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PubMed1996

CT and MRI characteristics of intracranial hemorrhage complicating breech and vacuum delivery.

The CT/MRI brain findings and sequelae of intracranial hemorrhage resulting from traumatic breech and vacuum delivery of 16 term newborn infants are presented. Eleven infants were vacuum extracted, while the remaining five infants were delivered breech. Except for three breech-delivered infants who had intraventricular hemorrhage, the location and nature of hemorrhage were similar in both groups. Nine of the 11 vacuum-extracted babies showed complete resolution of hemorrhage on follow-up examination. None of the breech cases had a normal outcome. All five of the latter group had hydrocephalus, and one case each demonstrated porencephaly and encephalomalacia.

Birth Injuries↗
PubMed1984

Sexual function during the puerperium.

Of 328 women interviewed at a postnatal clinic, 166 (50.6%) had resumed sexual intercourse, the average interval after delivery being 5 weeks postpartum. Of the various social and clinical factors examined, resumption of coitus was related only to marital status, vaginal laceration, and continuing vaginal bleeding. Of the sexually active group, 89% were practicing effective contraception.

Adult↗
PubMed1992

Leptomeningeal cyst: early diagnosis by color Doppler imaging.

A newborn with a leptomeningeal cyst over the anterior fontanelle due to birth trauma is described. Color Doppler flow sonograms were helpful to diagnose the leptomeningocele in its early stages and to differentiate it from a cephalhematoma or subgaleal haemorrhage by demonstrating cerebro-fugal flow in an arterial connection between the extracranial fluid collection and the dural space.

Arachnoid Cysts↗
PubMed1995

Mother-to-child transmission of human immunodeficiency virus type 1: influence of parity and mode of delivery. Paediatric AIDS Group of Switzerland.

UNLABELLED: In a national prospective study of risk factors for mother-to-child transmission of human immunodeficiency virus (HIV), 316 children of HIV-positive mothers were followed up for at least 6 months. Infection status was determined in 254 of them and 46 were found to be infected giving a transmission rate of 18.1%. Univariate analysis of potential risk factors for mother-to-child transmission showed an association between primiparity and increased transmission rate: odds ratio 2.2, 95% confidence interval (CI) 1.1-4.6, P < 0.05. Analysis by logistic regression confirmed this association (adjusted odds ratio 2.4) and showed, in addition, a negative association between transmission rate and elective Caesarean section (adjusted odds ratio 0.36, 95% CI 0.13-0.97, P < 0.05). The effect of primiparity was less pronounced in combination with elective Caesarean section (odds ratio 1.7) than with other delivery modes (odds ratio 2.5, difference not significant). HIV-infected children were less likely to experience the birth of a younger sibling during the observation period than their uninfected counterparts (2 of 46 vs 27 of 208, P < 0.05 by logrank test). CONCLUSION: Primiparous women appear to transmit HIV to their children at a higher rate. This could be explained by increased intrapartum transmission because of longer and more complicated labour in primiparas and/or by a self-selection of women with lower risk of transmission among those deciding to have additional children.

Adult↗
PubMed1986

Pregnancy and delivery after cone biopsy of the cervix.

Seventy-seven women had 98 pregnancies after a cone biopsy of the cervix. There were 62 deliveries, 26 legal abortions, 9 spontaneous abortions and 1 ectopic pregnancy. Cervical cerclage was done for 22 out of 62 conized parturients (35.4%) and for none in the matched control group. There were 4 (6.4%) preterm deliveries in the cone biopsy group and 1 in the control group. The perinatal mortalities were 3.2% and 0% respectively. The mean duration of labour was 2.4 h shorter in the conized parturients than in the controls (P less than 0.05) but there were no difference in the mode of delivery in the two groups.

Abortion, Spontaneous↗
PubMed1994

A survey of non-cardiac fetal intrathoracic malformations diagnosed by ultrasound.

Between November 1986 and April 1993, 22 cases of intrathoracic abnormality were detected prenatally by ultrasound, and examined postnatally. There were 11 cases of diaphragmatic hernia, 5 cases of cystic adenomatoid malformation of lung, one case of chylothorax, two cases of lung sequestration, and three cases of bronchogenic cyst. The total number of deliveries during that period was 48,281 and the total number of major anomalies at that time was 669 (1.38%). Cases of hydrothorax of various etiology, as well as thoracic cage anomalies were excluded. Prenatal diagnosis allows planned delivery and the assembly of neonatologists and pediatric surgeons.

Adenomatosis, Pulmonary↗
PubMedDate not supplied

Trends in neonatal outcome with low Apgar scores.

