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AJP Reports Apr 2019Pentalogy of Cantrell (PC) is an uncommon congenital disorder characterized by severe defects in the chest and abdomen, including abdominal visceral prolapsed via...
Pentalogy of Cantrell (PC) is an uncommon congenital disorder characterized by severe defects in the chest and abdomen, including abdominal visceral prolapsed via umbilical cord (omphalocele), defect in the lower part of the sternum, defect in the front of the diaphragm, defects in the anterior part of the pericardium, and the ectopiacordis. Here, we report a 2-hour-old girl, weighing 3,500 g, who was referred to Shahid Madani Hospital in Khorramabad due to the large omphalocele on her chest with pulsating mass above it. The baby was the first child of a 24-year-old mother who was born with an uncomplicated vaginal delivery. Very rare cases of PC are born as a term new-born.
PubMed: 30972230
DOI: 10.1055/s-0039-1683936 -
BMC Pregnancy and Childbirth Dec 2017Decision delivery interval (DDI) is the time line between a decision to conduct an emergency caesarean section and actual delivery of the baby. Prolong DDI constitute a...
The decision delivery interval in emergency caesarean section and its associated maternal and fetal outcomes at a referral hospital in northern Tanzania: a cross-sectional study.
BACKGROUND
Decision delivery interval (DDI) is the time line between a decision to conduct an emergency caesarean section and actual delivery of the baby. Prolong DDI constitute a third phase delay in provision of emergency obstetric care. Intervention designed to minimize DDI are vital, in attempt to prevent maternal morbidity and neonatal morbidity and mortality. The feasibility and practicability of the recommended DDI in recent studies have been questioned especially in limited resource setting and therefore the objective of our study was to determine the DDI and its associated fetalmaternal outcomes at a tertiary referral hospital in Tanzania.
METHODS
This was a retrospectivecross-sectional study of inpatient cases who underwent emergency caesarean section from January to September 2014. Data were collected from birth registry and case files of patients. Data analysis was performed using statistical package for social science (SPSS) version 22.0. Odds ratio (ORs) and 95% confidence interval for maternal and fetal outcomes associated with DDI were estimated using Logistic regression models. A p-value of less than 5% was considered statistically significant.
RESULTS
A total of 598 women who underwent emergency caesarean section were recruited. The median Decision Delivery Interval was 60 min [IQR 40-120]. Only 12% were operated within 30 min from decision time. Shortest DDI was seen in patients with Cephalopelvic Disproportion (CPD) and uterine rupture (40 min and 45.5 min) as compared to other conditions. Cases with impending uterine rupture, cord prolapse, APH and fetal distress showed to have shorter DDI. There was no significant association between DDI and neonatal transfer,1st and 5minute Apgar score, maternal blood loss (OR: 5.79; 95% CI 0.63-1.64) and hospital stay (OR: 1.02; 95% 0.63-1.64).
CONCLUSIONS
Contrary to the recommended DDI by ACOG & AAP of 30 min is not feasible in our setting, time frame of 75 min could be acceptable but clinical judgment is required to assess on the urgency of caesarean section in order to prevent maternal and neonatal morbidity and mortality.
Topics: Adult; Apgar Score; Cesarean Section; Clinical Decision-Making; Cross-Sectional Studies; Emergency Treatment; Female; Humans; Infant, Newborn; Length of Stay; Postpartum Hemorrhage; Pregnancy; Pregnancy Outcome; Retrospective Studies; Secondary Care Centers; Tanzania; Time Factors; Time-to-Treatment; Treatment Outcome
PubMed: 29212457
DOI: 10.1186/s12884-017-1608-x -
Acta Obstetricia Et Gynecologica... Feb 2024Umbilical cord prolapse (UCP) is a rare but severe obstetric complication in the presence of a rupture of the membranes. Although it is not possible to prevent a...
INTRODUCTION
Umbilical cord prolapse (UCP) is a rare but severe obstetric complication in the presence of a rupture of the membranes. Although it is not possible to prevent a spontaneous rupture of the membranes (SROM), it is possible to prevent an amniotomy, which is a commonly used intervention in labor. This study aimed to explore the incidence and risk factors that are associated with UCP in labor when amniotomy is used vs SROM.
MATERIAL AND METHODS
A retrospective nationwide register study was conducted of all births in Sweden from January 2014 to June 2020 that were included in the Swedish Pregnancy Register (n = 717 336). The main outcome, UCP, was identified in the data by the International Classification of Diseases (ICD-10) diagnosis code O69.0. Multiple binary logistic regression analysis was used to identify the risk factors.
