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At least 1,243 records · Page 69Linked to original sources
PubMed1997

[Effect of the mode of delivery on the newborn infant with gastroschisis. With data from the Styrian Malformation Register].

OBJECTIVE: Our purpose was to investigate the influence of the mode of delivery on the outcome of children with gastroschisis. METHODS: 38 children were born and treated at the University Hospital of Graz between 1977 and 1995. The perinatal and surgical data were analyzed retrospectively. Furthermore, we compared the prevalence of gastroschisis in Styria to international data. RESULTS: The mode of delivery did not influence the fetal outcome. The higher rate of acidosis and shorter interval from rupture of the membranes to delivery in cases of cesarean section may be attributable to the obstetric decision for an operative delivery. The prevalence of gastroschisis is high as compared to European data. CONCLUSIONS: Our data and the majority of publications do not show a benefit of cesarean section for children with gastroschisis. A randomized prospective trial is still lacking to end controversies.

Abdominal Muscles↗
PubMed1991

Total perineal reconstruction after major obstetrical injuries with extensive tissue loss: a report of 2 cases.

Major perineal injuries following obstetrical complications represent difficult problems of reconstruction. We describe 2 such patients with perineal injuries simulating infantile cloacas. Surgical repair using an abdominoperineal pullthrough procedure in 1 patient, and a Bricker loop type of repair in another resulted in successful restoration of function in both. The operative details and basis for the reconstruction are described.

Adult↗
PubMed1978

Quantification of obstetric traction.

Measurements of factors involved in the degree of traction exerted during obstetric cases were carried out. Bovine material force was approximately 150 lbs. Maximum manual effort would be approximately four times this and mechanical traction would be at least 50 per cent higher again. A workable maternal fetal ratio was established for use in cases of fetal oversize. Possible quantification of other factors is also discussed.

Animals↗
PubMedDate not supplied

Does relaxation education in anxious primigravid Iranian women influence adverse pregnancy outcomes?: a randomized controlled trial.

UNLABELLED: Maternal anxiety and stress are found to be predictors of adverse pregnancy outcomes, including low birth weight and prematurity. OBJECTIVE: The aim of the study was to determine whether relaxation education in anxious pregnant Iranian women in their first pregnancy affects selected pregnancy outcomes, including birth weight, preterm birth, and surgical delivery rate. SUBJECTS: A total of 110 obstetrically and medically low-risk primigravid women in Iran with a high anxiety level demonstrated by Spielberger's State-Trait Anxiety Inventory were randomly assigned into experimental and control groups. METHOD: In this randomized controlled trial, the experimental group received routine prenatal care along with 7-week applied relaxation training sessions, while the control group received only routine prenatal care. Anxiety and perceived stress were measured by pre-educational and post-educational intervention. Data related to pregnancy outcomes include birth weight, gestational age at birth, and type of delivery. RESULTS: Significant reductions in low birth weight, cesarean section, and/or instrumental extraction were found in the experimental group compared with the control group. No significant differences were found in the rate of preterm birth. CONCLUSION: The findings suggest beneficial effects of nurse-led relaxation education sessions during the prenatal period. This intervention could serve as a resource for improving pregnancy outcomes in women with high anxiety.

Adolescent↗
PubMed1999

Forceps-assisted vaginal delivery.

Operative vaginal delivery using forceps has been an important part of obstetric practice for nearly 400 years. Countless women and their children have benefited from timely and expertly performed procedures. Physicians must, therefore, make every effort to retain these skills, to modify and improve them in every possible way, and to pass them on. In this way, women and children of future generations will benefit from the many years of experience that have gone before them.

Equipment Design↗
PubMed2004

Does traumatic birth increase the risk of postnatal depression?

The aim of the study was to review if experiencing a traumatic birth, in the form of caesarean section or assisted vaginal births, increases the risk of developing postnatal depression. This issue is significant to health professionals when planning postnatal care. A focused search of databases containing medical and psychiatric research relevant to this question was performed and the selected papers critically appraised and reviewed. The numbers of mothers recording depressive symptoms for each birth method were measured using a validated outcome tool for postnatal depression. Two research papers met the inclusion criteria and were reviewed using a checklist for critically appraising cohort studies. Although the papers met many of the quality markers, both reported limited data relating to obstetric factors in the development of postnatal depression and both sets of published results were incomplete. More studies may be found by searching psychological and psychiatric medicine-oriented databases as just one was included in this evaluation. The conclusion of this review is that there is no evidence on which to base a reappraisal of current clinical practice.

