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At least 19 recordsLinked to original sources
PubMedDate not supplied

[Influences on decisions of pregnant patients with breech presentation for external fetal version or cesarean section--information status and anxiety pattern].

Within the framework of a retrospective and prospective analysis of 61 women with breech presentation in late pregnancy and with the help of a half-standardised questionnaire, we investigated the subjective reaction of these patients after they had been informed of their situation, as to what fears resulted and how well informed they were regarding the various obstetrical procedures in cases with breech presentation. The patients in the version group were clearly more anxious (n = 41). They were frightened of putting the child's well-being at risk, damaging personal health and having a cesarean section. The fear patterns were very varied in both groups. In the cesarean group (n = 20) the patients were not so afraid of the anesthesia and the risk of infection, whereas those in the version group were considerably more afraid; it was quite the reverse as regards the risk of permanent damage to the child due to the version--in the cesarean group this was rated as a high risk, whereas in the version group it was rated as a slight risk. The decision on the obstetrical procedure was mainly influenced by the doctor. In conclusion it can be said, that too little is known about the obstetrical procedure of cephalic version near to term and that it is tainted with unnecessary fears. We recommend that more intensive, specialised information should be given before undertaking obstetrical management of breech presentation.

Adult↗
PubMed1977

Value of external version in fetal malpresentation in combination with use of ultrasound.

During 1969--1974 six hundred and forty-nine external versions were attempted during the last trimester on 491 mothers with fetal malpresentation. The procedure was monitored with ultrasound in 1969--1974. Most of attempts (70.0%) were made during the 32nd-36th weeks. The final version rate after one or more attempt was 76.2%, being lower (67.0%) in nulliparous than parous women (84.6%). The incidence of breech presentation at birth decreased from 4.5 to 2.9% (p less than 0.001). The most serious complication was one premature labor but the infant survived. The perinatal mortality was 2.0% and, after excluding abnormal infants, 0.8%. The combination of external version and the use of ultrasound is a safe method which avoids hazardous vaginal breech delivery and is recommended in obstetric practice.

Apgar Score↗
PubMed1990

An altered IGF-I receptor is present in human leukemic cells.

We have characterized and analyzed IGF-I- and insulin-stimulated cell growth, receptor binding, and autophosphorylation in the human leukemic cell line HL-60. IGF-I-stimulated cell growth occurred at low (5 ng/ml) and insulin stimulated only at high (500 ng/ml) concentrations. Binding of 125I-IGF-I to partially purified plasma membrane proteins followed the characteristics of IGF-I receptor binding. 125I-IGF-I binding, as determined by chemical cross-linking, occurred to a 145-kDa protein. IGF-I, as well as insulin, stimulated the autophosphorylation of a 105-kDa band (pp105), but we could not detect a 95-kDa band corresponding to the known molecular mass of the IGF-I and insulin receptor beta-subunits. Phosphorylation of pp105 followed the dose-response characteristics of the IGF-I receptor. The phosphorylation of pp105 occurred at tyrosine and threonine, and the pattern of HPLC tryptic peptide maps showed marked differences when compared with that of a phosphorylated insulin receptor beta-subunit. Enzymatic deglycosylation of pp105 resulted only in a slight reduction of the molecular weight. These data suggest that pp105 is the beta-subunit of an IGF-I receptor variant with a higher molecular weight, similar to that found in fetal tissue. The HL-60 cell may acquire, at least in part, malignant growth characteristics through reexpression of the fetal version of the IGF-I receptor.

Cell Division↗
PubMed1990

Development and application of a simple expert system for the interpretation of the antepartum fetal heart rate tracings (version 88/2.29).

A simple expert system is developed for the interpretation of antepartum fetal heart rate tracings. The perinatal expert chose to use the phrase 'Fetal Reserve' to describe what the cardiotocogram is indirectly measuring. Our analysis program gives numerical values to each CTG such as 5, 4, 3, 2.5, 2 and 1 corresponding to the fetal reserve conditions of good, satisfactory, probably satisfactory with uncertainty, borderline, decreased, and critical respectively. This study consists of 33 normal pregnancies with normal outcome. Each patient is followed by our computerized system biweekly from the 28th to the 38th gestational week and weekly there after. The expert system's decision for 28th, 30th, 32nd, 34th, 36th, 38th, 39th and 40th gestational weeks were 3.3 +/- 1.0, 3.8 +/- 0.7, 3.8 +/- 1.0, 4.1 +/- 0.9, 4.1 +/- 0.7, 3.6 +/- 1.0, 4.2 +/- 1.0, 3.8 +/- 0.9 and 3.4 +/- 1.2, respectively. In this study, we have used confusion matrix to determine the normal, security, and danger zones according to the perinatal expert and the expert system and the discriminatory power of the system is found to be highly significant statistically (Q = 221). We also showed that the passive test (non-stress test) in normal pregnancies has demonstrated false positive results in 4.2 and 9.3% of the cases according to the evaluations of the perinatal expert and the expert system, respectively.

Expert Systems↗
PubMed1991

The validation of a computerized system for the interpretation of the antepartum fetal heart rate tracings (version 89/2.34).

