Occipito-posterior

BACKGROUND: The optimal relationship of the fetus to the mother's birth canal is when the fetus is in the longitudinal lie, cephalic presentation with well-flexed head (vertex presentation), and in the occipito-anterior position. Fetal malposition is described as occipito-posterior (OP) when the back of the fetal head lies posteriorly in the mother's pelvis, and occipito-transverse (OT) when the back of the fetal head lies transversely in the mother's pelvis. The fetal head will often be deflexed and may extend further to a mento-anterior or mento-transverse position, where the chin is anterior or transverse to the maternal pelvis...

A simplified and easily teachable method of performing Kiwi vacuums is described. The Kiwi Omnicup has several features which make it the ideal instrument for correcting malposition. Once the correct position of the fetus is ascertained using ultrasound, it is always possible to maneuver the cup over the flexion point. A retrospective study was undertaken of 239 consecutive patients in the author's private practice requiring assisted delivery from 2010 until 2016. No case was declined. Successful Kiwi vacuum delivery was achieved in 233 cases (98%) and complication rates were low...

BACKGROUND: Fetal malposition (occipito-posterior and persistent occipito-transverse) in labour is associated with adverse maternal and infant outcomes. Whether use of maternal postures can improve these outcomes is unclear. This Cochrane Review of maternal posture in labour is one of two new reviews replacing a 2007 review of maternal postures in pregnancy and labour. OBJECTIVES: To assess the effect of specified maternal postures for women with fetal malposition in labour on maternal and infant morbidity compared to other postures...

Birth trauma affects millions of women and infants worldwide. Levator ani muscle avulsions can be responsible for long-term morbidity, associated with 13-36% of women who deliver vaginally. Pelvic floor injuries are enhanced by fetal malposition, namely persistent occipito-posterior (OP) position, estimated to affect 1.8-12.9% of pregnancies. Neonates delivered in persistent OP position are associated with an increased risk for adverse outcomes. The main goal of this work was to evaluate the impact of distinct fetal positions on both mother and fetus...

BACKGROUND: Foetal occipto-posterior position during labour can contribute to negative outcomes. Encouraging women to adopt positions utilising thigh flexion with the aim of increasing pelvic diameters and promoting foetal rotation to the occpito-anterior position are often used. However, the efficacy of these strategies has not yet been determined. OBJECTIVE: To compare the effects of maternal hands and knees or lateral positions with flexed thighs versus control in rotating foetal occipito-posterior to occipito-anterior in the first stage of labour...

INTRODUCTION: The incidence of grade 3-4 perineal tears, also known as obstetric anal sphincter injury (OASI), is reported to be between 0.5 and 2.5%. Beyond the medico-economic burden, the consequences of OASI on a woman's emotional, psychological, sexual, and physical wellbeing are considerable. Among the various risk factors of OASI, few data are available about the impact of a language barrier on its incidence. MATERIAL AND METHODS: We conducted a case-control study to evaluate the effect of language barriers on the risk of OASI comparing 171 women with OASI and 163 matched controls...

Regulation of the internal homeostasis is modulated by the central autonomic system. So far, the view of this system is determined by animal and human research focusing on cortical and subcortical grey substance regions. To provide an overview based on white matter architecture, we used a global tractography approach to reconstruct a network of tracts interconnecting brain regions that are known to be involved in autonomic processing. Diffusion weighted imaging data were obtained from subjects of the human connectome project (HCP) database...

AIMS: To observe the corrective effects of maternal extreme flexure and hip abduction combined with contralateral side-lying on persistent foetal occipito-posterior position. BACKGROUND: Digital rotation and other methods are used for correction of a persistent foetal occipito-posterior position. However, digital rotation readily causes damage to mother and foetus, and the correction rates of other methods are low. DESIGN: In this observational study, pregnant women were randomly divided into 2 groups according to different postures and their outcomes were compared...

BACKGROUND: The rate of caesarean sections at full cervical dilatation with their high risk of morbidity continues to rise mirroring the overall increase in caesarean section rates internationally. OBJECTIVES: The objectives of this study were to determine the rate of full dilatation caesarean section in a tertiary referral unit and evaluate key labour, maternal and fetal factors potentially linked to those deliveries. We also assessed maternal and fetal morbidity at full dilatation sections...

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OBJECTIVE: To investigate (1) the placement of the BD Odon Device on the model fetal head and (2) perineal distention during simulated operative vaginal births conducted with the BD Odon Device. DESIGN: Observational simulation study. SETTING: North Bristol NHS Trust, UK. POPULATION OR SAMPLE: Four hundred and forty simulated operative vaginal births. METHODS: Three bespoke fetal mannequins were developed to represent (1) bi-parietal diameter of the 50th centile at term, (2) bi-parietal diameter at the 5th centile at term, and (3) 50th centile head with 2 cm of caput...

