ; Cohort Studies ; Delivery, Obstetric ; Female ; Gestational Age ; Humans ; Infant, Newborn ; Parity ; Pregnancy
Language	English
Publishing date	2022-05-20
Publishing country	Ireland
Document type	Journal Article ; Observational Study
ZDB-ID	190605-7
ISSN	1872-7654 ; 0301-2115 ; 0028-2243
ISSN (online)	1872-7654
ISSN	0301-2115 ; 0028-2243
DOI	10.1016/j.ejogrb.2022.05.010
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Article ; Online: Shining a light on postnatal perineal granulation tissue.

Brophy, Caroline / Corbett, Gillian A / O Brien, Laoise

International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics

2022 Volume 159, Issue 1, Page(s) 315–316

MeSH term(s)	Delivery, Obstetric ; Episiotomy ; Female ; Granulation Tissue ; Humans ; Lacerations ; Obstetric Labor Complications ; Perineum/injuries ; Pregnancy
Language	English
Publishing date	2022-06-25
Publishing country	United States
Document type	Journal Article
ZDB-ID	80149-5
ISSN	1879-3479 ; 0020-7292
ISSN (online)	1879-3479
ISSN	0020-7292
DOI	10.1002/ijgo.14297
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Article ; Online: The Ten Group Classification System-First Things First: Re: Postpartum haemorrhage trends in Sweden using the Robson 10-group classification system: a population-based cohort study: Re: Postpartum haemorrhage trends in Sweden using the Robson 10-group classification system: a population-based cohort study.

Corbett, Gillian A / O'Riordan, Nicola / Robson, Michael

BJOG : an international journal of obstetrics and gynaecology

2021 Volume 129, Issue 7, Page(s) 1170–1171

MeSH term(s)	Cesarean Section ; Cohort Studies ; Female ; Humans ; Postpartum Hemorrhage/epidemiology ; Postpartum Hemorrhage/therapy ; Pregnancy ; Research ; Sweden/epidemiology
Language	English
Publishing date	2021-12-27
Publishing country	England
Document type	Letter ; Comment
ZDB-ID	2000931-8
ISSN	1471-0528 ; 0306-5456 ; 1470-0328
ISSN (online)	1471-0528
ISSN	0306-5456 ; 1470-0328
DOI	10.1111/1471-0528.17049
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Article ; Online: Intravenous leiomyomatosis: the first reported case of intraoperative intracaval embolisation of tumour to the right atrium.

Corbett, Gillian A / O'Gorman, Catherine / Kamran, Waseem

BMJ case reports

2020 Volume 13, Issue 3

Abstract: Intravenous leiomyomatosis is extremely rare. This case describes a 42-year-old woman who presented with abdominal distension, cyclical bloating and urinary retention. Preoperative imaging showed a multilobulated uterine mass. Following multidisciplinary ...

Abstract	Intravenous leiomyomatosis is extremely rare. This case describes a 42-year-old woman who presented with abdominal distension, cyclical bloating and urinary retention. Preoperative imaging showed a multilobulated uterine mass. Following multidisciplinary team discussion, a complete staging surgery consisting of midline laparotomy, total hysterectomy and bilateral salpingo-oophrectomy was performed. Intraoperatively, a large multilobulated uterine mass was noted with engorgement of the infundibulopelvic ligaments due to intravascular extension of tumour. On removal of the uterus, the patient desaturated and became hypotensive. Intraoperative transoesophageal echocardiography revealed mass extending from the inferior vena cava (IVC) into the right atrium (RA). The cardiothoracic surgical team retrieved a worm-like mass extending from the IVC into the RA. Histopathological examination diagnosed a large uterine leiomyoma with intravenous leiomyomatosis. The mass from the RA was a bland spindle cell tumour which matched the uterine mass histopathologically. Intravenous leiomyomatosis is a rare variant of uterine leiomyoma. Although intracardiac extension has been described, this is the first case of intraoperative embolisation of pelvic tumour to the RA at hysterectomy.
MeSH term(s)	Adult ; Echocardiography, Transesophageal/methods ; Embolization, Therapeutic/methods ; Female ; Heart Atria/diagnostic imaging ; Heart Atria/pathology ; Heart Neoplasms/pathology ; Humans ; Hysterectomy/methods ; Intraoperative Period ; Laparotomy/methods ; Leiomyomatosis/surgery ; Salpingo-oophorectomy/methods ; Treatment Outcome ; Uterine Neoplasms/diagnostic imaging ; Uterine Neoplasms/pathology ; Vascular Diseases/pathology ; Vascular Neoplasms/pathology ; Vena Cava, Inferior/diagnostic imaging ; Vena Cava, Inferior/pathology
Language	English
Publishing date	2020-03-12
Publishing country	England
Document type	Case Reports ; Journal Article
ISSN	1757-790X
ISSN (online)	1757-790X
DOI	10.1136/bcr-2019-233341
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Article ; Online: Laparoscopic prepregnancy transabdominal cerclage: operative and pregnancy outcomes for a novel technique of suture placement using port closure device.

