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At least 1,657 records · Page 92Linked to original sources
PubMed2004

Does fetal head position at the term plus 12 scan influence induction, labor and delivery outcome?

AIMS: To assess the influence that fetal head position has on induction, labor and delivery outcome for both mother and baby. METHODS: During a one month period, in November 1999, all women attending for a post-dates scan were enrolled as the study population. In total, 91 women formed our study population for analysis of data. The sonographic, induction and labor details of all women were recorded on a dedicated data sheet. As well as documenting the maternal age, parity, liquor volume (mm) and BPS, the position of the fetal head was noted by the sonographer as occipitoanterior, occipitotransverse or occipitoposterior. All women had gestation confirmed by ultrasound early during the course of their pregnancy. Maternal, ultrasonographic, induction and labor variables were correlated with fetal head presentation at scan. RESULTS: There was no positive correlation found between fetal head position at the term plus 12 scan and associated induction, labor or delivery complications in the 91 women studied. CONCLUSIONS: Our study shows no positive correlation between fetal head position and induction, labor or delivery complications.

Adult↗
PubMed2006

[Is there a role for X-ray pelvimetry in the twenty-first century?].

The purpose of this article was to perform a critical analysis of publications having estimated the utility of X-ray pelvimetry, in order to allow tangible and useful conclusions for the clinical practice. X-ray pelvimetry was proposed in 3 indications: trial of labour among patients with a history of caesarean section, breech presentation, suspicion of cephalopelvic disproportion. The large majority of these publications are retrospective studies, studying a low number of patients and especially without control groups or randomisation. Their contradictory results and their methodological weaknesses do not allow any conclusion. Published randomised trials are exceptional. Among patients with a history of caesarean section, there is only one randomised trial; it demonstrates that ante-partum X-ray pelvimetry is not necessary prior to a trial labour in women with one previous caesarean section. It increases the caesarean section rate and is a poor predictor of the outcome of labour. There is also only one randomised trial which evaluated the interest of X-ray pelvimetry in patients with a breech presentation: the use of pelvimetry in breech presentation at term does not significantly reduce the overall caesarean-section rate, and does not improve the neonatal issues. However, it allows better selection of the delivery route, with a significantly lower emergency Caesarean-section rate. Finally, the only one randomised trial having studied the utility of X-ray pelvimetry for the prediction of cephalopelvic disproportion shows that pelvimetry is a poor predictor of the outcome of labour, has no influence on the neonatal issues and increases the caesarean sections rate. Furthermore, although radiation exposure during a X-ray pelvimetry is very weak, diagnostic X-ray studies during any stage of gestation have been shown to increase the risk of childhood cancer in the irradiated fetus. In the rare cases where pelvimetry is useful (trial of labour with a breech presentation), it is thus careful to perform a MRI pelvimetry.

Breech Presentation↗
PubMed2006

Meconium-stained amniotic fluid across gestation and neonatal acid-base status.

OBJECTIVE: To estimate whether the acid-base status of neonates born to women with meconium-stained amniotic fluid varies across gestation. METHODS: We carried out a retrospective cohort study of all pregnancies that were complicated by meconium-stained amniotic fluid in 2004. Cases were identified from a perinatal pathology database that contained data on all pregnancies complicated by meconium-stained amniotic fluid. Data abstracted from the charts included gestational age at delivery, umbilical arterial pH, birth weight, and the presence or absence of labor. Cases were stratified according to gestational age at delivery. The distribution of meconium-stained amniotic fluid across gestation was computed. The mean umbilical arterial pH values (with 95% confidence intervals) across gestation were assessed by analysis of variance. RESULTS: The mean umbilical arterial pH in women with meconium-stained amniotic fluid did not differ across gestation. The overall incidence of meconium-stained amniotic fluid was 12.0% (766 of 6,403 deliveries). The rates of meconium-stained amniotic fluid increased from 1.2% at 32 weeks to 100% at 42 weeks. CONCLUSION: The rising incidence of meconium-stained amniotic fluid with gestational age is consistent with the hypothesis that fetal maturation is a major etiologic factor in meconium passage. Also, the lack of variation of mean umbilical arterial pH across gestation suggests that fetal acidemia is not increased when meconium passage occurs earlier in pregnancy rather than at later gestational ages.

Adult↗
PubMed1995

[Manual rotation of vertex presentations in posterior occipital-iliac or transverse position. Technique and value].

OBJECTIVE: Evaluate of the usefulness of manual rotation of occipito-posterior or transverse presentation. DESIGN: One year retrospective study (1991). SETTING: Maternity hospital, Clinique Universitaire Baudelocque. SUBJECTS: All patients during labour having a spontaneous (n = 160) or a manual rotation (n = 368) of an occipito-posterior or occipitotransverse presentation. The manual rotation could be indicated for a fetal distress, a protracted first stage of labour or prophylactically. INTERVENTION: Manual rotation as described by Tarnier, was performed at least at 7 cm cervical dilatation. MAIN OUTCOME MEASURES: Success rate of manual rotation, cesarean section rate, maternal, fetal and neonatal complications.

Adolescent↗