R. W. Beard
Imperial College London
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Featured researches published by R. W. Beard.
British Journal of Obstetrics and Gynaecology | 1988
R. W. Beard; P. W. Reginald; Jane Wadsworth
Summary. The clinical features of 35 women with pelvic pain and demonstrable congestion on pelvic venography have been characterized by comparing their symptoms and signs with those of 22 women with pelvic pain due to classical pathology. Women with pelvic pain and congestion had a mean age of 32·4 years, were more often multiparous and had had symptoms for 6 months to 20 years. The pain was dull and aching with sharp exacerbations. In individual women it commonly occurred on one side of the abdomen but unlike the pain due to‘classical pathology’, it could occur on the other side. The pain was exacerbated by postural changes, and walking. Congestive dysmenorrhoea, deep dyspareunia and postcoital ache were common findings in women with pelvic congestion and 60% had evidence of significant emotional disturbance. The combination of tenderness on abdominal palpation over the ovarian point and a history of postcoital ache was 94% sensitive and 77% specific for discriminating pelvic congestion from other causes of pelvic pain.
The Lancet | 1989
Luca Fusi; MichaelJ.A. Maresh; PhilipJ. Steer; R. W. Beard
To establish the effect of pain relief on maternal temperature during labour forty patients who went into spontaneous labour with a single fetus, had a normal temperature (less than 37.5 degrees C), and had no clinical evidence of infection were investigated prospectively. They were divided into two comparable groups--one receiving pethidine and the other epidural analgesia. Both groups had much the same temperatures at the beginning of labour and before any analgesic administration. The mean temperature in the pethidine group remained constant during labour, whereas in the epidural analgesia group it showed a significant rise after only 6 hours of labour. This rise was not related to any clinical evidence of infection. Patients receiving epidural analgesia during labour are at increased risk of developing pyrexia. This pyrexia may be the result of vascular and thermoregulatory modifications induced by epidural analgesia.
British Journal of Obstetrics and Gynaecology | 1989
C. M. Farquhar; V. Rogers; S. Franks; R. W. Beard; Jane Wadsworth; S. Pearce
The value of medroxyprogesterone acetate (MPA) and of psychotherapy in the treatment of lower abdominal pain due to pelvic congestion was assessed in a randomized controlled trial. Eighty‐four women with abnormal pelvic venography were assigned to one of four treatment groups: MPA alone, MPA plus psychotherapy, placebo alone, and placebo plus psychotherapy. Women were treated for 4 months and thereafter followed up regularly for 9 months with pain assessments, pelvic ultrasound scanning, and hormone measurements. During treatment, MPA showed a significant benefit in terms of a reduction in visual analogue scale pain score, with 73% of women reporting at least 50% improvement compared with 33% of those treated with placebo. At 9 months after the end of therapy there was no overall significant effect of MPA or psychotherapy, but there was an interaction between MPA and psychotherapy, with 71 % of the women in this group showing a ≥50% reduction in pain score. Therapy with MPA is a useful first‐line therapy for women with pain associated with demonstrable pelvic congestion.
British Journal of Obstetrics and Gynaecology | 1991
R. W. Beard; R. G. Kennedy; K. F. Gangar; R. W. Stones; V. Rogers; Philip W. Reginald; M. Anderson
Objective— To determine whether bilateral oophorectomy combined with hysterectomy is an effective treatment for chronic pelvic pain due to congestion. Design—Prospective non‐randomized single centre study.
British Journal of Obstetrics and Gynaecology | 1990
D. W. Saxton; C. M. Farquhar; T. Rae; R. W. Beard; M. C. Anderson; Jane Wadsworth
Summary. Uterine size, endometrial thickness and ovarian volume were measured ultrasonically and the results compared with caliper measurements made shortly afterwards at the time of total hysterectomy and bilateral salpingo‐oophorectomy. The results establish the validity of ultrasound measurements. Histological studies also confirmed the diagnosis made with ultrasound of polycystic ovaries in women complaining of pain due to pelvic congestion.
British Journal of Obstetrics and Gynaecology | 1994
R. Cleary; R. W. Beard; J. Coles; H. B. Devlin; A. Hopkins; S. Roberts; D. Schumacher; H. I. Wickings
Objective To assess the validity of clinical information held on a regional maternity database, the St Marys Maternity Information System (SMMIS).