Corbett, Gillian A / Windrim, Catherine / Higgins, Shane / McAuliffe, Fionnuala M / Wilkinson, Michael / O'Brien, Donal / Corcoran, Siobhan

American journal of obstetrics and gynecology

2023 Volume 230, Issue 5, Page(s) 578–580

Abstract: Transabdominal cerclage is an effective surgical intervention for preterm birth prevention. Placement of cervical sutures using a port closure device for prepregnancy laparoscopic abdominal cerclage has been used at our unit in recent years. We report ... ...

Abstract	Transabdominal cerclage is an effective surgical intervention for preterm birth prevention. Placement of cervical sutures using a port closure device for prepregnancy laparoscopic abdominal cerclage has been used at our unit in recent years. We report the operative and pregnancy outcomes for prepregnancy laparoscopic abdominal cerclage using the port closure device and compare it with the outcomes of the traditional approach. For prepregnancy laparoscopic transabdominal cerclage (n=52), the port closure device approach was associated with less blood loss during surgery (0.95±4.4 mL vs 5.4±15.7 mL; P=.007) and a shorter hospital length of stay (0.0; 0.0-0.0 days vs 1.0; 0.0-1.0 days; P<.001). There were also trends toward shorter operating times (41.4±15.3 minutes vs 50.1±18.0 minutes; P=.167) and lower perioperative complication rates (0.0%; 0/21 vs 16.1%; 5/31; P=.065) when compared with the traditional technique. There was no significant difference between the port closure device technique and the traditional approach in the rate of preterm birth in a subsequent pregnancy (0.0%; 0/9 vs 22.6%; 7/39; P=.248). Use of the port closure device for suture placement during prepregnancy laparoscopic cerclage for preterm birth prevention was reported. This technique was associated with less blood loss and a shorter hospital length of stay, had trends toward shorter operating times and lower perioperative complication rates, and had similar rates of preterm birth.
MeSH term(s)	Humans ; Female ; Pregnancy ; Cerclage, Cervical/methods ; Cerclage, Cervical/instrumentation ; Laparoscopy/methods ; Adult ; Suture Techniques/instrumentation ; Pregnancy Outcome ; Premature Birth/prevention & control ; Length of Stay/statistics & numerical data ; Blood Loss, Surgical/prevention & control ; Uterine Cervical Incompetence/surgery ; Operative Time ; Retrospective Studies
Language	English
Publishing date	2023-12-06
Publishing country	United States
Document type	Journal Article
ZDB-ID	80016-8
ISSN	1097-6868 ; 0002-9378
ISSN (online)	1097-6868
ISSN	0002-9378
DOI	10.1016/j.ajog.2023.12.002
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Article ; Online: Non-diabetic fetal macrosomia: outcomes of elective delivery versus expectant management.

Corbett, Gillian A / Hunter, Samuel / Javaid, Amina / McNamee, Emma / O'Connell, Michael / Lindow, Stephen W / Martin, Aisling

Irish journal of medical science

2022 Volume 192, Issue 3, Page(s) 1249–1257

Abstract: Background: Macrosomia in the absence of diabetes can be associated with increased neonatal and maternal morbidity. Management is usually undertaken on a case-by-case basis.: Aims: In order to inform local practice, this study aimed to evaluate the ... ...

Abstract	Background: Macrosomia in the absence of diabetes can be associated with increased neonatal and maternal morbidity. Management is usually undertaken on a case-by-case basis. Aims: In order to inform local practice, this study aimed to evaluate the outcomes of the management of non-diabetic macrosomia in an Irish tertiary center. Methods: A retrospective observational study was performed on all women with estimated fetal weight over 4000 g after 37 weeks' gestation. Maternal demographics and obstetric and neonatal outcomes were recorded using the hospital information system. Women with diabetes, previous caesarean section, non-cephalic presentation, or any other complicating condition were excluded. Women were divided into two groups: 1. Active management: Elective delivery for macrosomia-between 38 + 0 and 40 + 6 weeks' gestation 2. Expectant management: with induction of labour offered after 41 weeks' gestation RESULTS: There were 397 women included, 188 with active and 209 with expectant management. There was no difference in adverse neonatal outcomes, major maternal morbidity, or mode of delivery, after exclusion of pre-labor caesarean section. Women with expectant management were more likely to go into spontaneous labor (46.9 vs 1.6%, p < 0.001) and to have a favorable cervix at the onset of induction of labor if nulliparous (86.1 vs 70.0%, p = 0.021), but have higher rates of episiotomy (28.6 vs 18.2%, p = 0.021). With active management, nulliparas with an unfavorable cervix had increased risk of anal sphincter injury (6.5 vs 0.0%, p = 0.007) and postpartum hemorrhage (59.0 vs 35.5%, p = 0.003). Conclusions: Overall, there was no difference in major maternal or neonatal outcomes between management options for fetal macrosomia. However, inducing nulliparas with an unfavorable cervix for non-diabetic macrosomia was associated with obstetric anal sphincter injury and postpartum hemorrhage.
MeSH term(s)	Infant, Newborn ; Pregnancy ; Female ; Humans ; Cesarean Section ; Fetal Macrosomia/epidemiology ; Watchful Waiting ; Postpartum Hemorrhage/etiology ; Labor, Induced/adverse effects
Language	English
Publishing date	2022-07-04
Publishing country	Ireland
Document type	Observational Study ; Journal Article
ZDB-ID	390895-1
ISSN	1863-4362 ; 0021-1265
ISSN (online)	1863-4362
ISSN	0021-1265
DOI	10.1007/s11845-022-03076-w
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Article ; Online: Drug use in pregnancy in Ireland's capital city: A decade of trends and outcomes.

