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https://www.readbyqxmd.com/read/28297186/the-new-obstetrical-dilemma-stunting-obesity-and-the-risk-of-obstructed-labour
#1
Jonathan C K Wells
The "obstetrical dilemma" refers to the tight fit between maternal pelvic dimensions and neonatal size at delivery. Most interest traditionally focused on its generic significance for humans, for example our neonatal altriciality and our complex and lengthy birth process. Across contemporary populations, however, the obstetrical dilemma manifests substantial variability, illustrated by differences in the incidence of cephalo-pelvic disproportion, obstructed labour and cesarean section. Beyond accounting for 12% of maternal mortality worldwide, obstructed labour also imposes a huge burden of maternal morbidity, in particular through debilitating birth injuries...
April 2017: Anatomical Record: Advances in Integrative Anatomy and Evolutionary Biology
https://www.readbyqxmd.com/read/28297185/allometry-and-sexual-dimorphism-in-the-human-pelvis
#2
Barbara Fischer, Philipp Mitteroecker
Sexual dimorphism in the human pelvis has evolved in response to several jointly acting selection regimes that result from the pelvis' multiple roles in locomotion and childbirth, among others. Because human males are, on average, taller than females, some aspects of sexual dimorphism in pelvis shape might result from allometry, the association between stature and pelvis shape across individuals. In this study, they aimed to disentangle and quantify the two components contributing to pelvic sex differences: the allometric component, which emerges as a consequence of dimorphism in stature, and the remaining non-allometric sexual dimorphism component...
April 2017: Anatomical Record: Advances in Integrative Anatomy and Evolutionary Biology
https://www.readbyqxmd.com/read/28297180/human-variation-in-pelvic-shape-and-the-effects-of-climate-and-past-population-history
#3
Lia Betti
The human pelvis is often described as an evolutionary compromise (obstetrical dilemma) between the requirements of efficient bipedal locomotion and safe parturition of a highly encephalized neonate, that has led to a tight fit between the birth canal and the head and body of the foetus. Strong evolutionary constraints on the shape of the pelvis can be expected under this scenario. On the other hand, several studies have found a significant level of pelvic variation within and between human populations, a fact that seems to contradict such expectations...
April 2017: Anatomical Record: Advances in Integrative Anatomy and Evolutionary Biology
https://www.readbyqxmd.com/read/28297178/morphological-integration-of-the-human-pelvis-with-respect-to-age-and-sex
#4
Angela M Mallard, Kristen R R Savell, Benjamin M Auerbach
Considerable research has shown that modern human pelvic dimensions, especially of the birth canal, are sexually dimorphic. Studies also suggest that females with younger ages-at-death have narrower canal dimensions than those who die at older ages, possibly due to continued independent growth of the pubis. A recent examination of this pattern argued that it is unlikely that these differences relate to mortality, but the source of the difference in pelvic dimensions with age remains unresolved. We use pelvic dimensions to assess differences in magnitudes of morphological integration between adult females and males across ages-at-death...
April 2017: Anatomical Record: Advances in Integrative Anatomy and Evolutionary Biology
https://www.readbyqxmd.com/read/28293791/pregnant-women-s-awareness-knowledge-and-beliefs-about-pelvic-floor-muscles-a-cross-sectional-survey
#5
Anne-Marie Hill, Steven M McPhail, Judith M Wilson, Richard G Berlach
INTRODUCTION AND HYPOTHESIS: Pregnant women benefit from completing pelvic floor muscle exercises (PFMEs). The aims of the study were to evaluate pregnant women's levels of awareness, knowledge, and beliefs about the pelvic floor muscles (PFMs) and PFMEs. METHODS: A cross-sectional survey was conducted. Respondents were pregnant women over the age of 18 years who attended antenatal clinics in Western Australia (WA). Questionnaire items measured awareness and knowledge about PFMs, confidence and beliefs about engaging in PFMEs, and attendance at antenatal education (ANE) classes...
