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At least 1,243 records · Page 69Linked to original sources
PubMed1993

[Evaluation of indications for cesarean section. Comparison of two decades. Preliminary results].

We have retrospectively analysed the incidence of cesarean section during the periods 1970-79 and 1981-90 and the evolution, if any, of the principal indication over time. The average incidence of cesarean section was 9.01% in the seventies and 11.63% in the eighties: the difference was statistically significant. Four classes of indication show significant differences between the periods considered: previous cesarean, feto-pelvic disproportion, anomalous presentation, gestosis. An evolution of cesarean section indications is shown: minus parity, better health, sanitary and environmental conditions, better physiopathological and clinical knowledge of pregnancy complication and labor seem to be causes of that evolution.

Cesarean Section↗
PubMed1993

[Integration of Doppler ultrasound into the obstetric department of a gynecologic clinic].

This study was performed to evaluate the time interval for Doppler ultrasound and sonographic diagnostic measurement at 267 patients during antenatal risk screening. Time for biometry, screening of malformation, Doppler ultrasound, documentation and discussion with the patients were measured. Although experienced colleagues used an standardized inquiry a mean time interval of 52 minutes were needed under optimal conditions. It is interesting to note that outstanding disturbance factors extend the examination time considerable. Many data must be calculated and recorded by the obstetrician. Several proposals are drawn up and discussed in this paper on the basis of this results. This study shows that high special knowledge and a large time expense is necessary to establish Doppler technology in the routine antenatal screening.

Appointments and Schedules↗
PubMed1993

Management of breech presentation at term.

The management of 159 consecutive women with singleton breech presentation occurring at 37 or more weeks of gestational age was reviewed. They were stratified into three groups: (a) caesarean section without trial of labour (87), (b) trial of labour resulting in caesarean section (21), and (c) trial of labour culminating in successful vaginal delivery (51). The criteria for allowing a trial of labour were described. Careful review of material and foetal variables indicated that a trial of labour in carefully selected patients resulted in vaginal delivery in 70.8% and that this was achieved without an increase in foetal or maternal mortality or morbidity.

Adult↗
PubMed1993

[Fetal-pelvic disproportion].

The files of 186 primiparous women with the diagnosis of fetal-pelvic disproportion were studied in order to depict maternal and fetal parameters determining the course of delivery. Three groups were compared. One group of women who delivered vaginally and two groups, that delivered by caesarean section, one with a dilated orifice and one with a non-dilated orifice. The maternal age, height and pelvic capaciousness as found by clinical examination were registered together with cardiotocography, birth weight, labour augmentation, instrumental delivery, fetal presentation, gestation age and the conjugata vera (measured at caesarian section). It was found that the maternal age and the gestational age were lower in the vaginal delivery group compared to the two caesarean section groups. There was no difference between all three groups with respect to the other parameters. On this basis it was concluded, that it was not possible to identify fetal-pelvic disproportion that would result in caesarean section in primiparous women.

Adult↗
PubMedDate not supplied

[Stress on the head of the fetus in spontaneous labor in relation to perinatal factors].

The pressure exerted on the fetal head during the second stage of labor was continuously measured in 42 spontaneous deliveries with a new instrument. The pressure values were correlated to various obstetric variables. Typically, the head pressure remained elevated beyond the end of the uterine contraction in primiparae, whereas it decreased simultaneously with the amniotic pressure in multiparae. On the average, the head pressure was higher in primiparae indicating, together with the longer lasting bearing down period, a higher resistance of the birth canal. Deliveries with pudendal block or peridural analgesia showed no differences, but these two groups differed in other factors which might have influenced the results. Infusion of oxytocin during the course of labor was associated with higher head pressure values that could not be deduced from the hormone administration per se, but from a higher resistance of the birth canal. Maternal age did not influence the head pressure. Within physiological limits, the head pressure was independent from the size of the child and the maternal pelvis.

Adult↗
PubMed1993

[Intraobserver and interobserver variation in measurement of the pelvic diameter using DeLee's internal pelvimeter in Cesarean section].

The method of measuring the true conjugata with DeLee's Internal Pelviometer at caesarean section was evaluated. In 58 women the true conjugata were blindly measured three times by the surgeon and also, in fifty cases, three times by the assistant. Only a slight intraobserver difference was found: median range was 0.42 cm. There was no significant interobserver variation. We conclude that DeLee's Internal Pelviometer can be used to measure the true conjugata at caesarean section, but the use of pelviometry in modern obstetrics is questioned.

Cesarean Section↗
PubMed1995

[Radiodiagnosis in obstetrics and gynecology].

Immediately after Röntgen's discovery, people started trying to find uses for the new rays in gynecology and obstetrics. Although the first reports date from 1896-97, even in the 1920's there were textbooks to be found without any mention of the use of radiology in both areas of medicine. The availability of reliable contrast media led to the development of new imaging techniques and to the golden age of obstetrical and gynecological radiology in the 1930-1970 period. Nowadays ultrasound has replaced most conventional techniques while MRI is becoming more and more important. A historical overview of the different radiological techniques is provided.

Female↗
PubMed1997

The relationship between shoe size and mode of delivery.