Clinical Endocrinology | 1990
H. D. Mason; R. Margara; Robert M.L. Winston; R. W. Beard; Michael J. Reed; S. Franks
Anovulation in women with polycystic ovary syndrome results from a disorder of FSH‐mediated follicular maturation which may involve paracrine modulation of FSH action by intra‐ovarian factors. Epidermal growth factor (EGF) is a potent inhibitor of FSH‐stimulated oestradiol production in the rat and has also been shown to inhibit aromatase activity in human granulosa cells obtained after superovulation. The purpose of this study was to investigate the action of EGF on granulosa cell function in human ovaries which had not been previously exposed to treatment with exogenous gonadotrophins and to compare the responses in tissue obtained from normal and from polycystic ovaries. Granulosa cells were obtained from antral follicles <10 mm in diameter after dissection of unstimulated normal or polycystic ovaries (PCO). Cells were pooled, washed, plated and incubated for 48h in the presence of 10‐7 M testosterone and various doses of human FSH. FSH dose responses were obtained with or without the addition of purified EGF (50 pg/ml). Testosterone in the absence of FSH resulted in a fourfold (range 2–7.5) increase in oestradiol accumulation in the medium after incubation of granulosa cells from both normal and polycystic ovaries. This increase was reversed by addition of EGF. FSH treatment stimulated a dose‐related increase in oestradiol regardless of the origin of the granulosa cells. The peak E2 response to FSH, obtained at a dose of 1–2.5 ng/ml was a 20‐fold increase above testosterone alone (range 4–55) in cells from PCO compared to sixfold (2–5.13) in cells from normal ovaries. The concurrent addition of EGF at 50 pg/ml caused an average 57% inhibition of the peak response to FSH. EGF also caused a dose‐dependent inhibition of oestradiol production stimulated by a fixed dose of FSH in cells from both normal and PCO. These data indicate that EGF inhibits FSH‐inducedoestradiol production by granulosa cells of both normal and polycystic ovaries and suggest that EGF, or its analogue, transforming growth factor α, which is known to be synthesized by theca cells, may have a role in human ovarian function.
The Lancet | 1987
P.W. Reginald; Jaspal S. Kooner; S.U. Samarage; R. W. Beard; Christopher J. Mathias; I.A. Sutherland; Jane Wadsworth
The selective venoconstrictor dihydroergotamine (DHE) was given intravenously to 12 women with evidence of pelvic congestion. In 6 the effect of the drug on pelvic veins was observed by pelvic venography. After DHE there was a mean reduction of 35% in the diameter of the pelvic veins measured and the contrast medium cleared rapidly, with a visible reduction in pelvic congestion. In the other 6 women DHE was given during an acute attack of pelvic pain. The effect of the drug on pain relief was assessed by a single-blind crossover trial with intravenous saline as the placebo and by a visual analogue scale to assess the intensity of pain. Pain was significantly lower post-DHE 4 and 8 h and 2 and 4 days after treatment than after placebo. The results confirm a close association between demonstrable pelvic congestion and pelvic pain.
British Journal of Obstetrics and Gynaecology | 1987
P. W. Reginald; R. W. Beard; J. Chapple; P. B. Forbes; H. S. Liddell; J.F. Mowbray; J. L. Underwood
Ninety‐seven women who had had three or more miscarriages had also had at least one pregnancy with a singleton birth that had reached 28 weeks gestation. Information was available on these 118 babies; 30% were small‐for‐gestational age (birthweight ≤ 10th centile using figures from Scotland 1973–79), 28% were born preterm, and the perinatal mortality rate (excluding babies of <28 weeks gestation) was 161/1000 births, all of which are significantly increased above the prevalence for a normal obstetric population. These observations may serve to alert the clinician to the increased risk of these complications when dealing with women who have a history of recurrent miscarriage.
British Journal of Obstetrics and Gynaecology | 1996
R. Cleary; R. W. Beard; Jean Chapple; J. Coles; M. Griffin; Michael Joffe; A. Welch
Objective To assess the suitability of the standard primipara (a subset of the obstetric population that has relatively low risk or intervention and of adverse outcome) for making inter‐unit comparisons of indicators of the process and outcome of maternity care.