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At least 811 records · Page 45Linked to original sources
PubMed1981

Engagement of the fetal head in the negro primigravida.

A prospective study into causes of non-engagement of the fetal head at term in the negroid primigravida showed no correlation with fetal birth weight nor with the pelvic brim inclination. However, there was a significant difference (p less than 0.05) between the mean head circumference of babies with heads which had not engaged (34.1 cm) and with those which had (33.1 cm). Labour was generally prolonged with a high head at term, but there was no increase in the incidence of fetal or maternal mortality and morbidity nor was it associated with an increase in the rate of operative interference. In addition, retrospective studies on pelvic brim inclination between 31 Nigerian primiparae and matched Caucasians at the Queen Charlotte's Maternity Hospital showed no statistically significant differences. It is suggested that an unengaged fetal head in early labour should not by itself be an indication for early delivery by caesarean section.

Adolescent↗
PubMed1982

Intrauterine-pressure studies in African nulliparae: delay, delivery and disproportion.

Uterine activity was measured in 43 African nulliparae who were in the active phase of spontaneous labour and in whom delay in cervical dilatation had occurred. Details of labour were recorded on a partogramme, on which an alert and an action line had been drawn, and which were 2 h apart. Delay was defined as a cervical dilatation rate of less than 1 cm/h. Uterine activity was measured with a fluid-filled intrauterine catheter, an external strain gauge and a pressure-curve integrator. The uterine activity levels which were observed in association with delay are considerably less than those associated with normal labour progress. The uterine activity levels that were associated with pitocin augmentation after the action line and which resulted in vaginal delivery have been analysed. They were similar to the levels observed in normal labour. The uterine activity levels which were associated with 'failure to progress in labour' beyond the action line have also been analysed. It is argued that a minimum uterine activity level of 1800 kPas/15 min is required to fully test the cephalopelvic relation.

Adolescent↗
PubMed1984

The pelvis as a passageway. I. Evolution and adaptations.

Man has an unusual pelvis, a large fetal head, and a complicated mechanism of labour. The evolution of the pelvic girdle, like that of the hind limb, is a story with some chapters still missing. In mammals the pelvis has been modified in various interesting ways to effect compromises between its locomotor function and the requirements of parturition. Among the primates, the increasing size of the fetal brain may have necessitated a change in the attitude of the head from extension to flexion as it goes through the pelvis. The distinctive shape of the hominid pelvis is probably an adaptation to bipedal gait. The birth canal has changed from a shallow bony ring to a deep curved tube, through which the mature fetal head can only pass by rotating as it descends.

Adaptation, Physiological↗
PubMed1984

The pelvis as a passageway. II. The modern human pelvis.

Following on from part I on evolution and adaptations of the pelvis, this paper suggests that variations in the shape and size of both ancient and modern human pelves may be better explained by nutritional factors than by hormonal influences or race.

Body Height↗
PubMed1990

Pelvic floor damage and childbirth: a neurophysiological study.

Ninety six nulliparous women were investigated to establish whether childbirth causes damage to the striated muscles and nerve supply of the pelvic floor. The techniques used were concentric needle electromyography (EMG), pudendal nerve conduction tests and assessment of pelvic floor contraction using a perineometer. There was EMG evidence of re-innervation in the pelvic floor muscles after vaginal delivery in 80% of those studied. Women who had a long active second stage of labour and heavier babies showed the most EMG evidence of nerve damage. Forceps delivery and perineal tears did not affect the degree of nerve damage seen. We conclude that vaginal delivery causes partial denervation of the pelvic floor (with consequent re-innervation) in most women having their first baby. In a few this is severe and is associated with urinary and faecal incontinence. For some it is likely to be the first step along a path leading to prolapse and/or stress incontinence.

Action Potentials↗
PubMed1991

Head circumference/abdominal circumference ratio, ponderal index and fetal malnutrition. Should head circumference/abdominal circumference ratio be abandoned?

Head circumference/abdominal circumference (HC/AC) ratios of the fetus are accepted as a means of distinguishing different patterns of growth retardation with a high ratio implying malnutrition of the fetus. Ponderal index (birthweight/length3) is used by paediatricians as a measure of neonatal wasting and would therefore be expected to correlate with HC/AC ratios at delivery. Anthropometric data on 999 newborn infants have been collected and analyzed by multiple regression. The results show a poor correlation between ponderal index and HC/AC ratio, worse than that between ponderal index and AC alone. The use of HC/AC ratios antenatally to identify subgroups of intrauterine malnutrition should be abandoned. The prediction of intrauterine malnutrition by weight/length ratios should be investigated further.

Anthropometry↗
PubMed1995

Single pre-delivery symphysis-fundal height measurement as a predictor of birthweight and multiple pregnancy.

OBJECTIVE: To compare the value of different pre-delivery maternal indices for predicting birthweight, and to examine the usefulness of a single pre-delivery symphysis-fundal height measurement for the detection of low birthweight and twin pregnancy or macrosomia. DESIGN: Symphysis-fundal height measurements were gathered from 1509 women who had both a singleton delivery and available data of pre-delivery weight, height and mid-upper arm circumference, and from 73 women who had a twin delivery. SETTING: A district hospital in rural Tanzania. RESULTS: Symphysis-fundal height, pre-delivery weight and mid-upper arm circumference, respectively, explain 41%, 13% and 4% of the observed variation in birthweight. At a cut-off level of 30 cm for symphysis-fundal height, the detection rate for birthweight below 2500 g and 2000 g was 66% and 68%, respectively, and the false positive rate was 9% and 14%, respectively. At a cut-off level of 38 cm for symphysis-fundal height the detection rate for twin pregnancy or birthweight > or = 4000 g was 76%, and the false positive rate was 4%. CONCLUSION: Symphysis-fundal height was a better predictor of birthweight than maternal height, pre-delivery weight or mid-upper arm circumference. It seems justified to investigate the value of a simple tricoloured symphysis-fundal height measuring tape for use in antenatal care in developing countries at village level.

Adolescent↗
PubMed1979

A technique for management of obstructed labour with antenatal fetal death.

A technique for management of obstructed labour associated with fetal death is presented. The new method makes it possible to decrease fetal head size by evacuation of brain tissue by suction using thoracic-type trocar. Three patients with obstructed labour and fetal death were managed successfully using this technique. The method permits a decrease of fetal head size easily and rapidly, avoiding the risks of other techniques. Moreover, its use makes it possible to eliminate craniotomy from obstetric practice. The method should be equally suitable for cases of major hydrocephaly.

Brain↗
PubMed1983

Term breech delivery--is a high Caesarean section rate justified?

The Caesarean section rate for breech presentation has fallen from 60% in 1978 to 38% in 1980 at the University teaching hospital in Hong Kong. The number of Caesarean sections carried out for the indication of "unfavourable pelvis' in 1980 was approximately half that in 1978. No significant difference in perinatal outcome was noted in the group delivered vaginally in these 2 years. It was concluded that a high Caesarean section rate in term breech presentation may not be justified in modern obstetric practice because of the associated increase in maternal morbidity. Many patients labelled as having an "unfavourable pelvis' can in fact have a safe vaginal breech delivery.

Adult↗