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At least 19 recordsLinked to original sources
PubMed1997

Effect of dystocia on yield, fertility, and cow losses and an economic evaluation of dystocia scores for Holsteins.

Lactation records of US Holstein cows were analyzed with mixed models to determine the effect of dystocia on 305-d milk, fat, and protein yields, days open, number of services, and cow losses and to estimate the economic loss associated with dystocia. The data were 122,715 records of 71,618 cows from 1980 to 1991. The single-trait animal model included herd-year-season, sex of calf, age of dam, and dystocia score as fixed effects and animal and permanent environment as random effects. The effect of dystocia was significant (P < 0.01) on all traits within and across parities. Over multiple parities, the differences between score 5 (extreme difficulty) versus score 1 (no problem) for milk yield, fat yield, protein yield, days open, number of services, and cow deaths were 703.6 kg, 24.1 kg, 20.8 kg, 33 d, 0.2 services, and 4.1%, respectively. The losses associated with traits were priced and summed to determine the total economic loss associated with dystocia. In addition, calf mortality was considered to be a cost. Across parities, estimates of costs were $0.00, $50.45, $96.48, $159.82, and $379.61 for scores 1 to 5, respectively. Cost of dystocia was relatively higher on a per incidence basis than would be expected from the mean of the population. The total cost associated with dystocia (i. e., within-parity sum of costs associated with dystocia scores weighted by the probability of occurrence) was $28.53 for an average heifer and about $10.00 for an average cow for other parities.

Animal Husbandry↗
PubMed1987

Reporting of dystocia scores and effects of dystocia on production, days open, and days dry from dairy herd improvement data.

Dystocia and livability scores are collected through the Mid-States Dairy Records Processing Center. Thirty-four percent of the cows had dystocia scores reported. Least difficult births were scored 1 and the most difficult births scored 5. Days open in first parity were 14 d greater for births scored 5 versus 1. The differences were larger in later parities. There were 26 more d open in second parity and 19 more d open in third and greater parities for score 5 versus 1. Differences between cows scored 5 versus 1 were 465 kg milk and 20.7 kg milk fat in first lactations, 576 kg milk and 20.9 kg milk fat in second lactations, and 725 kg milk and 25 kg milk fat in third and greater lactations. Cows produced more in lactations following an easy birth. Frequency of difficult births was less in lactations other than the first.

Animals↗
PubMed1975

[Constriction ring dystocia: a special form of uterine dystocia (author's transl)].

Constriction Ring Dystocia means a rare form of uterine dystocia (0.1%--1.7%). Pathophysiologically it means a hypertonic incoordinate anomaly of labor. The paper reports two cases of constriction ring, which had been recognized first during sectio cesarean. As the measure of choose is suggested to use tocolytica, although there do not exist any experiences and there was yet no chance to utilise these medicines because of lack of early recognition.

Adult↗
PubMed2006

Shoulder dystocia: the unpreventable obstetric emergency with empiric management guidelines.

OBJECTIVE: Much of our understanding and knowledge of shoulder dystocia has been blurred by inconsistent and scientific studies that are of limited scientific quality. In an evidence-based format, we sought to answer the following questions: (1) Is shoulder dystocia predictable? (2) Can shoulder dystocia be prevented? (3) When shoulder dystocia does occur, what maneuvers should be performed? and (4) What are the sequelae of shoulder dystocia? STUDY DESIGN: Electronic databases, including PUBMED and the Cochrane Database, were searched using the key word "shoulder dystocia." We also performed a manual review of articles included in the bibliographies of these selected articles to further define articles for review. Only those articles published in the English language were eligible for inclusion. RESULTS: There is a significantly increased risk of shoulder dystocia as birth weight linearly increases. From a prospective point of view, however, prepregnancy and antepartum risk factors have exceedingly poor predictive value for the prediction of shoulder dystocia. Late pregnancy ultrasound likewise displays low sensitivity, decreasing accuracy with increasing birth weight, and an overall tendency to overestimate the birth weight. Induction of labor for suspected fetal macrosomia has not been shown to alter the incidence of shoulder dystocia among nondiabetic patients. The concept of prophylactic cesarean delivery as a means to prevent shoulder dystocia and therefore avoid brachial plexus injury has not been supported by either clinical or theoretic data. Although many maneuvers have been described for the successful alleviation of shoulder dystocia, there have been no randomized controlled trials or laboratory experiments that have directly compared these techniques. Despite the introduction of ancillary obstetric maneuvers, such as McRoberts maneuver and a generalized trend towards the avoidance of fundal pressure, it has been shown that the rate of shoulder-dystocia associated brachial plexus palsy has not decreased. The simple occurrence of a shoulder dystocia event before any iatrogenic intervention may be associated with brachial plexus injury. CONCLUSION: For many years, long-standing opinions based solely on empiric reasoning have dictated our understanding of the detailed aspects of shoulder dystocia prevention and management. Despite its infrequent occurrence, all healthcare providers attending pregnancies must be prepared to handle vaginal deliveries complicated by shoulder dystocia.

Birth Injuries↗
PubMed2006

Labor dystocia and its association with interpregnancy interval.

