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Spinal Cord Oct 1999Spinal cord injury without fractures or bony malalignment on either plain radiographs or computed tomography (SCIWORA) is most commonly found in the paediatric age...
Spinal cord injury without fractures or bony malalignment on either plain radiographs or computed tomography (SCIWORA) is most commonly found in the paediatric age group. In recent years, magnetic resonance imaging (MRI) has been used to evaluate these patients. The present communication describes SCIWORA in 15 adult patients investigated by MRI. Of the 151 patients with spinal cord injury in 1 year, 15 adult patients had cervical SCIWORA. All patients were evaluated by MRI. The age ranged from 20 - 60 years. Eleven patients had partial cord injury, two had a complete cord syndrome while two had a central cord syndrome. MRI demonstrated an intervertebral disc prolapse in six patients, intramedullary haematoma/contusion in four and cord oedema in four patients. One patient had multiple disc prolapses and associated intramedullary haematoma. Patients with disc prolapse were operated upon and all showed neurological improvement. The rest of the patients were managed conservatively. There was mild improvement in patients with intramedullary haematomas while those with cord oedema alone showed moderate recovery. The pathogenesis of adult SCIWORA is possibly different from that in paediatric age group. Most of the patients with SCIWORA show some abnormality on MR imaging. MRI should therefore be done in all patients with spinal cord injury for diagnostic and prognostic purposes.
Topics: Adult; Cervical Vertebrae; Female; Humans; Intervertebral Disc; Magnetic Resonance Imaging; Male; Middle Aged; Spinal Cord Injuries; Treatment Outcome
PubMed: 10557129
DOI: 10.1038/sj.sc.3100900 -
Taiwanese Journal of Obstetrics &... Sep 2012To investigate the incidence, management, and perinatal and long-term outcomes of term pregnancies with umbilical cord prolapse (UCP) at Mackay Memorial Hospital,...
OBJECTIVE
To investigate the incidence, management, and perinatal and long-term outcomes of term pregnancies with umbilical cord prolapse (UCP) at Mackay Memorial Hospital, Taipei, from 1998 to 2007.
MATERIALS AND METHODS
For this retrospective study, we reviewed the charts, searched a computerized birth database, and contacted the families by telephone to acquire additional follow-up information.
RESULTS
A total of 40 cases of UCP were identified among 40,827 term deliveries, an incidence of 0.1%. Twenty-six cases (65%) were delivered by emergency cesarean section (CS). Of the neonates, 18 had an Apgar score of <7 at 1 minute, 10 of these scores being sustained at 5 minutes after birth, and three infants finally died. Eleven UCPs occurred at the vaginal delivery of a second twin, and nine with malpresentation. All of the infants who had good perinatal outcomes also had good long-term outcomes. Poor perinatal outcomes occurred in cases where there was a delayed diagnosis, or an inability to carry out an emergency CS or a prompt vaginal delivery.
CONCLUSION
Early detection of UCP and expeditious delivery are crucial to good perinatal outcomes. An emergency CS remains the mainstream management. Multiparous women whose cervixes are nearly fully dilated and who are expecting babies relatively smaller than their elder brothers or sisters born vaginally may still have vaginal deliveries managed by well-experienced birth teams, with good perinatal outcomes. Otherwise, vaginal delivery is not recommended and CS is the wiser choice.
Topics: Adult; Apgar Score; Cesarean Section; Extraction, Obstetrical; Female; Fetal Distress; Follow-Up Studies; Humans; Incidence; Infant, Newborn; Intensive Care, Neonatal; Male; Obstetric Labor Complications; Pregnancy; Prolapse; Retrospective Studies; Risk Factors; Taiwan; Term Birth; Treatment Outcome; Umbilical Cord
PubMed: 23040920
DOI: 10.1016/j.tjog.2012.07.010 -
Obstetrics and Gynecology Oct 1984Umbilical cord prolapse complicated one of 385 pregnancies occurring at the University of Colorado Health Science Center between 1969 and 1982. Whereas malpresentation...
Umbilical cord prolapse complicated one of 385 pregnancies occurring at the University of Colorado Health Science Center between 1969 and 1982. Whereas malpresentation of the fetus is frequently associated with prolapse of the funis, nearly 50% of all cases occurred in vertex presentations. Obstetric intervention is associated with nearly one in five cases of cord prolapse and represents a readily preventable cause of maternal and perinatal morbidity.
