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At least 973 records · Page 54Linked to original sources
PubMed1984

Injury to innervation of pelvic floor sphincter musculature in childbirth.

71 women delivered at St Bartholomew's Hospital, London, were studied by electrophysiological tests of the innervation of the external anal sphincter muscle and by manometry. The investigations were done 2-3 days after delivery and again, in 70% of these women, 2 months later. Faecal and urinary incontinence developing after vaginal delivery has been thought to be due to direct sphincter division, or muscle stretching, but the results of the study suggest that in most cases this incontinence results from damage to the innervation of the pelvic floor muscles.

Adolescent↗
PubMedDate not supplied

Syndrome auriculotemporal.

Two cases of auriculotemporal syndrome are presented in two male children that began in the first years of life to present reactions of linear erythema itinerary on the cheeks after eating several foods. The allergologic study with these foods was negative, reproducing the clinical picture after their ingestion.

Cheek↗
PubMed2003

A comparison of the neonatal morbidity of second twins to that of a low-risk population.

OBJECTIVE: To assess the neonatal morbidity of second twins. STUDY DESIGN: Cohort study in a department of perinatalogy. The neonatal morbidity of second twins was compared to that of a low-risk population: singletons in the cephalic presentation delivered vaginally. RESULTS: Five hundred fifty-nine second twins and 18,061 vaginally delivered singletons in the cephalic presentation were studied. Of 452 (81%) second twins delivered vaginally, 310 (69%) were extracted using obstetrical maneuvers: internal version and breech extraction, breech extraction alone, or assisted breech delivery if the breech was already engaged. Before 33 weeks of gestation, there was no significant difference between the neonatal morbidity of the vaginally delivered second twins and the vaginally delivered singletons in the cephalic presentation. After 33 weeks of gestation, only the 1-min Apgar score <7 and the rate of intubation at birth were significantly higher in the second twins. Whatever the gestational age, there was no significant difference between the neonatal morbidity of the vaginally delivered second twins and that of the second twins born by cesarean section before labor. At comparable gestational ages, there was no significant difference between the death rate of the vaginally delivered second twins and that in the reference population. CONCLUSION: The neonatal morbidity of second twins was comparable to that of a low-risk population. Immediate management of the vaginally delivered second twins was, however, more intensive than that of vaginally delivered singletons in the cephalic presentation. It, therefore, requires appropriate equipment in a suitable obstetric-pediatric setting.

Birth Order↗
PubMed2002

[Retrospective study of 34 urogenital fistulas of obstetricalal origin].

OBJECTIVES: The aim of the study was to determine the etiologic and epidemiological aspects of the obstetrical uro-genital fistulas in Congo in order to propose a strategy of prevention. PATIENTS AND METHODS: It is a retrospective study concerning 34 files of obstetrical uro-genital fistulas selected within 7 years in the department of Urology of the University Hospital Center of Brazzaville. The etiopathogenic, anatomoclinical and therapeutic aspects have been analysed for each file. RESULTS: The uro-genital fistula represents 23% of the female admissions in urology and 85% of them are related to obstetrical causes. Fifty-five percent of the patients were less than 30 years old, most of them being primiparas. Sixty-one percent of the patients came from rural areas. The prolonged time of the delivering labour and the foetal extraction manoeuvres were the main mechanisms causing the fistulas. With the surgical therapy, 77% of the abnormalities have been treated. CONCLUSION: In spite of progress made in the realm of surgical techniques, the best treatment for uro-genital fistulas remains their prevention as targeted on the education for health and the management of pregnant women. Besides, the development of the infrastructure of health and roads, the training and reeducation of the health personnel contribute to improve this management.

Adult↗
PubMed1995

[Torsion of the myoma pedicle as a rare cause of ileus in puerperium].

Myoma of the uterus could not only complicate pregnancy and delivery but also puerperium. The paper reports on an unusual, but severe complication due to myoma. A 35-year old woman with myoma of the uterus was admitted with an acute abdomen and ileus on the 16th day after delivery. Pregnancy, delivery and early puerperium were uneventful. During laparotomy a twisting of a pedicle of a myoma and compression of the bowel were found. The myoma was resected and the postoperative course was normal.

Abdomen, Acute↗
PubMed1992

Obstetric fractures.

The purpose of this study was to determine the risk factors predisposing to an obstetric fracture, and their long-term outcome. We reviewed 28 obstetric fractures treated in the County of Vaud, Switzerland, between 1976 and 1989. There were 12 fractures of long bones, 10 clavicles and 6 depressed skull fractures. The belief that obstetric fractures occur in large babies or after breech deliveries is no longer valid. The common risk factors of these fractures are obstetric maneuvers during delivery (75% of cases), especially Cesarean sections (35%), prolonged labor (33%), and prematurity (25%). Cephalic presentation (64.2% of cases) is more frequent than breech position (32.1%). Weight, size, age of gestation, age of the mother, parity, gestity, and time of delivery cannot be considered as risk factors for obstetric fractures. For each type of fracture some specific risk factors are pointed out: maneuvers at birth for depressed skull fracture, Cesarean section, breech delivery with assistance and low birth weight for the fractures of long bones. All fractures were treated conservatively, except for skull fractures with a depression of more than 2 cm. Early consolidation is achieved within 2 weeks. Long-term prognosis for obstetric fractures is good without sequelae.

Birth Injuries↗
PubMed2001

Epidural analgesia.

Explore the source record for details and available documents.

