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At least 991 records · Page 55Linked to original sources
PubMed1986

[Management of full term breech presentation--criteria for safe vaginal delivery (without extraction of the breech head)].

It is very important to appraise cephalo-pelvic disproportion (CPD), and to predict the necessity of extraction of the after-coming head on full-term breech presentation. Subjects were 47 cases of full-term breech presentation which delivered at our hospital during the 5-year period from 1979 to 1983. They were divided into the following groups: group A Assisted breech delivery. group B Extraction of after-coming head. group C Abdominal delivery for secondary inertia. In each case we subtracted the fetal occipitofrontal diameter from the individual pelvic diameter and compared the results for groups A and B. There were significant differences between groups A and B in the mean values (cm) for the following: True antero-posterior diameter of the wide; 1.341 +/- 1.009 and 0.380 +/- 0.379 (p less than 0.001). Antero-posterior diameter of the Fukushima's wide; 2.005 +/- 0.906 and 0.860 +/- 0.502 (p less than 0.01). Posterior-sagittal diameter of the wide; -5.300 +/- 1.026 and -6.020 +/- 0.340 (p less than 0.05). Antero-posterior diameter of the midpelvis; 1.414 +/- 1.035 and -0.110 +/- 0.718 Posterior-sagittal diameter of the midpelvis (Caldwell-Moloy); -5.759 +/- 1.041 and -6.560 +/- 0.573 (p less than 0.05). Posteriol-sagittal diameter of the midpelvis (Thoms): -6.173 +/- 1.083 and -7.430 +/- 0.750 (p less than 0.01). Furthermore, there were also significant differences between groups A and C: The margins of safety values for each pelvic diameter (cm) were as follows: Antero-posterior diameter of the midpelvis; (13.1): Posterior-sagittal diameter of the midpelvis (Thoms); (5.5): Inter-spinous diameter; (11.0): Inter-tuberous diameter; (11.3).(ABSTRACT TRUNCATED AT 250 WORDS)

Birth Weight↗
PubMedDate not supplied

[Characteristics of the external conjugate diameter in 7-to-14-year-old students].

Measuring the length of the external conjugate in school children aged 7-14 years the authors determined its standard values for this population group. The measurements were performed in 1942 school children of both sexes in the region of Pelagonija (Macedonia). The length of the external conjugate in the seventh and the eighth year of life proved to be higher in boys (12.0 cm and 12.26 cm respectively) and in the ninth year of life it was significantly longer in girls (13.46 cm; t = 3.1; P less than 0.05). The intensity of the increase in the length of the external conjugate in girls was found to be the highest in their ninth (11.7%), twelfth (11.16%), and fourteenth year (10.24%), i.e. in the period of their intensive growth in prepuberty and puberty. The standards determined by these measurements are adopted as norms for the length of this pelvis dimension in the population of Pelagonija.

Adolescent↗
PubMedDate not supplied

[Characteristics of the external conjugate diameter in children from birth to 6 years].

The authors measured the length of the external conjugate of the pelvis in 1513 children from their birth up to the age of six and determined the mean values of this parameter, by adopting them as the standard values for the region of Pelagonija (Macedonia). The increase of the external conjugate proved to be most intensive in the first year of life (IR = 49.9% in girls and 49.5% in boys), marking the beginning of the first phase of an intensive increase of the pelvis in children of both sexes.

Child↗
PubMed1985

Cesarean section.

