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PubMed2002

Obstetrical complications, parenting practices and risk of criminal behaviour among persons who develop major mental disorders.

OBJECTIVE: The present study examined whether socio-economic status (SES) of the family of origin, inadequate parenting, and pre and perinatal factors are antecedents of criminality among men and women who develop a major mental disorder. METHOD: The sample included the 82 men and 79 women from the 1953 Stockholm birth cohort who developed a major mental disorder by age 30. Information was extracted from obstetric files, health, social and work records and official criminal records. RESULTS: Among males, neonatal complications increased the risk of offending two-fold, the risk of violent offending 2.5 times, and the risk of early start offending 3 times. Neither pregnancy or birth complications, inadequate parenting, or SES of the family of origin increased the risk for offending. Among females, none of the factors that were examined were associated with offending. CONCLUSION: Complications in the neonatal period are associated with offending among men who develop major mental disorders.

Adult↗
PubMed1980

[Obstetric spoons (author's transl)].

The article describes "obstetric spoons" which are easy to apply and which can be used as well as the forceps and the vacuum extractor for vaginal-operative termination of labor. These spoons offer the following advantages: They are an effective and relatively harmless instrument which can be applied rapidly and easily even by those who are less skilled. During extraction, the spoons are only slightly pressed onto the head of the child by the operator's hands; the additional pressure required is exercised by the soft parts of the mother. It is hardly critical if the spoons are not applied exactly in transverse diameter. If the traction force applied is too strong, they separate and slide over the head without exercising any further pressure. This counteracts any possible overforceful extraction. The spoons can also be applied simultaneously in combination with vacuum extraction and girdle expression, which renders even complicated vaginal surgical procedures from the mid-pelvic plane relatively harmless with regard to the strain exercised on the child.

Extraction, Obstetrical↗
PubMed2002

[Trial vacuum extractor for cephalic engagement. 50 cases in French Guiana].

OBJECTIVE: Considering a population with an African culture traditionally opposed to a caesarean section, vertex engagement with a vacuum extractor could be a good alternative. PATIENTS AND METHODS: In a retrospective study of 50 cases of trial engagement with a vacuum extractor in French Guyana, there were 94% of vaginal deliveries. RESULTS: A high level of shoulder dystocia (14%) was noted, and the failure of this technique was the consequence of disproportions between foetus and pelvis that had not been correctly diagnosed. CONCLUSION: In this article, feasibility and obstetrical conditions to carry out a trial engagement with a vacuum extractor are discussed.

Adolescent↗
PubMed1993

Elevation of depressed skull fracture in the neonate by obstetrical vacuum extractor.

In this article, three cases of neonatal depressed skull fracture were successfully elevated by means of an obstetrical vacuum extractor. No complications from the procedure were observed. Neonatal depressed skull fractures which are not associated with neurological signs may be safely elevated without surgery by using the obstetrical vacuum extractor. This simple, atraumatic procedure should be considered first for the management of uncomplicated depressed skull fracture in the newborn.

Animals↗
PubMed2001

[Obstetrical vacuum: a modern instrument].

Contrary to the forceps, the vacuum extractor has clearly progressed in the last years. The use of the vacuum extractor increases in every developed countries, certainly because of an easier learning than forceps. Furthermore, maternal after-effects of the delivery like sphincters injuries and anal incontinence seem to be less frequent with vacuum extractor than with forceps. For these reasons the American College of Gynecologists and Obstetricians (ACOG) recommend a large use and a priority teaching of this fetal extraction instrument. The technical aspects of use of the vacuum extractor are developed in this article, and personnel results are added as commentaries.

Atmospheric Pressure↗
PubMed2006

Fetal deformations: a risk factor for obstetrical brachial plexus palsy?

