Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Data delivery”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 145 records · Page 8Linked to original sources
PubMedDate not supplied

Research-oriented image registry for multimodal image integration.

To provide multimodal biomedical images automatically, we constructed the research-oriented image registry, Data Delivery System (DDS). DDS was constructed on the campus local area network. Machines which generate images (imagers: DSA, ultrasound, PET, MRI, SPECT and CT) were connected to the campus LAN. Once a patient is registered, all his images are automatically picked up by DDS as they are generated, transferred through the gateway server to the intermediate server, and copied into the directory of the user who registered the patient. DDS informs the user through e-mail that new data have been generated and transferred. Data format is automatically converted into one which is chosen by the user. Data inactive for a certain period in the intermediate server are automatically achieved into the final and permanent data server based on compact disk. As a soft link is automatically generated through this step, a user has access to all (old or new) image data of the patient of his interest. As DDS runs with minimal maintenance, cost and time for data transfer are significantly saved. By making the complex process of data transfer and conversion invisible, DDS has made it easy for naive-to-computer researchers to concentrate on their biomedical interest.

Computer Communication Networks↗
PubMed2005

Effects of pregnancy and childbirth on postpartum sexual function: a longitudinal prospective study.

This study was conducted to evaluate the effects of pregnancy and childbirth on postpartum sexual function. Nulliparous, English-literate women were enrolled who had presented to the UNC Hospital's obstetrical practice; these women were 18 years of age and older and at 30-40 weeks' gestation. Questionnaires were completed regarding sexual function prior to pregnancy, at enrollment, and at 2, 6, 12, and 24 weeks postpartum. Demographic and delivery data were abstracted from the departmental perinatal database. One hundred and fifty women were enrolled. At 6, 12, and 24 weeks postpartum, 57, 82, and 90% of the women had resumed intercourse. At similar postpartum timepoints, approximately 30 and 17% of women reported dyspareunia; less than 5% described the pain as major. At these times, 39, 60, and 61% of women reported orgasm. Orgasmic function was described as similar to that prior to pregnancy or improved by 71, 77, and 83%. Delivery mode and episiotomy were not associated with intercourse resumption or anorgasmia; dyspareunia was only associated with breast-feeding at 12 weeks (RR = 3.36, 95% CI = 1.77-6.37). Most women resumed painless intercourse by 6 weeks and experienced orgasm by 12 weeks postpartum. Function was described as similar to or improved over that prior to pregnancy.

Adult↗
PubMedDate not supplied

Subarachnoid catheter placement after wet tap for analgesia in labor: influence on the risk of headache in obstetric patients.

BACKGROUND AND OBJECTIVES: The incidence of postdural puncture headache (PDPH) after epidural wet tap for obstetric patients may be as high as 75%. We have studied how subsequent placement of a subarachnoid catheter immediately after confirmation of a wet tap, and leaving the catheter in place for 24 hours affects the incidence of PDPH. METHODS: Over a 5-year interval, 115 consecutive patients who had unintentional dural puncture were divided into 3 groups by consecutive assignment. Group A had an epidural catheter placed at another interspace. Group B had a subarachnoid catheter placed for labor analgesia that was removed immediately after delivery. Group C had a subarachnoid catheter that was left in place for 24 hours after delivery. Data were collected retrospectively. The incidence of PDPH and blood patch was compared between groups. RESULTS: The overall incidence of PDPH was 46.9% and need for blood patch 36.5%, significantly less in both subarachnoid catheter groups, 31% in B and 3% in group C, compared with group A (PDPH 81%) (P <.001). CONCLUSION: Subarachnoid catheter placement after wet tap in obstetric patients reduces the PDPH rate and does so to a greater extent if left in place for 24 hours after delivery.

Adult↗
PubMed1996

Does station of the fetal head at epidural placement affect the position of the fetal vertex at delivery?

