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At least 667 records · Page 37Linked to original sources
PubMed1991

A properly conducted trial of a ventouse can prevent unexpected failure of instrumental delivery.

A retrospective study over a 5-year period reviewed 71 unexpected failures of instrumental delivery and compared them with a group of 21 trials of ventouse to identify causes for failure and their impact on neonatal outcome. There was a statistically significant difference between the two groups in terms of pre-application assessment of fetal size, maternal pelvis and palpable fetal head above the pelvic brim (P less than 0.00001). There was also a significant difference in neonatal morbidity (P less than 0.01). All 5 neonatal deaths occurred in the failure group and were associated with multiple instrumentation.

Extraction, Obstetrical↗
PubMed1984

Fetal heart bradycardia associated with the vacuum extractor. A case report.

The vacuum extractor has been gaining acceptance in the United States. As a result, physicians are becoming aware of potential problems with its use. We treated a patient for fetal bradycardia attributable to the negative pressure of the vacuum apparatus. This type of fetal heart bradycardia can be distinguished from "true" fetal distress by disconnecting the vacuum apparatus and observing the fetal heart rate response. Bradycardia caused by the negative pressure of the vacuum apparatus returns to normal after instrument disconnection.

Adult↗
PubMed2003

A comparison of the neonatal morbidity of second twins to that of a low-risk population.

OBJECTIVE: To assess the neonatal morbidity of second twins. STUDY DESIGN: Cohort study in a department of perinatalogy. The neonatal morbidity of second twins was compared to that of a low-risk population: singletons in the cephalic presentation delivered vaginally. RESULTS: Five hundred fifty-nine second twins and 18,061 vaginally delivered singletons in the cephalic presentation were studied. Of 452 (81%) second twins delivered vaginally, 310 (69%) were extracted using obstetrical maneuvers: internal version and breech extraction, breech extraction alone, or assisted breech delivery if the breech was already engaged. Before 33 weeks of gestation, there was no significant difference between the neonatal morbidity of the vaginally delivered second twins and the vaginally delivered singletons in the cephalic presentation. After 33 weeks of gestation, only the 1-min Apgar score <7 and the rate of intubation at birth were significantly higher in the second twins. Whatever the gestational age, there was no significant difference between the neonatal morbidity of the vaginally delivered second twins and that of the second twins born by cesarean section before labor. At comparable gestational ages, there was no significant difference between the death rate of the vaginally delivered second twins and that in the reference population. CONCLUSION: The neonatal morbidity of second twins was comparable to that of a low-risk population. Immediate management of the vaginally delivered second twins was, however, more intensive than that of vaginally delivered singletons in the cephalic presentation. It, therefore, requires appropriate equipment in a suitable obstetric-pediatric setting.

Birth Order↗
PubMed1978

Alpha-fetoprotein concentration in maternal serum and abortion via VA and PGF2alpha.

Most women undergoing abortion by vacuum aspiration (VA), extraamniotic prostaglandin instillation or vaginal prostaglandin suppositories showed a significant rise in their serum alpha-fetoprotein (AFP) concentrations during the procedure. We suggest this rise is due to a fetomaternal hemorrhage during the abortion procedure. Few women undergoing VA before 9 weeks' gestation showed this rise in serum AFP. To avoid fetomaternal hemorrhage during pregnancy termination, we recommend abortion by VA in early pregnancy.

Abortion, Therapeutic↗
PubMed1994

Serum cortisol levels are related to moods of elation and dysphoria in new mothers.

Serum cortisol levels were measured in 163 women on the third day after childbirth. Significantly elevated levels of cortisol were found to be associated with the "blues," and significantly lower levels characterized women who exhibited mild hypomania (the "highs"). Low levels of cortisol were independently associated with epidural anesthesia, while elevated levels were related to assisted delivery. There was no significant association with breast or bottle feeding. Changes in serum cortisol were thus found to parallel the mild bidirectional changes in affect that frequently follow childbirth.

Adult↗
PubMed2006

Spinal anaesthesia in a patient with hereditary spastic paraplegia: case report and literature review.

We report the use of spinal anaesthesia in a patient with hereditary spastic paraplegia who presented for manual removal of placenta following a normal vaginal delivery. This 18-year-old primigravida had been diagnosed with hereditary spastic paraplegia at 8 years of age when neurological examination revealed mild bilateral lower limb spasticity. A 25-gauge Whitacre spinal anaesthetic needle was inserted at the L3-4 intervertebral space and 0.5% plain bupivacaine 2 mL plus fentanyl 25 microg administered. The procedure was uneventful. At 24 hours postoperatively, there was full neurological recovery to pre-anaesthetic levels. The hereditary spastic paraplegias are a group of neurological disorders characterised by a slowly progressing spastic paraparesis. The neurological disorder and its anaesthetic implications are reviewed.

Adolescent↗