OBJECTIVE: The purpose of this study was to evaluate the prevalence of labor dystocia and its association with interpregnancy interval. STUDY DESIGN: We linked the birth data for Michigan infants who were born from 1994 to 2002 with the hospital discharge data. The International Classification of Diseases (9th revision, clinical modifications, ICD-9-CM) codes that indicate labor dystocia were identified by a physician panel and classified as functional and mechanical dystocia. We estimated the prevalence of labor dystocia and used stratified and logistic regression analyses to evaluate labor dystocia in relation to interpregnancy interval, controlling for other reproductive risk factors. RESULTS: Overall, 20.8% of the births involved labor dystocia (11.1% functional; 12.5% mechanical). Both functional and mechanical dystocia were more prevalent in first births than in subsequent births; mechanical dystocia was more prevalent in multiple births than in singleton births. In singleton births to multiparous mothers, labor dystocia was associated with the interpregnancy interval in a dose-response fashion. Compared with an interpregnancy interval of <2 years, the adjusted odds ratios that was associated with interpregnancy intervals of 2 to 3, 4 to 5, 6 to 7, 8 to 9, and 10+ years were 1.06 (95% CI, 1.04-1.08), 1.15 (95% CI, 1.12-1.17), 1.25 (95% CI, 1.21-1.29), 1.31 (95% CI, 1.26-1.37), and 1.50 (95% CI, 1.45-1.56), respectively, when we controlled for other reproductive risk factors. Functional dystocia was associated more strongly with interpregnancy interval than mechanical dystocia. CONCLUSION: Labor dystocia is common. In singleton births to multiparous mothers, labor dystocia increased with interpregnancy interval.

Adolescent↗
PubMed2003

Dystocia in a referral hospital setting: approach and results.

REASONS FOR PERFORMING STUDY: Dystocia in the mare is an emergency in which duration has a profound effect on survival of the foal. Specific examination of the effects of dystocia duration on foal survival provides information to enable horse care personnel and veterinarians to manage these cases more effectively and maximise the chances of obtaining a live foal. HYPOTHESIS: Dystocia duration would have a negative impact on foal survival while method of dystocia resolution would not have an effect on foal survival. Additionally, we were interested in determining the effects of dystocia on subsequent fertility. METHODS AND RESULTS: In the years 1986-1999, 247 dystocias were admitted. Of these, 91 % resulted in survival and discharge of the mare, 42% in delivery of a live foal, and 29% of foals survived to discharge. Period from hospital arrival to delivery for foals alive at discharge (23.0 +/- 14.1 mins) was not significantly different than for foals not surviving (24.8 +/- 10.6 mins) (P > 0.05); and from chorioallantoic rupture to delivery for foals alive at discharge (71.7 +/- 343 mins) was significantly less than for foals not surviving (853 +/- 37.4 mins) (P < 0.05). Average predystocia live foaling rates for all mares with available records was 84%. Overall post dystocia live foaling rates over the entire period of this study were 67%. Of mares bred in the year of the dystocia, 59% had a live foal in the year following. CONCLUSIONS: Based on these results, dystocia duration has a significant effect on foal survival and resolution methods should be chosen to minimise this time, as the difference between mean dystocia duration for foals that lived and those that did not in this study was 13.6 mins. Post dystocia foaling rates reported here are higher than previously reported for both same-season and overall breedings, indicating same-season breeding may be rewarding for select dystocia cases. POTENTIAL RELEVANCE: Dystocia resolution methods that minimise delivery time may maximise foal survival. Post dystoicia breeding may be rewarding in select cases.

Animals↗
PubMed1999

The incidence and severity of shoulder dystocia correlates with a sonographic measurement of asymmetry in patients with diabetes.

The objective of this paper is to examine the relationship between fetal asymmetry measured sonographically and the incidence and severity of shoulder dystocia in diabetic patients. Ultrasound data were collected retrospectively from examinations of women with gestational and pregastational diabetes who delivered at University of California, Irvine Medical Center from 1993-1995. Sonographic fetal asymmetry was quantified by calculating the difference between the abdominal diameter and the biparietal diameter in centimeters (AD-BPD). The residual AD-BPD was a patient's actual AD-BPD at the time of the ultrasound minus the mean AD-BPD obtained in our population at the patient's gestational age. The correlations between fetal asymmetry and the incidence and severity of shoulder dystocia were assessed using an analysis of variance as well as a logistic regression analysis. Mild shoulder dystocia was defined as a delivery requiring McRobert's maneuver and/or suprapubic pressure, while severe shoulder dystocia was assessed when delivery of the posterior arm with Wood's corkscrew maneuver was required. One hundred twenty-three women met the inclusion criteria for the study. Dividing the cohort into three groups based on AD-BPD residual values resulted in the following AD-BPD residual ranges and incidences of shoulder dystocia: Group I, -1.80 to -0.32 cm (9.8%), Group II, -0.31 to 0.32 cm (19.5%), and Group III .33 to 2.0 cm (34.1%), (p <0.03). The residual AD-BPD difference correlated with the incidence of shoulder dystocia after controlling for maternal age, weight, parity, birth weight, and the gestational age at ultrasound (P <0.03). Similar results were found with regards to dystocia severity as the mean residual AD-BPD difference between those with no dystocia, mild dystocia, and severe shoulder dystocia was -0.09, 0.23, and 0.46 cm, respectively, (p <0.006). The residual AD-BPD correlated with the severity of shoulder dystocia after controlling for the above-mentioned confounding variables (p <0.05) in a regression analysis. There is a direct correlation in diabetic patients between the level of fetal truncal asymmetry measured sonographically and the incidence and severity of shoulder dystocia.