Australia↗
PubMed1975

[The clininal management of breech presentation].

During the period 1969--1973, a total of 7933 deliveries was carried out at the First University Clinic of Obstetrics and Gynaecology in Vienna. Of these, 328 deliveries were breech presentations and 260 were single-born. The frequency of Caesarean sections in the case of breech presentations was 16,6%, i.e. about four times higher than the average frequency of Caesarean sections in relation to the overall number of obstetric patients of our clinic. The high frequency of premature deliveries in breech presentation (18,46%) is reflected in the perinatal mortality rate; 5,67% of all children born in breech position died sub or post partum. The net perinatal mortality rate was 1,15%.

Apgar Score↗
PubMed1986

[Fetal monitoring sub partu in West Germany. II. Effect of clinic size and clinic type on monitoring practice].

Data from 690 clinics concerning obstetric management and intensive monitoring of the fetus sub partu were classified according to the type of hospital (e. g., municipal clinic, district hospital...) and the size of the hospital based on the number of births per year. On the basis of the annual number of births four groups (I-IV) were formed, each with 172 clinics. While the average number of surgical deliveries (cesarean, forceps, vacuum) is not related to the hospital (Table 3), it is related to the type of hospital (Table 6): the average number of cesarean deliveries is highest in university clinics (n = 24; 14.9%), and on average more forceps (6.5%) than vacuum extractions (5.7%) are performed. In all other hospitals vacuum extraction is clearly preferred (7-8%). The quotient Q of the annual number of births per CTG unit is not constant, but increases with the size of the clinic: In large hospitals (Group IV) significantly more births are monitored with a CTG unit (maximum 607, average 215), so that there is a numerical "monitoring deficit" as compared to smaller departments. The monitoring capability is numerically highest in the university clinics (Q = 147) and lowest in the academic teaching hospitals (Q = 192). The larger the clinic, the more frequently fetal blood is analyzed: the figure in large clinics is 40%. Small clinics are less familiar with this method (approx. 16%). The larger the clinic, the more often intrauterine catheters are used to measure labor; the figure rises from 7% to 29%.(ABSTRACT TRUNCATED AT 250 WORDS)

Birth Rate↗
PubMed1993

Obstetric hemorrhage and blood utilization.

Patients on a busy obstetric service were prospectively evaluated to determine which ones required blood transfusion. During the period January-April 1990, 5,528 deliveries were performed. Fifty-five patients (0.99%) received blood transfusions during their pregnancy and puerperium. The most common conditions associated with transfusion were trauma due to instrumental delivery (16), uterine atony (15), placenta previa (12), retained products of conception (4), abruptio placentae (4) and coagulopathy secondary to the HELLP syndrome (1). Platelets, fresh frozen plasma, whole blood and cryoprecipitate were administered to 7, 6, 1 and 1 patients, respectively. The transfusion rates by procedure were emergency cesarean hysterectomy for bleeding placenta previa or atony, 7/7 (100%); vacuum extraction, 7/114 (6.1%); forceps delivery, 12/285 (4.2%); uncomplicated cesarean delivery, 10/704 (1.4%); and spontaneous vaginal birth, 19/4,425 (0.4%). The hemorrhage and subsequent need for a blood transfusion were not necessarily due to the procedure except in the case of trauma due to instrumental vaginal delivery. The rate of transfusion of red blood cells for patients undergoing vaginal instrumental delivery was significantly higher than the rate for those undergoing cesarean delivery (relative risk, 2.8; 95% confidence interval, 1.5-5.2). The need for transfusion can be anticipated on the basis of antepartum causes in only 23.7% of patients ultimately receiving blood products.

Adult↗
PubMed2003

Forceps delivery at the University College Hospital, Ibadan, Nigeria.

