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At least 523 records · Page 29Linked to original sources
PubMed2006

A modified technique to deliver the posterior arm in severe shoulder dystocia.

BACKGROUND: Posterior arm delivery resolves almost all cases of severe shoulder dystocia. However, if the posterior arm is extended or lies under the fetus's body, the usually described technique for its delivery may not be practicable. CASE: A young, multiparous woman with type II diabetes had a low-midcavity vacuum delivery. Severe shoulder dystocia was encountered. The usual maneuvers, including the usual technique described for delivery of the posterior arm, were unsuccessful. A modified technique for delivery of the posterior arm was used. CONCLUSION: Posterior axillary traction will deliver the posterior arm when it is not accessible by the usual technique.

Adult↗
PubMed1983

Effect of segmental epidural analgesia on neonatal serum bilirubin concentration and incidence of neonatal hyperbilirubinemia.

Neonatal serum bilirubin levels were determined at the ages of 12 hrs, 2 days, 3 days, 4 days and 5 days in 80 infants. Forty-three mothers had received segmental epidural analgesia at the height of Th 10-12 for pain relief during the first stage of labor. The analgesic agent used was 0.5% bupivacaine. The individual doses were of 4 ml. Thirty-seven mothers served as a control group. The groups were further divided into smaller groups according to whether oxytocin was used for induction or acceleration of labor--or not. The results showed no statistically significant differences in the neonatal serum bilirubin levels at different times between the epidural and the control groups, whether oxytocin was used or not. Nor did the incidence of neonatal hyperbilirubinemia cases differ between the groups.

Anesthesia, Epidural↗
PubMed1995

[Gynecologic and obstetric anesthesia in Hungary 1993].

Authors publish findings of a nationwide survey of pain relief in childbirth in Hungary carried out during the year of 1993. Informations were provided on 104,137 deliveries in 98 units. At 71,744 vaginal deliveries (81%) not any types of pain relief were used. The frequency ot different types of pain reliefs at vaginal deliveries were as follows: systemic opioids at 7387 cases (8.3%), epidural analgesia at 4611 cases (5.2%) and inhalational analgesia (nitrous oxide) at 4470 cases (5.0%). The availability of epidural analgesia at 62 units was absent. The rate of spinal--epidural analgesia at Cesarean sections was 37% (n = 13,240). At gynaecological laparotomies (n = 18,219) the rate of general anaesthesia was 98%, this rate at vaginal hysterectomies was 56.8% (n = 1568). Authors conclude that the rate of pain relief in labour in Hungary is unreasonably low. The reason of it is the lack of anaesthetists and also the traditional view, which does not recognize the importance of the pain relief in labour.

Adult↗
PubMed2002

A randomized trial of vaginal prostaglandin E2 for induction of labor. Insert vs. tablet.

OBJECTIVE: To compare the efficacy and safety of a prostaglandin E2 (PGE2) vaginal insert with PGE2 administered as a vaginal tablet. STUDY DESIGN: A randomized, observational study was performed. Women requiring induction of labor were randomly assigned to receive either a 10-mg PGE2 vaginal insert (group 1, n = 100) or 3-mg PGE2 tablets twice at six-hour intervals (group 2, n = 100). The primary efficacy outcome variable was vaginal delivery within 24 hours of insertion. The criteria for safety were the occurrence of uterine hyperstimulation, abnormal fetal heart rate patterns, use of beta 2-sympathomimetic drugs and fetal outcome. RESULTS: No differences in terms of vaginal delivery or cesarean section within 24 hours of induction were found. The cesarean section rate was 21% in group 1 and 22% in group 2. The interval from insertion of the induction agent to the onset of regular uterine contractions and the insertion-to-delivery interval were not different between the two cohorts. No difference in the frequency of uterine hyperstimulation, use of beta 2-sympathomimetic drugs, abnormal fetal heart rate patterns, fetal outcome, or oxytocin and analgesic requirements were found. In seven of eight patients in group 1 who experienced uterine hyperstimulation, removal of the insert was sufficient to stop it, whereas in group 2, of nine cases, eight needed medical interventions to end hyperstimulation (P = .003). CONCLUSION: The continuous release of PGE2 from the vaginal insert permits controlled induction of labor, and easy removal of the drug in cases of uterine hyperstimulation is possible.

Adult↗
PubMed1997

[Zinc blood levels in 73 puerperal women. Correlation with obstetric and neonatal complications].

