BACKGROUND: The present study was designed to determine neonatal mortality and morbidity in non-malformed singleton term infants delivered in breech presentation and identify a possible correlation between outcome on the one hand and mode of delivery, parity and birth weight on the other. METHODS: Register-based cohort study of all (n ...

The perinatal and maternal outcomes of 65 symphysiotomies and 108 caesarean sections carried out after failed trial of assisted delivery at the Port Moresby General Hospital between 1988 and 1994 were retrospectively analyzed. There were no significant differences in perinatal outcomes between the treatment groups. There were no maternal deaths ...

OBJECTIVE: Our purpose was to determine the feasibility of resolving the controversy regarding route of delivery for breech presentation in a randomized, prospective fashion. STUDY DESIGN: The National Institute of Child Health and Human Development-sponsored Maternal-Fetal Medicine Units Network, which is composed of 11 perinatal centers, was surveyed to determine ...

BACKGROUND: The aim of this study was to determine plasma levels of oxytocin in women immediately after delivery. METHODS: Oxytocin was measured in 18 healthy women at 15 minute intervals after normal vaginal deliveries with healthy infants. The mothers had their infants put skin-to-skin on their chests immediately after birth. ...

OBJECTIVES: To investigate current attitudes to management of labor and delivery in pregnancies complicated by breech presentation. STUDY DESIGN: A questionnaire was sent to the directors of 23 units of maternal-fetal medicine, all members of the Israel Society of Perinatal Obstetricians. The survey included 69,072 deliveries in the year 1993. ...

The world-wide incidence of Caesarean section continues to rise with dystocia recognized as the major indication. Active management of labour has been proposed as an alternative treatment to Caesarean section for dystocia. At the National Maternity Hospital, Dublin, a recent increase in the Caesarean section rate has been observed. This ...

OBJECTIVE: To establish whether the timing of delivery between 37 and 42 weeks gestation influences neonatal respiratory outcome and thus provide information which can be used to aid planning of elective delivery at term. DESIGN: All cases of respiratory distress syndrome or transient tachypnoea at term requiring admission to the ...

Meconium staining of the amniotic fluid is a common complication during labour. When facilities like electronic monitoring, foetal blood sampling are not available, it is difficult to decide whether labour should be allowed to continue or caesarean section should be done. Even when caesarean section is done, meconium aspiration syndrome ...

Literature data indicate that rupture of arterovenous malformations is 4 times more frequent in pregnant women. The Authors present a case of cerebral hemangioma of the third medium anterior of the corpus callosum diagnosed in a patient at the 28th gestational week by Magnetic Resonance scan. The patient underwent elective ...

We retrospectively analyzed 7,317 fully documented deliveries to assess the effect of epidural anaesthesia (EA) on surgical delivery rates, on the incidence of intrapartum fever and on peripartal blood loss. 1,056 (14.4%) had EA and 6,261 (85.6%) had no or other analgesia. The use of EA was associated with a ...

Breech presentation is prevalent among preterm deliveries and contributes to neonatal mortality far beyond its prevalence. The management of a preterm breech delivery is controversial. We present our retrospective experience with 185 consecutive preterm breech deliveries, part delivered by cesarean section and part delivered vaginally as assisted breech delivery or ...

We reviewed the deliveries in a teaching hospital in a multiracial community over the period of one year (1988), and investigated the relationship between maternal height, ethnic origin, and the extremes of birth weight with the likelihood of emergency lower segment caesarean section (LSCS). After excluding patients with obvious indications ...

The outcome of 100 patients undergoing instrumental delivery with vacuum extractor is compared with that of 100 women delivered with the aid of obstetric forceps. Forceps deliveries were more commonly associated with maternal birth canal trauma (including episiotomy) whilst vacuum extractor carried higher odds of the neonate developing jaundice. Apart ...

OBJECTIVE: Our goal was to examine and compare clinician-applied loads during simulated vaginal delivery. STUDY DESIGN: We developed a birthing model and a microcomputer data acquisition system and used them to measure clinician-applied extraction forces, moment, and rates for three perceived categories of delivery. In 39 experiments, clinicians simulated delivery ...

14 years experience with 354 infants born with myelomeningocele are reviewed in view of prelabor and pre-rupture of amniotic membranes vs vaginal delivery or delivery by cesarian section after labor and rupture of amniotic membrane. The apparent lack of effect of severity of impairment determined by prenatal diagnosis on parental ...

BACKGROUND: Fetal replacement into the uterus for ceasarean delivery after failed vaginal delivery has been reported for both vertex and breech presentations. Although an option, this mode of delivery frequently is the last maneuver to deliver a viable infant after other methods to allow vaginal delivery have failed. We report ...

OBJECTIVE: To analyze the trends in vaginal operative deliveries in Italy. DESIGN: Analysis of information on all deliveries after the 28th week of gestation, routinely collected by the Italian Central Institute of Statistics using a standard form. SETTING: National data on all Italian deliveries in the period 1981-85. SUBJECTS: All ...