We have developed a knowledge-based system for the interpretation of the antepartum fetal heart rate tracings. This study consists of four groups of patient: (1) 49 normal pregnancies with a normal perinatal outcome; (2) 13 normal pregnancies with abnormal perinatal outcome; (3) 33 high-risk pregnancies with abnormal perinatal outcome; and (4) 16 high-risk pregnancies with normal perinatal outcome. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of our expert system (version 89/2.34) were estimated to be 60.0, 85.7, 75.0 and 75.0%, respectively. When the normal pregnancies with abnormal outcome and the high-risk pregnancies with normal outcome were excluded from the population, sensitivity, specificity, PPV and NPV were calculated to be 57.7, 82.9, 68.2 and 75.6%, respectively (corrected values). The prevalance of abnormal outcome for this study was 41.7%.

Cardiotocography↗
PubMed1992

External cephalic version and daily post-versional maternal self-assessment of fetal presentation. A prospective study.

External cephalic version (ECV) using tocolysis is a widely recognized low-risk intervention in cases of breech presentation, particularly in areas where resources are scarce and the perinatal mortality is high in vaginal breech deliveries. In such a setting, pregnant women were trained to make regular self-assessments of the presenting fetal part after ECV in order to detect spontaneous reversions to breech presentation. It was found that such maternal involvement could significantly improve the final results of ECV.

Breech Presentation↗
PubMed1987

Fetal heart rate changes following external cephalic version under tocolysis near term.

Fifty eight gravidas near-term underwent external cephalic version using tocolytic treatment and continuous fetal monitoring by cardiotocograph and real-time ultrasound. No unfavorable maternal or fetal effects were recorded. Fetal heart rates showed a significant decline at 10 and 30 min after the procedure with complete recovery at 1 h after external version, but no pathologic tracing was recorded. No uniform heart rate patterns due to external cephalic version could be found.

Breech Presentation↗
PubMed1989

[A 1-year study of the management of fetal breech presentation by monitoring follow-up during second-stage labor instead of using external version, x-ray pelvimetry and ultrasonic assessment of fetal weight].

The authors studied 246 parturients with breech presentation of the fetus. All women were examined by an obstetric monitor. Cesarean section was performed on 33 women/ = 13.41% of women with breech presentation). Perinatal morbidity and mortality were the same as those of women with vertex presentation. The frequency of cesarean section was 11.98% of multiparas and 31.57% of nulliparas. According to the authors careful observation of advancement of delivery as well as the state of the fetus (by an obstetric monitor) could lead to management of delivery with breech presentation just as that of vertex presentation. This management of breech presentations should reduce the fear of delivery, which is observed in most parturients with breech presentation of the fetus.

Body Weight↗
PubMed1987

Maternal and fetal factors affecting success of antepartum external cephalic version.

We studied 172 patients who were considered for external cephalic version with tocolysis at term. Before a single attempt at version, a variety of maternal and fetal factors considered likely to affect success were coded for each patient. Maternal age, height, and Quetelet index did not affect success. However, successful version was more likely in parous women than in nulliparous women, and less likely with cornual than with other placentations. Amniotic fluid volume, fetal abdominal circumference, type of breech, and the specific nature of the maternal-fetal spatial relation were also important determinants of success. Fetal biparietal diameter, gestational age, and estimated fetal weight were not. All of these factors can be evaluated before attempting version and can be used when counseling candidates for version.

Adolescent↗
PubMed1985

Fetal movement and fetal presentation.

Fetal movements were analyzed by means of ultrasonography in an attempt to clarify the causative factor of frank breech presentation. Fetal posture, position, presentation and movements, as well as posture of the extremities and the volume of amniotic cavity were analyzed by ultrasonography in 112 fetuses ranging from 12 to 42 weeks of gestation. There existed three different fetal states: inactivity; slow sporadic movements without changes of presentations; active whole body movements with changes of presentations. It appears likely that version of fetal presentation from breech to cephalic occurs as the fetus tries to accommodate itself to the shape of the uterus during the state of active whole body movements, and the frank breech presentation of the fetus might result when the whole body movements are weak or absent.

Female↗
PubMedDate not supplied

Umbilical cord prolapse: a true obstetrical emergency.

The case of a 23-year-old woman with umbilical cord prolapse and fetal distress is described. This serious obstetrical complication is unfamiliar to many emergency physicians although it represents an acute emergency with high mortality. Appropriate prehospital, emergency department, and obstetrical suite care is discussed including a bladder-filling technique and tocolysis that can buy valuable time by temporarily relieving pressure on the cord.

Administration, Intravesical↗
PubMed1990

[Delivery in cases of twin pregnancy].

A retrospective analysis of 233 cases of twin pregnancies has demonstrated an increased frequency of prophylactic caesarean sections (27%) due to an increased performance of caesarean sections when the first twin is a breech and when premature babies are delivered before the 34th week of amenorrhea. When the first twin is a head, a natural delivery is possible with the same criteria as a single pregnancy. The vaginal delivery is also possible if the 2nd twin is a head. In deliveries where the 2nd twin is a breech, there is an increased frequency of early neonatal mortality and Apgar tests under 7 at 5 min, in comparison with the 2nd twin when it is a head. The type of delivery does not seem affected for babies over 1,500 grams. If the 2nd twin is a breech and under 1,500 g, a review of the literature and our results prompt us to broaden the indications of caesarean section. A delay before the birth of the 2nd twin, of under 10 min is usually associated with a better Apgar score at 1 min. without any significant differences at 5 min. It is advisable, at 38 weeks, to induce labor by rupturing the membranes and starting a perfusion of Syntocinon. If the conditions are unfavorable, pursuing the pregnancy requires a close supervision until term.

Apgar Score↗