Abdomen↗
PubMed2006

Incidence and breed predilection for dystocia and risk factors for cesarean section in a Swedish population of insured dogs.

OBJECTIVES: To estimate the incidence and breed predilection for canine dystocia using data from insurance claims. The risk factors for cesarean section (CS) were assessed for bitches with dystocia. STUDY DESIGN: Retrospective, longitudinal study. SAMPLE POPULATION: Insurance claims records (1995-2002) from a Swedish animal insurance database (Agria), including approximately 200,000 bitches. METHODS: The overall incidence rate of dystocia in insured bitches was calculated by dividing the number of reimbursed dystocia claims with the number of dog years at risk. Subsequently, incidence rates were stratified by breed, region, and habitat. The proportion of bitches with a dystocia claim that had CS were calculated, and risk factors for CS were assessed using a logistic regression model. RESULTS: Between 1995 and 2002, 3894 (2%) of 195,931 Swedish bitches included in the study had a reimbursed insurance claim for dystocia. The overall incidence rate of dystocia was 5.7 cases/ 1000 dog years at risk. Some breeds like the Scottish terrier were at increased risk of dystocia. Among bitches with dystocia, 63.8% were treated by CS. CONCLUSION: Dystocia in the bitch is more common than reported earlier. The risk of developing dystocia varies by breed, and a high percentage (63.8%) of affected bitches undergo CS. Clinical Relevance- Breeders and veterinarians could use this information to better predict which bitches are likely to experience dystocia and/or CS.

Animals↗
PubMed1987

Shoulder dystocia: a fetal-physician risk.

Trauma that occurs as a result of shoulder dystocia is an important cause of neonatal morbidity. If the occurrence of severe shoulder dystocia, resulting in fetal asphyxia and trauma, could be accurately predicted from maternal risk factors, then a cesarean section would be indicated to prevent the poor outcome. The information available in the obstetric literature, however, is contradictory regarding whether shoulder dystocia can be predicted. In the present study, the patients at greatest risk of shoulder dystocia (all 394 mothers delivering neonates with birth weights greater than or equal to 4000 gm over a 2-year period) were examined. A three-way discriminant analysis was used to determine if a model could be developed that could effectively predict those patients who would be included in each of the groups of no shoulder dystocia, shoulder dystocia without trauma (29 patients), and shoulder dystocia with trauma (20 patients). Three factors, including birth weight, prolonged deceleration phase, and length of second stage labor, were found individually to contribute significantly to the classification. However, when examined in detail, it was noted that while 94% of cases with no shoulder dystocia would be detected, only 16% of the cases of shoulder dystocia with trauma would be predicted by this model. We conclude that in the group of pregnancies delivering neonates greater than or equal to 4000 gm, the occurrence of shoulder dystocia cannot be predicted from clinical characteristics or labor abnormalities, and that the occurrence of shoulder dystocia is not evidence of medical malpractice.

Birth Injuries↗
PubMed1995

Perinatal implications of shoulder dystocia.

OBJECTIVE: To assess the antecedents of shoulder dystocia, the risk of recurrence, and the perinatal morbidity associated with the different maneuvers used for its management. METHODS: We conducted a 10-year (1980-1989) retrospective case record review of all instances of shoulder dystocia in a teaching maternity hospital. RESULTS: There were 254 cases of shoulder dystocia in 40,518 vaginal cephalic deliveries (0.6%), with 33 cases (13.0%) of brachial plexus palsy and 13 fractures (5.1%). There were no perinatal deaths attributable to shoulder dystocia. The risk of shoulder dystocia was increased with prolonged pregnancy (threefold), prolonged second stage of labor (threefold), mid-forceps deliveries (tenfold), and increasing birth weight. Of the maneuvers used to deal with shoulder dystocia, strong downward traction on the head was significantly correlated with brachial plexus palsy compared with other individual methods of delivering the shoulders. There was only one case of recurrent shoulder dystocia in 80 women having 93 cephalic vaginal deliveries after their original delivery coded with shoulder dystocia. CONCLUSION: Shoulder dystocia is not a reliably predictable event in labor. Although the risk of shoulder dystocia is increased with prolonged pregnancy, prolonged second stage of labor, increasing birth weight, and mid-forcepts delivery, the majority of cases occur without these risk factors. Strong downward traction on the head is associated with the greatest degree of neonatal trauma, whereas McRoberts maneuver has the least. The risk of recurrent shoulder dystocia is low.

Birth Injuries↗