OBJECTIVE: The objective study was to determine whether epidural placement before engagement of the fetal head is associated with an increase in the incidence of malposition at delivery. STUDY DESIGN: We performed a retrospective cohort study to ascertain the relation between station at epidural placement and malposition. Three hundred fifty-seven patient records were reviewed; 320 records of patients in spontaneous or induced labor who received epidural analgesia were included in the analysis. Patients with a contraindication to labor, antepartum fetal death, or twins were excluded. Maternal demographics, cervical examination at epidural placement, epidural medication characteristics, and labor and delivery data were abstracted from medical records. Station was characterized as high if the fetal vertex was above the level of the maternal ischial spines or low if the vertex was at or below the level of the ischial spines at the time of epidural placement. RESULTS: The relative risk of occiput malposition was significantly increased with epidural placement at high station. This risk remained after we controlled for age and birth weight. Cervical dilatation was not independently associated with occiput position at delivery. CONCLUSIONS: Epidural placement before engagement of the fetal head is associated with an increased incidence of malposition at delivery. This finding may provide an insight into the empiric observation that operative delivery is variably increased for patients laboring under epidural anesthesia.

Adult↗
PubMed1991

The relationship of nasal septal deformity and palatal symmetry in neonates.

Results are reported of a study to evaluate possible associations between nasal septal deformity and palatal symmetry in neonates. Five hundred babies, born consecutively, were examined within three days of birth. Prenatal and delivery data were recorded for each baby and the nose was examined to determine airway patency and possible septal deformity. When a deviation of the septum was discovered an alginate impression of the palate was taken along with photographs of the nostrils. A matched control was then selected for each study group baby and similar records were obtained. Only 14 cases of septal deformity were found, an incidence of 2.8 per cent. No evidence of palatal asymmetry was found. The theory that moulding pressures during delivery may be a major cause of nasal septal deformity was not supported.

Delivery, Obstetric↗
PubMed1989

Semliki Forest virus capsid protein acts as a pleiotropic regulator of host cellular protein synthesis.

The Semliki Forest virus capsid (C) protein was introduced into various target cells by electroporation-, liposome-, and erythrocyte-ghost-mediated delivery. Data are presented which show that the incorporated C protein is biologically active and, at low concentrations (10(3) to 10(4) molecules per cell), markedly induces host cellular protein synthesis (average value, up to 90%). On the other hand, high concentrations (10(5) to 10(6) molecules per cell) led to a significant inhibition (average value, up to 60%). The cellular response to C protein was found to be identical in P3X63Ag8 suspension cells, CV-1 cells, and GpBind4 cells. Following electroporation-mediated delivery of C-protein molecules, both induction and repression of cellular protein synthesis were immediate, whereas with liposome-mediated delivery these events were delayed by about 1 h. Maximum stimulation and repression occurred between 0 and 1 h after delivery of C protein and decreased thereafter to reach control values at about 4 h. The analysis of the proteins synthesized suggests that low amounts of microinjected C protein are responsible for the induction of classes with specific Mrs, whereas high amounts lead to an inhibition of overall protein synthesis.

Animals↗
PubMedDate not supplied

Resilience among African American adolescent mothers: predictors of positive parenting in early infancy.

OBJECTIVE: To use Nath et al.'s (1991) conceptual model of adolescent parenting to examine the relationship between resiliency factors measured shortly after delivery and maternal parenting behavior at 6 months. METHOD: We recruited 181 first-time, adolescent African American mothers at delivery. Data on resiliency factors (maturity, self-esteem, and mother-grandmother relationships) were collected when infants were 1-4 weeks of age. Data on parental nurturance and parenting satisfaction were examined through observations and self-report at 6 months. RESULTS: Multiple regression analyses were used to examine the longitudinal impact of resiliency factors on parental nurturance and parenting satisfaction. Maternal maturity, positive self-esteem, and positive adolescent mother-grandmother relationships (characterized by autonomy and mutuality) were associated with better parenting outcomes. Maternal parenting satisfaction was lowest when infants were temperamentally difficult and mothers and grandmothers had a confrontational relationship. CONCLUSIONS: Longitudinal associations between mother-grandmother relationships at delivery and parental behavior and satisfaction 6 months later may suggest an intergenerational transmission of parenting style. Recommendations are provided for intervention programs to enhance mother-grandmother relationships in contexts where adolescents are required to live with a guardian to receive government assistance.