March 14, 2017: International Urogynecology Journal
https://www.readbyqxmd.com/read/28285396/pelvic-organ-support-several-years-after-a-first-birth
#6
Caroline W S Ferreira, Ixora K Atan, Andrew Martin, Ka Lai Shek, Hans Peter Dietz
INTRODUCTION AND HYPOTHESIS: Female pelvic organ prolapse is highly prevalent and childbirth has been shown to be an important risk factor. The study was carried out to observe if pelvic organ support deteriorates over time following a first birth. METHODS: This is a retrospective review using archived data sets of women seen in the context of two prospective perinatal imaging studies. All subjects had undergone a standardised interview, a clinical examination and 4D translabial ultrasound, 3 months and 2-5 years post-partum...
March 11, 2017: International Urogynecology Journal
https://www.readbyqxmd.com/read/28257809/the-global-health-impact-of-vaginal-dysbiosis
#7
Janneke H H M van de Wijgert, Vicky Jespers
The most common dysbiosis of the vaginal microbiome (defined here as a vaginal microbiome not dominated by lactobacilli) is bacterial vaginosis, an anaerobic polybacterial dysbiosis. Other dysbiotic states of importance to global health are vaginal microbiota with a high abundance of streptococci, staphylococci or Enterobacteriaceae, vaginal candidiasis and trichomoniasis. Knowledge about the different types of dysbiosis and their relationship to urogenital and reproductive disease burden has increased in recent years by applying non-culture-based techniques, but is far from complete...
March 1, 2017: Research in Microbiology
https://www.readbyqxmd.com/read/28256409/-the-emergence-of-obstetrical-mechanism-from-lucy-to-homo-sapiens
#8
P Frémondière, L Thollon, F Marchal
The evolutionary history of modern birth mechanism is now a renewed interest in obstetrical papers. The purpose of this work is to review the literature in paleo-obstetrical field. Our analysis focuses on paleo-obstetrical hypothesis, from 1960 to the present day, based on the reconstruction of fossil pelvis. Indeed, these pelvic reconstructions usually provide an opportunity to make an obstetrical assumption in our ancestors. In this analysis, we show that modern birth mechanism takes place during the emergence of our genus 2 million years ago...
February 27, 2017: Gynecol Obstet Fertil Senol
https://www.readbyqxmd.com/read/28254156/three-dimensional-computed-tomography-analysis-on-bony-birth-canal-after-bilateral-periacetabular-osteotomy
#9
Tetsuro Ishimatsu, Masatoshi Naito, Koichi Kinoshita, Satohiro Ishii, Takuaki Yamamoto
BACKGROUND: Curved periacetabular osteotomy (CPO) is one of the joint preserving procedures for developmental dysplasia of the hip. CPO requires osteotomy of the medial wall of the acetabulum, which may cause narrowing of the bony birth canal and this step may result in increased risk of cesarean delivery. We analyzed the narrowest part of the bony birth canal using three-dimensional computed tomography (3D-CT) before and after bilateral CPO. METHODS: Between February 2007 and March 2014, there were 29 cases of bilateral CPO in which both pre- and post-operative 3D-CT were available...
February 18, 2017: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
https://www.readbyqxmd.com/read/28253469/thirty-years-of-the-world-health-organization-s-target-caesarean-section-rate-time-to-move-on
#10
Stephen J Robson, Caroline M de Costa
It has been 30 years since the World Health Organization first recommended a "maximum" caesarean section (CS) rate of 15%. There are demographic differences across the 194 WHO member countries; recent analyses suggest the optimal global CS rate is almost 20%. Attempts to reduce CS rates in developed countries have not worked. The strongest predictor of caesarean delivery for the first birth of "low risk" women appears to be maternal age; a factor that continues to increase. Most women whose first baby is born by caesarean delivery will have all subsequent children by caesarean delivery...
March 6, 2017: Medical Journal of Australia
https://www.readbyqxmd.com/read/28179200/laparoscopic-management-of-abdomininal-pregnancy
#11
Francesco Cosentino, Cristiano Rossitto, Luigi Carlo Turco, Salvatore Gueli Alletti, Carmine Vascone, Lavinia Di Meglio, Giovanni Scambia, Mario Malzoni
CASE REPORT OBJECTIVE: To show the surgical management in laparoscopy of a particular localization of an extra-uterine pregnancy misunderstood until 12 week of EG complicated by hemoperitoneum and abortion. BACKGROUND: The prevalence of ectopic pregnancy among women who go to an emergency department with first trimester bleeding, pain, or both ranges from 1 to 16 percent [1]. The most common localization of ectopic pregnancy are the Fallopian tubes while abdominal pregnancy represent at least 1 percent of extra-uterine pregnancies...
