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https://www.readbyqxmd.com/read/29683307/maternity-care-update-labor-and-delivery
#1
Andrew Smith, Wendy B Barr, Erin Bassett-Novoa, Nicholas LeFevre
Labor is defined as contractions with cervical change and active labor starts when the cervix is dilated 6 cm. Updated labor curves and definitions should be used to define labor dystocia. Oxytocin and amniotomy have important roles in the management of labor dystocia. Structured intermittent fetal monitoring should be considered for women with low-risk pregnancies but continuous electronic fetal monitoring still is used most commonly. Moderate fetal heart rate variability is the most reliable marker of fetal well-being...
April 2018: FP Essentials
https://www.readbyqxmd.com/read/29680682/effect-of-head-orthoses-on-skull-deformities-in-positional-plagiocephaly-evaluation-of-a-3-dimensional-approach
#2
Klaus W W Dörhage, Jörg Wiltfang, Vera von Grabe, Annalena Sonntag, Stephan T Becker, Benedicta E Beck-Broichsitter
PURPOSE: The positional non-synostotic plagiocephaly represents a cranial asymmetry affecting all 3 dimensions. The aim of this study was to evaluate volumetric indices to assess the efficiency in improving non-synostotic cranial asymmetries in treatment with head orthoses. MATERIAL AND METHODS: A total of 96 infants were included in this observational retrospective study. The cohort was further divided into subgroups according to age of helmet supply (younger/older than 7...
March 29, 2018: Journal of Cranio-maxillo-facial Surgery
https://www.readbyqxmd.com/read/29620665/thera-band-application-changes-muscle-activity-and-kyphosis-and-scapular-winging-during-knee-push-up-plus-in-subjects-with-scapular-winging-the-cross-sectional-study
#3
A-Reum Shin, Ji-Hyun Lee, Da-Eun Kim, Heon-Seock Cynn
Scapular winging (SW) is defined as increased prominence of the whole medial border of the scapula. Many researchers recently recommended knee push-up plus (KPP) for enhancing serratus anterior (SA) activation. However, during push-up plus, thoracic kyphosis (TK) may usually occur as a compensatory movement. Thus, the purpose of this study was to investigate the effect of Thera-Band application during KPP on rectus abdominis (RA) activity, TK angle (TKA), SA activity, and amount of SW in subjects with SW.Fifteen subjects performed KPP with Thera-Band applied to different posterior body parts (no Thera-Band, in the occiput, and in the thoracic region)...
April 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29560295/a-case-of-sciatica-during-labor-due-to-an-occiput-posterior-fetus
#4
Cassandra Wasson, Telianne Chon
A 28-year-old term G3P0020 received an epidural with complete pain relief. Approximately 19 hours after the epidural placement, the pain increased. Sensory levels were rechecked and were bilateral and adequate at T8. Further discussion revealed that the pain was unrelated to her contractions; it was in her buttocks and radiating down the leg. The possibility of the fetus being positioned occiput posterior (OP) was discussed. The patient was placed into knee-chest position with instantaneous relief of her pain...
January 17, 2018: Curēus
https://www.readbyqxmd.com/read/29538039/endoscopic-endonasal-approach-to-the-upper-cervical-spine-for-decompression-of-the-cervicomedullary-junction-following-occipitocervical-fusion
#5
Ibrahim Hussain, Theodore H Schwartz, Jeffrey P Greenfield
Basilar invagination is defined as abnormal upward and/or posterior displacement of the odontoid leading to ventral compression of the cervicomedullary junction. This condition leads to lower cranial neuropathies, sensorimotor deficits, and myelopathy. These symptoms can persist even after posterior decompression, which is an indication for ventral decompression. Transoral approaches to the upper cervical spine carry significant morbidity, limiting their utility. The endonasal approach to the upper cervical spine presents an alternative for patients with amenable anatomy...
March 13, 2018: Clinical Spine Surgery
https://www.readbyqxmd.com/read/29537658/efficiency-of-the-modified-sims-maternal-position-in-the-rotation-of-persistent-occiput-posterior-position-during-labor-a-randomized-clinical-trial
#6
Vanessa Bueno-Lopez, Carmen Fuentelsaz-Gallego, Manel Casellas-Caro, Ana Maria Falgueras-Serrano, Silvia Crespo-Berros, Ana Maria Silvano-Cocinero, Carolina Alcaine-Guisado, Manuela Zamoro Fuentes, Elena Carreras, Carmen Terré-Rull
BACKGROUND: Fetal occiput posterior position in labor is associated with more painful and prolonged labor, and an increase in both maternal and fetal morbidity. The aim of this study is to assess whether the modified Sims position on the side of the fetal spine increases the rotation to occiput anterior position in women with epidural analgesia and a fetus in persistent occiput posterior (POP) position. METHODS: This is an open, randomized controlled, clinical trial...