Adolescent↗
PubMed1998

Prediction of preterm delivery by fetal fibronectin: a meta-analysis.

OBJECTIVE: To assess the cervicovaginal fetal fibronectin test to predict preterm delivery. DATA SOURCES: We searched MEDLINE, Current Contents, Index Medicus, and proceedings of meetings for studies published between 1991 and June 1997. METHODS OF STUDY SELECTION: Inclusion criteria were prospective cohort study; test performed between 20 and 36 weeks' gestation; fetal fibronectin measured by a previously described assay, with a cutoff level set at 50 ng/mL; test results not disclosed to women or physicians; and fewer than 20% of study participants excluded from the analysis. TABULATION, INTEGRATION, AND RESULTS: Twenty-nine relevant studies were stratified according to the prevalence of preterm delivery, the number of tests performed, and delivery before 34, 35, or 37 weeks. Sensitivities, specificities, and likelihood ratios were calculated in each study. The summary estimates of the likelihood ratio for tests yielding positive results or tests yielding negative results along with their 95% confidence intervals (CIs) were computed in each stratum according to a random-effects model. All summary likelihood ratios for a test yielding positive results indicated a significant association with preterm delivery. The strongest association was found between a single test with positive results and delivery before 37 weeks in a low-risk population (likelihood ratio 7.5; 95% CI 4.6, 12.3). This association also was found in high-risk women (likelihood ratio 3.5; 95% CI 2.6, 4.6). In high-risk women, a test yielding negative results was associated with a reduction in risk of preterm delivery (likelihood ratio 0.4; 95% CI 0.3, 0.5). CONCLUSION: Fetal fibronectin in cervicovaginal secretions is associated with preterm delivery in both high-risk and low-risk women.

Cervix Uteri↗
PubMed2001

Abnormal vascular coiling of the umbilical cord in gestational diabetes mellitus.

The objective of this study was to identify abnormal vascular coiling of the umbilical cord in neonates of mothers with gestational diabetes mellitus. The umbilical cords of 57 neonates of gestational diabetic mothers were examined and the coiling index determined by dividing the total number of complete vascular coils by the length of the cord in centimeters. Obstetric history, delivery data and neonatal outcome were also evaluated. These variables were compared with those obtained for 389 normal pregnancies. The frequency distribution of umbilical coiling index in the control population and gestational diabetic mothers were normal (10th and 90th percentiles = 0.17 and 0.37; mean +/- SD = 0.26 +/- 0.09 and 0.24 +/- 0.12 coils/cm, respectively). Non-coiling and hyper-coiling were significantly more frequent with diabetic than with normal pregnancy (p = 0.004; p = 0.008, respectively). Both abnormalities of umbilical vascular coiling were also significantly associated with adverse perinatal outcome (p = 0.04) and emergency cesarean delivery (p < 0.0001) in the diabetic and control (p = 0.03; p < 0.0001, respectively) groups. Neonates of gestational diabetic mothers are therefore more likely to have hyper-coiled or non-coiled umbilical blood vessels. Perinatal morbidity and emergency cesarean delivery are increased in this subgroup.

Adult↗
PubMedDate not supplied

[Diagnosis of subependymal cysts by brain ultrasound].