Corbett, Gillian A / Carmody, Deirdre / Rochford, Marie / Cunningham, Orla / Lindow, Stephen W / O'Connell, Michael P

European journal of obstetrics, gynecology, and reproductive biology

2022 Volume 282, Page(s) 24–30

Abstract: Objective: The aim of this study was to present contemporary trends in opiate use disorder (OUD) and substance use in pregnancy in Ireland, with associated obstetric outcomes, over the last ten years.: Study design: This retrospective observational ... ...

Abstract	Objective: The aim of this study was to present contemporary trends in opiate use disorder (OUD) and substance use in pregnancy in Ireland, with associated obstetric outcomes, over the last ten years. Study design: This retrospective observational cohort study was conducted at an Irish tertiary maternity unit. All women with OUD or substance use in pregnancy delivered under this service between 2010 and 2019 were included. Drug-exposure was self-reported. Data was collected by combining electronic and hand-held patient records. Trends and outcomes were analysed by year of delivery. Approval for the study was granted by the institution's clinical governance committee. Results: Of the 82,669 women delivered, 525 had OUD or substance use in pregnancy (1 in every 160 women booking). 11.6% were homeless, 20.0% were in full-time employment and 91.0% smoked tobacco in pregnancy. 66.3% had a history of psychiatric disorders. Over the ten years, there was a significant reduction in women delivered with OUD or substance use in pregnancy (0.8 % to 0.4 %, RR 0.55, 95 % CI 0.36-0.85), significant reduction in the proportion of women on Opioid-Substitute-Treatment (OST, RR 0.66 95 % CI 0.51-0.87) and an increase in mean maternal age (30.7to32.0 years). Rates of cocaine and cannabis consumption increased (20.6 %, RR 3.8, 95 % CI 1.57-9.44: 24.0 %, RR 3.7, 95 % CI 1.58-8.86 respectively). The maternal mortality rate was 380.9:100,000 births. The perinatal mortality rate was 15.6:1000 births. The preterm birth rate was 17.9 %, with a mean birth weight of 2832 g. The rate of NICU admission was 52.0 % and the mean length of stay was 22.4 days. Amongst the smaller OUD population, the rate of NICU admission for Neonatal Abstinence Syndrome (NAS) and treatment for NAS increased over the study timeframe (36.0 %, RR 2.97, 95 % CI 1.86-4.75: 28.5 %, RR 2.92, 95 % CI 1.70-5.0 respectively). Conclusions: The obstetric population attending an Irish antenatal service with opiate use disorder or substance exposure is reducing in size with older patients, less opioid substitute therapy and increasing cocaine and cannabis use. These women have high rates of maternal and perinatal morbidity and mortality. Specialist antenatal addiction services, coordinated by the drug-liaison midwife, are critical in adapting care to respond to this dynamic and vulnerable patient cohort.
MeSH term(s)	Pregnancy ; Infant, Newborn ; Female ; Humans ; Adult ; Premature Birth/epidemiology ; Analgesics, Opioid/therapeutic use ; Retrospective Studies ; Ireland/epidemiology ; Substance-Related Disorders/epidemiology ; Cocaine ; Opiate Alkaloids
Chemical Substances	Analgesics, Opioid ; Cocaine (I5Y540LHVR) ; Opiate Alkaloids
Language	English
Publishing date	2022-12-22
Publishing country	Ireland
Document type	Observational Study ; Journal Article
ZDB-ID	190605-7
ISSN	1872-7654 ; 0301-2115 ; 0028-2243
ISSN (online)	1872-7654
ISSN	0301-2115 ; 0028-2243
DOI	10.1016/j.ejogrb.2022.12.021
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Article ; Online: Outcomes of Uterine Rupture in the Setting of the Unscarred Compared With the Scarred Uterus.