OBJECTIVE: To gather, synthesize, and present useful scientific information concerning the anal continence mechanism that will aid obstetrician-gynecologists in managing vaginal birth and evaluating women with anal incontinence not caused by disruption of the external anal sphincter. DATA SOURCES: Sources included a Medline search and reference lists of relevant articles ...

The results of a four month descriptive study on low Birth weight (LBW) deliveries in Nyanza Provincial General Hospital, Kisumu from 15th March to 30th July 1987 are presented. The incidence of LBW was 15.0%. Premature labour accounted for 55.3% while term small for gestational age contributes 44.7% of all ...

The purpose of this study was to determine the circumstances in which trial of scar is conducted in the obstetric unit of Tikur Anbessa Hospital, Addis Ababa, Ethiopia, and evaluate the safety of the undertaking in terms of maternal and perinatal morbidity and mortality. Between 11 September, 1991 to 10 ...

BACKGROUND: During the past years a major change in the use of delivery position has occurred in Sweden. Recumbent delivery positions have been replaced by a variety of positions: squatting, standing, lateral, kneeling and quadruped. The consequences of this shift in obstetrical practice for development of perineal lacerations are largely ...

Comparison of two different methods of vaginal disinfection was made with regard to prevention of neonatal infections. In method I, an antepartum vaginal douche with a chlorhexidine solution was used; method II involved the use of chlorhexidine gluconate obstetrical gel during vaginal exploration. We studied 2853 normal deliveries from a ...

The result of a one year retrospective study on stillbirths (SBs) occurring at Eldoret District Hospital labour unit between 1st November and 31st October, 1992 is presented. The stillbirth rate (SBR) was 30.5 per 1000 births. 72.2% were fresh stillbirths (FSB). Intrapartum foetal asphyxia was the commonest probable cause of ...

A hospital-based case-controlled study was undertaken to determine maternal and neonatal characteristics associated with fractured clavicle. A total of 11,604 consecutive vaginal deliveries of liveborn infants in vertex presentation at the Mount Sinai Hospital from 1988 to 1990 were reviewed. Maternal and neonatal characteristics were compared for the neonates with ...

We compared the transmission rate of Chlamydia trachomatis infection from infected women to their infants after various modes of delivery. After vaginal birth, Chlamydia trachomatis was isolated from 58 of 125 infants with a cephalic presentation, and serological evidence of chlamydial infection was found in another eight. C. trachomatis was ...

OBJECTIVES: To review the evidence that the package of labour interventions collectively called "active management"--namely, strict diagnostic criteria for labour, early amniotomy, early use of oxytocin, and continuous professional support--reduce rates of caesarean sections and operative vaginal delivery in first labours. DESIGN: Review of observational data, supplemented by evidence from ...

Caesarean section is thought to be indicated by an ominous antepartum cardiotocograph (CTG). However, the fear remains that infants delivered for this indication in the presence of antepartum haemorrhage, especially when premature, are destined to have severe hypoxic neurological damage. We therefore reviewed our experience of cardiotocography in women with ...

The connection between the amount of antenatal care and pregnancy outcome was studied using the 1987 Finnish Medical Birth Registry. A total of 57,108 women were included in the analysis. The timing of initiation of antenatal care and the relative number of antenatal visits (adjusted by gestation length), were used ...

OBJECTIVES: Our purpose was to evaluate factors that may influence perinatal outcomes in the very-low-birth-weight infant with breech presentation. STUDY DESIGN: An observational study that included all consecutive singletons and twins with the first fetus with breech presentation weighing between 500 and 1500 gm delivered at Chicago Lying-In Hospital from ...

OBJECTIVES: Our purpose was to evaluate the outcome of deliveries with fetuses in breech presentation at labor and to compare the results by route of delivery. Specially reviewed were fetuses weighing > or = 1500 gm. STUDY DESIGN: An observational study of consecutive cases of all singleton pregnancies and twin ...

OBJECTIVE: to assess the effect of low haemoglobin (Hb) on the mental and physical health of postnatal women. DESIGN: survey conducted between May 1991 and February 1992. SETTING: maternity unit in district general hospital in the UK. PARTICIPANTS: 1010 postnatal women who had delivered a live baby, did not stay ...

Every child with severe or moderate haemophilia A or B, born in Sweden during the period 1970-1990, was treated in the national haemophilia register, all 117 case records being surveyed for mode of delivery and perinatal complications. Of the 117 deliveries, 13 were by caesarean section and the remaining 104 ...

OBJECTIVE: To evaluate the effects of abdominal versus vaginal delivery in the groups of newborns with different birth weights. METHODS: 5012 single breech deliveries with birth weight over 1000 g, lethal malformations and stillbirths excluded, were enrolled in the study. The comparison of early neonatal mortality and the incidence of ...

