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001-es BibID:BIBFORM065300
Első szerző:Brimacombe, Michael
Cím:Shoulder dystocia related fetal neurological injuries: the predisposing roles of forceps and ventouse extractions / Michael Brimacombe, Leslie Iffy, Joseph J. Apuzzio, Valeria Varadi, Balint Nagy, Vijaya Raju, Nuris Portuondo
Dátum:2007
ISSN:0932-0067 1432-0711
Megjegyzések:On the basis of 333 documented cases of permanent perinatal neurological damage, associated with arrest of the shoulders at birth, the authors conducted a retrospective study in order to evaluate the predisposing role, if any, of the utilization of extraction instruments. The investigation revealed that 35% of all injuries occurred in neonates delivered by forceps, ventouse or sequential ventouse-forceps procedures. This frequency was several-fold higher than the prevailing instrument use in the practices of American obstetricians during the same years. A high rate of forceps and ventouse extractions was demonstrable in all birth weight categories. Average weight and moderately large for gestational age fetuses underwent instrumental extractions more often than grossly macrosomic ones. This circumstance indicates that forceps and ventouse are independent risk factors, unrelated to fetal size. Their use entailed central nervous system injuries significantly more often than did spontaneous deliveries. The findings suggest that extraction procedures may be as important as macrosomia among the factors that lead to neurological damage in the child in connection with shoulder dystocia. Because they augment the intrinsic dangers of excessive fetal size exponentially, the authors consider their use in case of > or =4,000 g estimated fetal weight inadvisable. Sequential forceps-ventouse utilization further doubles the risks and is, therefore, to be avoided in all circumstances.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
shoulder
dystocia
neurological
injuries
Megjelenés:Archives Of Gynecology And Obstetrics. - 277 : 5 (2007), p. 415-422. -
További szerzők:Iffy, Leslie Apuzzio, Joseph J. Váradi Valéria Nagy Bálint (1956-) (molekuláris genetikus) Raju, Vijaya Portuondo, Nuris
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001-es BibID:BIBFORM065313
Első szerző:Iffy, Leslie
Cím:The risk of shoulder dystocia related permanent fetal injury in relation to birth weight / Leslie Iffy, Michael Brimacombe, Joseph J. Apuzzio, Valeria Varadi, Nuris Portuondo, Balint Nagy
Dátum:2008
ISSN:0301-2115
Megjegyzések:OBJECTIVE:To examine birth weight related risks of fetal injury in connection with shoulder dystocia.STUDY DESIGN:The investigation was based on a retrospective analysis of 316 fetal neurological injuries associated with deliveries complicated by arrest of the shoulders that occurred across the United States.RESULTS:The study revealed that the distribution of birthweights for the high risk shoulder dystocia population differs from the standard birthweight distribution. The relative difference per birthweight interval is used to adjust an assumed 1:1000 baseline risk of injury due to shoulder dystocia following vaginal deliveries. These adjusted risks show a need to consider new thresholds for elective cesarean delivery.CONCLUSIONS:Current North American and British guidelines, that set 5000 g as minimum estimated fetal weight limit for elective cesarean section in non-diabetic and 4500 g for diabetic gravidas, may expose some macrosomic fetuses to a high risk of permanent neurological damage. The authors present the opinion that the mother, having been informed of the risks of vaginal versus abdominal delivery, should be allowed to play an active role in the critical management decisions.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
shoulder
dystocia
birth
weight
risk
Megjelenés:European Journal Of Obstetrics Gynecology And Reproductive Biology 136 : 1 (2008), p. 53-60. -
További szerzők:Brimacombe, Michael Apuzzio, Joseph J. Váradi Valéria Portuondo, Nuris Nagy Bálint (1956-) (molekuláris genetikus)
Internet cím:Szerző által megadott URL
DOI
Intézményi repozitóriumban (DEA) tárolt változat
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