Showing papers on "Vaginal delivery published in 1981"
TL;DR: Preliminary data suggest that ECV-T late in pregnancy reduces the risk of maternal, fetal, or neonatal complications and outcome was uniformly good.
109 citations
TL;DR: The first breath of newborn infants delivered by cesarean section was studied to find Inspiratory pressure and volume were found to be similar to those in infants born vaginally, but the expiratory and delivery pressures were finding to be smaller.
107 citations
TL;DR: The effect of administering corticosteroids to the mother before delivery in order to raise the infant's platelet is examined.
Abstract: THE obstetrical management of women with autoimmune thrombocytopenic purpura (ATP) is controversial. Because of transplacental passage of antiplatelet antibody, children of these women are frequently born with low platelet counts, and there is concern that pressure on the head during vaginal delivery may bring about intracranial hemorrhage. For this reason, most authors have advocated that infants of mothers with this disease be delivered by cesarean section.1 2 3 4 5 Others have recommended vaginal delivery unless there is some recognized obstetrical indication for section.6 , 7 We have examined the effect of administering corticosteroids to the mother before delivery in order to raise the infant's platelet . . .
98 citations
TL;DR: Ultrasonically guided percutaneous needle placement was used for the antenatal management of a case of progressive hydrocephalus detected at a gestational age of 24 weeks.
Abstract: PERCUTANEOUS cephalocentesis without ultrasound is used as an adjunct to the delivery of a fetus with massive cranial enlargement due to hydrocephalus.1 The procedure carries substantial risks of fetal morbidity and is selected when cranial dimensions preclude uncomplicated vaginal delivery. Precise antenatal evaluation of the intracranial anatomy and selective guidance for percutaneous needle placement are complementary methods of ultrasound imaging for the early diagnosis and potential treatment of hydrocephalus. Ultrasonically guided percutaneous needle placement was used for the antenatal management of a case of progressive hydrocephalus detected at a gestational age of 24 weeks. Six serial, atraumatic, cephalocenteses with withdrawal . . .
92 citations
TL;DR: The rate of multiple pregnancies with more than 2 fetuses has significantly increased since the introduction of ovulation induction agents as discussed by the authors and the diagnosis of more than two fetuses was made earlier in the induced than in the uninduced pregnancies, and the main neonatal complications resulted from prematurity and maternal complications noted were postpartum hemorrhage necessitating hysterectomy in 2 patients.
84 citations
TL;DR: In this article, the authors evaluated 6 years of vaginal breech deliveries and found that approximately half the term breech presentations that are properly selected and managed may be safely delivered vaginally, thereby avoiding a significant number of cesarean sections and subsequent inherent risks.
40 citations
TL;DR: It is concluded that cesarean section is of benefit for infants weighing 1000–1500 g, however, it is doubtful if abdominal delivery is of Benefit for the fetus weighing 1500‐2500 g.
Abstract: Three hundred and sixty-six consecutive singleton breech presentations were analyzed for clinical factors associated with fetal complications related to vaginal delivery, and for the impact of different cesarean section rates on the incidence of fetal complications. The condition at birth of the vaginally delivered (243 cases) infants was found to correlate with maternal pre-pregnancy weight, and size of the fetal head. During the period of study the cesarean section rate changed from approximately 20 per cent of term breech presentations at the beginning to almost 50 per cent at its end. This was accompanied by a decrease in the traumatic morbidity. However, at follow-up only a small minority of those registered were found to be significantly affected. The fetal asphyxia rate was not influenced by the increased cesarean section rate. At follow-up one of 33 infants born asphyxiated showed late psychomotor development.
35 citations
34 citations
TL;DR: Patients who have had a previous cesarean section should be allowed an attempt to deliver vaginally based on carefully selected criteria, because of decreased operative risks, postpartum morbidity, and shorter hospital stays.
32 citations
TL;DR: A method for calculating blood loss at vaginal delivery using a special plastic drape is described and the final result could be available to the obstetrician within approximately four hours after delivery.