February 4, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28164035/proximal-ureteral-atresia-a-rare-congenital-anomaly-incidental-finding-a-case-report
#12
Cosimo Bleve, Maria Luisa Conighi, Lorella Fasoli, Valeria Bucci, Francesco Battaglino, Salvatore Fabio Chiarenza
Ureteral atresia is a rare disease usually associated with a non-functioning dysplastic kidney. The condition may be unilateral or bilateral; focal, short or long and may involve any part of the ureter. Association with other urinary anomalies is rare. We report the case of a 10-month-old boy with prenatal diagnosis of multicystic right kidney. This suspicion was confirmed after birth by ultrasound and static scintigraphy; a right vesicoureteral reflux (VUR) was recorded at cystography. The boy presented a regular renal function but was hospitalized twice for suspected pyelonephritis between the 8th and the 10th month of life and were recorded occasional mild changes in blood pressure...
January 2017: Translational pediatrics
https://www.readbyqxmd.com/read/28156005/different-insulin-types-and-regimens-for-pregnant-women-with-pre-existing-diabetes
#13
REVIEW
Sinéad M O'Neill, Louise C Kenny, Ali S Khashan, Helen M West, Rebecca Md Smyth, Patricia M Kearney
BACKGROUND: Insulin requirements may change during pregnancy, and the optimal treatment for pre-existing diabetes is unclear. There are several insulin regimens (e.g. via syringe, pen) and types of insulin (e.g. fast-acting insulin, human insulin). OBJECTIVES: To assess the effects of different insulin types and different insulin regimens in pregnant women with pre-existing type 1 or type 2 diabetes. SEARCH METHODS: We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (30 October 2016), ClinicalTrials...
February 3, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28143501/safe-and-successful-birth-following-pelvic-radiotherapy-for-rectal-mucosa-associated-lymphoid-tissue-lymphoma-a-case-report
#14
Yoshiomi Hatayama, Masahiko Aoki, Hideo Kawaguchi, Katsumi Hirose, Mariko Sato, Hiroyoshi Akimoto, Mitsuki Tanaka, Ichitaro Fujioka, Shuichi Ono, Yoshihiro Takai
BACKGROUND: Mucosa-associated lymphoid tissue lymphomas can occur in various parts of the body, and half of mucosa-associated lymphoid tissue lymphomas occur in the gastrointestinal tract. Gastric mucosa-associated lymphoid tissue lymphoma is the most common lymphoma of the gastrointestinal tract and primary rectal mucosa-associated lymphoid tissue lymphoma is very rare. Because of the high radiosensitivity of mucosa-associated lymphoid tissue lymphomas, this condition can be controlled with radiotherapy of approximately 30 Gy alone...
February 1, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28140423/obstetrisk-nervp%C3%A3-verkan-%C3%A3-r-oftast-inte-ryggbed%C3%A3-vningens-fel
#15
Lovisa Brehmer, Johan Rutfors
Postpartum nerve injury is usually not caused by neuroaxial anesthesia - a case report In this case report we describe a woman who after giving birth had numbness and could not support her weight on the right leg. Three attempts of epidural anesthesia had been made during labor. MRI imaging of the spinal cord showed no pathology. She was treated conservatively by a physiotherapist and recovered gradually. After six months all symptoms had resolved. Postpartum nerve injury is often thought to be due to neuroaxial anesthesia, although in most cases it is caused by labor itself...
January 27, 2017: Läkartidningen
https://www.readbyqxmd.com/read/28099135/mycoplasma-ureaplasma-infection-in-pregnancy-to-screen-or-not-to-screen
#16
Gilbert G G Donders, Kateryna Ruban, Gert Bellen, Ljubomir Petricevic
Mycoplasmata have been linked to pregnancy complications and neonatal risk. While formerly a limited number of species could be discovered by cultures, molecular biology nowadays discovers both lower quantities and more diverse species, making us realize that mycoplasmata are ubiquitous in the vaginal milieu and do not always pose a danger for pregnant women. As the meaning of mycoplasmata in pregnancy is not clear to many clinicians, we summarized the current knowledge about the meaning of different kinds of mycoplasmata in pregnancy and discuss the potential benefits and disadvantages of treatment...
