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The Veterinary Clinics of North... Nov 2021Add "in dogs and cats"? This article covers image acquisition of the fetus and the reproductive organs of the female (cervix, gravid and nongravid uterus, and ovaries)... (Review)
Review
Add "in dogs and cats"? This article covers image acquisition of the fetus and the reproductive organs of the female (cervix, gravid and nongravid uterus, and ovaries) and male (testicles and prostate) reproductive tracts. This article is a brief overview of normal sonographic anatomy and important clinical conditions for each sex using point-of-care ultrasound as a screening test. In addition to normal sonographic appearance and common conditions of the scrotum and testes, prostate, uterus, and ovaries, this article discusses the use of ultrasound for diagnosis of and evaluating pregnancy, fetal maturation, and fetal stress during dystocia.
Topics: Animals; Cat Diseases; Cats; Dog Diseases; Dogs; Dystocia; Female; Fetus; Male; Pregnancy; Uterus
PubMed: 34535336
DOI: 10.1016/j.cvsm.2021.07.008 -
Obstetrics and Gynecology Clinics of... Sep 1999Shoulder dystocia is one of the most dreaded complications of vaginal delivery encountered by the obstetrician. Although risk factors for shoulder dystocia exist,... (Review)
Review
Shoulder dystocia is one of the most dreaded complications of vaginal delivery encountered by the obstetrician. Although risk factors for shoulder dystocia exist, approximately 50% of cases do not demonstrate the classic predisposing signs. Obstetricians can help patients decrease their risk for fetal macrosomia by frequent attention to weight gain, nutrition, and exercise during pregnancy and by aggressive management of diabetes. All obstetricians must be familiar with the maneuvers used to effect delivery of impacted shoulders and must be prepared to institute these maneuvers immediately in a crisis situation.
Topics: Dystocia; Emergencies; Emergency Treatment; Female; Fetal Macrosomia; Humans; Obesity; Pregnancy; Pregnancy in Diabetics; Risk Factors; Shoulder
PubMed: 10472064
DOI: 10.1016/s0889-8545(05)70089-9 -
Modern Midwife Oct 1996
Review
Topics: Causality; Dystocia; Female; Humans; Nurse Midwives; Pregnancy; Shoulder; Version, Fetal
PubMed: 9052143
DOI: No ID Found -
Journal of Feline Medicine and Surgery Jan 2017Objectives The aim of this study was to describe the incidence of feline dystocia with respect to breed. Methods The data used were reimbursed claims for veterinary care...
Objectives The aim of this study was to describe the incidence of feline dystocia with respect to breed. Methods The data used were reimbursed claims for veterinary care insurance and/or life insurance claims in cats registered in a Swedish insurance database from 1999-2006. Results The incidence rates for dystocia were about 22 cats per 10,000 cat-years at risk, 67 per 10,000 for purebred cats and seven per 10,000 for domestic shorthair cats. The median age was 2.5 years. A significant effect of breed was seen. An incidence rate ratio (IRR) that was significantly higher compared with other purebred cats was seen in the British Shorthair (IRR 2.5), the Oriental group (IRR 2.2), Birman (IRR 1.7), Ragdoll (IRR 1.5) and the Abyssinian group (IRR 1.5). A significantly lower IRR was seen in the Norwegian Forest Cat (IRR 0.38), the Maine Coon (IRR 0.48), the Persian/Exotic group (IRR 0.49) and the Cornish Rex (IRR 0.50). No common factor among the high-risk breeds explained their high risk for dystocia. There was no effect of location; that is, the incidence rate did not differ depending on whether the cat lived in an urban or rural area. Caesarean section was performed in 56% of the cats with dystocia, and the case fatality was 2%. Conclusions and relevance The incidence rate for dystocia was of a similar magnitude in purebred cats as in dogs. The IRR varied significantly among breeds, and the main cause for dystocia should be identified separately for each breed. A selection for easy parturitions in breeding programmes is suggested.
Topics: Animals; Breeding; Cat Diseases; Cats; Dystocia; Female; Incidence; Insurance, Health; Pregnancy; Pregnancy, Animal; Sweden
PubMed: 26297020
DOI: 10.1177/1098612X15600482 -
European Journal of Obstetrics,... Nov 2022This study will present our results in management of fetal shoulder dystocia with special consideration of maternal and neonatal outcome.
OBJECTIVES
This study will present our results in management of fetal shoulder dystocia with special consideration of maternal and neonatal outcome.
STUDY DESIGN
A retrospective study was performed at a university tertiary perinatal center. The study included data of singleton vaginal term deliveries in the period of 15 years (2006-2020). Analized informations include: obstetrics maternal and neonatal data and outcomes.