The purpose of this report is to discuss the association of brachial plexus palsy and congenital deformations. We reviewed all charts of patients less than 1 year of age with obstetrical brachial plexus palsy evaluated by one of the authors (IA) between January 1998 and October 2005 at Miami Children's Hospital Brachial Plexus Center. Of 158 patients with obstetrical brachial plexus palsy, 7 had deformations (4.4%). Deformations were present in 32% of patients delivered by cesarean section, but in only 2% of patients delivered vaginally. The deformations were ipsilateral, involving the chest in two patients, distal arms in two patients, proximal arm in one patient, ear in one patient, and the leg in one patient. All patients with deformations had unilateral Erb's palsies. None had a history of maternal uterine malformation. Two presumptive mechanisms of injury, one causing the deformation (compressive forces) and one causing brachial plexus palsy at the time of delivery (traction forces), were present in all cases. The higher incidence of deformation in patients with obstetrical brachial plexus palsy born by cesarean sections and the presence of two presumptive mechanisms in all of the cases presented here raises the possibility that fetal deformations are a risk factor for obstetrical brachial plexus palsy.

Birth Injuries↗
PubMed1992

[Shoulder dystocia--a rare obstetrical complication].

Shoulder dystocia is an uncommon complication of delivery with a high neonatal morbidity rate. This review describes the use of the most important shoulder dystocia maneuvers and underlines the demand to perform a written description of all details of the management during delivery.

Birth Injuries↗
PubMed1984

Characteristics of hypertension in pregnancy. A retrospective study of 261 consecutive cases.

During the period 1969-73, 0.3% of 17 000 unselected non-diabetic pregnancies in our hospital were complicated by severe pre-eclampsia, 0.6% by mild pre-eclampsia and 0.6% by hypertension in pregnancy. Records from affiliated maternity centres and the hospital regarding these 261 women were studied and pertinent data assembled for comparison with 260 matched normotensive pregnancies. Instrumental deliveries were more common in all types of hypertensive pregnancy, with a 35% frequency of caesarean section in severe pre-eclampsia compared with fewer than 5% for controls. Significantly longer hospitalization and increased perinatal mortality were observed in hypertensive pregnancies, most pronounced in severe pre-eclampsia. The combination of high blood pressure and proteinuria was associated with the greatest risk for premature birth, low infant weight and perinatal mortality. The overall incidence of hypertensive disorders in pregnancy was relatively low, 1.5%, but these women counted for a significant proportion of obstetric complications requiring hospitalization and instrumental delivery.

Apgar Score↗
PubMedDate not supplied

[Breech presentation--information, anxiety and pattern of expectations of established obstetricians and pregnant patients. 2: Results of a survey of women with breech presentation].

The frequency of caesarean section is increasing. A corresponding reason for this development is the increasing quota of primary caesarean section in patients with breech presentation. The aim of this study was to extend the expectation- fear- and information-profile in these patients and therefore the influence on the caesarean section rate. 100 patients with breech presentation were randomized and prospectively questionnaired. In summary, the study shows that women with breech presentation prefer primary caesarean section as the favourite delivery mode. Fears experienced before the delivery were focused accordingly on the condition of the child were in conflict to the higher incidence of maternal risk factors. Only an objective clearing of the obstetrical conditions and risk factors of the delivery modes (vaginal delivery mode, caesarean section) can induce patient's compliance which is the presupposition for a vaginal delivery mode of breech presentation.

Adult↗
PubMed2001

Obstetric complications, parenting, and risk of criminal behavior.

BACKGROUND: The results of studies that have examined the relationship between prenatal and perinatal complications and adult criminality and violence are contradictory. Supporting evidence for this relationship comes from studies of samples drawn from a single cohort. The present study was designed to examine the associations between prenatal and perinatal complications and criminality, defining more precisely than past investigations subject characteristics and the types of offenses. METHODS: The cohort includes the 15 117 persons born in Stockholm, Sweden, in 1953 and followed up to age 30 years. Information was extracted from obstetric files, health, social, work, and criminal records. Obstetric complications were defined as deviations from normal development occurring at any point from conception through the neonatal period. Inadequate parenting was indexed by social intervention. RESULTS: Inadequate parenting was experienced by 19.1% of the men and 18.1% of the women, and was shown to increase the risk of offending (men, 1.39 times [95% confidence interval [CI], 1.28-1.50]; women, 2.09 [95% CI, 1.70-2.56]) and of violent offending (men, 2.02 times [95% CI, 1.67-2.44]; women, 2.09 [95% CI, 1.70-2.56]). Obstetric complications in the absence of family problems did not increase the risk of offending. A combination of pregnancy complications and inadequate parenting affected 3.1% of the men and 4.0% of the women, and increased the risk of offending (1.64 times [95% CI, 1.43-1.89]; 1.79 times [95% CI, 1.16-2.75], respectively) and violent offending (2.86 times [95% CI, 2.09-3.91]; 1.81 times [95% CI, 0.57-5.79]). CONCLUSIONS: A combination of pregnancy complications and inadequate parenting increased the risk of violent and nonviolent offending only slightly more than inadequate parenting alone. However, inadequate parenting was experienced by 5 times more cohort members than was the combination of inadequate parenting and pregnancy complications.

