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Results for “Prenatal Injuries”

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PubMed1995

Clinical aspects of perinatal hypoxic-ischemic brain injury.

Perinatal hypoxic-ischemic cerebral injury is a significant cause of neurological morbidity and mortality in childhood. It is often difficult to determine the precise timing of such injury. Data from epidemiological and neuropathological studies have identified several maternal and fetal risk factors that seem to be associated with suspected prenatal brain injury. Hypoxic-ischemic cerebral injury that originates earlier in gestation may result in few, if any, clinical abnormalities during the newborn period. Clinical abnormalities may also be difficult to recognize in the premature newborn, and greater reliance must be placed on other adjunctive investigations, eg, neuroimaging. In contrast, term infants who sustain acute, intrapartum hypoxic-ischemic insult of sufficient magnitude to result in long-term sequelae invariably show recognizable encephalopathy during the newborn period. A combination of clinical data and adjunctive investigations during the neonatal period is a powerful predictive tool for long-term outcome.

Birth Injuries↗
PubMed1990

[Neonatal death following injuries in utero, in the absence of maternal lesions].

The authors report a case of neonatal death at 24 hours following maternal trauma during a traffic accident. The abdominal trauma did not result in any maternal injury. Caesarean delivery was justified by fetal rhythm disorders. A wide variety of fetal injuries, in the absence of maternal injuries, are reported in the literature. Some benefit from an early diagnosis, improving therefore the fetal prognosis.

Abdominal Injuries↗
PubMed1996

The role of medico-legal reviews in medical research.

Serial malpractice reviews offer an opportunity for the study of the effects of various practice patterns. In the specialty of obstetrics, the usefulness of this approach has been demonstrated repeatedly: (a) Much of the data indicating that bromocriptine, when given postpartum for milk suppression, has life endangering propensities have derived from medico-legal reviews. (b) Important new information about factors predisposing to or associated with neonatal brachial plexus injuries have emerged from critical analysis of malpractice claims. There is reason to anticipate that objective evaluation of the background of other prenatal birth injuries can provide more useful clinical information than traditional randomized prospective studies.

Brachial Plexus↗
PubMed1995

Prenatal health behaviors as predictors of breast-feeding, injury, and vaccination.

OBJECTIVE: To identify maternal prenatal preventive health behaviors associated with breast-feeding, early childhood injuries, and vaccination. DESIGN: Secondary analysis of the 1988 National Maternal and Infant Health Survey. SETTING: Questionnaires were mailed to the mother's home. PATIENTS: The response rate to this nationally representative sample was 71%. These analyses include the 10,868 mothers whose infants had ever been at home. INTERVENTIONS: None. MAIN OUTCOME MEASURE(S): Multivariable logistic regression was used to predict the following: (1) having "ever" breast-fed; (2) having breast-fed for at least 6 weeks; (3) "an accident or bad fall" during any of the first 6 months of the child's life ("early" injury) or (4) in the month prior to the interview ("recent" injury); (5) having received "any" vaccinations or (6) having received three diphtheria, pertussis, tetanus immunizations. RESULTS: Children of mothers who reduced alcohol consumption during the pregnancy, had higher incomes, and were white had the best preventive health outcomes. Adequacy of prenatal care was predictive of vaccination, but not of breast-feeding or injury. CONCLUSIONS: These data suggest that prenatal sociodemographic characteristics and maternal health behaviors have significant and continued effects on the preventive health outcomes of infants and children.

Adolescent↗
PubMed1992

Assessing for abuse during pregnancy. Severity and frequency of injuries and associated entry into prenatal care.

OBJECTIVE: To assess the occurrence, frequency, and severity of physical abuse during pregnancy and associated initiation of prenatal care. DESIGN: Stratified, prospective cohort analysis. SETTING: Public prenatal clinics in Houston, Tex, and Baltimore, Md. PARTICIPANTS: Total population-based sample of 691 black, Hispanic, and white pregnant women. All of the women were urban residents and most of the Hispanic women were Mexican American. All participants were invited into the study at the first prenatal visit and were followed up until delivery. MAIN OUTCOME MEASURE: Identification of abuse status. RESULTS: A three-question Abuse Assessment Screen detected a 17% (1/6) prevalence of physical or sexual abuse during pregnancy, which is more than double all previous published reports. When evaluated against nationally tested research instruments, the three-question screen that was asked at the first prenatal visit was sensitive and specific to abuse status. Abuse was recurrent, with 60% of abused women reporting two or more episodes of assault. Location of abuse focused on the head. Frequency and severity of abuse and potential danger of homicide was appreciably worse for white women. Abused women were twice as likely as nonabused women to begin prenatal care during the third trimester. CONCLUSIONS: A simple clinical assessment screen completed by the health care provider in a private setting and with the male partner absent is as effective as research instruments in identifying abused women. Straightforward, routine clinical assessment is recommended as essential in preventing potential trauma, interrupting existing abuse, and protecting health.

Adolescent↗
PubMed1995

Porencephaly secondary to fetal trauma during amniocentesis.

BACKGROUND: There has been one reported case of porencephaly diagnosed postnatally as a result of amniocentesis. We report the first antenatal diagnosis of porencephaly, which apparently resulted from penetration of the fetal skull during amniocentesis. CASE: A 37-year-old woman had genetic amniocentesis at 16 weeks' gestation. The fetal skull was penetrated during the unguided procedure. Porencephaly discovered at 28 weeks' gestation was confirmed by imaging studies in the neonatal period. CONCLUSION: Inadvertent fetal skull penetration appeared to result from amniocentesis unguided by continuous ultrasound.

Adult↗
PubMedDate not supplied

Electric shock in pregnancy.

Emergency physicians need to be alert to the potential effects of electric shock in pregnancy. A review of all case reports in the English language literature of pregnant women exposed to electric shock was performed. Information on voltage, gestation, injury-to-delivery interval, and outcome was collected. There were 15 victims of electric shock in pregnancy. Fetal mortality (N = 11) was 73% and there was only one normal pregnancy following electric shock. The fetus is much less resistant to electric shock than the mother. Any woman who suffers from an electric shock in pregnancy, however minor, requires prompt fetal monitoring and careful obstetric supervision.

Electric Injuries↗