Although the cesarean section rate has increased steadily for the past 12 years, further increase seems unlikely since the indications for performing the operation are already broadly defined. Most of the earlier indications will remain unchanged (eg, the presence of placenta previa and cephalopelvic disproportion). The trend toward vaginal delivery in perhaps 30% to 40% of breech births will probably have no material effect on the number of cesarean sections performed, and the present use of cesarean section for multiple pregnancy will probably continue. The two conditions under which cesarean section rates might become significantly lower are (1) automatic repeat cesarean section (which now accounts for more than 25% of all cesarean sections), a procedure which will probably decline as increasing numbers of such women have vaginal deliveries, and (2) a redefinition of the present midforceps classification, which will permit some of the easy midforceps deliveries from a low level to be performed without the legally abhorrent stigma of mid-forceps delivery. The value of prophylactic antibiotics for women predisposed to infection has now been proved, and further placebo studies to demonstrate this are not warranted. In the past, "type and match 2 units" was a routine prelude to cesarean section, and for every unit of blood transfused to cesarean section patients, some 25 units were cross-matched and held in (unnecessary) readiness. This formula is gradually giving way to type and screen, eliminating countless crossmatches. Because of possible harmful fetal effects, preoperative fluid loading, a necessary part of conduction anesthesia, is changing from the customary 5% glucose to the use of fluids containing no glucose. It has been suggested that conduction anesthesia may not offer unlimited time for cesarean section, as used to be thought. Apgar scores are lower if the time from uterine incision to delivery is longer than three minutes, a diminution that may be a function of the anesthesia or may reflect difficulty in delivery. Cesarean section mortality is much lower than it was in former years, but one may expect from one to two deaths per 1,000 operations. Overall, the maternal mortality from cesarean section per se is probably from three to five times higher than that of vaginal delivery (in one series, 11.5 times higher than vaginal delivery). The incidence of mild, transient respiratory signs in the newborn is higher after cesarean than after vaginal delivery, and the incidence of respiratory distress syndrome is also slightly higher.(ABSTRACT TRUNCATED AT 400 WORDS)

Anesthesia, Obstetrical↗
PubMed1986

[Active management of labor].

The active management of labour in the National Maternity Hospital in Dublin has the general aim that labour will not last longer than 12 hours. Since the outstanding cause of dystocia is inefficient uterine action the proper use of oxytocin has a position of great importance, especially in primigravidae. In 1984 under this procedure perinatal mortality was 12/1000 and the rate of caesarean sections 4.2 per cent. Total births--7853.

Cesarean Section↗
PubMed1985

Determination of sex with a discriminant analysis of new pelvic bone measurements: Part II.

The pelves of 100 white skeletons were measured on both sides for the following: (1) length from the superiormost aspect of the pubic symphysis to the nearest rim of the acetabulum (PS-A), (2) length from the highest point of the pubic tubercle to the nearest rim of the acetabulum (PT-A), (3) acetabular diameter (AD), (4) the vertical distance from the anterior aspect of the ischial tuberosity to the farthest rim of the acetabulum (IT-A), and (5) greatest femur head diameter. From these, three indices were derived: AD/PS-A (acetabulum/pubis index), AD/PT-A (acetabular diameter/pubic tubercle-acetabular rim index), and IT-A/PS-A (ischium-acetabulum height/pubic symphysis-acetabular rim index). The left AD/PS-A ratio and left IT-A height proved statistically to be of greatest discriminating value. Using these two variables, a discriminant function was derived which correctly separated 98% of our sample. The acetabulum/pubis ratio alone correctly assigned 95%. With either the discriminant function analysis of two variables or the acetabulum/pubis index as a single predictor, 97% of our sample of known sex was correctly identified if all specimens that fell within a doubtful or overlapping range of values were sorted by femur head diameter.

Anthropology, Physical↗
PubMed1985

Vaginal delivery after cesarean section: a five-year study.

All pregnancies that were complicated by a previous cesarean section were reviewed for a five-year period from 1978 to 1982. Of 799 such pregnancies, 216 underwent a trial of labor, and 66% experienced successful vaginal delivery. When the primary cesarean section was for cephalopelvic disproportion, 54% delivered vaginally, 75% breech, and 70% for fetal distress or other nonrepeating indications. There was no evidence of uterine scar disruption in the vaginally delivered group. Vaginal delivery after previous cesarean section can be a safe alternative for carefully selected patients cared for in the proper environment.

Breech Presentation↗
PubMed1985

High cesarean section rate: a new perspective.

Cesarean section rates in the United States have increased dramatically in recent years, whereas perinatal mortality rates have fallen. To investigate the hypothesis that these two events are not necessarily causally related, a prospective attempt to modify obstetric management directed at minimizing the rate of abdominal delivery while preserving excellent perinatal survival was done at a university-affiliated hospital in the Denver metropolitan area. Unselected patients who were admitted to separate services at the hospital were used for comparison, with one group subject to the specific management criteria. Corrected mortality rates and low five-minute Apgar scores on the two services were not significantly different after two years. The total cesarean section rate on the first service was 5.7%, and the total cesarean section rate on the comparison service was 17.6%. Analysis of the data showed major differences in indications for cesarean section in the areas of repeat cesarean section, cephalopelvic disproportion, breech presentation, fetal distress, and genital herpes. These data support the contention that excellent perinatal outcome can be achieved with modest abdominal delivery rates.

Breech Presentation↗