RESULTS
Amniotomy was performed in 230 699 (43.6%) of all pregnancies. A UCP occurred in 293 (0.13%) of these cases. SROM occurred in 298 192 (56.4%) of all cases, of which 352 (0.12%) were complicated by UCP. Risk factors that increased the odds of UCP for both amniotomy and SROM were: higher parity, non-cephalic presentation and an induction of labor. Greater gestational age reduced the odds of UCP. Risk factors associated with only amniotomy were previous cesarean section and the presence of polyhydramnios. Identified risk factors for UCP in labor with SROM were a higher maternal age and maternal origin outside of the EU.
CONCLUSIONS
UCP is a rare complication in Sweden. Beyond confirming the previously recognized risk factors, this study found induction of labor and previous cesarean section to be risk factors in labor when amniotomy is used.
Topics: Pregnancy; Humans; Female; Sweden; Cesarean Section; Amniotomy; Incidence; Rupture, Spontaneous; Retrospective Studies; Labor, Induced; Umbilical Cord; Risk Factors; Fetal Membranes, Premature Rupture; Prolapse
PubMed: 37969005
DOI: 10.1111/aogs.14717 -
African Health Sciences Sep 2023Apgar score is conducted to a baby immediately after birth checking how the baby tolerated the birth process and outside the uterus.
INTRODUCTION
Apgar score is conducted to a baby immediately after birth checking how the baby tolerated the birth process and outside the uterus.
OBJECTIVES
To describe the neonatal factors associated with immediate low Apgar score and analysing the associations among factors associated with low Apgar score in new-born babies.
METHODS
A quantitative, case-control, descriptive research design was used. Study population were all maternal records of deliveries conducted between 01 January 2019 and 31 December 2019. Simple random sampling was used to select the sample size for 194 cases and 194 controls using a 1:1 case-control ratio. Records indicating low Apgar scores were the cases while normal Apgar scores were the controls. A total of 388 maternal files were reviewed. Data were collected using a document review checklist and analysed using SPSS version 26.
RESULTS
The study found that, neonatal factors associated with immediate low Apgar score are; gestational age, foetal presentation, cord prolapse, cord around the neck and the importance of cardiotocography interpretation as they had a P-value > 0.005.
CONCLUSION
Gestational age, birth weight, foetal presentation, cord around the neck and lack of cardiotocography assessment were found to be associated with immediate low Apgar score.
Topics: Infant, Newborn; Female; Pregnancy; Humans; Case-Control Studies; Apgar Score; Namibia; Birth Weight; Cardiotocography
PubMed: 38357167
DOI: 10.4314/ahs.v23i3.18 -
Acta Obstetricia Et Gynecologica... May 2021Fetal bradycardia due to sentinel events such as placental abruption, cord prolapse or uterine rupture is associated with an increased risk of acidemia at birth. In the... (Comparative Study)
Comparative Study
INTRODUCTION
Fetal bradycardia due to sentinel events such as placental abruption, cord prolapse or uterine rupture is associated with an increased risk of acidemia at birth. In the absence of a sentinel event, data regarding neonatal prognosis are scarce, and it seems plausible that the depth of bradycardia might be associated with an increased risk of acidosis at birth. The objective was to determine whether the depth of bradycardia is associated with a higher risk of umbilical artery acidemia at birth in term singleton pregnancies requiring cesarean delivery during labor.
MATERIAL AND METHODS
A retrospective comparative study of all cesarean deliveries for bradycardia in an academic tertiary center in the 6-year period of 2013-2018, among term singleton pregnancies. Bradycardia associated with a sentinel event such as placental abruption, cord prolapse or uterine rupture, were excluded. The nadir of the bradycardia was defined as the lowest fetal heart rate baseline lasting at least 3 minutes during bradycardia. Women who delivered an infant with an umbilical pH at birth <7.00 (acidosis group) were compared with women who delivered an infant with an umbilical pH at birth ≥7.00 (non-acidosis group).