Abstract: We describe a method for calculating blood loss at vaginal delivery using a special plastic drape. Blood loss is calculated from the sum of three components: (1) blood lost in sponges, (2) blood loss represented by clots, and (3) blood loss represented by unclotted RBC. The procedure has been used in ten patients and the results are presented. The obstetrician would know the maximal potential blood loss immediately after delivery. If this figure is less than 15% of the estimated blood volume, further calculation might be deemed unnecessary. If this figure exceeds 15% of the estimated blood volume, however, the full procedure described should be done. The final result could be available to the obstetrician within approximately four hours after delivery.
31 citations
TL;DR: In 17 patients selected for vaginal delivery, caesarean section was necessary for abnormal uterine activity, prolapse of the umbilical cord of fetal distress, or if the fetal head was extended.
TL;DR: In this article, percutaneous cephalocentesis without ultrasound is used as an adjunct to the delivery of a fetus with massive cranial enlargement due to hydrocephalus.
Abstract: PERCUTANEOUS cephalocentesis without ultrasound is used as an adjunct to the delivery of a fetus with massive cranial enlargement due to hydrocephalus.1 The procedure carries substantial risks of fetal morbidity and is selected when cranial dimensions preclude uncomplicated vaginal delivery. Precise antenatal evaluation of the intracranial anatomy and selective guidance for percutaneous needle placement are complementary methods of ultrasound imaging for the early diagnosis and potential treatment of hydrocephalus. Ultrasonically guided percutaneous needle placement was used for the antenatal management of a case of progressive hydrocephalus detected at a gestational age of 24 weeks. Six serial, atraumatic, cephalocenteses with withdrawal . . .
TL;DR: A full-term newborn infant, born after an uncomplicated delivery, in whom a large intracerebral hemorrhage developed within the first 12 hours of life is described.
Abstract: Intracerebral hemorrhage in full-term infants is infrequent and has most often been associated with birth asphyxia or trauma.1.2This report describes a full-term newborn infant, born after an uncomplicated delivery, in whom a large intracerebral hemorrhage developed within the first 12 hours of life. The infant had the clinical and laboratory features of the hyperviscosity syndrome,3and an association with cerebral hemorrhage is postulated. Report of a Case.—The patient was a 2,880-g male born after 38 weeks of gestation to a 17-year-old gravida 1 woman following an uncomplicated pregnancy, labor, and delivery. Artificial rupture of membranes was performed four hours prior to spontaneous, controlled vaginal delivery. Total labor was 14 hours. Apgar scores were 8 and 9 at one and five minutes, respectively. The baby was noted to have minimal respiratory distress in the first hour after birth. In 24% oxygen, an arterial blood sample showed Po
TL;DR: Both mothers and fathers tended to show less animation in interactions with their infants following a Cesarean delivery: mothers engaged less frequently in vigorous physical stimulation and showed less reciprocal positive affect with their babies, and fathers smiled less at their infants.
Abstract: Home observations, ratings of interaction, and interviews were carried out in families with first-born 5-month-old infants. Comparisons were made between two groups of families differing as to whether the childbirth had been a Cesarean or vaginal delivery. Fathers whose babies had been born by Cesarean delivery reported greater involvement in child care and were rated as more responsive to infant distress. Both mothers and fathers tended to show less animation in interactions with their infants following a Cesarean delivery: mothers engaged less frequently in vigorous physical stimulation and showed less reciprocal positive affect with their infants, and fathers smiled less at their infants.
TL;DR: Retained tissues of conception were present in 10 cases and were passed spontaneously in four women within the first 3 days postpartum, indicating support for surgical evacuation of the uterus.
Abstract: One hundred uncomplicated pregnancies of primigravida and secundigravida gestation were scanned within 24 hr of delivery. The ultrasonic appearances of the uterus were categorized into three groups: (1) empty uterus; (2) cavity separation indicating blood or clot; and (3) dense cavity echoes representing retained tissue. The presence of blood and clot in the puerperium is a common occurrence that resolves spontaneously. Retained tissues of conception were present in 10 cases and were passed spontaneously in four women within the first 3 days postpartum. The presence of retained tissue after the fourth day is support for surgical evacuation of the uterus. Gray-scale ultrasonic examination was accurate in diagnosing all of these cases.