This study investigates whether a woman with a small shoe size has a higher chance of being delivered by cesarean section. Data on shoe size and mode of delivery were collected by chart review and telephone survey from clients of a freestanding birth center. Purposive sampling was done to include all women transferred and delivered by cesarean section for CPD or FTP, and an equivalent number of women who had a normal spontaneous vaginal delivery. Data on twenty two first time mothers who were delivered by cesarean section and twenty three who delivered vaginally were compared. This study did not find any relationship between small shoe size and cesarean section delivery.

Adolescent↗
PubMed1997

Risk factors associated with development of pelvic canal stenosis secondary to sacroiliac separation: 84 cases (1985-1995).

OBJECTIVE: To measure pelvic canal diameter in dogs from a ventrodorsal radiographic view of the pelvic region, to define a normal pelvic canal diameter, to evaluate risk factors associated with stenosis of the pelvic canal secondary to sacroiliac separation, and to determine clinical signs associated with pelvic canal stenosis. DESIGN: Retrospective case series. ANIMALS: 84 case-group and 46 control-group dogs. PROCEDURE: Medical records and radiographs of dogs with conditions unrelated to pelvic fracture (control group) and dogs with sacroiliac separation (case group) in which radiographs were obtained before surgery, after surgery, or after fracture healing were reviewed. Discriminant analysis was used to determine a normal pelvic canal diameter. An ANOVA and Dunnett's two-sided test were used to determine factors associated with pelvic canal stenosis. RESULTS: Pelvic canal diameter ratio determined from control-group dogs was > or = 1.1. Pelvic canal diameter ratios were significantly less for case-group dogs on radiographs obtained before surgery and after fracture healing than for control-group dogs, regardless of fracture type or treatment, except for dogs with ilial fractures treated conservatively. Pelvic canal diameter ratios did not differ for case-group dogs on radiographs obtained after surgery from those for control-group dogs, except when ilial fractures were surgically reduced. None of the dogs had clinical signs associated with pelvic canal stenosis. CLINICAL IMPLICATIONS: Pelvic canal diameter in dogs can be determined from a ventrodorsal radiographic view of the pelvic region. Dogs with pelvic fractures that have a normal pelvic canal diameter before surgery tend to have a normal pelvic canal diameter after fracture healing.

Animals↗
PubMed1976

The determinants of pelvic brim morphology in the female.

There is a significant positive correlation between the brim index and the conjugate dimension (r = 0,66). The latter also shows a high degree of correlation with stature (r = 0,58). The inverse covariability between the transverse inlet diameter and the brim index is weak (r = -0,17). The larger brim areas and brim indices of taller women are due to their greater sagittal inlet measurements.

Adult↗
PubMedDate not supplied

[What effect does leg position in breech presentation have on mode of delivery and early neonatal morbidity?].

The objective of the present study is to establish whether the position of the legs in breech presentation deliveries affects the vaginal or abdominal mode of surgical delivery and the early neonatal morbidity. The patient population investigated (n = 266) comprised 163 primiparae (61.3%) and 103 multiparae (38.7%). Of the 266 term infants (more than 37 complete WOP) with breech presentation, 71.3% (127/178) could be delivered vaginally from a simple pelvic presentation and 55.3% (42/76) from an incomplete or complete footling presentation. The average duration of labor was 460 minutes in a pelvic presentation delivery, and 400 minutes in a footling presentation delivery. The rate of acidosis (pHNA < 7.20) was 26% in the neonates delivered from the pelvic presentation as compared to 11.9% in the footling presentation deliveries. The number of neonates with a 5/10 minute APGAR score of seven points was 0/0% in pelvic and 4.8/2.4% in footling presentation. Of the neonates delivered from pelvic presentation, 10.2% (13/127) were moved to the neonatology department as compared to 14.3% (6/42) babies delivered from footling presentation. A secondary Cesarean section was indicated in 28.7% of pelvic presentation deliveries commenced vaginally (51/178) and in 44.7% of the footling deliveries (34/76). The rate of acidosis was 49% (25/51) in the babies with pelvic presentation and 21% (7/34) in the babies with footling presentation. The percentage of neonates with respiratory depression (5/10 minute APGAR score < 7 points) was 3.9/2.9% in the babies delivered from pelvic presentation and 2/0% in the babies delivered from footling presentation. Correspondingly, the rate of transfer to the neonatology ward was extremely high: 33.3% (17/51) of the pelvic presentation babies and 8.8% (3/34) of footling babies. In 11 pregnant women (5.8%) with a fetus in pelvic presentation, a primary Cesarean section was indicated, in half of these cases (n = 5) because of "suspicion of a discrepancy", three times at request of the patients and three based on fetal and on maternal indication. Because she had rejected vaginal delivery, primary Cesarean section was performed in one pregnant mother (1.3%) with a fetus in footling presentation. Fetuses with simple pelvic presentation at term were more frequently delivered vaginally than fetuses in footling presentation (71.3% compared to 55.3%). The rate of respiratory acidosis was higher in the neonates with pelvic presentation than those with footling presentation (26% as compared to 11.9%). They compensated this acidotic metabolism within a short time, so that the transfer to the neonatology ward was only temporary. The same applied to the babies delivered by secondary Cesarean section.

Adult↗