RESULTS
Among 111 eligible cases, 32 women in the acidosis group were compared with 79 in the non-acidosis group. The median nadir of the bradycardia was lower in the acidosis than in the non-acidosis group (60 bpm, interquartile range [56-65] vs 70 [60-76], P < .01). A bradycardia nadir <60 bpm emerged as the optimal threshold for predicting acidemia and was more frequently observed in the acidosis than in the non-acidosis group (10 [31%] vs 10 [13%], P = .02). In the multivariable analysis, a nadir <60 bpm was independently associated with an umbilical artery pH <7.00 (adjusted OR 3.16, 95% CI 1.10-9.04).
CONCLUSIONS
A bradycardia nadir <60 bpm was associated with a tripled risk of umbilical artery acidemia at birth.
Topics: Academic Medical Centers; Acidosis; Adult; Bradycardia; Cesarean Section; Female; France; Heart Rate, Fetal; Humans; Infant, Newborn; Pregnancy; Retrospective Studies; Tertiary Care Centers; Umbilical Arteries
PubMed: 33314025
DOI: 10.1111/aogs.14061 -
Journal of Family Medicine and Primary... Jun 2020Disc herniation is a condition where tearing occurs in the outer annular layer of the intervertebral pad leading the inner gel-like material to bulge ouwards the spinal...
BACKGROUND
Disc herniation is a condition where tearing occurs in the outer annular layer of the intervertebral pad leading the inner gel-like material to bulge ouwards the spinal cord, due to the high load of the vertebrae. This will produce back pain and symptoms in different sites according to the level of the herniation in the vertebral column.
AIM
To compare the level of awareness regarding disc herniation among the general population and medical students in Jeddah.
METHODOLOGY
A descriptive cross-sectional study was conducted through an electronic questionnaire to assess the level of awareness regarding disc prolapse among the general population and medical students in Jeddah. The questionnaire was in the Arabic language, it was taken and validated by the previous study which took place in Taif.
RESULTS
Our studied sample involved 1026 individuals aged between 11 and 99 years, with a mean age of 34.03 ± 13.28 years old. More than half of the respondents were female (55.4%), most of them were Saudi nationals (90.1%), and most of them have received a higher education (67.7%). Results showed that 54.1% of the general population and 77.7% of medical students reported good knowledge regarding this condition.
CONCLUSION
This study revealed that the level of awareness regarding disc prolapse among the general population and medical students was poor in some respects such as: knowledge about the preventive measures, symptoms of the disease, the most common site in the spine affected by the disease, and the gold standard imaging method to diagnose this disease.
PubMed: 32984168
DOI: 10.4103/jfmpc.jfmpc_36_20 -
Clinical Case Reports Dec 2015Subcutaneous fat necrosis (SCFN) is a rare fat tissue inflammation of the newborn. Risk factors include cord prolapse, perinatal asphyxia, therapeutic hypothermia,...
Subcutaneous fat necrosis (SCFN) is a rare fat tissue inflammation of the newborn. Risk factors include cord prolapse, perinatal asphyxia, therapeutic hypothermia, meconium aspiration, and sepsis. When present, hypercalcemia comes with lethargy, hypotonia, irritability, vomiting, polyuria, polydipsia, constipation, and dehydration. Kidney injury must be avoided. SCFN is often completely autoresolutive.
PubMed: 26734138
DOI: 10.1002/ccr3.423 -
Case Reports in Obstetrics and... 2018Uterovaginal prolapse is a rare condition in newborns which is usually associated with spinal cord defects. It is usually diagnosed at birth. Different treatment options...
BACKGROUND
Uterovaginal prolapse is a rare condition in newborns which is usually associated with spinal cord defects. It is usually diagnosed at birth. Different treatment options have been proposed for genital prolapse in newborns. Most of the treatment options recommended are conservative; radical approach is rarely suggested for the treatment of these cases.
CASE DETAILS
We report a 6-hour-old newborn that was diagnosed to have congenital uterovaginal prolapse and was successfully managed conservatively with digital reduction of the mass and strapping of both legs together.
CONCLUSION
Congenital uterovaginal prolapse in newborns can be managed conservatively with simple digital reduction followed by strapping of the legs together; this approach is simple and cost-effective and has no associated complications.
PubMed: 30050707
DOI: 10.1155/2018/1425953 -
Canine Medicine and Genetics Jun 2022The English Bulldog has risen sharply in popularity over the past decade but its distinctive and extreme conformation is linked to several serious health conditions....
BACKGROUND
The English Bulldog has risen sharply in popularity over the past decade but its distinctive and extreme conformation is linked to several serious health conditions. Using multivariable analysis of anonymised veterinary clinical data from the VetCompass Programme, this study compared the odds of common disorders between English Bulldogs and all remaining dogs in the UK during 2016.