Journal Article•
TL;DR: The hypothesis, primiparas having an emergency cesarean birth will have a less positive perception of their birth experience than those who deliver vaginally, was supported at the .01 level of significance (t test).
Abstract: A comparative field study was done to collect both quantitative and qualitative data to determine if women perceived their childbirth experience less positively when they had cesarean deliveries and in what ways. The hypothesis, primiparas having an emergency cesarean birth will have a less positive perception of their birth experience than those who deliver vaginally, was supported at the .01 level of significance (t test). Perceptions of 20 primiparas having an emergency cesarean birth and 30 primiparas having a vaginal birth were measured by a 29 item questionnaire within 48 hours postpartally. More cesarean delivered women had not named their infants; this difference was significant at the 0.005 level. Within the cesarean group, those who had general anesthesia had less positive perceptions of their experience than those who had regional anesthesia (0.05 level of significance). The presence of a support person with them during surgery did not significantly affect perceptions, but further research is recommended. The qualitative analysis of the data revealed a number of concepts. There was an underlying theme that a cesarean delivery signified weakness in relation to her potential mothering ability. Cesarean delivered mothers suffered a loss in self-esteem, possibly due to unfulfilled expectations for a vaginal delivery and the physical trauma and corresponding loss of control due to the surgery. These women experienced a sense of failure due to the procedure and expressed doubts that the infant was their own newborn. As a group they exhibited little physical or emotional energy for mothering.
TL;DR: What is believed to be the first reported case of TSS occurring in a postpartum woman, a previously healthy 24-year-old woman who had an uneventful labor and delivery, has the onset of nausea, vomiting, and diarrhea.
Abstract: TOXIC shock syndrome (TSS), a recently recognized, severe, multisystem disorder, has occurred predominantly in menstruating women. We describe what we believe is the first reported case of TSS occurring in a postpartum woman. Report of a Case A previously healthy 24-year-old woman (gravida 1, para 0, abortus 0) was admitted to a hospital for a term, vaginal delivery. The pregnancy had progressed without complications, and she had an uneventful labor and delivery that lasted seven hours. Post partum, she used a perineal pad and had no intravaginal packing. She felt well until approximately 14 hours after delivery, when she had the onset of nausea, vomiting, and diarrhea. She also noted the acute onset of sore throat, headache, and myalgias. Sixteen hours post partum, her temperature was 39.5 °C, and therapy was begun with ampicillin sodium, 1 g intravenously (IV) every four hours. Approximately 24 hours after becoming febrile, her systolic
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TL;DR: No differences were found between children born vaginally and those born by cesarean section after some labour, except for a larger variability in the outcomes of the latter group.
Abstract: This study compared the subsequent development of children in breech presentation according to the method of their delivery - vaginal or cesarean section. No differences were found between children born vaginally and those born by cesarean section after some labour, except for a larger variability in the outcomes of the latter group. Only 4% of the deliveries were by cesarean section without labour, and when analysed separately the data for this group frequently showed the poorest outcome. Reasons for the observations are suggested, and proposed further research is outlined.
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TL;DR: A successful pregnancy and vaginal delivery of a woman with Eisenmenger complex is described and the problems associated with Eisenmanger complex and pregnancy are discussed.
Abstract: Eisenmenger complex is a congenital heart disease, which causes considerable maternal mortality. Data from the literature suggest a maternal mortality of 26%, with an infant survival of 57%. We describe a successful pregnancy and vaginal delivery of a woman with Eisenmenger complex and discuss the problems associated with Eisenmenger complex and pregnancy.
TL;DR: Endocervical cultures showed a marked increase in the incidence of Escherichia coli and anaerobic bacteria after delivery in both groups in similar proportions and was not affected by manual exploration.
TL;DR: All other viable breech presentations should be considered for cesarean section after extreme prematurity and serious congenital malformations have been excluded.
Journal Article•
TL;DR: Three cases of contracted pelvis in Bedouin women, appearing after two and three previous normal vaginal deliveries, are presented, and in these three cases cesarean section had to be performed to deliver the babies.