RESULTS
This period included 45,687 deliveries with diagnosed shoulder dystocia in 254 (0.7 %) cases in vaginal deliveries. Most of the deliveries were spontaneous births 69.7 %, induced deliveries 30.3 %, 47.2 % primiparas and preexisting or gestational diabetes in 21.7 %. The delivery was managed by vacuum extraction in 13.8 %, mediolateral episiotomy in 48.0 % of births, most of the shoulder dystocia were unilateral anterior, while only two cases were diagnosed as more difficult bilateral and 5 cases were recurrent. 87.4 % cases were resolved by McRobert's maneuver, 7.8 % by Barnum's 3.9 % by Wood's maneuver and one case was managed by Menticoglou and by Bourgoise-Siegemundin maneuver. 4.3 % injuries were classified as OASIS of III/IV degree, early postpartum hemorrhage due in 1.6 %. 54.3 % of newborns were male sex, 61.0 % of newborns had birth weight of above 4000 g (mean 4071 g). Maximal Apgar scores were atributed to 92.5 % in first and to 97.2 % in fifth minute, one case that requaired resuscitation. Clavicle fracture was found in 9.5 %, humerus fracture in 0.4 %, transient form of Duchenne Erb obstetrics brachial palsy was diagnosed in only in 7.5 % newborns, while we have not found any case of permanent brachial palsy.
CONCLUSIONS
Our results confirmed that strategy of prompt identification of shoulder dystocia accompanied by cessation of axial fetal head traction decrease the risk of brachial plexus strain, injury or tear, while performance of exact obstetrical maneuvers resulted in decanceration of fetal shoulders without permanent obstetrics brachial palsy or cerebral morbidity. We think that our good results corelate with our opinion that the performance of external obstetrical manoeuvres should be done without one minute postpone since efforts should be put in sooner shoulder liberation decreasing the time of fetal hypoxia.
Topics: Pregnancy; Female; Infant, Newborn; Male; Humans; Dystocia; Shoulder Dystocia; Birth Injuries; Retrospective Studies; Delivery, Obstetric; Brachial Plexus Neuropathies; Shoulder; Paralysis; Risk Factors
PubMed: 36113284
DOI: 10.1016/j.ejogrb.2022.09.009 -
Obstetrics and Gynecology Clinics of... Jun 2011Despite persisting controversy over shoulder dystocia prediction, prevention, and injury causation, the authors find considerable evidence in recent research in the... (Review)
Review
Despite persisting controversy over shoulder dystocia prediction, prevention, and injury causation, the authors find considerable evidence in recent research in the field to recommend additional guidelines beyond the current American College of Obstetricians and Gynecologists and Royal College of Obstetricians and Gynecologists guidelines to improve clinical practice in managing patients at risk for experiencing shoulder dystocia. In this article, the authors offer health care providers information, practical direction, and advice on how to limit shoulder dystocia risk and, more importantly, to reduce adverse outcome risk.
Topics: Birth Injuries; Brachial Plexus; Dystocia; Female; Humans; Incidence; Pregnancy; Risk Factors; Shoulder
PubMed: 21575800
DOI: 10.1016/j.ogc.2011.02.015 -
Journal de Gynecologie, Obstetrique Et... 1989In this study, 49 cases of shoulder dystocia have been examined. These cases took place in Athens University Second Gynecological and Obstetrics Department, over a...
In this study, 49 cases of shoulder dystocia have been examined. These cases took place in Athens University Second Gynecological and Obstetrics Department, over a period of ten years, from 1975 to 1985. In 23 cases, the delivery was normal, in 20 cases it was necessary to use a vacuum extractor and in 6 cases a forceps. In none of the above cases was there a Cesarean Section, because the cases were not regarded as a fetopelvic disproportion, but as cases which justify normal delivery. There follows a general outline of the treatment to be applied in cases of shoulder dystocia, including a generous episiotomy, the application, if possible, of a muscular relaxation by inhalation anesthesia, and the application of certain obstetric manipulations. In our cases, we applied general anesthesia in 7 cases and local in 39, whereas in 3 was no anesthesia at all. The obstetric manipulations we applied were those of McRoberts in 15 cases, of Jacquemier in 10 cases, of Wood in 15 cases, of Barnum in 5 cases, of Hibbard in 8 cases and of Couder in 6 cases. Our results also appear in tables I and II. In 36 cases, out of 49, (73.49%), the fetal weight was over 4,000 g. In 23 cases (47%) the mother had gained 12 kg during pregnancy. Also, in our study, 20% of the cases (10 mothers) were multiparous and 45% (22 mothers) had a prolonged second stage of labour by more than one hour. Class A (by White) diabetes was found in 5 cases.(ABSTRACT TRUNCATED AT 250 WORDS)
Topics: Adult; Dystocia; Female; Humans; Labor Presentation; Pregnancy; Shoulder
PubMed: 2723356
DOI: No ID Found -
The Journal of Reproductive Medicine Jul 2000
Topics: Adult; Dystocia; Female; Humans; Labor Presentation; Obstetrics; Pregnancy; Shoulder
PubMed: 10948478
DOI: No ID Found -
Animal Reproduction Science Jul 2016The objectives of this study were to investigate the prevalence of dystocia in camel herds, its forms in primi- and multipara, the risks to fetus and dam, and the...
