المؤلفون: Le Lous, Maela^1,2,3,4 (AUTHOR) maela.le.lous@chu-rennes.fr, Vasconcelos, Francisco⁴ (AUTHOR), Di Vece, Chiara⁴ (AUTHOR), Dromey, Brian^4,5 (AUTHOR), Napolitano, Raffaele^5,6 (AUTHOR), Yoo, Soojoeong⁴ (AUTHOR), Edwards, Eddie⁴ (AUTHOR), Huaulme, Arnaud² (AUTHOR), Peebles, Donald^5,6 (AUTHOR), Stoyanov, Danail⁴ (AUTHOR), Jannin, Pierre² (AUTHOR)

المصدر: European Journal of Obstetrics & Gynecology & Reproductive Biology. Jul2024, Vol. 298, p13-17. 5p.

مصطلحات موضوعية: *FETAL abnormalities, *FETAL presentation, *ANGULAR acceleration, *ACCELERATION (Mechanics), *ANGULAR velocity

مستخلص: • Why was this study conduted? • Some study investigated probe motion in simulated settings, but few in a clinical setting during second trimester scans. We hypothesized that probe trajectory might differ according to operator's level, fetal presentation (e.g., cephalic or breech) or patient body mass index (BMI). • What does this study add? • In a clinical setting, some differences in the path metrics (velocity, acceleration, jerk and working volume) were noticed according to participant level. However, angular metrics, i.e., the quantity of rotation applied to the probe, were not affected by operator's level, fetal presentations nor patient's BMI. This study aims to investigate probe motion during full mid-trimester anomaly scans. We undertook a prospective, observational study of obstetric sonographers at a UK University Teaching Hospital. We collected prospectively full-length video recordings of routine second-trimester anomaly scans synchronized with probe trajectory tracking data during the scan. Videos were reviewed and trajectories analyzed using duration, path metrics (path length, velocity, acceleration, jerk, and volume) and angular metrics (spectral arc, angular area, angular velocity, angular acceleration, and angular jerk). These trajectories were then compared according to the participant level of expertise, fetal presentation, and patient BMI. A total of 17 anomaly scans were recorded. The average velocity of the probe was 12.9 ± 3.4 mm/s for the consultants versus 24.6 ± 5.7 mm/s for the fellows (p = 0.02), the average acceleration 170.4 ± 26.3 mm/s2 versus 328.9 ± 62.7 mm/s2 (p = 0.02), and the average jerk 7491.7 ± 1056.1 mm/s3 versus 14944.1 ± 3146.3 mm/s3 (p = 0.02), the working volume 9.106 ± 4.106 mm3 versus 29.106 ± 11.106 mm3 (p = 0.03), respectively. The angular metrics were not significantly different according to the participant level of expertise, the fetal presentation, or to patients BMI. Some differences in the probe path metrics (velocity, acceleration, jerk and working volume) were noticed according to operator's level. [ABSTRACT FROM AUTHOR]

المؤلفون: Gleed, Alexander D.¹ (AUTHOR) alexander.gleed@eng.ox.ac.uk, Mishra, Divyanshu¹ (AUTHOR), Self, Alice² (AUTHOR), Thiruvengadam, Ramachandran³ (AUTHOR), Desiraju, Bapu Koundinya³ (AUTHOR), Bhatnagar, Shinjini³ (AUTHOR), Papageorghiou, Aris T.² (AUTHOR), Noble, J. Alison¹ (AUTHOR)

المصدر: Ultrasound in Medicine & Biology. Jul2024, Vol. 50 Issue 7, p985-993. 9p.

مصطلحات موضوعية: *FETAL anatomy, *FETAL presentation, *ULTRASONIC imaging, *VIDEOS, *MACHINE learning

مستخلص: We present a statistical characterisation of fetal anatomies in obstetric ultrasound video sweeps where the transducer follows a fixed trajectory on the maternal abdomen. Large-scale, frame-level manual annotations of fetal anatomies (head, spine, abdomen, pelvis, femur) were used to compute common frame-level anatomy detection patterns expected for breech, cephalic, and transverse fetal presentations, with respect to video sweep paths. The patterns, termed statistical heatmaps, quantify the expected anatomies seen in a simple obstetric ultrasound video sweep protocol. In this study, a total of 760 unique manual annotations from 365 unique pregnancies were used. We provide a qualitative interpretation of the heatmaps assessing the transducer sweep paths with respect to different fetal presentations and suggest ways in which the heatmaps can be applied in computational research (e.g. , as a machine learning prior). The heatmap parameters are freely available to other researchers (https://github.com/agleed/calopus_statistical_heatmapsTest). [ABSTRACT FROM AUTHOR]

