Minnesota responds to fetal alcohol syndrome.
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Adolescent↗
Biomedical subjects
R Lussky
Publications and source records attributed to R Lussky.
Forceps operations in perspective. I. Midforceps rotation operations.
Four hundred fifty-eight consecutive midforceps rotation operations were evaluated with a specially designed Perinatal Morbidity Index (PMI) and Maternal Morbidity Index (MMI). An unfavorable fetal outcome occurred in 30.8% of the midforceps rotation operations, and an unfavorable maternal outcome occurred in 13.5% of the cases. Twelve risk factors were found to be associated with suboptimal results. Among patients with no risk factors, an unfavorable fetal outcome occurred in 11% of the cases. Of the patients with three or more risk factors, in contrast, an unfavorable fetal outcome was found in 47% of the cases. A uniformly good fetal outcome was noted among patients selected as controls. Under ordinary circumstances, midforceps rotation operations should not be attempted in a patient already at significant risk. "Significant risk" is defined in the article.
Apgar Score↗
The effect of fetal monitoring on the incidence of cesarean section.
To determine whether routine fetal monitoring inevitably increases the cesarean section rate, we studied the pertinent literature and analyzed the cesarean sections performed at Evanston Hospital during the last 8 years. Many authors have found a slight to moderate increase in cesarean section rates, whereas others have found no change or a decrease. At Evanston Hospital, the primary cesarean section rate has increased from 2.6% in 1968-1969 to 6.9% in 1974-1975. Only 19.2% of this increase is due to increased fetal distress; the magnitude of the increase is due to changes in other factors, notably, breech deliveries (29.5% of the increase) and "dystocia" (60.2% of the increase). The incidence of cesarean section is controlled by several complex variables, only one of which is fetal monitoring. To describe the fetal monitors as the cause of the increased cesarean section rate is to ignore these other equally profound changes in obstetric technic and philosophy.
Breech Presentation↗