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At least 757 records · Page 42Linked to original sources
PubMed1988

Pelviometry in the normal and the partially obstructed porcine kidney: recordings before and three weeks after application of ureteral obstruction.

In 11 pigs a standardized proximal ureteric obstruction was applied. The effect of the obstruction was examined three weeks later. In both the normal and the obstructed systems the pressure-volume relationship was exponential. Mean pelvic capacity increased from 6.5 ml. to 44.1 ml. (p less than 0.002). Mean intrapelvic baseline pressure increased from 10.0 to 16.8 cm. H2O (p less than 0.02), and this parameter correlated positively to volume (rS = 0.79 - p less than 0.05). There was a slight decrease in the relative function of the obstructed kidney on renography (from 49% to 39% of the total renal function), but this was not significant. The decrease in function was correlated to the increase in capacity (rS = -0.69 - p less than 0.05). In this series renal deterioration occurred in the hydronephrotic kidneys, and at least in this model of acute ureteral obstruction there was no support for the theory that hydronephrotic transformation is a compensatory mechanism which protects the kidney when the upper urinary tract is obstructed.

Animals↗
PubMed1998

First delivery after cesarean delivery for strictly defined cephalopelvic disproportion.

OBJECTIVE: To examine the outcome of trial second labor after a first cesarean performed because of cephalopelvic disproportion, defined according to strict diagnostic criteria. METHODS: Obstetric details of nulliparous women delivering at 37 or more weeks' gestation by cesarean for cephalopelvic disproportion, between 1975 and 1990, were recorded prospectively. The diagnostic criteria for cephalopelvic disproportion were cervical dilation arrested after 5 cm, unresponsive to oxytocin augmentation, after active dilatation of 2 cm or more in 2 hours. Fetal malpresentations and malpositions were excluded. The outcome of next delivery in our hospital by each woman enrolled was then examined. RESULTS: Eighty-four of 42,793 women met the criteria for disproportion, and 40 with cephalic presentations delivered their next baby in our hospital. All 40 underwent a trial of labor and 27 (68%) delivered vaginally, comprising seven (47%) women with larger second and 20 (80%) with smaller second babies. Of 15 women previously delivered by cesarean at full dilatation, 11 (73%) delivered vaginally with no serious maternal or neonatal morbidity. CONCLUSION: The strictly defined diagnosis of nulliparous cephalopelvic disproportion should not constitute an automatic "recurrent" indication for elective cesarean delivery, because 68% of patients in our series had successful vaginal deliveries in their next pregnancies. This rate is similar to those reported after all nulliparous cesareans for dystocia.

Cesarean Section↗
PubMed2001

Term breech trial.

Explore the source record for details and available documents.

Breech Presentation↗
PubMed1978

Is fetal radiography really necessary?

A survey of fetal radiographs taken in a teaching maternity hospital during one year showed that less than 10% of fetuses were radiographed. This figure could be reduced further if ultrasound were more widely available.

England↗
PubMed2001

Symphysis-fundal measurement as a predictor of low birthweight.

OBJECTIVE: To prospectively test the value of a symphysis-fundal measurement in labor of less than or equal to 29 cm as a predictor of birth mass below 2000 g. METHOD: Women admitted to Kalafong Hospital in labor with a singleton pregnancy were included in the study. Symphysis-fundal measurement according to the method of Westin was performed on two separate occasions and recorded together with other pertinent details. A receiver-operator curve was constructed to test various cut-off measurements. RESULTS: A total of 1216 women were included in the study. One hundred twenty-one fetuses had a birth mass less than 2000 g (10%). A measurement of less than or equal to 29 cm had a sensitivity of 69% and a specificity of 98% with a positive predictive value of 81% and a negative predictive value of 97%. On the receiver-operator curve a cutoff of 30 cm showed a better sensitivity with little loss of specificity. CONCLUSION: A symphysis-fundal measurement of less than or equal to 29 cm is a good predictor of birth mass less than 2000 g and can be used as an indication for referral to centres with neonatal facilities.

Adult↗
PubMed2002

Metric assessment of race from the pelvis in South Africans.

It is well known that there are measurable differences between whites and blacks in the size and proportions of skeletal components. There are also metric differences among populations within these racial phenotypes. The population specific quantification of this variation can be used to aid in the identification of racial affinity in the absence of a more racially definitive skeletal element like the skull. Therefore, the purpose of this research is to quantify these differences in the pelvis of South African whites and blacks. A sample of 400, ostensibly healthy known sex/race os coxae was examined. Skeletal material was obtained from the Pretoria and Dart collections. A series of 13 measurements were taken Data were subjected to SPSS stepwise and direct discriminant function analysis. Pubic length was chosen as best for discriminating between races for males and iliac breadth as best in females. Highest average accuracies (Function 1) were 88% for males (pubic length, greater sciatic notch posterior width, acetabulum diameter, total height) and 85% for females (pubic length, greater sciatic notch posterior width, acetabulum diameter, iliac breath). In conclusion, this research resulted in the development of standards of identification tailored to this population and unquestionably demonstrates that race differences in the skeleton are highly significant and must be considered in all skeletal analyses.

Anthropology, Physical↗
PubMed2002

Forceps delivery.

This chapter reviews the role for instrumental delivery in current practice and gives a critical account of current techniques of operative vaginal delivery by forceps. Important issues, including case choice, documentation, forceps application, avoidance of complications, and training and education are included.

Extraction, Obstetrical↗
PubMed2001

[Clinical use of the birth simulation program "Anapelvis 2.0" for prediction of feto-maternal disproportion].

