Now showing 1 - 2 of 2
  • Publication
    The interplay between maternal obesity and gestational diabetes mellitus
    There is a strong epidemiological association between maternal obesity and gestational diabetes mellitus (GDM). Since the publication of the Hyperglycemia and Adverse Pregnancy Outcome (HAPO) study on women with mild hyperglycemia in 2008, new criteria have been introduced in maternity services internationally for the diagnosis of GDM. As a result, the diagnosis of GDM may be made in one-third of obese women (n=68). The aim of this review was to examine the interplay between maternal obesity and GDM in light of the HAPO study and the subsequent revised diagnostic criteria. Obesity and GDM are important obstetric risk factors because they both are potentially modifiable. However, the new international criteria for the diagnosis of GDM have serious resource implications for maternity services provided to the large number of women attending for care in developed countries. Further consideration needs to be given as to whether obese women with mild hyperglycemia need to be referred to a multidisciplinary team antenatally if they do not require insulin treatment.
    Scopus© Citations 18  745
  • Publication
    The Irish Maternity Early Warning System (IMEWS)
    In the acute hospital setting, the use of early warning scores (EWS) to monitor vital signs (including heart rate, respiratory rate [RR], blood pressure and temperature) has been shown to be beneficial in the early diagnosis and prompt initiation of treatment in adults with a critical illness. This led to the development of the National Early Warning Score (NEWS) in Ireland by the Health Services Executive’s (HSE) Acute Medicine Clinical Care Programme. The NEWS was the first guideline endorsed by the National Clinical Effectiveness Committee (NCEC) and was launched by the Minister of Health Dr James Reilly in 2013. The implementation of NEWS is now mandatory in all acute hospitals. However, NEWS is not suitable for use in pregnancy because a woman's vital signs change physiologically from early in pregnancy. National reports in Ireland and the United Kingdom (UK) on maternal mortality have led to recommendations that a modified obstetric EWS be introduced. In Ireland, these recommendations have been further supported by separate investigations in 2008 and 2013 on two maternal deaths from sepsis.
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