March 14, 2018: Birth
https://www.readbyqxmd.com/read/29510425/impact-of-peanut-ball-device-on-the-duration-of-active-labor-a-randomized-control-trial
#7
Rebecca J Mercier, Mei Kwan
OBJECTIVE:  To evaluate whether the use of a peanut ball device shortens the duration of active labor in nulliparas. STUDY DESIGN:  Single-site, nonblinded randomized trial in nulliparous women admitted for labor or labor induction. English-speaking women > 18 years of age with singleton pregnancies were enrolled. Participants were randomized to the use of peanut ball or usual care upon reaching the active phase of labor (≥ 6 cm cervical dilation) with an epidural...
March 6, 2018: American Journal of Perinatology
https://www.readbyqxmd.com/read/29462820/comment-on-higher-rates-of-operative-delivery-and-maternal-and-neonatal-complications-in-persistent-occiput-posterior-position-with-a-large-head-circumference-a-retrospective-cohort-study
#8
Paul Guerby, Olivier Parant, Christophe Vayssiere, Fabien Vidal
No abstract text is available yet for this article.
February 20, 2018: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/29450878/antepartum-risk-factors-for-moderate-to-severe-neonatal-hypoxic-ischemic-encephalopathy-a-swedish-national-cohort-study
#9
Lena Liljestrom, Anna-Karin Wikstrom, Johan Agren, Maria Jonsson
INTRODUCTION: Our aim was to identify antepartum risk factors for neonatal hypoxic ischemic encephalopathy, with a focus on maternal body mass index and height. MATERIAL AND METHODS: National population-based cohort study of 692 428 live-born infants ≥36 gestational weeks in Sweden, 2009-2015. Data from the Swedish Medical Birth Register and the Swedish Neonatal Quality Register were linked. Short maternal stature was defined as ≤155 cm, and overweight as body mass index ≥25 kg/m2 ...
February 16, 2018: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/29444695/the-impact-of-manual-rotation-of-the-occiput-posterior-position-on-spontaneous-vaginal-delivery-rate-study-protocol-for-a-randomized-clinical-trial-rmos
#10
C Verhaeghe, E Parot-Schinkel, P E Bouet, S Madzou, F Biquard, P Gillard, P Descamps, G Legendre
BACKGROUND: The frequency of posterior presentations (occiput of the fetus towards the sacrum of the mother) in labor is approximately 20% and, of this, 5% remain posterior until the end of labor. These posterior presentations are associated with higher rates of cesarean section and instrumental delivery. Manual rotation of a posterior position in order to rotate the fetus to an anterior position has been proposed in order to reduce the rate of instrumental fetal delivery. No randomized study has compared the efficacy of this procedure to expectant management...
February 14, 2018: Trials
https://www.readbyqxmd.com/read/29443820/unstable-c1-fracture-managed-with-internal-fixation-using-lateral-mass-screws-a-case-report
#11
Jonathan C Yu, Thomas E Niemeier, Sakthivel R Manoharan
CASE: A 47-year-old woman presented with an unstable C1 fracture after falling down several stairs. She was found to have a sagittal split fracture of the right C1 lateral mass extending into the posterior arch. The fracture was treated with a direct posterior osteosynthesis of C1 using lateral mass screws. CONCLUSION: Surgical management of unstable C1 fractures has traditionally involved posterior fusion of C1 to C2 or fusion from the occiput to C2. These fusion procedures can be quite functionally limiting...
February 14, 2018: JBJS Case Connector
https://www.readbyqxmd.com/read/29430326/-adult-grisel-syndrome-and-cervical-skull-instability-transnasal-endoscopic-odontoidectomy-and-occipito-cervical-fusion-case-report-and-literature-review
#12
Roberto Herrera, Héctor Rojas, Ariel Estramian, Julieta Gómez, José Luis Ledesma, José Pablo, Julián Pastore
Background: Craniocervical junction pathology is infrequent in daily neurosurgical practice. In general, most of these lesions are of traumatic or rheumatic origin. Atlantoaxial instability of inflammatory origin (Grisel syndrome) is a rare entity of which only 16 adult cases have been reported in the literature. This pathology is characterized by the development of an osteolytic lesion at the level of the atlantoaxial joint after an infectious event, usually of the upper airways. Case Description: We present the case of a 76-year-old patient who attended our office for clinical symptoms of spinal instability secondary to an osteolytic lesion, with involvement of C1 and C2...
