Ulysses Directives for Advanced Mental Health Care Planning

Posted by Dr Mike O'Connor on 22 March 2023
One of the papers delivered on 25 Feb 2023 at the ACLM was by Prof Judy Clausen on the recent Nebraska legislation to introduce Advanced Mental Health Care Plans in that State. So called ‘Ulysses directives’ enable psychiatric patients such as bipolar or schizophrenic patients subject to episodic relapses to make advanced decisions regarding what they wish to receive when they are incapacitated by psychotic states. As Ulysses and his men were returning home after the Trojan War, ...
Posted in:Medicolegal  

NIPT testing has significant diagnostic limitations

Posted by Professor Mike O’Connor AM on 11 February 2022
The advent of NIPT testing in 2011 in Hong Kong was a breakthrough after many years of fruitless research which focussed on examining complete fetal cells in the maternal blood. Only one fetal cell is usually present per 1 ml of maternal blood. By contrast there are approximately 4.5 x 106 maternal red cells per ml of maternal blood. So it was like looking for a needle in a haystack! Non-invasive prenatal testing (NIPT) has revolutionized the prenatal screening landscape with its high accura...
 

Progesterone supplementation for IVF pregnancies and pregnancies at high risk for spontaneous preterm birth

Posted by Professor Mike O’Connor AM on 30 August 2021
It will not have gone unnoticed by many of you that IVF patients in particular are being treated with progesterone vaginal pessaries as a means of enhancing the process of implantation. Progesterone is necessary for successful implantation of the embryo. Luteal phase support is therefore a requirement for optimal outcome following egg collection and embryo transfer in an in-vitro fertilization (IVF) cycle It has been shown that ovarian stimulation during IVF treatment, particularly in cycles...
Posted in:IVF  

Cervical length assessments for the risk of preterm delivery

Posted by Professor Mike O’Connor AM on 30 August 2021
Cervical length assessments for the risk of preterm delivery
Cervical Length Assessment
The median cervical length at 20 weeks is 42mm, the 1st centile is 23mm. There appears to be value in linking shortened cervical lengths with an increase in the risk of preterm delivery.Cervical lengths of 30mm (10th centile), 27mm (5th centile) and 22mm (2.5th centile) gave relative risks of preterm birth prior to 37 weeks of 3.8, 5.4, and 6.3, respectively, with even greater relative risk at earlier gestations If a transabdominal ultrasound is undertaken and the c...
Posted in:Obstetrcis  

Covid-19 Vaccination in Pregnancy

Posted by Professor Mike O’Connor AM on 15 June 2021
Covid-19 Vaccination in Pregnancy
The RANZCOG and ATAGI recommend that pregnant women are routinely offered Pfizer mRNA vaccine (Cominarty) at any stage of pregnancy. This is because the risk of severe outcomes from COVID-19 is significantly higher for pregnant women and their unborn baby. (9 June 2021) High risk women include those who: Are immunosuppressed Recent bone marrow transplant Graft versus host disease Leukaemia, lymphoma, Myelodysplastic syndrome Chemotherapy or radiotherapy O...
Posted in:ObstetrcisOther  

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