Topics: Breech Presentation; Cesarean Section; Extraction, Obstetrical; Female; Fetal Death; Gestational Age; Humans; Infant, Newborn; Labor Presentation; Obstetric Labor Complications; Obstetrical Forceps; Pregnancy; Prolapse; Retrospective Studies; Umbilical Cord
PubMed: 6483298
DOI: No ID Found -
Journal of Emergency Nursing Aug 2005
Topics: Adaptation, Psychological; Attitude of Health Personnel; Attitude to Health; Delivery, Obstetric; Emergencies; Emergency Nursing; Emergency Treatment; Fatal Outcome; Female; Gestational Age; Grief; Humans; Nurse's Role; Nursing Staff, Hospital; Parents; Pregnancy; Pregnancy Complications; Pregnancy Outcome; Pregnancy Trimester, Third; Prolapse; Social Support; Umbilical Cord
PubMed: 16126101
DOI: 10.1016/j.jen.2005.04.020 -
Lancet (London, England) Nov 1997
Topics: Adult; Cesarean Section; Female; Humans; Obstetric Labor Complications; Placenta Previa; Pregnancy; Prolapse; Ultrasonography, Doppler, Color; Ultrasonography, Prenatal; Umbilical Cord
PubMed: 9371174
DOI: 10.1016/S0140-6736(05)64209-2 -
BJOG : An International Journal of... Dec 2004
Review
Topics: Adult; Anti-Bacterial Agents; Cesarean Section; Erythromycin; Female; Fetal Diseases; Humans; Pregnancy; Pregnancy Outcome; Pregnancy Trimester, Second; Prenatal Care; Prolapse; Umbilical Cord
PubMed: 15663142
DOI: 10.1111/j.1471-0528.2004.00252.x -
The Australian & New Zealand Journal of... Aug 1983The outcome of pregnancies with prolapse and presentation of the umbilical cord at Tsan Yuk Hospital, Hong Kong, 1976 to 1982, was reviewed. The incidence was 0.17%, 70...
The outcome of pregnancies with prolapse and presentation of the umbilical cord at Tsan Yuk Hospital, Hong Kong, 1976 to 1982, was reviewed. The incidence was 0.17%, 70 of 41,939 deliveries; 98% of cases were diagnosed in hospital. Breech presentation, low birth-weight and artificial rupture of membranes were found to be significant associations; 78% of cases were discovered by vaginal examination and the diagnosis-delivery interval was less than 30 minutes in 75%. There were 8 perinatal deaths and 3 of these occurred in babies whose birth-weights were less than 1,000 g; 2 stillbirths were associated with presentation of the cord. The corrected perinatal mortality was 8.6% with a corresponding Caesarean section rate of 73.3%. 80% of the babies born by Caesarean section had 5 minutes Apgar scores of 7 or more. It was concluded that early diagnosis of umbilical cord prolapse followed by prompt treatment are effective in reducing the perinatal mortality rate. Energetic intrapartum monitoring is also essential in order that patients with occult prolapse or presentation of the umbilical cord be diagnosed early and treated promptly.
Topics: Adolescent; Adult; Breech Presentation; Cesarean Section; Female; Fetal Death; Fetal Membranes, Premature Rupture; Humans; Infant Mortality; Infant, Low Birth Weight; Infant, Newborn; Maternal Age; Obstetric Labor Complications; Pregnancy; Umbilical Cord
PubMed: 6580880
DOI: 10.1111/j.1479-828x.1983.tb00563.x -
International Journal of Gynaecology... Oct 2006
Topics: Delivery, Obstetric; Female; Fetal Death; Humans; Nigeria; Pregnancy; Pregnancy Complications; Pregnancy Outcome; Prolapse; Retrospective Studies; Stillbirth; Umbilical Cord
PubMed: 16828093
DOI: 10.1016/j.ijgo.2006.05.030 -
Journal of Obstetrics and Gynaecology :... Apr 2010Umbilical cord prolapse (UCP) is an obstetric emergency. The objective of our study was to determine the frequency of cord prolapse, its aetiological factors and to...
Umbilical cord prolapse (UCP) is an obstetric emergency. The objective of our study was to determine the frequency of cord prolapse, its aetiological factors and to evaluate fetal prognosis. This was a retrospective review of cord prolapse deliveries in the main two civil hospitals in North Jordan between 1995 and 2005, at Princess Badeea Hospital and at King Abdullah University Hospital (KAUH) in Irbid, North Jordan. There were 146 patients identified with UCP among a total of 64,192 consecutive births. The incidence of cord prolapse was one in 440 cases (146/64,192). It occurred mostly in women over 25 years, and significantly more in pre-term births, low birth weight babies, multigravida, and only a few were associated with induced cases. It was not associated with higher rates of perinatal mortality and this supports the benefit of clinical management of UCP by emergency (crash) delivery.
Topics: Adult; Case-Control Studies; Female; Fetal Diseases; Hospitals, Teaching; Humans; Jordan; Pregnancy; Prolapse; Retrospective Studies; Risk Factors; Umbilical Cord
PubMed: 20373926
DOI: 10.3109/01443610903474330 -
Obstetrics and Gynecology May 1985
Topics: Female; Humans; Obstetric Labor Complications; Pregnancy; Prolapse; Umbilical Cord
PubMed: 4039048
DOI: No ID Found