Analgesia, Epidural↗
PubMed2002

Impact of midtrimester dilation and evacuation on subsequent pregnancy outcome.

OBJECTIVE: This study was undertaken to evaluate the impact of second-trimester dilation and evacuation (D&E) on subsequent pregnancy outcome. STUDY DESIGN: Medical record review of 600 patients undergoing midtrimester (14-24 weeks) D&E from 1996 to 2000 and evaluation of subsequent pregnancy outcome. Mann Whitney U, Spearman rho, and chi(2) tests were used in statistical analysis with a P value <.05 considered significant. RESULTS: Ninety-six subsequent pregnancies were identified, including 12 first-trimester spontaneous abortions, 1 second-trimester fetal death, 1 ectopic pregnancy, and 5 elective terminations. Seventy-seven pregnancies resulted in the delivery of a live-born infant at a median gestational age of 39.0 weeks. Five pregnancies (6.5%) were complicated by spontaneous preterm birth. Patients delivered preterm had an earlier gestational age at D&E (18.0 vs 20.0 weeks, P =.02) and a trend toward less preoperative cervical dilation (2.0 vs 3.0 cm, P =.09) than patients delivered at term. CONCLUSION: Second-trimester D&E is not a risk factor for midtrimester pregnancy loss or spontaneous preterm birth. Preterm delivery in future gestations appears less likely when greater preoperative cervical dilation is achieved with laminaria, possibly because of a decrease in cervical trauma.

Abortion, Induced↗
PubMed2003

Uterine contractility in women whose fetus is delivered in the occipitoposterior position.

OBJECTIVE: Most fetuses in the occipitoposterior position rotate spontaneously after striking the pelvic floor. The increased prevalence of prolonged labor, operative delivery, and oxytocin augmentation in women with an occipitoposterior fetal position seems consistent with decreased uterine contractility. We sought to test the hypothesis that women with a persistent occipitoposterior fetal position have inadequate intrauterine pressure. STUDY DESIGN: Intrauterine pressure was measured prospectively electronically in 94 women whose labor pain was controlled by patient-requested epidural analgesia. Eleven women (12%) were delivered as a persistent occipitoposterior fetal position. In a nested case-control study, these women were compared with 22 women who were delivered as an occipitoanterior fetal position who were matched for age, parity, gestational age, cervical examination at study enrollment, and body mass index. The intrauterine pressure measurements were initiated during the first stage of labor and continued throughout the entire labor process. Women were encouraged in the second stage of labor, after a period of recording baseline contractility, to push using a standardized Valsalva maneuver once the vertex reached the +2 station. The area under the intrauterine pressure curve (integral) was used to estimate uterine contractility and expulsive performances. RESULTS: Five women (45%) in the occipitoposterior group required operative delivery. The average duration of the second stage of labor in the occipitoposterior group was 91.4 +/- 23.2 minutes compared with 51.7 +/- 6.6 minutes in the occipitoanterior fetal position (P =.04). Ninety percent of women in the occipitoposterior group required oxytocin, compared with 59% of the women in the occipitoanterior group (P =.11). There were no differences in uterine contractility between occipitoposterior and occipitoanterior groups during either the first stage of labor (integral mean +/- SEM: occipitoposterior [1685.3 +/- 194.6 mm Hg. s] vs occipitoanterior fetal position [1700.8 +/- 128.9 mm Hg. s, P =.98]) or second stages of labor (occipitoposterior [1952.6 +/- 186.5 mm Hg. s] vs occipitoanterior fetal position [1740.8 +/- 104.3 mm Hg. s, P =.46]). Further, there were no significant differences in pushing performances between the occipitoposterior and occipitoanterior groups (Valsalva maneuver: occipitoposterior 2864.9 +/- 328.8 mm Hg. s] vs occipitoanterior [2898.6 +/- 222.2 mm Hg. s, P =.90]). CONCLUSION: Women who were delivered as a persistent occipitoposterior fetal position do not have lower intrauterine pressure levels immediately before or during the second stage of labor.

Adult↗
PubMedDate not supplied

Hector Landouzy on facial paralysis in newborn children: the case studies of a 19th-century French hospital physician.

Marc-Hector Landouzy (1812-1864) was one of the first to describe facial paralysis in newborn, through a series of case studies. By examining these four cases in the context of Landouzy's life, publications and professional circumstances, this study shows how case studies were an important part of the scientific revolution within medicine in the 19th century. Landouzy, soon followed by others, used the growing clinical populations of Parisian hospitals, patho-anatomy and cutting-edge physiologic techniques to help describe a previously ignored disease among newborns. His case studies, in particular, are a valuable example of the emerging interest in children as a clinical population and of early interest in child neurology.

Birth Injuries↗
PubMed1975

Serum gamma-glutamyl transpeptidase activity in normal children.

Serum gamma-glutamyl transpeptidase (GGT) activities of 82 healthy neonates (aged 9 hours to 11 days) and 106 healthy children (aged 2 months to 15 years) were determined. Serum GGT activity of 47 neonates (51%) was higher than the accepted upper limit of normal for adults. By three months of age, all of the children had serum GGT activities that were within the accepted normal range for adults. Thereafter there was only minimal variation in serum GGT activities of older children. Although mean serum GGT activity was higher in male children than in female children, there was no significant difference between the values for male and female neonates. That after the neonatal period serum GGT activity is constant in the adult range and is not affected by bone growth as is alkaline phosphatase suggests that GGT may be of value in the evaluation of hepatobiliary disease in children.

ABO Blood-Group System↗