Adult↗
PubMed2001

Failure to progress in the second stage of labour.

Spontaneous vaginal delivery without obstetric intervention remains the goal for most pregnant women. Midwives and obstetricians aim to support women in achieving this result, which is associated with the lowest risk of morbidity for both mother and baby. Despite the best efforts of the labouring woman and her carers, some women will fail to progress in the second stage of labour, and obstetric intervention will be required. This review evaluates recent data addressing the diagnosis, aetiology and management of failure to progress in the second stage of labour, and explores aspects of maternal and neonatal morbidity associated with this event.

Analgesia, Epidural↗
PubMed1985

[Fetal monitoring sub partu in West Germany. I. Basic data].

An inquiry was circulated among all Departments of Gynaecology and Obstetrics in West Germany and West-Berlin with regard to their procedure to effect foetal intensive-care management and monitoring, obstetrical management, and the results obtained. 58% of these Departments responded. With an average number of 55 beds, the annual birth rate is 628. A mean of 191 births are covered by one CTG unit, the scatter being 110-290 births per year and per unit (10th and 90th percentile). The mean incidence of Caesarean section is 11%, the mean incidence of forceps delivery 3.6%, and the mean incidence of extraction by suction 8.0%. An estimated 95% of all births are monitored via cardiotocography. 25% of all Departments use other monitoring methods as well, microanalysis of blood gas after Saling being by far the most prominent one (94%). Transcutaneous foetal pO2 measurement has been adopted by 8 centres only. 74% of the Departments are using CTG units recording beat-to-beat with a chart speed of 1 cm per minute (82.2%). Few (18%) Departments employ intrauterine pressure measurement for recording labour pains. Telemetry is used by 27.7% of the Departments. In most cases (72.9%) the cardiotocograms are jointly assessed by the physician and the midwife. From the obstetrician's point of view it would be desirable to achieve greater technical perfection of external monitoring methods, as well as further miniaturisation and computerisation of the CTG equipment.

Acid-Base Equilibrium↗
PubMed1986

[Facts on the topic "gentle birth": a representative survey of Austrian gynecologists].

With regard to discussions in the public being held in this country throughout the past months, a representative inquiry was carried out among Austrian gynaecologists and obstetricians. Aim of the study was to determine the percentage of obstetricians performing the so-called "birth without violence" according to Leboyer as well as their opinion to this alternative obstetrical thinking: Approximately one half of Austrian gynaecologists is carrying out so-called "births without violence." However, the vast majority of them (78%) prefers for their own wives and their own children "electronic fetal monitoring" during labour and delivery. Analysis of our data according to the age of the doctor, the geographic region of his office, and the number of treated patients shows a considerable discrepancy between performance and personal preference of "alternative" obstetrical methods. These results should be taken into account for further discussions in the public about "births without violence", as obstetricians are among all professions those experts who can estimate the risks of pregnancy and delivery best.

Attitude of Health Personnel↗
PubMed1992

Review of obstetric operative intervention rates.

The trends in obstetric operative intervention at a major teaching hospital in Sydney, Australia, were reviewed during the decade 1979-1989. While the caesarean section rate has increased by 36.4%, forceps deliveries have decreased. The normal delivery rate has remained constant at 67%.

Cesarean Section↗
PubMed1986

Obstetric management of the very low birth weight fetus.

Obstetric management of the very low birth weight fetus (less than 1500 gm) is reviewed based on current literature. Issues of the pharmacologic therapy of preterm labor, enhancement of lung maturity, and management of labor and delivery are discussed.

Adrenal Cortex Hormones↗