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Fetal Malpresentation

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81. Value of Measuring Cervical Angle and Length by Ultrasound in Prediction of Successful Induction of Delivery

table for eligibility information Ages Eligible for Study: 18 Years to 37 Years (Adult) Sexes Eligible for Study: Female Accepts Healthy Volunteers: No Criteria Inclusion Criteria: Singleton pregnancy Gestational age between 35 and 42 Presence of an indication for induction of labour as post-term pregnancy or rupture of membranes The fetus is living Cephalic presentation Exclusion Criteria: Estimated fetal weight more than 4 kilograms Malpresentation Oligohydramnios Polyhydramnios Non-reassuring non (...) -stress test before induction of labor Cephalo-pelvic disproportion Previous operation on the cervix as cautery or cerclage Previous cesarean section Any contraindication to vaginal delivery including placenta previa Anomalous fetus Morbid obesity Contacts and Locations Go to Information from the National Library of Medicine To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor. Please refer to this study by its

2017 Clinical Trials

82. Inter-delivery weight gain and risk of cesarean delivery following a prior vaginal delivery. Full Text available with Trip Pro

delivery.The objective of the study was to determine whether interdelivery weight gain is associated with an increased risk of intrapartum cesarean delivery following a vaginal delivery.This was a case-control study of women who had 2 consecutive singleton births of at least 36 weeks' gestation between 2005 and 2016, with a vaginal delivery in the index pregnancy. Women were excluded if they had a contraindication to a trial of labor (eg, fetal malpresentation or placenta previa) in the subsequent (...) % confidence interval, 1.15-4.76 for body mass index increase of ≥4 kg/m2). Contrarily, women who lost ≥2 kg/m2 were less likely to undergo any cesarean delivery (adjusted odds ratio, 0.41, 95% confidence interval, 0.21-0.78) as well as less likely to undergo cesarean delivery for an arrest disorder (adjusted odds ratio, 0.29, 95% confidence interval, 0.10-0.82). Weight gain or loss was not significantly associated with a cesarean delivery for fetal indications.Among women with a prior vaginal delivery

2017 American Journal of Obstetrics and Gynecology

83. Committee Opinion No 697 Summary: Planned Home Birth. (Abstract)

and timely transport to nearby hospitals. The Committee on Obstetric Practice considers fetal malpresentation, multiple gestation, or prior cesarean delivery to be an absolute contraindication to planned home birth.

2017 Obstetrics and Gynecology

84. Committee Opinion No. 697: Planned Home Birth. (Abstract)

and timely transport to nearby hospitals. The Committee on Obstetric Practice considers fetal malpresentation, multiple gestation, or prior cesarean delivery to be an absolute contraindication to planned home birth.

2017 Obstetrics and Gynecology

85. Finding the breech: Influence of breech presentation on mode of delivery based on timing of diagnosis, attempt at external cephalic version, and provider success with version. (Abstract)

Finding the breech: Influence of breech presentation on mode of delivery based on timing of diagnosis, attempt at external cephalic version, and provider success with version. Breech presentation affects 3-4% of pregnancies at term and malpresentation is the primary indication for 10-15% of cesarean deliveries. External cephalic version is an effective intervention that can decrease the need for cesarean delivery; however, timely identification of breech presentation is required. We (...) hypothesized that women with a fetus in a breech presentation that is diagnosed after 38 weeks' estimated gestational age have a decreased likelihood of external cephalic version attempted and an increased likelihood of cesarean delivery.This was a retrospective cohort study. A chart review was performed for 251 women with breech presentation at term presenting to our tertiary referral university hospital for external cephalic version, cesarean for breech presentation, or vaginal breech delivery.Vaginal

2017 Birth

86. Planned home births: the need for additional contraindications. Full Text available with Trip Pro

criteria are necessary to guide the selection of appropriate candidates for planned home birth. The committee lists 3 absolute contraindications for a planned home birth: fetal malpresentation, multiple gestations, and a history of cesarean delivery.The aim of this study was to evaluate whether there are risk factors that should be considered contraindications to planned home births in addition to the 3 that are listed by the American College of Obstetricians and Gynecologists.We conducted a population (...) , malpresentation, multiple gestations) for a total of 5 contraindications for planned home births.Copyright © 2017 Elsevier Inc. All rights reserved.

2017 American Journal of Obstetrics and Gynecology

87. Spontaneous Vaginal Delivery

Spontaneous Vaginal Delivery Aka: Spontaneous Vaginal Delivery , Vaginal Delivery , Vaginal Birth , Normal Spontaneous Vaginal Delivery , NSVD From Related Chapters II. Epidemiology Vaginal Birth accounts for 70% of deliveries in the United States Of the 4 million births in the U.S. in 2013, three million were vaginal deliveries III. Contraindications Complete Active genital (or prodromal symptoms) at time of labor Malpresentation Non- with mentum anterior Prior uterine surgery that raises risk of labor (...) click) to open the source website in a new browser window. Related Studies (from Trip Database) Ontology: Normal delivery (C1384485) Definition (NCI) Birth of the fetus through the vagina without the application of vacuum or forceps or any other instrument. (adapted from reVITALize)(NICHD) Concepts Finding ( T033 ) ICD9 650 SnomedCT 48782003 , 267325009 , 267353009 , 281686002 , 200477006 , 199313007 English FTND - Full term norm delivery , SVD - Spont vaginal delivery , Spontaneous vaginal delivery