UNLABELLED: The incidence of forceps delivery has reduced in Nigeria and in the world in general. Some Obstetricians have not been trained in its use and lack the skill. OBJECTIVE: To determine the outcome of forceps delivery at this centre. METHODOLOGY: A retrospective analysis of all forceps delivery done at this centre between the 1st of January 1997 and 31st December 2001, a 5-year period was done. RESULTS: The incidence of forceps delivery was 1.57% or 16 per 1000 births and they were all low cavity deliveries. Most of the patients (68.5%) were booked at this centre. The mean age was 28.21 +/- 4.79 years and most (64.4%) were nulliparious. The mean gestational age at delivery was 38.7 +/- 3.0 weeks. The most common indications were prolonged second stage of labour (58.9%), maternal distress (43.8%) and fetal distress (15.1%). There were multiple indications in some patients. The mean birth weight was 3.03 +/- 0.69 kgs and 90.4% were live births. The main maternal complications were maternal injuries (8.1%), primary post partum haemorrhage (5.5%), anaemia (5.5%) and retained products of conception (4.1%). Maternal deaths occurred in 2 eclamptics and birth asphyxia in 6.9% of babies. The perinatal mortality rate was 54.8 per 1000 births. There were no fetal injuries. CONCLUSION: Obstetrics forceps delivery is on the decline in Nigeria. It is an art that can safely and quickly deliver the fetus. It could be offered in the place of a caesarean section in some instances with a good outcome to both the mother and fetus in skilled hands. Obstetricians should be trained to use it more frequently.

Adult↗
PubMed1986

[Facial paralysis of obstetrical origin. Etiology, evolution].

In the case of 17 obstetrical facial paralyses occurring in a total of 20,409 births, the authors have studied the circumstances of their appearance and the prognosis for this lesion. It is a rare lesion favoured by asymmetric purchase when using articulated forceps. The authors insist that use of Thierry's forceps do not harm the facial nerve. They emphasise the possibility that progression may not always be favourable.

Birth Injuries↗
PubMed1996

Neonatal subgaleal haematoma: associated risk factors, complications and outcome.

OBJECTIVE: To describe the obstetric and perinatal factors, in particular the method of delivery, associated with development of a subgaleal haematoma (SGH) and to determine the outcome of survivors with this type of birth trauma. METHODOLOGY: Perinatal and obstetric data were retrospectively reviewed for 37 infants admitted to the neonatal unit of the sole tertiary paediatric referral hospital in Western Australia with an SGH, over a 24 year period from 1970 to 1993. These data were compared to data for all Western Australian births. The long-term outcome was obtained through medical and private paediatric records for 26 of these infants. RESULTS: All except one of the neonates had instrumental deliveries; 89% had a vacuum extractor applied to the head at some stage of delivery compared to 10% of the general population of births in Western Australia. There was also a significantly increased risk of failure of attempted vacuum extraction. Of the cases where a vacuum extraction was attempted, 45% also had forceps applied to the head. Coagulopathy was associated with the severity of the SGH. There was also a high frequency of occurrence (40%) of associated head trauma such as intracranial haemorrhage, skull fracture and cerebral oedema, as well as neonatal encephalopathy (73%). The occurrence of these associated features did not correlate significantly with the severity of SGH. Minor complications of SGH included jaundice and facial bruising. There was an excess mortality associated with SGH; however, the long-term outcome for neonatal survivors with this disorder was good. None of the cases studied subsequently developed cerebral palsy or intellectual disability, and minor neurological sequelae only were documented in four infants. CONCLUSIONS: SGH is an uncommon type of birth trauma, and is associated with delivery or attempted delivery by vacuum extraction. The most commonly associated clinical problems were hypovolaemia and coagulopathy. The long-term outcome for neonates with this condition is good.

Australia↗
PubMed1992

The development and testing of new instruments for operative vaginal delivery.

OBJECTIVE: Little innovation has occurred in recent years in the instruments available for operative vaginal delivery. The purpose of this study is to develop a technique to test the utility of an investigational device, the obstetric bonnet, and measure the forces it places on the fetal head. STUDY DESIGN: We constructed a model of the fetal head capable of measuring both compression and vacuum created by an applied device. A total of 18 devices were tested to a maximum traction of 60 pounds. RESULTS: A significant linear relationship exists between the traction applied and the compression (R2 = 0.42, p = 0.0004) and vacuum (R2 = 0.85, p = 0.0001) created. Compression and vacuum recorded at maximum recommended traction were 1.1 lb/sq in and 31 cm Hg, respectively. CONCLUSION: These findings explain the mechanics of this interesting device, and demonstrate forces that compare favorably with those known to occur with forceps or vacuum extraction.