INTRODUCTION: The birth simulation program Anapelvis 2.0 was developed to predict feto-maternal disproportion in order to avoid the unfavourable accompanying phenomena of a secondary caesarean section. - PATIENTS AND METHODS: The system was used in 71 patients of the Women's Hospital of the University of Mannheim during the period 01. 01. 1999 to 28. 02. 2001. These women were prone to feto-maternal disproportion according to their obstetrical history or to clinical findings. They were informed about the possibility of a computed birth simulation which was carried out in accordance with a standardized scheme. - RESULTS: 87.3 % of all patients followed the suggestion of the birth simulation in their decision concerning birth planning. In 76.1 % of the evaluated cases the delivery process was correctly predicted. - DISCUSSION: Even though the computed birth simulation has not yet been finally evaluated, it represents a source of important information for birth planning which numerous patients appreciate. It is essential for the acceptance and validity of the procedure to inform the patient comprehensively and to generate exact pelvimetric and fetometric data.

Cesarean Section↗
PubMed1993

[Apple-Macintosh compatible software for documentation, management and evaluation of ultrasound findings in obstetrics].

The advantage of using a computer to automate routine calculations and print out charts of the obstetrical ultrasound examination is obvious. This report describes a software designed to simplify the documentation and analysis of ultrasound data in obstetrics. The system is easy to use, even for persons with little computer knowledge. The programme was written in FoxBase+/Mac (Fox Software, Inc., USA). FoxBase+/Mac takes full advantage of the easy-to-learn, easy-to-use Macintosh interface and is also very fast. Another advantage of this software is that it can be used in teaching. Non-experienced examinators can double-check the correctness of their scanning planes by observing the ultrasound pictures with the markers indicating the right measurement sites and the lists of standard values of biometrical parameters for the corresponding gestational age on the screen. In routine obstetrical ultrasound examinations it takes less than 5 min to enter the foetal biometry data and print out reports. These reports are informative and easy to interpret.

Female↗
PubMed1992

[Comparative studies of the uterine cervix in pregnancy using palpation and vaginal sonography].

Ultrasonography and manual palpation were used to evaluate the uterine cervix of 71 pregnant women between 14th and 36th week of gestational age. The sonographic length of the uterine cervix was about 4.2 cm according to the relevant cervix palpation (Group I), about 3.2 cm in the moderately shortened cervix (Group II) and about 2.8 cm in the severely shortened cervix (Group III). The distance between the surface of the ectocervix to the urinary bladder corresponded to the cervical palpation showing a constant difference of about 0.5 cm. No difference could be found in the width of the upper cervix. The index was determined as ratio of the sonographically ascertained cervical length and width of the supravaginal cervix. A value of 0.8 or lower describes a cervical incompetence of a higher degree and signifies an unfavourable prognosis. The evaluation of cervical incompetence and the relevance of the sonographically detected opened internal os have not yet been clarified. A hitherto unsolved problem is the dilatation of the cervical canal in case of immature palpatory findings with traumatic anamnesis.

Adult↗
PubMed1992

[Cephalic index: a neglected parameter of standard fetal biometry].

From 1.1.1990 to 15.3.1991, in 1074 women between the 13th and 40th weeks of pregnancy, the biparietal diameter (BIP), fronto-occipital diameter (FOD) and kephalic index (KI = BIP/FOD) were measured. The median of the kephalic index varied between 0.81 and 0.84 during different pregnancy weeks, with a range between 0.67 and 1.00. Correction to normokephaly (KI = 0.84) produced differences of up to 10 mm to measured values of BIP. We believe it necessary to determine the kephalic index in each kephalometry and to correct the measured value of BIP at least in those cases where the measured kephalic index differs significantly from normokephaly (KI = 0.84).

Female↗
PubMed1992

[The value of prepartal ultrasound estimation of birth weight in breech presentation].

Biometric data, i.e. the biparietal (BPD) and fronto-occipital diameter (FOD) of the skull as well as the transverse (TTD) and the longitudinal trunk diameter (LTD) were obtained in 127 cases of breech and 95 cases of vertex presentations within one week before birth. These data were compared with the birth weight measured postpartally. From these data, an optimized equation was derived for both breech and vertex presentations and compared to the equation known from the literature. The optimized equation for breech presentations requires only the biometric data of the trunk (TTD and LTD). In spite of this optimization, the quality of the foetal weight estimation of breech presentations seems to be more inaccurate in comparison to the estimation of vertex presentations. Concerning the obstetrical management the foetal weight estimation by ultrasound has to be evaluated more critically for breech presentations than for vertex presentations.

Birth Weight↗
PubMed1989

Dystocia in late labor: determining fetal position by clinical and ultrasonic techniques.

A failure of adequate progression during late labor occurs often and may prohibit an accurate determination of the fetal head position from scalp edema or caput formation. This investigation was undertaken to determine whether ultrasonic evaluation could confirm or correct the digital examination impressions of the fetal head position. Eighty-six attempted vaginal deliveries had recent evidence for arrested cervical dilation after 7 cm or more. An occiput transverse position in 24 (28%) cases was diagnosed accurately, with the need for additional ultrasonic information only in the presence of scalp edema. Distinguishing between a persistent occiput posterior (15 cases, 17%) or anterior (47 cases, 55%) position was often inexact by palpation alone. Combined clinical and ultrasonic impressions allowed for a significantly more precise diagnosis. Ultrasonic imaging allowed for more security while waiting, more confidence with midforceps application, or a prompter decision for cesarean section, depending on the head position.

Adult↗