-
Prehospital Emergency Care 2022Umbilical cord prolapse is an acute obstetric emergency associated with high fetal morbidity and mortality. To avoid poor outcomes, rapid diagnosis with immediate... (Review)
Review
Umbilical cord prolapse is an acute obstetric emergency associated with high fetal morbidity and mortality. To avoid poor outcomes, rapid diagnosis with immediate intervention is required, especially in the prehospital setting where resources are limited. In this case report, we describe a 38-year-old woman with umbilical cord prolapse, with a review of appropriate prehospital maneuvers and treatment.
Topics: Adult; Emergency Medical Services; Female; Humans; Obstetric Labor Complications; Pregnancy; Prolapse; Umbilical Cord
PubMed: 33595425
DOI: 10.1080/10903127.2021.1890285 -
American Journal of Obstetrics and... Jun 1962
Topics: Disease Management; Female; Humans; Pregnancy; Pregnancy Complications; Umbilical Cord
PubMed: 13876063
DOI: 10.1016/s0002-9378(16)35989-0 -
International Journal of Gynaecology... Jul 2004
Topics: Apgar Score; Cesarean Section; Emergencies; Female; Gestational Age; Humans; Infant Mortality; Infant, Newborn; Obstetric Labor Complications; Pregnancy; Pregnancy Outcome; Prolapse; Risk Factors; Time Factors; Umbilical Cord
PubMed: 15207667
DOI: 10.1016/j.ijgo.2003.11.013 -
American Journal of Obstetrics and... Dec 2022
Topics: Humans; Female; Prolapse; Obstetric Labor Complications; Umbilical Cord
PubMed: 35841940
DOI: 10.1016/j.ajog.2022.07.008 -
Journal of Perinatal Medicine Jul 2017Umbilical cord prolapse occurs when the cord prolapses ahead of or alongside the presenting part. It is an acute obstetric emergency with potential catastrophic effects....
OBJECTIVE
Umbilical cord prolapse occurs when the cord prolapses ahead of or alongside the presenting part. It is an acute obstetric emergency with potential catastrophic effects. We set out to assess incidence of cord prolapse, as well as rates and characteristics of perinatal death associated with the condition.
STUDY DESIGN
This was a retrospective cohort study. All recorded cases of cord prolapse were included, and rates of perinatal death and encephalopathy, as well as intrapartum and maternal characteristics were examined.
RESULTS
There were 156,130 deliveries at the hospital over the 20-year study period. Three hundred and seven cases of cord prolapse were identified (1.9/1000 deliveries). There was a decrease in the incidence of cord prolapse over the course of the study. The rate peaked in 1999 at 3.9/1000 and was just 0.8/1000 of all deliveries in 2007. The majority of cases (216/307, 70%) occurred in multiparas; however, nulliparous parturients were more likely to have a perinatal death [12% (11/91) vs. 4.6% (10/216)]. The rate of perinatal death in cases of cord prolapse was 6.8% (21/307). Over half of perinatal deaths (11/21) occurred in infants of mothers who presented with ruptured membranes, seven of these infants were already dead on reaching hospital. There was just one case of neonatal encephalopathy associated with cord prolapse, giving an incidence of 0.32%.
CONCLUSION
Cord prolapse carries a significant risk of perinatal death, approximately 7%. The corresponding rate of encephalopathy is low. A significant number of deaths were diagnosed on presentation to hospital and were not deemed preventable.
Topics: Female; Humans; Infant, Newborn; Ireland; Perinatal Death; Perinatal Mortality; Pregnancy; Retrospective Studies; Tertiary Care Centers; Umbilical Cord
PubMed: 27831923
DOI: 10.1515/jpm-2016-0223 -
Current Urology Reports Mar 2019We highlight the substantial gaps in knowledge on urologic care of female spinal cord injury (SCI) patients. (Review)
Review
PURPOSE OF REVIEW
We highlight the substantial gaps in knowledge on urologic care of female spinal cord injury (SCI) patients.
RECENT FINDINGS
Males account for approximately 80% of people living with SCI in developed nations. Although there is a robust body of literature in some aspects of urologic care of individuals with SCI, such as treatments for neurogenic detrusor overactivity, there are relatively few studies focusing specifically on females. There are also few studies focusing on other aspects of urologic care of women with SCI such as sexual dysfunction, pelvic organ prolapse, and bladder cancer. Established guidelines for bladder management exist, generally recommending intermittent catheterization, but the fact remains that a substantial number of women with SCI utilize indwelling catheters for bladder management. There remains a paucity of literature using patient-reported measures regarding both outcomes and experiences of urologic management in the SCI population. Bladder management is challenging for many women with SCI. There are few studies on other urologic concerns in women with SCI.