The objectives of this study were to investigate the prevalence of dystocia in camel herds, its forms in primi- and multipara, the risks to fetus and dam, and the associated hematobiochemical changes. A total of 1890 calvings were surveyed for the prevalence of dystocia. Cases with dystocia (n=107) were examined for causes and treated with traction, fetotomy or Cesarean section. Logistic regression was performed to identify risk factors. The dependent variables were the fetal and maternal mortality, while the independent variables were parity, duration of dystocia, causes of dystocia, and method of treatment. Blood samples were collected from all dystocia camels and six controls for hematology and concentrations of serum amyloid A (SAA), haptoglobin (Hp), estradiol-17β (E2), progesterone (P4), total protein, albumin, calcium, phosphorus, magnesium, blood urea nitrogen (BUN), creatinine and aspartate aminotransferase (AST). The overall prevalence of dystocia was 8.6%. Risk of dystocia was higher in camels managed in an intensive system than in those in a free system (Odds ratio=1.9, P=0.0003) and higher in primipara than in multipara (Odds ratio 1.7, P=0.005). Abnormal posture was the most important cause of dystocia (51.4%). Uterine torsion was the second most important cause (23.4%) and was mainly observed in multipara (P=0.0006). Dystocia was linked to high fetal mortality (87.9%). A significant relationship was found between fetal death and duration of dystocia (Odds ratio=8.04, P=0.005). The percentage of dam mortality was 17.8%. Significant associations were detected between dam mortality rate and the duration of dystocia (Odds ratio=4.74, P=0.03) and fetal viability (Odds ratio=5.82, P=0.02). Increasing duration of dystocia was associated with significant increases in SAA, Hp, BUN and AST, but with decreases in E2 (P<0.05). After a transient period of elevation, the white blood cell and neutrophil counts decreased (P<0.05). In conclusion, abnormal posture and uterine torsion were found to be the common causes of dystocia in dromedary camels, and fetal and maternal deaths were mainly associated with the duration of dystocia.
Topics: Animals; Camelus; Cesarean Section; Dystocia; Female; Fetal Death; Odds Ratio; Parity; Pregnancy; Risk Factors
PubMed: 27211280
DOI: 10.1016/j.anireprosci.2016.05.004 -
Journal of Nurse-midwifery 1994Shoulder dystocia is a rare but serious obstetric complication that can result in significant neonatal and maternal morbidity and in costly litigation. Conflict exists... (Review)
Review
Shoulder dystocia is a rare but serious obstetric complication that can result in significant neonatal and maternal morbidity and in costly litigation. Conflict exists in the literature regarding definition, incidence, predictability and preventability, relationship to neonatal injury, and appropriate management models. Anticipatory clinical interventions for potential shoulder dystocia have included ultrasound assessment of macrosomia; elective induction of labor; elective caesarean section; altered place of birth; and generous episiotomy/episioproctotomy. The authors note that these interventions often conflict with client desires and nurse-midwifery philosophy of birth, generate significant risks and costs in themselves, and do not address the poor predictability of shoulder dystocia. In recent literature, the safety and efficacy of maternal position change maneuvers (such as McRoberts maneuver, hands-knees position, and squatting) have been presented as methods to resolve most cases of shoulder dystocia. Despite the success of these more benign, external maneuvers, the episiotomy mandate remains in nearly all obstetric and midwifery texts and handbooks (1-8) and journal references (9-19). A literature review of related professional disciplines was undertaken to study these conflicts and to identify support for applying a philosophy of minimal, appropriate intervention to the complex issue of shoulder dystocia.
Topics: Delivery, Obstetric; Dystocia; Episiotomy; Female; Humans; Liability, Legal; Models, Nursing; Nurse Midwives; Posture; Pregnancy; Pregnancy Outcome; Risk Factors; Shoulder
PubMed: 8035249
DOI: 10.1016/0091-2182(94)90067-1