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PubMed2003

Breech presentation and tossing a coin: heads or tails.

Through a retrospective review of our own materials and data from peer-reviewed journals, among medical entities a greater probability than 0.5 was not found for breech presentation. Submitting the occurrence of breech presentation to the classical laws of probability means that each fetus in breech presentation has its 'pair' in cephalic presentation. Among medical entities with a probability of less than 0.5 for breech presentation, the group of fetuses in cephalic presentation consist of two subgroups: (1) fetuses which are by chance in cephalic presentation and whose number is identical to the number of fetuses in breech presentation, (2) fetuses which are in cephalic presentation because of the postural development. Likewise, introducing a medical entity with a small number of cases does not allow a conclusion to be drawn about a relationship between that entity and breech presentation.

Breech Presentation↗
PubMed1992

Substance use in rural Midwestern pregnant women.

OBJECTIVE: To determine the rate of prenatal use of cocaine, cannabis, amphetamines, opiates, and cigarettes in rural midwestern women by analysis of reported use of cigarettes, maternal urine drug screening at admission to labor and delivery, and newborn meconium screening. DESIGN: The cohort of all women presenting to labor and delivery and their newborns were screened by urine and meconium analysis. Demographic information was also collected and matched to the urine and meconium samples. SETTING: Four primary care hospitals in rural Minnesota. Hospitals range in size from 66 to 140 beds, with 400 to 780 deliveries each year. PARTICIPANTS: All women presenting to labor and delivery for evaluation of term or preterm labor between April 4, 1991, and October 4, 1991. MEASUREMENTS/MAIN RESULTS: Overall, drugs not administered during labor were found in a mean (+/- SD) of 3.2% +/- 1.1% of all urine screens. Cannabis was found in 1.2% +/- 0.7% of maternal urine samples, amphetamines in 0.8% +/- 0.58%, opiates in 1.2% +/- 0.7%, and cocaine in 0% +/- 0.3%. Meconium samples were positive in 1.8% +/- 0.9% of cases. Cannabis was found in 1.1% +/- 0.7% of meconium samples, opiates in 0.6% +/- 0.5%, and cocaine in 0.1% +/- 0.1%. No urine samples were positive for more than one drug. One meconium sample tested positive for both cocaine and cannabis. Nearly 4% of patients had either a positive urine specimen or a positive meconium specimen. By history, 24.5% of women admitted to smoking during pregnancy. CONCLUSION: The use of cocaine, cannabis, opiates, and amphetamines was uncommon in this rural population. However, one quarter of the women admitted to smoking during pregnancy, exposing their fetuses to a dangerous substance.

Adult↗
PubMed1980

Cesarean section in premature delivery.

Cesarean sections were performed in 24 cases before the end of the 32nd week of pregnancy. Despite the fact that the indications for the operations were severe obstetric complications, the perinatal mortality was 25%, which should be compared to 23% for all children born in Sweden at that age., 2 of the surviving children developed definite neurological sequelae, which is a lower incidence than reported for vaginal premature deliveries. The results indicate that cesarean section can be recommended even for deliveries before the end of the 32nd week of pregnancy for fetal indications such as breech presentation, premature rupture of the membranes, premature labor with rigid cervix and for fetal asphyxia.

Apgar Score↗