المؤلفون: BISWAS, DIWASHISH¹ biswasdiwa@gmail.com, NAAGAR, JAGRATI KIRAN² dr.jagratikirannaagar@gmail.com, JHA, ANJU³ dranjujhabmc@gmail.com, MISHRA, NITU⁴ dr.nitumishra@gmail.com, SAAD, TALHA⁵ dr.talhasaad@gmail.com, JAIN, ANIL⁶ draniljainbmc@gmail.com, MISHRA, SATYENDRA⁷ satyendrasgo@gmail.com, SINGH, PUJA⁸ Dr.pujasingh@gmail.com

المصدر: Journal of Cardiovascular Disease Research (Journal of Cardiovascular Disease Research). 2023, Vol. 14 Issue 6, p1515-1522. 8p.

مصطلحات موضوعية: *FETAL presentation, *ABRUPTIO placentae, *BREECH delivery, *HEMORRHAGE, *PLACENTA praevia, *BIRTH weight, *BLOOD transfusion

مستخلص: Antepartum hemorrhage is bleeding from the vagina after 24 weeks. It is a significant cause of foetal and maternal death and occurs in 2-5% of pregnancies.1 Antepartum hemorrhage accounts for 30% of maternal deaths, 50% of which are linked to preventable causes. The three primary categories of antepartum hemorrhage causes include placenta previa, placental abruption, and others. The present study was conducted to assess maternal and fetal outcome in patients with antepartum hemorrhage. 120 cases of antepartum hemorrhage were studied. Abdominal examination, per speculum and per vaginum examination was done. Intravenous fluids were given according to severity of bleeding and patient's general condition. USG was done to establish the cause of APH. Common type of APH was abruptio placentae seen in 62, placenta Praevia in 40 and undetermined in 18 patients. The difference was significant (P< 0.05). Among AP, PP and undetermined cases, 48, 28 and 15 cases had emergency C/S. Elective C/S was seen in 10, 7 and 2 and vaginal in 4, 5 and 1 case respectively. Most common complication in AP was anemia seen in 7 in AP, 4 in PP and 3 in undetermined. 15 patients in AP, 9 in PP and 5 in undetermined need blood transfusion. Maternal death was seen 2 in AP, 1 in PP and 1 in undetermined type. The difference was significant (P< 0.05). Birth weight <2500 grams was seen in 40, 24 and 12. Fetal presentation was breech in 32, 26 and 13. In maximum cases cause of death was sepsis seen in 2, 1 and 1. There were 58 live birth, 39 and 15 in AP, PP and undetermined respectively. The difference was significant (P< 0.05). Common reason of APH was abruptio placentae, placental previa and undetermined. Sepsis was most common cause of death. [ABSTRACT FROM AUTHOR]

المؤلفون: Li, Pin¹ (AUTHOR), Pan, Xiuyu¹ (AUTHOR), Yue, Chaomin¹ (AUTHOR), Zheng, Zheng¹ (AUTHOR), Liu, Huishu¹ (AUTHOR) huishuliu@hotmail.com

المصدر: BMC Pregnancy & Childbirth. 10/3/2023, Vol. 23 Issue 1, p1-5. 5p.

مصطلحات موضوعية: *FETAL death, *FETAL presentation, *ABORTION, *HEMORRHAGE, *FETAL distress

مستخلص: Antepartum and intrapartum hemorrhage from vasa previa (VP) is one of the main causes of intrauterine fetal death (IUFD). Here, we present two cases with type I VP in which velamentous cord insertion below the fetal head and overlying the cervix were reported by prenatal ultrasound scanning, and IUFD occoured after 35 weeks with no signs of prenatal bleeding but with engaged fetal head at presentation. We hypothesized that the IUFD may attributed to the compression of the unprotected umbilical vessels by the engaged fetal head. Thus we suggest that VP with a velamentous cord insertion should be considered for earlier termination of the pregnancy to avoid the risk of non-hemorrhagic adverse fetal outcomes. [ABSTRACT FROM AUTHOR]

المؤلفون: Pasko, Daniel N., McGee, Paula, Grobman, William A., Bailit, Jennifer L., Reddy, Uma M., Wapner, Ronald J., Varner, Michael W., Thorp Jr., John M., Caritis, Steve N., Prasad, Mona, Saade, George R., Sorokin, Yoram, Rouse, Dwight J., Tolosa, Jorge E.