RESULTS
From 905,544 dogs under veterinary care during 2016, the analysis included a random sample of 2,662 English Bulldogs and 22,039 dogs that are not English Bulldogs. English Bulldogs had 2.04 times the odds of diagnosis with ≥ 1 disorder than dogs that are not English Bulldogs (95% confidence interval [CI] 1.85 to 2.25). At a specific-level of diagnostic precision, English Bulldogs had increased odds of 24/43 (55.8%) disorders. These included: skin fold dermatitis (odds ratio [OR] 38.12; 95% CI 26.86 to 54.10), prolapsed nictitating membrane gland (OR 26.79; 95% CI 18.61 to 38.58) and mandibular prognathism (OR 24.32; 95% CI 13.59 to 43.53). Conversely, English Bulldogs had significantly reduced odds of 6/43 (14.0%) disorders. These included: retained deciduous tooth (OR 0.02; 95% CI 0.01 to 0.17), lipoma (OR 0.06; 95% CI 0.01 to 0.40) and periodontal disease (OR 0.23; 95% CI 0.18 to 0.30). At a grouped-level of diagnostic precision, English Bulldogs had significantly increased odds of 17/34 (50.0%) disorders. These included: congenital disorder (OR 7.55; 95% CI 5.29 to 10.76), tail disorder (OR 6.01; 95% CI 3.91 to 9.24) and lower respiratory tract disorder (OR 5.50; 95% CI 4.11 to 7.35). Conversely, English Bulldogs had significantly reduced odds of 3/34 (8.8%) disorders. These were: dental disorder (OR 0.25; 95% CI 0.20 to 0.31), spinal cord disorder (OR 0.31; 95% CI 0.14 to 0.71) and appetite disorder (OR 0.43; 95% CI 0.20 to 0.91).
CONCLUSIONS
These results suggest that the health of English Bulldogs is substantially lower than dogs that are not English Bulldogs and that many predispositions in the breed are driven by the extreme conformation of these dogs. Consequently, immediate redefinition of the breed towards a moderate conformation is strongly advocated to avoid the UK joining the growing list of countries where breeding of English Bulldogs is banned.
PubMed: 35701824
DOI: 10.1186/s40575-022-00118-5 -
Trials Dec 2022Lumbar disc herniation is one of the leading causes of chronic low back pain. Surgery remains the therapy of choice when conservative approaches fail. Full-endoscopic... (Randomized Controlled Trial)
Randomized Controlled Trial
Full-endoscopic versus conventional microsurgical therapy of lumbar disc herniation: a prospective, controlled, single-center, comprehensive cohort trial (FEMT-LDH trial).
BACKGROUND
Lumbar disc herniation is one of the leading causes of chronic low back pain. Surgery remains the therapy of choice when conservative approaches fail. Full-endoscopic approaches represent a promising alternative to the well-established microsurgical technique. However, high-grade evidence comparing these techniques is still scarce.
METHODS
Patients presenting with lumbar disc herniation will be included. The intervention group will obtain full-endoscopic disc decompression, whereas the control group will be treated by microsurgical disc decompression. We will apply a comprehensive cohort study design involving a randomized and a prospective non-randomized study arm. Patients who do not consent to be randomized will be assigned to the non-randomized arm. The primary outcome will be the Oswestry Disability Index (ODI). Secondary outcomes involve the visual analog scale (VAS) of pain and the SF-36 health questionnaire. Furthermore, clinical characteristics including duration of hospital stay, operation time, and complications as well as laboratory markers, such as C-reactive protein, white blood cell counts, and interleukin 6 will be determined and compared.
DISCUSSION
This study will significantly contribute to the current evidence available in the literature by evaluating the outcome of the full-endoscopic technique against the gold standard for lumbar disc herniation in a clinically relevant study setup. Additionally, the study design allows us to include patients not willing to be randomized in a prospective parallel study arm and to evaluate the impact of randomization on outcomes and include. The results could help to improve the future therapy in patients suffering from lumbar disc herniation.
TRIAL REGISTRATION
This study was prospectively registered in The German Clinical Trials Register (DRKS), a German WHO primary registry, under the registration number: DRKS00025786. Registered on July 7, 2021.
Topics: Humans; Intervertebral Disc Displacement; Prospective Studies; Cohort Studies
PubMed: 36476361
DOI: 10.1186/s13063-022-06892-8