Publications
49 results found
Mullins E, Evans D, Viner R, et al., 2020, Coronavirus in pregnancy and delivery: rapid review and expert consensus, Publisher: Cold Spring Harbor Laboratory
BACKGROUND Person to person spread of COIVD-19 in the UK has now been confirmed. There are limited case series reporting the impact on women affected by coronaviruses (CoV) during pregnancy. In women affected by SARS and MERS, the case fatality rate appeared higher in women affected in pregnancy compared with non-pregnant women. We conducted a rapid, review to guide management of women affected by COVID -19 during pregnancy and developed interim practice guidance with the RCOG and RCPCH to inform maternity and neonatal service planningMETHODS Searches were conducted in PubMed and MedRxiv to identify primary case reports, case series, observational studies or randomised-controlled trial describing women affected by coronavirus in pregnancy and on neonates. Data was extracted from relevant papers and the review was drafted with representatives of the RCPCH and RCOG who also provided expert consensus on areas where data were lackingRESULTS From 9964 results on PubMed and 600 on MedRxiv, 18 relevant studies (case reports and case series) were identified. There was inconsistent reporting of maternal, perinatal and neonatal outcomes across case reports and series concerning COVID-19, SARS, MERS and other coronaviruses. From reports of 19 women to date affected by COVID-19 in pregnancy, delivering 20 babies, 3 (16%) were asymptomatic, 1 (5%) was admitted to ICU and no maternal deaths have been reported. Deliveries were 17 by caesarean section, 2 by vaginal delivery, 8 (42%) delivered pre-term. There was one neonatal death, in 15 babies who were tested there was no evidence of vertical transmission.CONCLUSIONS Morbidity and mortality from COVID-19 appears less marked than for SARS and MERS, acknowledging the limited number of cases reported to date. Pre-term delivery affected 42% of women hospitalised with COVID-19, which may put considerable pressure on neonatal services if the UK reasonable worse-case scenario of 80% of the population affected is realised. There has been
Mullins E, Lees C, Brocklehurst P, 2017, Is continuous electronic fetal monitoring useful for all women in labour?, BMJ, Vol: 359, ISSN: 0959-8138
Routine monitoring of all women would prevent much neonatal morbidity, argue Edward Mullins and Christoph Lees, but Peter Brocklehurst believes that it will increase the risk of harm from unnecessary caesarean sections.
Hanson M, Mullins E, Modi N, 2017, Time for the UK to commit to tackling child obesity, BMJ, Vol: 356, ISSN: 1756-1833
The UK government published its report Childhood Obesity: a Plan for Action, after a protracted delay, on 18 August 2016, when parliament was in recess and the nation was focused on the success of Team GB at the Rio Olympics.1 The plan received very little media coverage or public response. There was, however, an immediate outcry from the medical and public health communities, who had hoped for much more.23456 The draft version had been 50 pages in length, but the published plan ran to just 10 pages; strong actions were conspicuous by their absence, and the desired discussion of anti-obesogenic medicine had been watered down to an emphasis on voluntary actions by industry, consumers, and schools.One of the most important omissions was reference to the recommendations of the World Health Organization Commission on Ending Childhood Obesity (ECHO).7 The final ECHO report, published in January 2016, was the culmination of about 18 months of evidence review and wide consultation. It was presented at the World Health Assembly in May 2016,8 where a decision was made to request the director general to develop an implementation plan to guide further action on the recommendations, in consultation with member states. The implementation report is now available.
Mullins E, Murphy O, Davies SC, 2016, Pre-conception public health to address maternal obesity, BJOG-AN INTERNATIONAL JOURNAL OF OBSTETRICS AND GYNAECOLOGY, Vol: 123, Pages: 159-160, ISSN: 1470-0328
Davies SC, Mullins E, 2015, Annual Report of the Chief Medical Officer, 2014, The Health of the 51%: Women, Annual Report of the Chief Medical Officer, 2014 The Health of the 51%: Women, London, Publisher: Department of Health
Independent reportChief Medical Officer annual report 2014: women’s healthContains analysis of, and recommendations on, a range of women's health issues, including obesity, cancer and reproductive health.
Mullins EWS, Agarwal N, Oliver R, et al., 2015, Implications of perihepatic adhesions in women undergoing laparoscopic surgery for ectopic pregnancy, Int J Gynaecol Obstet.