Abstract: Three cases of contracted pelvis in Bedouin women, appearing after two and three previous normal vaginal deliveries, are presented. In these three cases cesarean section had to be performed to deliver the babies. A roentgenray screening revealed osteomalacic pelves in all cases with typical psuedo-fractures (Milkman) and Looser zones. Pelvic deformities of the osteomalacic type are considered rare medical curiosities, and elective cesarean section is usually indicated. It has been found that Bedouins consume large quantities of "raghif", an unleavened bread with high content of phytic acid, very similar to Indian "chapati". Phytic acid impairs the absorption of calcium from the intestine by the precipitation of an amorphous calcium phytate and causes probably some interference with the action of vitamin D. Withdrawal of this alimentation improves the illness. There is emphasis on the fact that vaginal delivery is not granted from a pelvic point of view for multiparous women who have delivered normally in the past. Bedouin women constitute a rather important fraction of the obstetric population admitted to our hospital, the only one in the Negev area. Almost 15 per cent of the deliveries in our Obstetrics Department belong to Bedouin women. The sudden appearance of three consecutive cases of contracted pelvis in which we had to perform ceasarean section on women who had previously delivered vaginally at least twice, produced this investigation, whose interesting results we describe herewith.
Journal Article•
TL;DR: Vaginal delivery should be strongly considered for patients in premature labor with intact membranes and breech presentation when there is ultrasound evidence of an abnormally shaped fetal head, absence of the fetal bladder, and severe oligohydramnios.
01 Jan 1981
TL;DR: Of the 23501 women who delivered at a hospital in Calcutta between 1976-79 754 (3.21%) suffered from hypertensive disease and 42 (0.18%) from eclampsia; over 73% accomplihsed vaginal delivery; caesarean section was resorted to in the rest.
Abstract: Of the 23501 women who delivered at a hospital in Calcutta between 1976-79 754 (321%) suffered from hypertensive disease and 42 (018%) from eclampsia In the 1st group 557% had convulsions Of the eclamptic patients 5475% had regular antenatal care and 2381% were emergency admissions The majority were primagravida under 20 years of age Trouble usually set in after 37 weeks of gestation Postpartum convulsions occurred in 3333% Over 73% accomplihsed vaginal delivery; caesarean section was resorted to in the rest Recovery was uneventful in 60% of the vaginal delivery cases and in 7144% of the caesarean The medications administered in the course of management are discussed
Journal Article•
TL;DR: Lack of postoperative pain and of vulvar edema, minimal blood loss and easy vaginal delivery at term were significant factors in this case.
Abstract: A young patient in the third trimester of pregnancy had massive condylomata acuminata, successfully treated with the carbon dioxide laser. Lack of postoperative pain and of vulvar edema, minimal blood loss and easy vaginal delivery at term were significant factors in this case.
TL;DR: A case report of cephalothoracopagus (Janiceps) twinning is described, where spontaneous labour at 32 weeks' gestation resulted in vaginal delivery of stillborn twins.
Abstract: A case report of cephalothoracopagus (Janiceps) twinning is described. Multiple pregnancy was suspected clinically but the diagnosis was not revealed by ultrasound. Spontaneous labour at 32 weeks' gestation resulted in vaginal delivery of stillborn twins.
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TL;DR: These measures led to a reduction of the mortality rate (reduced to the corrected values), the average of which had been 12.5% during 1970-1971, to 1.85% during 1972-1979.