Topics: Catheters, Indwelling; Female; Humans; Lower Urinary Tract Symptoms; Patient Reported Outcome Measures; Pelvic Organ Prolapse; Quality of Life; Sex Factors; Sexual Dysfunction, Physiological; Spinal Cord Injuries; Urethra; Urinary Bladder, Neurogenic; Urinary Bladder, Overactive; Urinary Incontinence
PubMed: 30904966
DOI: 10.1007/s11934-019-0884-6 -
American Journal of Obstetrics and... May 2022
Topics: Acidosis; Female; Fetal Diseases; Heart Rate, Fetal; Humans; Pregnancy; Prolapse; Umbilical Cord
PubMed: 34896316
DOI: 10.1016/j.ajog.2021.12.002 -
Acta Neurochirurgica. Supplement 2023Video-assisted thoracic surgery (VATS) has been growing in popularity over the past 2 decades as an alternative to open thoracotomy for the treatment of several spinal...
UNLABELLED
Video-assisted thoracic surgery (VATS) has been growing in popularity over the past 2 decades as an alternative to open thoracotomy for the treatment of several spinal conditions, and in the field of minimally invasive surgery, it now acts as a keyhole to the thoracic spine.
MATERIALS AND METHODS
Most VATS approaches are from the right side for pathologies involving the middle and upper thoracic spine because there is a greater working spinal surface area lateral to the azygos vein than that lateral to the aorta. Below T-9, a left-sided approach is made possible because the aorta moves away from the left posterolateral aspect of the spine to an anterior position as it passes through the diaphragm.
RESULTS
VATS has been used extensively in spinal deformities such as scoliosis. The use of VATS in spine surgery includes the treatment of thoracic prolapsed disk diseases, vertebral osteomyelitis, fracture management, vertebral interbody fusion, tissue biopsy, anterior spinal release, and fusion without or with instrumentation (VAT-I) for spinal deformity correction. As the knowledge and the comfort of using such techniques have expanded, the indications have extended to corpectomy for tumor resections.
DISCUSSION AND CONCLUSIONS
In the field of minimally invasive surgery, VATS now acts as a keyhole to the thoracic spine and an alternative to open thoracotomy for the treatment of several spinal conditions.Although VATS can be performed in such spine conditions, it is most beneficial in the treatment of scoliotic deformity, which requires taking a multilevel approach, from the upper to the lower thoracic spine.
Topics: Humans; Spinal Cord Diseases; Spine; Intervertebral Disc Degeneration; Intervertebral Disc Displacement
PubMed: 38153497
DOI: 10.1007/978-3-031-36084-8_58 -
Nederlands Tijdschrift Voor Geneeskunde Dec 1971
Topics: Adult; Cesarean Section; Electrocardiography; Female; Fetal Heart; Humans; Infant, Newborn; Obstetric Labor Complications; Pregnancy; Umbilical Cord
PubMed: 5130777
DOI: No ID Found -
BMC Pregnancy and Childbirth Feb 2022In twin pregnancies, the cord prolapse of either fetus during the pre-viable period leads to fetal death but can also cause an intrauterine infection, leading to...
BACKGROUND
In twin pregnancies, the cord prolapse of either fetus during the pre-viable period leads to fetal death but can also cause an intrauterine infection, leading to death or prematu-re birth of the remaining fetus. However, there are no validated protocols to prolong the gestational period or decrease the morbidity and mortality of the remaining fetus.
CASE PRESENTATION
The present cases were PPROM and cord prolapse very early during the second trimester (around 17 weeks in the first case and 19 weeks in the second case). The first fetus was evacuated, and cervical cerclage was performed at 23 and 20 weeks in the two cases, respectively. After maintaining the pregnancy, the second baby was born around 27 and 39 weeks in the first and second cases, respectively. The delivery interval between the first and second fetuses was 46 days in the first case and 126 days in the second case.
CONCLUSION
If cord prolapse is identified at a pre-viable time in twin fetuses, evacuation and cerclage should be performed as soon as possible after the cord prolapse to reduce intrauterine infection and increase the survival chances of the remaining fetus.
Topics: Adult; Cerclage, Cervical; Delivery, Obstetric; Female; Fetal Membranes, Premature Rupture; Humans; Live Birth; Pregnancy; Pregnancy Outcome; Pregnancy Trimester, Second; Pregnancy, Twin; Prolapse; Umbilical Cord
PubMed: 35144573
DOI: 10.1186/s12884-022-04438-z