المصدر: American Journal of Perinatology; Jul2024, Vol. 41 Issue 9, p1223-1231, 9p

مصطلحات موضوعية: CESAREAN section, SECONDARY analysis, DATA analysis, RESEARCH funding, LOGISTIC regression analysis, HOSPITALS, DESCRIPTIVE statistics, INDUCED labor (Obstetrics), STATISTICS, RESEARCH, COMPARATIVE studies, FETAL presentation

مصطلحات جغرافية: UNITED States

مستخلص: Objective We sought to (1) use the Robson 10-Group Classification System (TGCS), which classifies deliveries into 10 mutually exclusive groups, to characterize the groups that are primary contributors to cesarean delivery frequencies, (2) describe inter-hospital variations in cesarean delivery frequencies, and (3) evaluate the contribution of patient characteristics by TGCS group to hospital variation in cesarean delivery frequencies. Study Design This was a secondary analysis of an observational cohort of 115,502 deliveries from 25 hospitals between 2008 and 2011. The TGCS was applied to the cohort and each hospital. We identified and compared the TGCS groups with the greatest relative contributions to cohort and hospital cesarean delivery frequencies. We assessed variation in hospital cesarean deliveries attributable to patient characteristics within TGCS groups using hierarchical logistic regression. Results A total of 115,211 patients were classifiable in the TGCS (99.7%). The cohort cesarean delivery frequency was 31.4% (hospital range: 19.1–39.3%). Term singletons in vertex presentation with a prior cesarean delivery (group 5) were the greatest relative contributor to cohort (34.8%) and hospital cesarean delivery frequencies (median: 33.6%; range: 23.8–45.5%). Nulliparous term singletons in vertex (NTSV) presentation (groups 1 [spontaneous labor] and 2 [induced or absent labor]: 28.9%), term singletons in vertex presentation with a prior cesarean delivery (group 5: 34.8%), and preterm singletons in vertex presentation (group 10: 9.8%) contributed to 73.2% of the relative cesarean delivery frequency for the cohort and were correlated with hospital cesarean delivery frequencies (Spearman's rho = 0.96). Differences in patient characteristics accounted for 34.1% of hospital-level cesarean delivery variation in group 2. Conclusion The TGCS highlights the contribution of NTSV presentation to cesarean delivery frequencies and the impact of patient characteristics on hospital-level variation in cesarean deliveries among nulliparous patients with induced or absent labor. Key Points We report on the cesarean delivery frequencies in a multicenter U.S. cohort. NTSV gestations (groups 1 and 2) are a primary driver of cesarean deliveries. Patient characteristics contributed most to hospital variation in cesarean deliveries in group 2. [ABSTRACT FROM AUTHOR]

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المؤلفون: Roto, Suoma, Nupponen, Irmeli, Kalliala, Ilkka, Kaijomaa, Marja

المصدر: BMC Pregnancy & Childbirth; 6/12/2024, Vol. 24 Issue 1, p1-9, 9p

مصطلحات موضوعية: CEREBRAL anoxia-ischemia, THERAPEUTIC hypothermia, DELIVERY (Obstetrics), INDUCED labor (Obstetrics), FETAL presentation, SECOND stage of labor (Obstetrics)