OBJECTIVE: The aim of this study was to describe the clinical data and sonographic evolution of subependymal cysts (SEC) and to compare alone SEC versus SEC combined with other brain abnormalities. METHODS: The diagnosis of SEC relied on the discovery of one/several cysts at the outer angle of one/both lateral ventricles detected by routine brain ultrasound tests in the first days of life. During the 1981-2000 period, 66 neonates had evidence of SEC in Port-Royal Department of Neonatal Medicine. The cases were divided into two groups: G-I, alone SEC; G-II, SEC combined with other brain abnormalities. Hospital charts were reviewed for gestational and delivery data and ultrasound scans were analyzed according to a preset list of items (dates, measurements, other findings). RESULTS: Patients with alone SEC had a higher gestational and birthweight, better birth conditions, and less respiratory morbidity. High rates of associated congenital anomalies were observed in both groups (19% in G-I, 13% in G-II, NS). Rare pre/perinatal infections did not show any association with SEC. SEC were uni or bilateral, single or multiple (string), with no difference between G-I and G-II. Unilateral SEC predominated in the left side (26/28, P<0.01). Serial examinations were carried out in 49/66 (74%), showing an increase in size of SEC in 21/49 (45%) in the first month of life, while 12 SEC (24%) disappeared. The 11 deaths occurred in neonates with other severe brain injuries (five peri-intraventricular hemorrhages, four periventricular leukomalacias) except one (diaphragmatic hernia). CONCLUSIONS: Alone SEC and SEC combined with other brain abnormalities follow the same morphologic pattern and evolution. The striking predominance in the left side may suggest another etiology. Both are in favor of a developmental deviation and not a viral fetopathy.

English Abstract↗
PubMed2002

[Evaluation of respiratory tract function in healthy women in the last month of uncomplicated pregnancy].

UNLABELLED: The aim of this work was to examine the function of the respiratory system in pregnant women in the last month of non-complicated pregnancy. Spirometry with Lungtest 1000 was performed in 31 pregnant women at a mean gestational age of 37.72 weeks. In 24 of them the test was repeated after delivery (mean time from delivery = 39.40 days). The results were compared with a control group of 31 healthy non-pregnant resident of Szczecin. Prior to spirometry, all women underwent a physical examination with measurement of blood pressure, heart rate, body weight and height, chest and abdominal circumference, symphysis-fundus distance and blood analysis. Dyspneic symptoms characteristic of pregnancy were assessed with the St. George Hospital questionnaire. Spirometric parameters were recorded during three stages of the examination: 1. Components of vital capacity (IRV, ERV, TV, IC), breathing rate and minute ventilation. 2. Forced respiratory parameters (FEV0.5, FEV1, FEV1/FVCEX, FEV1/FVCIN, FEV2, FEV3, FVCEX, VPEF, FIV1, PIF, MIF50, FVCIN, VPIF, PEF, MEF25, MEF50, MEF75, FEF25/75, FEF75/85, MEF25/FVCIN, MEF50/FVCEX, MEF50/FVCIN, MEF75/FVCIN, FET, FET/FIT, FIT, TTOT, TMEF25, TMEF50, TMEF75, TPEF, TPIF, TPEF/FET, TPIF/FIT, MTT, AEX). 3. Maximum voluntary ventilation, maximum breathing frequency and breathing reserve. The results in all groups were compared with reference values. Furthermore, comparative analysis was performed in the same women before and after delivery. Data from questionnaires were related to results of spirometry. Parametric and nonparametric tests were applied. Spearman's rank test was used to study relations between respiratory symptoms and spirometric parameters. Most spirometric parameters deviated from reference values. Vital capacity was greater than expected. FEV0.5, FEV3, FEV1/FVCEX were reduced. FEV1/FVCIN were reduced in pregnant women only. Parameters of forced expiratory flow: FEF25/75, FEF75/85, MEF25, MEF25/FVCIN, MEF50/FVCEX were lower than expected. Significant difference were disclosed for MTT, AEX and MVV. MTT and MVV were increased and AEX was reduced. PEF and MEF75 were decreased in pregnant women. Other parameters did not differ significantly. Detailed analysis performed in 24 women before and after delivery revealed differences in components of vital capacity. Additionally, FEV0.5, FEV1/FVCEX, FEF25/75, MEF25, MEF50, MEF25/FVCIN, MEF50/FVCEX were increased in pregnancy. Time parameters of forced expiration--FET and TMEF25 were shorter. Minute ventilation was increased in pregnancy although the breathing rate was decreased. Values of maximum voluntary ventilation and breathing reserve were decreased in pregnancy. Correlation analysis revealed that respiratory symptoms in pregnant women depended on changes in proportions among static components of vital capacity and abnormalities in forced inspiration (FIT, TPIF/FIT). Intensity of symptoms was related to increased heart rate and diastolic pressure. CONCLUSIONS: 1. Chief spirometric parameters in the examined women differed significantly from reference values. Reliable information about respiratory function in pregnant women requires comparison of findings during and after pregnancy. 2. Vital capacity in the last month of pregnancy did not differ from values after delivery and in the control group. Component volumes changed: tidal volume was increased, expiratory reserve volume was decreased, inspiratory reserve volume remained unchanged. 3. Minute ventilation recorded at rest in pregnancy increased despite decreased breathing rate, whereas maximum voluntary ventilation was lower than after delivery and in the control group, evidencing reduced breathing reserve. 4. Chief forced expiratory parameters remained unchanged in pregnancy. Parameters characterizing bronchioles revealed increased air flow (bronchodilation). 5. Dyspneic symptoms found in pregnant women correlated with changes in vital capacity components. Symptoms depended on the mechanics of ventilation and not on the status of bronchi.