BACKGROUND: Low plasma zinc concentrations in pregnant women have been associated with certain obstetric and foetal complications. However, there is no agreement in previous studies and mediterranean populations have not been extensively studied. METHODS: The plasmatic zinc was tested in 73 mothers, within 24 hours post-partum, in order to evaluate an association between plasmatic zinc and various obstetric and fetal complications. The women were all from the Florence province and were admitted for delivery at the II Maternity Ward of the University of Florence (Third level Center); mothers of twins and foreign mothers were excluded. Subjects were consecutively included in the study. The values pointed out in a control group (n = 28) were compared with the hematic zinc of a) women who delivered by cesarean section (CS) for acute fetal distress or by operative delivery with vacuum extractor (n = 9), b,c) mothers whose children weighted over the 90th (LGA: n = 11) or under the 10th percentile (SGA: n = 13), and d) mothers who delivered prematurely (n = 12). The subjects included in two or more groups, were not considered. RESULTS: The plasmatic zinc of the control group has been significantly higher than that of mothers who delivered by vacuum extractor or by urgent CS (p < 0.0001) and than that of mothers whose newborns were LGA (p < 0.0024). The hematic zinc of the control group is not higher than that of mothers with SGA or premature children. CONCLUSIONS: The conclusions is drawn that even a relative zinc deficiency may negatively potentiate certain obstetric abnormalities in fetal development or in delivering.

Adult↗
PubMed1982

[Perinatal mortality from 1969 to 1979].

From January 1969 to December 1979 a total number of 26,255 births took place at the Department of Obstetrics and Gynecology of the General Hospital Steyr. During this period the perinatal mortality decreased from 35.7% to 11.2% and the standard perinatal mortality (according to the WHO criteria) from 23.8% to 4.8%. The premature birth rate decreased from 7.4% to 4.4%. The chance of survival for low-birthweight newborns was increased impressively. The factors which account for the improvement of these obstetrical results are analyzed.

Austria↗
PubMed1979

Depressed skull fracture in the neonate. Report of three cases.

The authors describe three cases of neonatal depressed skull fracture that were elevated by means of an obstetrical vacuum extractor. In one case, a transparent breast pump shield replaced the metal vacuum extractor cup, permitting direct observation as the depression was elevated. Neonatal depressed skull fractures not associated with neurological signs may be safely elevated without surgery using the obstetrical vacuum extractor.

Birth Injuries↗
PubMed2005

Anal function during pregnancy and postpartum after ileal pouch anal anastomosis for ulcerative colitis.

PURPOSE: Total proctocolectomy and ileal pouch anal anastomosis (IPAA) is now a common procedure for ulcerative colitis (UC). Moreover, it has been reported that fertility is preserved in women who undergo this procedure, many of whom can experience normal delivery. METHODS: We assessed the perinatal outcomes and changes in anal function in four women, aged from 27 to 35 years, who gave birth after undergoing IPAA for UC. Pregnancies were confirmed 15-111 months after IPAA, three women had full-term pregnancies, and one gave birth after 31 weeks' gestation. RESULTS: Cephalic delivery with a vacuum extractor was used for one patient, and another underwent cesarean section. The other two patients experienced normal delivery. None of the patients needed artificial insemination and none had any symptoms of intestinal obstruction during their pregnancy. After delivery, two patients suffered a transient increase in bowel frequency and soiling, which gradually resolved. CONCLUSIONS: Although transient anal dysfunction occurred in the puerperal period, there were no changes in anal function during pregnancy. Therefore, there are no factors directly prohibiting pregnancy and vaginal delivery in women who undergo IPAA for UC.

Adult↗
PubMed1989

Medical approaches to termination of early pregnancy.

Termination of early pregnancy by vacuum aspiration is a well-established technique. The procedure is highly effective and has a low complication rate, particularly when performed during the first few weeks after missed menses. However, this parasurgical method requires skilled health care personnel, and attempts have therefore been made to find medical alternatives. Prostaglandins were the first agents to be used successfully for this purpose, but the high incidence of mainly gastrointestinal side-effects has limited their widespread use. More recently, attention has focused on antiprogestational steroids, i.e., compounds that prevent the action of progesterone either by inhibiting its biosynthesis or by preventing it from binding to the cellular receptors in target organs. Current experience indicates that these compounds, particularly when used in combination with a low dose of a synthetic prostaglandin analogue, have the potential to become a safe, effective, and acceptable medical method for the termination of early pregnancy.

Abortifacient Agents↗
PubMed2002

[Trial vacuum extractor for cephalic engagement. 50 cases in French Guiana].

OBJECTIVE: Considering a population with an African culture traditionally opposed to a caesarean section, vertex engagement with a vacuum extractor could be a good alternative. PATIENTS AND METHODS: In a retrospective study of 50 cases of trial engagement with a vacuum extractor in French Guyana, there were 94% of vaginal deliveries. RESULTS: A high level of shoulder dystocia (14%) was noted, and the failure of this technique was the consequence of disproportions between foetus and pelvis that had not been correctly diagnosed. CONCLUSION: In this article, feasibility and obstetrical conditions to carry out a trial engagement with a vacuum extractor are discussed.

Adolescent↗
PubMed1993

Elevation of depressed skull fracture in the neonate by obstetrical vacuum extractor.

In this article, three cases of neonatal depressed skull fracture were successfully elevated by means of an obstetrical vacuum extractor. No complications from the procedure were observed. Neonatal depressed skull fractures which are not associated with neurological signs may be safely elevated without surgery by using the obstetrical vacuum extractor. This simple, atraumatic procedure should be considered first for the management of uncomplicated depressed skull fracture in the newborn.

Animals↗