BACKGROUND: Fetal occiput posterior positions are associated with poorer maternal outcomes than occiput anterior positions. Although methods that include instrumental and manual rotation can be used at the end of labor to promote the rotation of the fetal head, various maternal postures may also be performed from the beginning of labor in occiput posterior position. Such postures might facilitate flexion of the fetal head and favor its rotation into an occiput anterior position. OBJECTIVE: The purpose of this study was to determine whether a lateral asymmetric decubitus posture facilitates the rotation of fetal occiput posterior into occiput anterior positions...

OBJECTIVE: Our aim is to evaluate the capacity of intrapartum translabial ultrasound (ITU) with pushing in the prediction of difficulty of fetal extraction in vacuum assisted deliveries. Prospective, observational study performed (2/2015-8/2015) on 75 nulliparous women, ≥37 weeks with singleton pregnancies at full dilatation who had ITU-with-pushing performed, previous to vacuum-placement for fetal extraction. Working on the translabial sagittal-plane, we assessed: Angle-Progression (AoP), Progression-Distance (PD) and Head-Direction (HD); in the axial plane we evaluated: Midline-Angle (MLA) and Head-Perineum-Distance (HPD)...

INTRODUCTION: The aim of this study was to compare to compare immediate delivery outcome as well as healing, pain, anal incontinence and sexuality in a short-term and a long-term follow up after episiotomy performed before or at crowning in nulliparous women. MATERIAL AND METHODS: This cohort study is a comparison of prospectively collected data evaluating the importance of the timing of episiotomy. Patients with episiotomy performed before crowning (n = 86) and at crowning (n = 404) were compared...

BACKGROUND: Previous studies found that the facet joint of the C1 vertebra were removed (C1 facetectomy) before extirpation from the extramedullary tumor in craniocervical junction, leading to postoperative upper cervical instability or deformity. Occipito-cervical fusion (OCF) is a demanding and morbid surgical procedure, which can be used in such patients. This study is to analyze the clinical manifestation and surgical outcome of patients with craniocervical extramedullary tumor undergoing an extirpation of spinal tumors and OCF by one-stage posterior approach...

OBJECTIVE: To estimate the association of fetal head position prior to vacuum extraction (VE) and pregnancy outcome. STUDY DESIGN: A retrospective cohort study of singleton pregnancies who underwent VE. Pregnancy outcome of occipito-anterior (OA) position of the fetal head was compared to those with occipito-posterior (OP) position. RESULTS: Amongst overall 12,063 women undergoing trial of labor, there were 1118 (9.2%) VE deliveries. Of them, 871 (77...

Neuroimaging studies have identified a network of regions in the human ventral occipito-temporal cortex (VOTC) sensitive to faces. Using intra-cerebral electrophysiological recordings, we compared the relative responsivity of the different regions to face-structure using a periodic visual stimulation paradigm. Recordings were made in 17 epileptic patients implanted with linear-array depth-electrodes (>1000 contacts in the VOTC). In Experiment 1, we presented sequences of phase-scrambled and intact face stimuli (equalised for low-level image properties) alternating at a fixed frequency of 3Hz (6 images/s) while patients completed an orthogonal task...

Humans are extremely rapid at categorizing visual inputs, an ability which relies on occipito-temporal brain processes. Functional neuroimaging studies have identified the spatial organization of neural responses in these regions to ecologically-relevant categories such as faces, bodyparts or houses. However, much less is known about the spatio-temporal dynamics of these category-selective responses at the system level of organization. Here we investigate this issue by recording scalp electroencephalogram (EEG) during fast periodic visual stimulation (FPVS) with natural images (Rossion et al...

To date, the neural mechanisms of feature information integration across saccades, also known as trans-saccadic integration (TSI), of low-level object features are relatively unknown. Using fMRI adaptation (fMRIa), we found that the right inferior parietal lobule (IPL; specifically, SMG) and extrastriate cortex (putative V4) are sensitive to stimulus orientation in a space-fixed reference frame (Dunkley & Crawford, Society for Neuroscience Abstracts, 2012). To identify the neural mechanisms of underlying TSI in multiple reference frames, we employed fMRIa to probe three spatial conditions: 1) Space-fixed, 2) Retina-fixed and 3) Frame-independent (neither Space-fixed, nor Retina-fixed)...

Over the last two decades neurophysiological and neuroimaging studies have identified a network of brain regions in occipito-temporal, parietal, and frontal cortex that are involved in visual processing of actions. What remains unclear are the neural computations and representational properties in each area. In this study, we investigated the representational content of human brain areas in the action observation network using fMRI and representational similarity analysis. Observers were shown video clips of 8 different actions performed by 3 different agents (actors) during fMRI scanning...