الشركة/الكيان: HELSINGIN yliopisto

مستخلص: Background: Peripartum asphyxia is one of the main causes of neonatal morbidity and mortality. In moderate and severe cases of asphyxia, a condition called hypoxic-ischemic encephalopathy (HIE) and associated permanent neurological morbidities may follow. Due to the multifactorial etiology of asphyxia, it may be difficult prevent, but in term neonates, therapeutic cooling can be used to prevent or reduce permanent brain damage. The aim of this study was to assess the significance of different antenatal and delivery related risk factors for moderate and severe HIE and the need for therapeutic hypothermia. Methods: We conducted a retrospective matched case-control study in Helsinki University area hospitals during 2013–2017. Newborn singletons with moderate or severe HIE and the need for therapeutic hypothermia were included. They were identified from the hospital database using ICD-codes P91.00, P91.01 and P91.02. For every newborn with the need for therapeutic hypothermia the consecutive term singleton newborn matched by gender, fetal presentation, delivery hospital, and the mode of delivery was selected as a control. Odds ratios (OR) between obstetric and delivery risk factors and the development of HIE were calculated. Results: Eighty-eight cases with matched controls met the inclusion criteria during the study period. Maternal and infant characteristics among cases and controls were similar, but smoking was more common among cases (aOR 1.46, CI 1.14–1.64, p = 0.003). The incidence of preeclampsia, diabetes and intrauterine growth restriction in groups was equal. Induction of labour (aOR 3.08, CI 1.18–8.05, p = 0.02) and obstetric emergencies (aOR 3.51, CI 1.28–9.60, p = 0.015) were more common in the case group. No difference was detected in the duration of the second stage of labour or the delivery analgesia. Conclusions: Smoking, induction of labour and any obstetric emergency, especially shoulder dystocia, increase the risk for HIE and need for therapeutic hypothermia. The decisions upon induction of labour need to be carefully weighed, since maternal smoking and obstetric emergencies can hardly be controlled by the clinician. [ABSTRACT FROM AUTHOR]

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المؤلفون: Mappa, Ilenia, Masturzo, Bianca, Carbone, Ilma Floriana, Kiener, Ariane, Maruotti, Giuseppe Maria, Pintucci, Armando, Suprani, Alice, Visentin, Silvia, Ghi, Tullio, Rizzo, Giuseppe

المصدر: Journal of Perinatal Medicine; Jun2024, Vol. 52 Issue 5, p509-514, 6p

مصطلحات موضوعية: HOSPITAL birthing centers, DELIVERY (Obstetrics), VAGINA, MATERNAL health services, CHILD health services, QUESTIONNAIRES, FETAL ultrasonic imaging, LABOR (Obstetrics), DESCRIPTIVE statistics, FIRST stage of labor (Obstetrics), INTRAPARTUM care, SECOND stage of labor (Obstetrics), SIMULATION methods in education, PHYSICIAN practice patterns, QUALITY assurance, FETAL presentation

مصطلحات جغرافية: ITALY

مستخلص: Use of ultrasonography has been suggested as an accurate adjunct to clinical evaluation of fetal position and station during labor. There are no available reports concerning its actual use in delivery wards. The aim of this survey was to evaluate the current practice regarding the use of ultrasonography during labor. A questionnaire was sent to members of the Italian Society of Ultrasound in Obstetrics and Gynecology employed in delivery wards. The qFeuestionnaire was made up of 22 questions evaluating participant characteristics and the current use of ultrasound in labor in their hospital of employment. The answers were grouped according to participant characteristics. A total of 200 participants replied. Ultrasound was considered useful before an operative vaginal delivery by 59.6 % of respondents, while 51.8 and 52.5 % considered it useful in the management of prolonged first and second stages of labor, respectively. The major indication for ultrasound use during labor was the assessment of fetal occiput position. The major difficulties in its application were the perceived lack of training and the complexity of the ultrasound equipment use. Participants that reported fewer difficulties were those employed in hospitals with a higher number of deliveries or having delivery units with more years of experience using ultrasound in labor, or those who had attended specific training courses. The results indicate that, despite the reported evidence of a higher accuracy of ultrasound compared to clinical evaluation in assessing fetal position and station, its use is still limited, even amongst maternal-fetal medicine practitioners specialized in ultrasonography. [ABSTRACT FROM AUTHOR]

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المؤلفون: Ramírez-Rosete, Judit A., Hurtado-Vazquez, Alonso, Miranda-Duarte, Antonio, Peralta-Cruz, Sergio, Cuevas-Olivo, Ramiro, Martínez-Junco, José Antonio, Sevilla-Montoya, Rosalba, Rivera-Paredez, Berenice, Velázquez-Cruz, Rafael, Valdes-Flores, Margarita, Rangel-Escareno, Claudia, Alanis-Funes, Gerardo J., Abad-Azpetia, Laura, Grimaldo-Galeana, Sacnicte G., Santamaría-Olmedo, Monica G., Hidalgo-Bravo, Alberto

المصدر: Diagnostics (2075-4418); May2024, Vol. 14 Issue 9, p898, 13p

مصطلحات موضوعية: SINGLE nucleotide polymorphisms, CONGENITAL hip dislocation, DYSPLASIA, FETAL presentation, YOUNG adults, TRANSFORMING growth factors-beta, LOGISTIC regression analysis