Adult↗
PubMed2006

Risk factors associated with congenital malaria in Enugu, South Eastern Nigeria.

There is paucity of data on the risk factors associated with congenital malaria in Nigeria. This study assessed the risk factors for congenital malaria in a population of neonates delivered at the University of Nigeria Teaching Hospital, Enugu, South Eastern Nigeria. It was a prospective cross-sectional study of neonates who were delivered in the institution from 2 April 2003 to 15 April 2004 as well as their mothers. Thick and thin blood films were made from maternal, baby and cord blood as well as the placenta for each mother/baby pair to determine malaria parasite density counts and for species identification. The maternal samples were obtained as soon as labour was confirmed while the cord and baby's blood as well as placental smears were taken within 1 h of delivery. Data analysis was by means of descriptive and inferential statistics as well as univariate and multivariate logistic regression at the 95% confidence level using the statistical software SPSS for Windows Version 10. A total of 658 mother/baby pairs were recruited into the study within the 13-month period. Out of this number, 625 mother/baby pairs completed the study and their data were subsequently analysed. A total of 356 (56.96%) mothers and 203 (32.48%) babies were smear positive for Plasmodium falciparum. On univariate logistic regression with presence or absence of the congenital malaria as the dependent variable, six out of the 13 putative risk factors tested were statistically significant. These were low compared with higher socioeconomic classes (OR = 1.41, 95% CI = 1.18 - 1.69, p = 0.00); low compared with normal birth weight (OR = 2.14, 95% CI = 1.39 - 3.30, p = 0.001); positive placental malaria parasitaemia (OR = 6.29, 95% CI, 4.73 - 8.37, p = 0.000), positive maternal blood malaria parasitaemia (OR = 5.04, 95% CI = 3.74 - 6.78, p = 0.000), positive cord blood malaria parasitaemia (OR = 26.87, 95% = 15.79 - 45.74, p = 0.000) and parity of 0 - 1 compared with other parities (OR = 1.31, 95% CI = 1.11 - 1.55, p = 0.002). On multivariate logistic regression, three of the six factors that were significant on univariate logistic regression remained significant. These were: positive placental malaria parasitaemia (OR = 2.55, 95% CI = 1.45 - 4.47, p = 0.001); positive cord malaria parasitaemia (OR = 18.90, 95% CI = 10.68 - 33.46, p = 0.000 and parity of 0 - 1 compared with other parities (OR = 1.66, 95% CI = 1.09 - 2.52, p = 0.02). It was concluded that the risk factors for congenital malaria identified in this study emphasise the need for effective preventive and curative treatment of malaria not only during pregnancy but also during delivery in malaria endemic areas. Additionally, congenital malaria should now rank high among the list of differential diagnosis of fever in the newborn in such endemic areas.

Adolescent↗
PubMed2000

Prophylactic corticosteroids for preterm birth.