Mullins EWS, Story L, Sankaran S, et al., 2015, Survival of pregnancies with small for gestational age detected before 24 weeks gestation., European Journal of Obstetrics and Gynecology and Reproductive Biology, ISSN: 0301-2115
Prior T, Mullins E, Bennett P, et al., 2014, Influence of parity on fetal hemodynamics and amniotic fluid volume at term, ULTRASOUND IN OBSTETRICS & GYNECOLOGY, Vol: 44, Pages: 688-692, ISSN: 0960-7692
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- Citations: 18
Prior T, Mullins E, Bennett P, et al., 2014, Are 1st-trimester β-human chorionic gonadotrophin and pregnancy-associated plasma protein A levels predictive of intrapartum fetal compromise in a selected normal population?, AUSTRALIAN & NEW ZEALAND JOURNAL OF OBSTETRICS & GYNAECOLOGY, Vol: 54, Pages: 418-423, ISSN: 0004-8666
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- Citations: 4
Prior T, Mullins E, Bennett P, et al., 2014, Prediction of Fetal Compromise in Labor, OBSTETRICS AND GYNECOLOGY, Vol: 123, Pages: 1263-1271, ISSN: 0029-7844
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- Citations: 34
Prior T, Mullins E, Bennett P, et al., 2014, Umbilical venous flow rate in term fetuses: can variations in flow predict intrapartum compromise?, AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY, Vol: 210, ISSN: 0002-9378
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- Citations: 26
Mullins E, Prior T, Roberts I, et al., 2013, Changes in the Fetal and Neonatal Cytokine Profile in Pregnancies Complicated by Fetal Growth Restriction, AMERICAN JOURNAL OF REPRODUCTIVE IMMUNOLOGY, Vol: 69, Pages: 441-448, ISSN: 1046-7408
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- Citations: 6
Prior T, Wild M, Mullins E, et al., 2013, Sex specific differences in fetal middle cerebral artery and umbilical venous doppler, PLoS One, Vol: 8, Pages: 1-5, ISSN: 1932-6203
BackgroundThe incidence of several adverse pregnancy outcomes including fetal growth restriction are higher in pregnancies where the fetus is male, leading to suggestions that placental insufficiency is more common in these fetuses. Placental insufficiency associated with fetal growth restriction may be identified by multi-vessel Doppler assessment, but little evidence exists regarding sex specific differences in these Doppler indices or placental function. This study aims to investigate sex specific differences in fetal and placental perfusion and to correlate these changes with intra-partum outcome.Methods and FindingsThis is a prospective cohort study. We measured Doppler indices of 388 term pregnancies immediately prior to the onset of active labour (≤3 cm dilatation). Fetal sex was unknown at the time of the ultrasound assessment. Information from the ultrasound scan was not made available to clinical staff. Case notes and electronic records were reviewed following delivery. We report significantly lower Middle Cerebral artery pulsatility index (1.34 vs. 1.43, p = 0.004), Middle Cerebral artery peak velocity (53.47 cm/s vs. 58.10 cm/s, p = <0.001), and Umbilical venous flow/kg (56 ml/min/kg vs. 61 ml/min/kg, p = 0.02) in male fetuses. These differences however, were not associated with significant differences in intra-partum outcome.ConclusionSex specific differences in feto-placental perfusion indices exist. Whilst the physiological relevance of these is currently unknown, the identification of these differences adds to our knowledge of the physiology of male and female fetuses in utero. A number of disease processes have now been shown to have an association with changes in fetal haemodynamics in-utero, as well as having a sex bias, making further investigation of the sex specific differences present during fetal life important. Whilst the clinical application of these findings is currently limited, the results from this study do provide further insight
Prior T, Mullins E, Bennett P, et al., 2013, Prediction of intrapartum fetal compromise using the cerebroumbilical ratio: a prospective observational study, AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY, Vol: 208, ISSN: 0002-9378
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- Citations: 152
Saha E, Mullins EWS, Paramasivam G, et al., 2012, Perinatal outcomes of fetal echogenic bowel, PRENATAL DIAGNOSIS, Vol: 32, Pages: 758-764, ISSN: 0197-3851
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- Citations: 11
Mullins E, Prior T, Roberts I, et al., 2012, Changes in the maternal cytokine profile in pregnancies complicated by fetal growth restriction, AMERICAN JOURNAL OF REPRODUCTIVE IMMUNOLOGY, Vol: 68, Pages: 1-7, ISSN: 1046-7408
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- Citations: 15
Mullins E, Kumar S, 2012, Older mothers do not confer greater perinatal risk to dichorionic diamniotic twins, ACTA OBSTETRICIA ET GYNECOLOGICA SCANDINAVICA, Vol: 91, Pages: 152-154, ISSN: 0001-6349
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- Citations: 11
Mehta N, Mytton O, Mullins E, et al., SARS-CoV-2 (COVID-19): what do we know about children? a systematic review, Publisher: Elsevier BV
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