مستخلص: Diagnosis of developmental dysplasia of the hip (DDH) mostly relies on physical examination and ultrasound, and both methods are operator-dependent. Late detection can lead to complications in young adults. Current evidence supports the involvement of environmental and genetic factors, such as single nucleotide variants (SNVs). Incorporating genetic factors into diagnostic methods would be useful for implementing early detection and management of affected individuals. Our aim was to analyze environmental factors and SNVs in DDH patients. We included 287 DDH cases and 284 controls. Logistic regression demonstrated an association for sex (OR 9.85, 95% CI 5.55–17.46, p = 0.0001), family history (OR 2.4, 95% CI 1.2–4.5, p = 0.006), fetal presentation (OR 3.19, 95% CI 1.55–6.54, p = 0.002), and oligohydramnios (OR 2.74, 95%CI 1.12–6.70, p = 0.026). A model predicting the risk of DDH including these variables showed sensitivity, specificity, PPV, and NPV of 0.91, 0.53, 0.74, and 0.80 respectively. The SNV rs1800470 in TGFB1 showed an association when adjusted for covariables, OR 0.49 (95% CI 0.27–0.90), p = 0.02. When rs1800470 was included in the equation, sensitivity, specificity, PPV and NPV were 0.90, 0.61, 0.84, and 0.73, respectively. Incorporating no-operator dependent variables and SNVs in detection methods could be useful for establishing uniform clinical guidelines and optimizing health resources. [ABSTRACT FROM AUTHOR]

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المؤلفون: Lennon, Roisin

المصدر: British Journal of Midwifery; May2024, Vol. 32 Issue 5, p226-232, 7p

مصطلحات موضوعية: BIOMECHANICS, CESAREAN section, MATERNAL health services, EXERCISE, PREGNANCY outcomes, RETROSPECTIVE studies, INTRAPARTUM care, FETAL presentation

مستخلص: Background/Aims 'Labour hopscotch' is a visual tool that encourages activity during pregnancy and childbirth. It has been used in one advanced midwife practitioner service since 2017 and more widely across in Ireland since 2020. The biomechanics for birth toolkit was added to advanced midwife practitioner care in 2022. This study's aim was to ascertain if the biomechanics for birth toolkit impacted gestation of spontaneous onset of labour rates and birth outcomes. Methods A retrospective study of onset of labour and birth outcomes was conducted for women before (n=155) and after (n=154) the biomechanics for birth toolkit was incorporated into care. Results Before the toolkit was included, there was a 57.2% spontaneous onset of labour rate, with 33.2% birthing before 41 weeks. After the kit's inclusion, there was a 72.2% spontaneous onset of labour, with 91.8% birthing before 41 weeks. Induction rates dropped from 42.8% to 27.8%, with emergency caesarean section rates following induction dropping from 33.1% to 23.8%. Conclusions Using the biomechanics for birth toolkit alongside the labour hopscotch tool could increase spontaneous onset of labour rates, optimise physiological birth, reduce inductions and emergency caesarean section following induction. [ABSTRACT FROM AUTHOR]

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المؤلفون: Ferraro, Zachary M.¹ (AUTHOR), Silverberg, Orli M.¹ (AUTHOR), Kingdom, John C.¹ (AUTHOR), Shirreff, Lindsay¹ (AUTHOR) Lindsay.Shirreff@sinaihealth.ca

المصدر: Canadian Medical Association Journal (CMAJ). 11/27/2023, Vol. 195 Issue 46, pE1577-E1579. 3p.

مصطلحات موضوعية: *FETAL presentation, *BREECH delivery, *FETAL movement, *UMBILICAL cord clamping, *UMBILICAL cord, *STILLBIRTH

مستخلص: This article discusses a case of cord entrapment in a footling breech presentation with decreased fetal movements. Cord obstruction events account for one-fifth of stillbirths in the absence of structural or genetic defects. The use of fetal movement counting in the third trimester is currently the only effective screening test for cord obstruction. Patients who present with decreased fetal movement should undergo thorough investigation with a nonstress test and comprehensive ultrasonography. The article emphasizes the importance of detecting decreased fetal movement to mitigate the risk of stillbirth caused by umbilical cord complications. [Extracted from the article]