BACKGROUND: Respiratory distress syndrome is a serious complication of prematurity causing significant immediate and long-term mortality and morbidity. OBJECTIVES: The objective of this review was to assess the effects of corticosteroids administered to pregnant women to accelerate fetal lung maturity prior to preterm delivery. SEARCH STRATEGY: The Cochrane Pregnancy and Childbirth Group trials register was searched. SELECTION CRITERIA: Randomised and quasi-randomised trials of corticosteroid drugs capable of crossing the placenta compared with placebo or no treatment in women expected to deliver preterm as a result of either spontaneous preterm labour, prelabour rupture of the membranes preterm, or elective preterm delivery. DATA COLLECTION AND ANALYSIS: Eligibility and trial quality were assessed by one reviewer. MAIN RESULTS: Eighteen trials including data on over 3700 babies were included. Antenatal administration of 24 milligrams of betamethasone, of 24 milligrams of dexamethasone, or two grams of hydrocortisone to women expected to give birth preterm was associated with a significant reduction in mortality (odds ratio 0.60, 95% confidence interval 0.48 to 0.75), respiratory distress syndrome (odds ratio 0.53, 95% confidence interval 0.44 to 0.63) and intraventricular haemorrhage in preterm infants. These benefits extended to a broad range of gestational ages and were not limited by gender or race. No adverse consequences of prophylactic corticosteroids for preterm birth have been identified. REVIEWER'S CONCLUSIONS: Corticosteroids given prior to preterm birth (as a result of either preterm labour or elective preterm delivery) are effective in preventing respiratory distress syndrome and neonatal mortality. However there is not enough evidence to evaluate the use of repeated doses of corticosteroids in women who remain undelivered, but who are at continued risk of preterm birth. (This abstract has been prepared centrally.)

Female↗
PubMed1993

Prevalence and risk factors for diabetes and diabetes-related amputations in American Indians in southern Arizona.

OBJECTIVE: To describe the prevalence of NIDDM and LEA using data from a computer-based patient data base. RESEARCH DESIGN AND METHODS: Diabetic patients with and without LEA, and nondiabetic patients were identified by computer search. Charts of diabetic patients were reviewed for confirmation of diagnosis of diabetes and diabetes-related amputation. The diabetic and nondiabetic populations were described, and certain risk factors were identified. RESULTS: The overall prevalence of NIDDM in this tribe in 1985-1986 was 18.3/100 adults (> or = 18 yr of age), whereas the prevalence of LEA/100 adults with NIDDM was 10.3%. Females were 1.3 times as likely to have diagnosed diabetes as males (95% CI 1.2-1.4), and males with diabetes were 1.4 times more likely to have had LEA than females with diabetes (95% CI 1.1-1.9). CONCLUSIONS: Automated health-care delivery data base used for this tribe can be used to maintain surveillance for diabetes and amputations in diabetic patients. Effective programs to prevent complications of diabetes, such as LEA, in this tribe are urgently needed.

Adolescent↗
PubMed1984

Factors influencing the feeding of first-born infants.

Influences on the choice and use of an infant feeding method by primigravidae were studied from late pregnancy until six months after delivery. Data were collected by home interviews and postal questionnaires, and from hospital case-notes. Three-quarters of the women had chosen a method before their first hospital visit and most adhered to their choice. Mothers named midwives and health visitors more often than other health professionals as appropriate for discussions about feeding. However, there was little evidence of the influence of health professionals apart from an association between hospital feeding practices and duration of breast feeding. The major influences on mothers were socio-cultural. Findings suggest that breast feeding can be encouraged by a wide dissemination of information, by enabling mothers to discuss feeding with their preferred professional, by respecting an early choice of method, and by encouraging demand feeding which should begin soon after delivery.

Attitude↗
PubMed1999

Perianal Crohn's disease and pregnancy: role of the mode of delivery.