McEvoy, Aoife / Corbett, Gillian A / Nolan, Ciara / Daly, Ronan / Murnane, Megan / Higgins, Shane / Malone, Fergal D / O'Connell, Michael P / Hehir, Mark P / Walsh, Jennifer M

Obstetrics and gynecology

2023 Volume 141, Issue 4, Page(s) 854–856

Abstract: Uterine rupture is a rare obstetric complication that is associated with maternal and neonatal morbidity and mortality. The aim of this study was to examine uterine rupture and its outcomes in the setting of the unscarred compared with the scarred uterus. ...

Abstract	Uterine rupture is a rare obstetric complication that is associated with maternal and neonatal morbidity and mortality. The aim of this study was to examine uterine rupture and its outcomes in the setting of the unscarred compared with the scarred uterus. A retrospective observational cohort study was performed examining all cases of uterine rupture in three tertiary care hospitals in Dublin, Ireland, over a 20-year period. The primary outcome was perinatal mortality rate with uterine rupture, which was 11.02% (95% CI 6.5-17.3). There was no significant difference in perinatal mortality between cases of scarred and unscarred uterine rupture. Unscarred uterine rupture was associated with higher maternal morbidity , defined as major obstetric hemorrhage or hysterectomy.
MeSH term(s)	Pregnancy ; Infant, Newborn ; Female ; Humans ; Uterine Rupture/etiology ; Uterine Rupture/surgery ; Pregnancy Outcome ; Retrospective Studies ; Uterus ; Hysterectomy/adverse effects ; Perinatal Death
Language	English
Publishing date	2023-03-09
Publishing country	United States
Document type	Observational Study ; Journal Article
ZDB-ID	207330-4
ISSN	1873-233X ; 0029-7844
ISSN (online)	1873-233X
ISSN	0029-7844
DOI	10.1097/AOG.0000000000005108
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Article ; Online: Childbirth in Ireland's capital city over sixty years.

Corbett, Gillian A / Fitzpatrick, Chris / Daly, Sean / Turner, Michael J / Sheehan, Sharon R / Farah, Nadine

Irish journal of medical science

2020 Volume 189, Issue 3, Page(s) 1135–1141

Abstract: Background: Ireland has changed over the past sixty years, and the dynamic practice of obstetrics and gynaecology has changed with it.: Study design and methods: To describe these changes, a review was performed of clinical reports of a tertiary ... ...

Abstract	Background: Ireland has changed over the past sixty years, and the dynamic practice of obstetrics and gynaecology has changed with it. Study design and methods: To describe these changes, a review was performed of clinical reports of a tertiary referral teaching hospital over six decades. Results: Since the 1960s, the hospital's total births per annum has risen (3050 to 8362 births). Teenage pregnancy is less common (4.7 to 2.0%, p < 0.001), with more women over age 40 at booking (2.6 to 6.4%, p < 0.001). There are more multiple pregnancies now (1.8 to 4.1%, p < 0.001) and less grand-multiparous woman (10.1 to 1.3%, p < 0.001). Eclampsia is less common (0.18 to 0.02%, p = 0.003), with a slight decrease in rate of preeclampsia (3.8 to 3.0%, p = 0.03). Induction of labour increased considerably (8.8 to 32.1%, p < 0.001). While the instrumental delivery rate remained stable, the instrument of choice has changed from forceps (11.3 to 5.4%, p = 0.001) to ventouse delivery (0.6 to 9.1%, p = 0.001). The caesarean section rate rose (5.9 to 29.7%, p < 0.001). Vaginal birth after caesarean section rate dropped (90.4 to 28.2%, p < 0.001) without significant change in rate of uterine rupture (0.4 to 0.7%, p = 0.1). The perinatal mortality rate improved (48.5 to 5.4 per 1000 births, p < 0.001). Preterm birth rate rose (4.9 to 6.6%, p = 0.001). Foetal macrosomia decreased in this time (2.5 to 1.7%, p = 0.007), despite a rise in the incidence of gestational diabetes mellitus. Conclusion: This study provides an intriguing glimpse into the changes in the practice of obstetrics and demonstrates how it adapts to the population it serves.
MeSH term(s)	Adult ; Female ; Humans ; Infant, Newborn ; Ireland ; Parturition/physiology ; Pregnancy ; Time Factors
Language	English
Publishing date	2020-02-14
Publishing country	Ireland
Document type	Journal Article
ZDB-ID	390895-1
ISSN	1863-4362 ; 0021-1265
ISSN (online)	1863-4362
ISSN	0021-1265
DOI	10.1007/s11845-020-02192-9
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