Female↗
PubMed1994

[Breech presentation--information, anxiety and expectations of established obstetricians and pregnant patients. 1: Results of a survey of established obstetricians].

In a anonymous questionnaire we studied the advise of gynecologists to breech presented pregnant women in the area around Nürnberg-Fürth-Erlangen in Germany. 61.5% of gynecologists participated the study, 71.2% of them (n = 57) prefer primary caesarean section in primapara. 13.8% (n = 11) of the questioned doctors favour a vaginally delivery procedure. Advise to multiparas for primarous caesarean section was given in 8.8% (n = 7) and for vaginally delivery mode in 80.0% (n = 64). Reasons for caesarean section was a decreased fetal delivery risk (90%, n = 72) and the possibility of prospective delivery planing (26.3%, n = 21). Other reasons were various obstetrical risk factors and forensic aspects. Benefits of vaginally delivery mode in multiparas was a low fetal delivery risk (72.5%, n = 58) and a low maternal morbidity (66.3%, n = 53). Results of actual studies are suggesting, that there is a controlled fetal risk of vaginally delivery mode in breech presented labour. According to these studies a change of labour procedure is essential.

Attitude of Health Personnel↗
PubMed1992

Contralateral occipital depression related to obstetric forceps injury to the eye.

Obstetric forceps pressure strong enough to leave a periorbital depression and corneal injury would probably be severe enough to leave an occipital depression from the opposite forceps blade. The presence of a depression at the correct occipital position would support the diagnosis of forceps injury when the birth history is unknown and the cornea has decompensated enough to make observation of the Descemet's membrane scrolls difficult. We studied six patients with known or suspected obstetric forceps injury to the cornea. Complete ocular examinations included examination for periorbital forceps depressions and posterior skull depressions 180 degrees from the affected cornea (which correlates with the opposite blade of the forceps). All of the patients with Descemet's scrolls had posterior skull depressions. This method of palpation for a contralateral skull depression may assist in the diagnosis of forceps-induced corneal decompensation.

Adult↗
PubMed1984

Active management of labor as an alternative to cesarean section for dystocia.

There is general agreement that a solution to the problem of dystocia would go a long way toward resolving the contentious issue of high cesarean birth rates that have become such a prominent feature of obstetric practice in recent years. At the National Maternity Hospital in Dublin, one of the largest obstetric units in Western Europe, this situation has been averted through a coordinated policy of early detection and effective treatment of abnormal uterine action over a period of 15 years. During 1980 the number of births was 8742, the incidence of cesarean section was 4.8%, and mothers were assured of delivery within 12 hours after admission to the labor unit. It is proposed that these results could be reproduced elsewhere.

Adult↗
PubMed1985

[The Munich obstetric instruments for cattle. Use during the birth of calves in VEL].

The consequent use of the Munich obstetrics instruments can lower the dystochia rate of cows. Based upon the measured traction energy, it is possible to give an objective prognosis of the further process of parturition. By the aid of the traction energy, measured during one labour, the decision to the C. section at the time can get easier. Beside the better survival changes of the calf, injuries of the cow, happened during the delivery, will be extensively avoidable.

Animals↗
PubMed1986

[Current aspects of engagement dystocia].

It seems likely, in view of the large number of caesarean operations that are now being carried out and that too have complications, that the mechanism of obstetric procedures will sooner or later become of interest again to obstetricians. This study looks at a consecutive series of cases where dystocia in the upper part of the pelvis occurred and tries by analysing different obstetrical parameters to work out the best time for carrying out different obstetrical manoeuvres. It is possible to come to two conclusions, so long as both the mother and the fetus are watched carefully during the labour: the trial of delivery of the fetal head using the obstetric ventouse will bring about a significant reduction in the numbers of caesarean operations. it is always rewarding to be patient and it does not seem sensible to intervene too quickly. Two important results come from this approach: mechanical dystocia has practically disappeared, as it now only occurs in about 1% of labours. on the other hand, particularly in primiparous women, dystocia in the upper straight of the pelvis is quite common.

Adolescent↗