Trends in incidence and neonatal outcome following low Apgar scores (1 min Apgar score < 6) were prospectively studied during the years (1981, 1983, 1986 and 1988. The incidence of birth asphyxia was 7.6% of live births during the study period; it was 5.8% in 1981, increased to highest of 8.9% in 1986 with slight reduction to 7.2% in 1988. Birth weight distribution of asphyxiated babies and 1 min Apgar score < 3 (severe asphyxia) remained unchanged. A significant decline in neonatal mortality with asphyxia was noted from 46.0% to 28.4% during 1981 and 1988 respectively. Aetiological factors for asphyxia could be identified in nearly 90% of infants during 1988, and all but 2 of 12 factors studied registered significant differences from control non-asphyxiated group.

Apgar Score↗
PubMed1993

Clinical evaluation of the fetus and neonate. Relation between intra-partum cardiotocography, Apgar score, cord blood acid-base status and neonatal morbidity.

The relation between intra-partum cardiotocography (CTG), cord blood acid-base status, Apgar score and neonatal morbidity was studied in 1228 consecutively live-born babies and in a subgroup of 200 babies (148 babies with a 1 min Apgar score < or = 8 and 52 randomly selected babies with a 1 min Apgar score > or = 9). The scores for the individual components of the 1 min Apgar score were strongly associated with each other, whereas the scores for the individual components of the 5 min Apgar score were less strongly associated. At 1 min the scores for muscle tone, reflex irritability and respiration but not the scores for heart rate and skin colour were associated with arterial and venous cord blood pH (low scores being associated with low pH). Out of the individual components of the Apgar score, heart rate and reflex irritability at 1 min were the best discriminators between "healthy or relatively healthy" and "severely ill" babies. Intrapartum CTG, total Apgar score and cord blood acid-base status were only weakly related. Venous cord blood pH was the best predictor of the 1 min Apgar score. Intra-partum CTG (silent pattern), 5 min Apgar score and venous cord blood pH were the best predictors of severe neonatal morbidity.

Acid-Base Equilibrium↗
PubMed2002

Asymptomatic coronary artery disease in a pregnant patient. A case report and review of literature.

BACKGROUND: Acute myocardial infarction during pregnancy has been reported and has been shown to be associated with poor maternal and fetal outcomes. However, the vast majority of these patients do not have previously recognized ischemic heart disease. Pregnancy and delivery pose significant cardiac stress and risk to the mother and fetus. However, it is unknown how available therapies can be utilized in the pregnant patient with identified ischemic heart disease to minimize these risks. CASE REPORT: We present a 39-year-old asymptomatic diabetic female with a positive stress echocardiogram at 16 weeks of pregnancy who remained asymptomatic throughout pregnancy with medical management and went on to have a normal vaginal delivery in the process suffering a small non-ST elevation myocardial infarction with pulmonary edema following delivery due to volume overload. She ultimately underwent cardiac catheterization and successful four-vessel CABG 1 months after her delivery. CONCLUSION: We present this patient to suggest a successful strategy of managing a patient with non-revascularized asymptomatic coronary artery disease during pregnancy. In addition to reviewing the appropriate medical therapy during pregnancy, we discuss the data on revascularization procedures as well as recommendations for delivery and stress testing for such patients.

Adult↗
PubMed2005

Vesicouterine fistula as a complication of forceps delivery: a case report.

We report a case of vesicouterine fistula as a complication of forceps delivery revealed by urinary incontinence in a 68-year-old woman. Diagnosis was confirmed by examination and cystography. The treatment was a transperitoneal excision of the fistula. The literature is briefly reviewed and the treatment options are discussed.

Aged↗
PubMed2000

Relationship between the length of the perineum and position of the anus and vaginal delivery in primigravidae.

The aim of the study was to determine perineal length and anal position in primigravidae and to evaluate their effect on vaginal delivery. The distances between the fourchette and each of the center of the anal orifice and the inferior margin of the coccyx were measured in 212 primigravidae with singleton term pregnancies during the first stage of labor. Anal position index was calculated by dividing the first measurement by the second. The mean +/- SD length of perineum was 4.6 +/- 0.9 cm. The mean +/- SD anal position index was 0.49 +/- 0.12. Women with a short perineum (<4 cm) or a small anal position index (<0.42) had significantly higher rates of episiotomy, perineal tears and instrumented delivery. This association was also significant by multiple logistic regression analysis. It was concluded that a short perineum and anterior displacement of the anus were associated with traumatic vaginal delivery in primigravidae.

Adult↗
PubMed1999

"Growing fontanelle": a serious complication of difficult vacuum extraction.

Growing skull fractures in combination with leptomeningeal cysts are well known in childhood. A rare case of a growing fontanelle due to a leptomeningeal cyst is presented. The cyst occurred due to a traumatic delivery with vacuum extraction. Operative repair of the cyst revealed a dural tear at the border of the fontanelle. The imaging findings are discussed.

Arachnoid Cysts↗