Abstract: UNLABELLED The article reports on the experiences collected during treatment and delivery of 316 pregnant diabetic women hospitalized in the municipal hospital of Vienna-Lainz. 1. Close co-operation between diabetologist, obstetricians and pediatricians in imperative. 2. Early diagnosis and recording - as far as possible before conception -, accurate control and intensive care by the diabetologist and obstetrician right from the beginning is most essential; the aim should be to attain normoglycaemic levels preferably during the first 3 months of pregnancy. 3. In the case of diabetic patients requiring insulin who are difficult to stabilize, it would be desirable to effect stabilization in the hospital, followed by self-control of blood sugar levels with self-adjusted insulin variation. Above all, overweight should be avoided. 4. Obstetric intensive care can be effected only in a department with modern equipment. 5. In case of complications, it will always be necessary to provide for additional hospitalization over and above the routine cases; such hospitalization must always consist of combined obstetric and internistic medical care. 6. Prognostically Bad Signs of Pregnancy (PBSP) groups must be kept as small as possible. 7. Childbirth should be approximated as closely as possible to the calculated date of birth (in While A cases up to the 40th week of pregnancy, with the other patients at least up to the 38th week of pregnancy). The necessary controls which can justify postponing the time of birth, are explained. The approximation to the calculated data of birth depends largely on optimal stabilization of the diabetes to normoglycaemic levels during the entire pregnancy period. This is documented, inter alia, by normal weight of the newborn at the time of birth, corresponding to the duration of pregnancy. 8. Vaginal delivery should be aimed at. 9. Newborn are always high-risk infants; the first few minutes of live are absolutely decisive. The infants should be placed in the care of a team of pediatricians as early as possible, combined with transfer to a children's hospital with intensive-care ward, using an intensive-care ambulance for effecting the transfer. 10. RESULTS These measures led to a reduction of the mortality rate (reduced to the corrected values), the average of which had been 12.5% during 1970-1971, to 1.85% during 1972-1979. The proportion of PBSP groups, which was originally 32.42%, dropped during the same period to 20.79%, the perinatal mortality in this group being reduced from 50% to 17.24%.
TL;DR: In this paper, a prospective study of 208 women in labor at term with singleton fetuses in a frank breech presentation was carried out, where one hundred fifteen patients were randomized to a vaginal delivery group and 93 to an elective cesarean section group.
Abstract: A prospective study of 208 women in labor at term with singleton fetuses in a frank breech presentation was carried out. One hundred fifteen patients were randomized to a vaginal delivery group and 93 to an elective cesarean section group. Of the 93 women scheduled for cesarean section, 88 were delivered according to protocol. Five women progressed rapidly in labor and were delivered vaginally without complications. Of the 115 women scheduled for vaginal delivery, x-ray pelvimetry was obtained on 112. Three women were delivered vaginally without incident before x-ray pelvimetry could be obtained. One of these women was delivered of an infant who died shortly after birth of lethal congenital anomalies. Of the 112 women with x-ray pelvimetry, 52 had one or more inadequate pelvic measurements and were scheduled for indicated cesarean section. Three women, however, were delivered vaginally without incident before operation could be performed. Of the remaining 60 patients in this group, 49 were delivered vaginally without a perinatal death. Eleven women required cesarean section for difficulties during labor. There were no maternal deaths, but 73 (49.3%) of the 148 women who were delivered by cesarean section in this study experienced postpartum morbidity. Only four (6.7%) of the 60 women delivered vaginally had postpartum complications. Based on the data, it seems resonable to allow vaginal delivery in carefully selected cases of term frank breech presentation.
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TL;DR: The study shows an improvement in the cervical score with both PGE2 and estradiol but the aim of cervical ripening must be to improve the chances of vaginal delivery of a healthy infant.
Abstract: Dr. P.M. Tromans and others (February 28 p. 679) draw important attention to the risk associated with attempts to increase cervical ripeness with (PGs) prostaglandins. The study shows an improvement in the cervical score with both PGE2 and estradiol but the aim of cervical ripening must be to improve the chances of vaginal delivery of a healthy infant. The cesarean section rates in the PGE2 group (23%) and the estradiol group (27%) remain high and no less than the rates reported in the control groups of other studies of cervical ripening. Cervical assessment is highly subjective and some improvement in score has been reported after application of an inert gel. The minimal manipulation of the initial assessment is likely to result in an underestimate of the score. There is no need to minimize manipulation at the subsequent examination which is therefore more likely to produce a favorable score. In comparing the 2 groups it would be of value to know the birth weights. The management of the 7 patients in whom surgical induction was not feasible despite 2 ripening attempts was not clear from the text. I would also be interested to know what cervical score was given to the 2 patients who labored spontaneously. The patient who delivered vaginally after 1 hour is likely to have contributed substantially to the improved cervical score in that group. (Full Text)