2018: Surgical Neurology International
https://www.readbyqxmd.com/read/29390372/dynamic-paraspinal-muscle-impingement-causing-acute-hemiplegia-after-c1-posterior-arch-laminectomy-a-case-report
#13
Naoki Notani, Masashi Miyazaki, Toyomi Yoshiiwa, Toshinobu Ishihara, Shozo Kanezaki, Hiroshi Tsumura
RATIONALE: Acute neurological deficits following spinal surgery commonly result from epidural hematoma, surgical trauma, vascular compromise, and graft or hardware impingement, with the cause identified by magnetic resonance imaging (MRI). We present a rare case of dynamic paraspinal muscle impingement after C1 posterior arch laminectomy, which was diagnosed by myelography, with no significant findings on MRI. PATIENT CONCERNS: An 81-year-old, severely obese male, was referred to our department for the treatment of vertebral disease of the lumbar spine...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29381931/biomechanical-evaluation-of-a-novel-integrated-artificial-axis-a-finite-element-study
#14
Yongqiang Zheng, Jianhua Wang, Suixiang Liao, Dongsheng Zhang, Jinshan Zhang, Limin Ma, Hong Xia
Various modified instruments are used for the anterior reconstruction of the tumor lesion affecting the second cervical vertebra, but there have been no reports regarding individual integrated artificial axis (IAA) prosthesis fabricated by selective laser melting. In the present work, a new type of IAA prosthesis has been designed with a 3-dimensional (3D) finite element model of normal occiput-the fourth cervical vertebra being established to assess its biomechanics. For easy comparison, another 3D finite element model is also established for the T-shaped Harms cage and an additional posterior fixation was performed on each model...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29366610/-occiput-posterior-presentation-at-delivery-materno-foetal-outcomes-and-predictive-factors-of-rotation
#15
V Othenin-Girard, M Boulvain, M-J Guittier
OBJECTIVES: To describe the maternal and foetal outcomes of an occiput posterior foetal position at delivery; to evaluate predictive factors of anterior rotation during labour. METHODS: Descriptive retrospective analysis of a cohort of 439 women with foetuses in occiput posterior position during labour. Logistic regression analysis to quantify the effect of factors that may favour anterior rotation. RESULTS: Most of foetuses (64%) do an anterior rotation during labour and 13% during the expulsive phase...
February 2018: Gynecologie, Obstetrique, Fertilite & Senologie
https://www.readbyqxmd.com/read/29301014/pedicled-vascularized-bone-grafts-for-posterior-occipitocervical-and-cervicothoracic-fusion-a-cadaveric-feasibility-study
#16
Michael A Bohl, Michael A Mooney, Joshua S Catapano, Kaith K Almefty, Jay D Turner, Steve W Chang, Mark C Preul, Edward M Reece, U Kumar Kakarla
BACKGROUND: Arthrodesis is critical for achieving favorable outcomes in reconstructive spine surgery. Vascularized bone grafts (VBGs) have been successfully used to augment fusion rates in a variety of skeletal pathologies, and pedicled VBG has numerous advantages over free transfer VBG. Pedicled VBG has not previously been described for the posterior occipitocervicothoracic spine. OBJECTIVE: To identify, describe, and assess potential donor sites for pedicled VBGs from occiput to T12 using a cadaver model and to describe important technical considerations for graft harvest and placement...
December 30, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29137599/neonatal-outcomes-of-deliveries-in-occiput-posterior-position-when-delayed-pushing-is-practiced-a-cohort-study
#17
Kristina Dahlqvist, Maria Jonsson
BACKGROUND: To examine the impact of occiput posterior position, compared to occiput anterior position, on neonatal outcomes in a setting where delayed pushing is practiced. The specific aim was to estimate the risk of acidaemia. METHODS: Cohort study from a university hospital in Sweden between 2004 and 2012. Information was collected from a local database of 35,546 births. Umbilical artery sampling was routine. Outcomes were: umbilical artery pH < 7.00 and <7...
November 14, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29078945/fetal-malpresentation-and-malposition-diagnosis-and-management
#18
REVIEW
Rachel A Pilliod, Aaron B Caughey
Fetal malpresentation and fetal malposition are frequently interchanged; however, fetal malpresentation refers to a fetus with a fetal part other than the head engaging the maternal pelvis. Fetal malposition in labor includes occiput posterior and occiput transverse positions. Both fetal malposition and malpresentation are associated with significant maternal and neonatal morbidity, which have significant impact on patients and providers. Accurate diagnosis of both conditions is necessary for appropriate management...
December 2017: Obstetrics and Gynecology Clinics of North America
https://www.readbyqxmd.com/read/29040149/the-pantheon-variant-of-the-classic-cathedral-dome-procedure-for-parieto-occipital-skull-deformities
#19
Sebastian Eibach, Hop N Le, John Zovickian, Dachling Pang
OBJECTIVE: To describe a new technique for the reconstruction of parieto-occipital skull deformities. METHODS AND RESULTS: The technique is a variant of the previously described "cathedral dome procedure" used for frontal skull deformities. The authors apply the same principle of remodeling by making meridional slat craniotomies surrounding the depressed dome of the posterior skull deformity, followed by "green-stick fracture-reshaping" of the meridional slats to elevate and support the excised depressed dome...
January 2018: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28965445/temporary-occipital-fixation-in-young-children-with-severe-cervical-thoracic-spinal-deformity
#20
Brian J Kelley, Anas A Minkara, Peter D Angevine, Michael G Vitale, Lawrence G Lenke, Richard C E Anderson
OBJECTIVE The long-term effects of instrumentation and fusion of the occipital-cervical-thoracic spine on spinal growth in young children are poorly understood. To mitigate the effects of this surgery on the growing pediatric spine, the authors report a novel technique used in 4 children with severe cervical-thoracic instability. These patients underwent instrumentation from the occiput to the upper thoracic region for stabilization, but without bone graft at the craniovertebral junction (CVJ). Subsequent surgery was then performed to remove the occipital instrumentation, thereby allowing further growth and increased motion across the CVJ...
October 2017: Neurosurgical Focus
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