OBJECTIVE: Elective cesarean section (CS) is a standard recommendation for pregnant women with perianal Crohn's disease. In this study we examined the mode of delivery for pregnant women with Crohn's disease and assessed the relationship between perianal disease activity and delivery mode. METHODS: The University of Manitoba's Inflammatory Bowel Disease Database, a population-based database, was interfaced with a provincial birth database to compare the mode of delivery for women with Crohn's disease and ulcerative colitis to that of the general population for the years 1985-1995. To describe clinical issues related to perianal Crohn's disease in relation to mode of delivery, data were obtained from a subset of women with Crohn's disease who had given birth between 1985 and 1995 using a standardized questionnaire. Data regarding Crohn's disease and birth history were verified through chart review (93.8%) and corroboration with the personal physician (87.5%). RESULTS: The total and (elective) CS rates were higher for Crohn's disease 20.9% (9.0%), and for UC 20.8% (9.3%) than the general population 15% (5.4%) (p < 0.01 for each). Among primiparous women, patients with Crohn's disease and UC were also significantly more likely to have CS than the general population. In the target group of 281 women, 52 had births in the years in question and were contactable. There were 54 vaginal births and 10 sections. Fifteen of 54 vaginal births were predated by perianal disease; 4 of 15 reported active perianal disease at birth; and all reported worsening of perianal symptoms postpartum. Those with inactive perianal disease (n = 11) had no relapse of perianal disease in 1 yr of follow-up postpartum. Of 39 vaginal deliveries with no known perianal disease, only 1 ultimately developed perianal disease within 1 yr of postpartum follow-up. CONCLUSIONS: Women with inflammatory bowel disease undergo CS more often compared to the general population. For those with either no history of perianal disease or inactive perianal disease at birth, the risk of perianal disease relapse is very low and does not justify CS. Active perianal disease at time of delivery is an indication for CS.

Adolescent↗
PubMed2003

Three-dimensional ultrasound imaging of the pelvic floor: the effect of parturition on paravaginal support structures.

OBJECTIVE: It is assumed that support of the female urethra and bladder is maintained by paraurethral and paravaginal fascial structures, with hypermobility resulting from delivery-related trauma. This study used three-dimensional translabial ultrasound to assess these structures and document peripartal changes. DESIGN: A clinical observational pilot study was performed on 26 nulliparous women recruited in the third trimester of pregnancy. They underwent translabial two- and three-dimensional ultrasound. Twenty-three women were again seen 2-5 months postpartum. The assessor was blinded against two-dimensional ultrasound and delivery data. Vaginal tenting was rated as being present, indeterminate or absent at each of three levels, and was correlated with bladder neck descent (BND) and urethral rotation on Valsalva maneuver. RESULTS: Tenting was visible at all levels in 21 of 26 women antepartally. In three women tenting was absent on one level; in two cases tenting was rated indeterminate. There was no significant difference in BND between women with visible tenting and those without. The BND range for women with intact tenting was 5.4-41.6 mm. Twenty-one of the 26 women were included in the postpartum analysis. Of these, obvious peripartal changes were documented in five. Loss of tenting did not correlate significantly with changes in BND. CONCLUSIONS: Most nulliparous women showed evidence of intact paravaginal support structures. Tenting occurred in women with widely varying BND, implying that excess bladder neck mobility may be due to increased fascial compliance. Postnatally, fascial disruption was suspected in a minority of patients only. In some women delivery-related changes may be due to attenuation rather than disruption of structures.

Adult↗
PubMed2002

Distribution of components of the glutathione detoxification system across the human placenta after uncomplicated vaginal deliveries.

The function of the glutathione-related detoxification system plays an important role to ensure an uncomplicated pregnancy outcome. This study was performed to investigate whether the components of the glutathione-related detoxification system are equally distributed among the different cotelydons in the human placenta. We measured glutathione, cysteine, glutathione S-transferase (GST) isoenzyme levels (GSTA1+A2, GSTP1, GSTM1 and GSTT1), enzyme activities of glutathione S-transferase and glutathione peroxidases, protein carbonyl levels, and antioxidant capacities at twelve different standardized positions in six placentae from healthy women after uncomplicated pregnancy and vaginal delivery. Data were statistically evaluated with a Friedman two-way ANOVA with Bonferroni correction. 'Foetal'-side values were not significantly different from those at the 'maternal'-side. Except for GSTA1+A2, no significant differences were found between different sampling sites indicating that the distribution of all parameters measured was homogenous throughout the placenta. Since levels of GSTA1+A2 were minor compared to those of GSTP1 and GSTT1, the clinical relevance of this heterogeneity may be limited. These results implicate that the location of sampling is not important as long as biopsies are taken from physiological cotelydons.

Adult↗