Supervisor View Full Details

• Other - please suggest keyword(s):

• Obstetrics and Gynaecology

• Other

Fetal and Maternal Health

Dr Niamh Daly, PhD: randomised controlled trial to examine a personally supervised intensive exercise intervention for the improvement of maternal glycaemic control in obese women during pregnancy.
Ms Laura Mullaney, PhD: maternal weight & body composition trajectories during AND after pregnancy.
Dr Maria Farren: randomised control trial evaluating the use of a pseudovitamin in the prevention of GDM.
Dr Georsan Caruth, MD: use of a customised Smartapp for women after the delivery of their baby, designed to modify lifestyle behaviour & improve weight management.
Dr Aoife McKeating, PhD: examine peri-conceptual folic acid supplementation in obese women.
Dr Patrick Maguire, MD: evaluating the IMEWS and the customisation of a standardised national Sepsis Six box for the early diagnosis and treatment of maternal infection.
Ms Rachel Kennedy, PhD: evaluation of a customised Smartapp for the management of maternal diet and GDM.
Ms Ciara Reynolds, PhD: evaluate a Smartapp in a randomised control trial to evaluate its effectiveness in smoking cessation in pregnant women.
Ms Shona Cawley, PhD: observational study examining dietary and peri-conceptional folic acid intake in the first trimester of pregnancy.
Dr Amy O?Higgins, MD: longitudinal observational study on gestational weight gain in women booking for antenatal care at the hospital.

Gestational Diabetes Mellitus (GDM) is important because it is common, associated with fetal and maternal complications, associated with increased obstetric interventions, financially costly and the diagnosis has lifelong consequences for the woman and her offspring. Since 2008, the diagnostic criteria have been made more sensitive because there is evidence that even mild maternal hyperglycaemia may be associated with adverse clinical outcomes. Thus, the diagnosis may now be made on the basis of a single abnormal value on a 75g Oral Glucose Tolerance Test (OGTT).

New laboratory guidelines have also been published which have highlighted the need for strict preananalytical handling of plasma glucose samples to minimise glycolysis and thus, avoid false negative OGTTs and the diagnosis of GDM being missed (Daly and Turner, 2016). One solution is to place the samples on a slurry of ice in a bottle containing citrate to inhibit glycolysis. This however may not be practical in all clinical scenarios. Our group has recently demonstrated the potential of using adjusted point of care testing glucose measurements as a way of improving diagnostic accuracy (Daly et al, 2016). There is however little information examining the relationship between point of care results and feto-maternal clinical outcomes.

This prospective observational study would compare the value of point of care maternal glucose testing with customary maternal plasma glucose testing in predicting feto-maternal outcomes, including comparing the independent value of fasting, one hour and two hour values.

The proposed project would recruit women at their convenience following sonographic confirmation of a healthy ongoing singleton pregnancy in the first trimester of pregnancy. Clinical and sociodemographic details would be computerised. Women would be selectively screened for GDM according to national guidelines. In addition to the customary OGTT, women would also be screen using a point of care test. Women diagnosed with GDM on the OGTT would be referred as usual to the multidisciplinary diabetes clinics for management. Clinicians would be blinded to the point of care test. The clinical outcomes would be again computerised after delivery.

The primary end point would be birth weight. Other end points would include the need for operative intervention and biomarkers such as maternal C-reactive protein and triglycerides.

Approval would be sought from the Hospital Research Ethics Committee and statistical advice would be required to power the study.