January 18, 2017: Journal of Perinatal Medicine
https://www.readbyqxmd.com/read/28094073/muscle-function-of-the-pelvic-floor-in-healthy-puerperal-women-with-pelvic-floor-dysfunction
#17
M A Castro-Pardiñas, M Torres-Lacomba, B Navarro-Brazález
OBJECTIVES: To understand the function of the pelvic floor muscles (PFM) at different ages in healthy women and in puerperal women with pelvic floor dysfunctions (PFD) and to ascertain whether there are differences among them. MATERIAL AND METHODS: A descriptive cross-sectional study was conducted between June 2014 and September 2016 and included 177 women, 70 of whom had no symptoms of PFD, 53 primiparous mothers in late postpartum and 54 with PFD. The function of the PFM was measured through vaginal palpation (quality of the contraction); manometry (force); dynamometer (tone, strength, and response to stretching), and surface electromyography (neuromuscular activity and resistance)...
January 13, 2017: Actas Urologicas Españolas
https://www.readbyqxmd.com/read/28073797/physical-and-cultural-determinants-of-postpartum-pelvic-floor-support-and-symptoms-following-vaginal-delivery-a-protocol-for-a-mixed-methods-prospective-cohort-study
#18
Ingrid E Nygaard, Erin Clark, Lauren Clark, Marlene J Egger, Robert Hitchcock, Yvonne Hsu, Peggy Norton, Ana Sanchez-Birkhead, Janet Shaw, Xiaoming Sheng, Michael Varner
INTRODUCTION: Pelvic floor disorders (PFDs), including pelvic organ prolapse (POP), stress and urgency urinary incontinence, and faecal incontinence, are common and arise from loss of pelvic support. Although severe disease often does not occur until women become older, pregnancy and childbirth are major risk factors for PFDs, especially POP. We understand little about modifiable factors that impact pelvic floor function recovery after vaginal birth. This National Institutes of Health (NIH)-funded Program Project, 'Bridging physical and cultural determinants of postpartum pelvic floor support and symptoms following vaginal delivery', uses mixed-methods research to study the influences of intra-abdominal pressure, physical activity, body habitus and muscle fitness on pelvic floor support and symptoms as well as the cultural context in which women experience those changes...
January 10, 2017: BMJ Open
https://www.readbyqxmd.com/read/28027607/third-or-fourth-degree-intrapartum-anal-sphincter-tears-are-associated-with-levator-ani-avulsion-in-primiparas
#19
Dan V Valsky, Sarah M Cohen, Michal Lipschuetz, Drorith Hochner-Celnikier, Hagit Daum, Itai Yagel, Simcha Yagel
OBJECTIVES: We evaluated primiparous women with clinically diagnosed third- and fourth-degree and anal sphincter tears, to evaluate the rate of levator ani muscle injury compared to primiparous women without sphincter tears. METHODS: Primiparous women delivering in our maternity ward with intrapartum diagnoses of third- or fourth-degree anal sphincter tears, repaired by the overlapping technique, were recruited to undergo 3-dimensional transperineal sonography of the pelvic floor anatomy, including the anterior and posterior compartments...
April 2016: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/28025682/impact-of-subsequent-birth-and-delivery-mode-for-women-with-previous-oasis-systematic-review-and-meta-analysis
#20
REVIEW
Sara S Webb, Derick Yates, Margarita Manresa, Matthew Parsons, Christine MacArthur, Khaled M K Ismail
INTRODUCTION AND HYPOTHESIS: Obstetric anal sphincter injuries (OASIS) are serious complications of vaginal birth. In a pregnancy following OASIS women may be keen to avoid an elective caesarean section, yet cautious about pursuing another vaginal birth that may result in further damage to the pelvic floor and possible long-term anal incontinence. This review aimed to evaluate the impact of subsequent birth and its mode on anal incontinence (AI) and/or quality of life (QoL), for women with previous OASIS...
December 26, 2016: International Urogynecology Journal
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