The relation of umbilical cord blood arterial pH, Apgar score, leucocyte count, and erythroblast count at delivery with the diagnosis of fetal distress in labour was studied prospectively in three groups of singleton pregnancies delivering at term vaginally (55 infants), by elective caesarean section (39 infants), or by emergency caesarean ...

We report the anaesthetic management of a mother, and airway management of a neonate with a prenatal diagnosis of cervical cystic hygroma causing upper airway obstruction. The mortality of such neonates due to upper airway obstruction is reported to exceed 20% following deliveries. Elective Caesarean section was performed under general ...

One hundred and three patients with eclampsia were managed during a period of eleven years. The perinatal mortality rate was 136 per 1000 total births and there were six maternal deaths. The maternal mortality rate was less among eclamptics delivered by Caesarean Section. Liberal use of diazepam and/or magnesium sulphate ...

James Walsh and Moira McQueen accurately conclude that the early delivery of anencephalic fetuses is morally acceptable, but the reasoning they use to reach that conclusion is flawed. First, the principle of double effect does not require a weighing of good and evil, but rather seeks a sufficient reason for ...

We report a four year follow-up of 39 of 47 infants born after pre-labour Caesarean section and 68 of 79 born vaginally. Loss of motor function due to late complications was more frequent in the Caesarean section group (Fisher's Exact; P = 0.004). However, the means of the differences between ...

The objective of this paper is to characterise and quantify the association between vaginal bleeding and pregnancy outcome. A meta-analysis was performed in order to quantify the risk of adverse reproductive outcome by combining evidence from all previous studies of vaginal bleeding. The reproductive endpoints considered were low birthweight, preterm ...

External cephalic version (ECV) at > or = 37 weeks' gestation in suitable women with breech presentation was introduced in 1991 as a new management option at a University Teaching Hospital. After 16 months, the policy was audited by analysing a prospectively collected database of women offered ECV at term ...

We performed a retrospective study of 564 vaginal occiput posterior (OP) deliveries to investigate the influence of this position on maternal and fetal morbidity. The cases were compared to 1,068 controls matched for race, parity and delivery method. The OP group had a higher incidence of severe perineal laceration and ...

The pattern and associations of 62 instances of external birth trauma (EBT) in 57 of 2222 consecutive hospital-born neonates were studied. Macrosomia and vaginal instrumental or breech delivery were identified as significant risk factors for EBT. In contrast to previous reports, subgaleal hemorrhage (SGH) was the predominant form of trauma ...

The safety of vaginal birth for breech-vertex twins has not been addressed directly before. We retrospectively compared the perinatal outcome of two groups of breech-vertex twins: 24 delivered vaginally and 35 delivered abdominally. Vaginal delivery was allowed under the same protocol developed for singletons in breech presentation. Both groups had ...

Homozygous alpha-thalassaemia Hb Bart is a very rare illness in North America and Western Europe, but is a common cause of NIHF especially in South East Asia. It causes severe hydrops fetalis with lethal outcome and maternal complications as preterm labour, pre-eclampsia and retained placenta. A case report of an ...

OBJECTIVE: To determine whether planned vaginal or elective cesarean delivery is better for singleton term breech infants. DATA SOURCES: Articles that included singleton term pregnancies with breech presentation published in English between 1966 and September 1992 were searched through the Index Medicus, Oxford Database of Perinatal Trials, and MEDLINE. METHODS ...

To evaluate the effects of interventions during delivery on the maternal and neonatal C-reactive protein (CRP) we prospectively measured CRP by immunoturbidometry in 238 mother-infant pairs (179 normal vaginal deliveries, 36 cesarean sections and 23 vacuum extractions) at 24 and 72 hours after delivery. We additionally measured CRP in peripheral ...

The outcomes of 41 patients with prolonged, premature rupture of membranes in the midtrimester (19.5 to 26 weeks) managed conservatively were retrospectively analyzed. The maternal obstetric history was notable for a high incidence of second trimester bleeding and a prior history of preterm delivery. The mean duration of ruptured membranes ...

Of 48,519 deliveries conducted at Jinnah Postgraduate Medical Centre (JPMC) over 7 years (January, 1986 to December, 1992), 257 were of ruptured uterus, giving a rate of one in 189 deliveries. Main cause of rupture was obstructed labour. Maternal mortality was 3.9% and foetal mortality 88% in cases admitted with ...

The purpose of this Historical Prospective Study was to analyze factors associated with neonatal hyperbilirubinemia. Data were collected from summary labour records and individual patients' records at Ramathibodi Hospital between January 1, 1988 and December 31, 1988. Of the 7,644 livebirths, neonatal hyperbilirubinemia (> or = 15 mg/100 ml) occurred ...

OBJECTIVE: To explore the association between midline episiotomy and the risk of third- and fourth-degree lacerations during operative vaginal delivery with either vacuum extractor or forceps. METHODS: This retrospective cohort study analyzed all operative vaginal deliveries at a university hospital in 1989 and 1990. Univariate analysis of the relationships between ...