2018 FP Notebook

88. Preterm Labor Management

for pain control Anticipate malpresentations Complete cervical dilation may be less than 10 cm Elective ceserean <36 weeks offered in some settings Consider transport to tertiary center with NICU Strongly consider if <34 weeks gestation Contraindications Imminent delivery or maternal status unstable No safe transport to referral center III. Management: Corticosteroids Indications Intact membranes at 24-34 weeks without at 24 to 32 weeks Consider in women 23 weeks gestation who are likely to delivery (...) . Management: Tocolytic agents See Contraindications or lethal fetal anomaly or Maternal bleeding with hemodynamic instability Preferred s (also used for neuroprotective benefit, in addition to ) Load: 6 grams bolus IV over 20 min (Very high dose!) Maintenance: 2 grams/hour IV infusion Must follow protocols for patient safety and neuroprotective (with decreased risk of in deliveries before 32 weeks) Load: 50-100 mg orally or rectally Maintenance: 25-50 mg orally every 4-6 hours Avoid use >48 hours (risk

2018 FP Notebook

89. Premature Rupture of Membranes

, voortijdig gebroken Portuguese Ruptura prematura da bolsa das águas , Ruptura Prematura de Membranas Fetais , Ruptura Prematura de Membrana (Gravidez) French Rupture prématurée des membranes , Rupture prématurée des membranes (RPM) , Rupture prématurée des membranes foetales Derived from the NIH UMLS ( ) Ontology: Preterm premature rupture of membranes (disorder) (C0729264) Definition (NCI) Spontaneous rupture of fetal membranes that occurs before the onset of labor and before 37 weeks.(NICHD) Concepts (...) of fluid from vagina Fluid leakage increases with movement change V. Signs See evaluation below VI. Differential diagnosis Water from recent bathing VII. Complications Premature Birth (PPROM) Cord compression Respiratory distress syndrome e Malpresentation VIII. Course prior to delivery Term: Labor starts within 24 hours in 95% of cases Weeks 28 to 34 Labor starts within 24 hours in 50% of cases Labor starts within 1 week in 80% of cases Weeks 24 to 26 Labor starts within 1 week in >50% Labor delayed 4

2018 FP Notebook

90. Cesarean Section

Elective repeat cesarean delivery or ERCD (30%) (30%) Malpresentation such as (11%) s suggesting (10%) Other indications Active genital HSV See Maternal See Maternal comorbidity Cardiopulmonary disease Emergent condition Structural anomaly Contracted (congenital, prior ) Obstructive pelvic tumor Vaginal reconstruction Fetal indications Conjoined twin IV. History: Rounds Abdominal and perineal Pain Lochia or V. Exam: Rounds Cardiopulmonary exam Abdominal examination Fundal height Uterine tenderness (...) of the uterus. This could cause problems with an attempted vaginal birth later. However, more than half of women who have a C-section can give vaginal birth later. Definition (NCI) Surgical delivery of one or more intrauterine fetuses though an abdominal incision.(NICHD) Definition (MSH) Extraction of the FETUS by means of abdominal HYSTEROTOMY. Definition (CSP) extraction of the fetus by means of abdominal hysterotomy. Concepts Therapeutic or Preventive Procedure ( T061 ) MSH ICD9 74, 74.9 ICD10 , SnomedCT

2018 FP Notebook

91. Occiput Posterior

Posterior , Occipitoposterior Malpresentation , OP Presentation From Related Chapters II. Definition Abnormal with occiput at maternal Fetal face towards maternal symphysis pubis III. Epidemiology Represents 10% of s IV. Physiology Less favorable fetal head diameter for delivery Deflexion of fetal head Posterior presentation Usually corrects spontaneously Rotates to position in 90% of cases V. Symptoms Back labor Prolonged labor Nulliparous: Additional two hours Multiparous: Additional one hour VI (...) . Signs: Digital cervical exam Asymmetric cervical dilation Persistant anterior lip Palpation of fetal head Fetal anterior most palpable Follow sagittal to posterior Posterior , lambdoid with be posterior VII. Complications Extended episiotomy or perineal VIII. Management Spontaneous Delivery (anticipate in 45% of cases) Maternal position changes (unclear efficacy) Any position in which mother curls forward from hips Hands and knees Squatting Manual rotation during vaginal exam See Vacuum Delivery

2018 FP Notebook

92. Breech Presentation

window. Related Studies (from Trip Database) Ontology: Breech Presentation (C0006157) Definition (NCI) A fetal presentation in which the baby descends into the birth canal with hips, buttocks or its foot first during delivery.(NICHD) Definition (MSH) A malpresentation of the FETUS at near term or during OBSTETRIC LABOR with the fetal cephalic pole in the fundus of the UTERUS. There are three types of breech: the complete breech with flexed hips and knees; the incomplete breech with one or both hips (...) or Incomplete Breech (35-45%) One or both hips and knees extended One or both feet presenting IV. Risk Factors Prematurity Multiple prior pregnancies Polyhydramnios or oligohydramnios Uterine abnormalities Fetal abnromalities (e.g. , ) Macrosomia Breech Presentation in prior pregnancy Absolute V. Signs Longitudinal Firm lower pole Limbs to one side Hard head at uterine fundus Head may be obscured by maternal ribs Fetal heart tone auscultation Breech Fetal heart best heard above Cervical examination No hard

2018 FP Notebook

93. Vacuum Assisted Delivery

injury) IV. Indications Suspicion of fetal compromise (e.g. nonreassuring ) Maternal exhaustion Prolonged second stage of labor Nulliparous: Failed preogression over 3 hours with anesthesia and 2 hours without Multiparous: Failed preogression over 2 hour with anesthesia and 1 hours without V. Contraindications Fetal head not engaged earlier than 34 weeks Known fetal disorders predisposing to complication Bone mineralization disorders s Malpresentation Noncephalic presentation Occipitoposterior (...) presentation is not a contraindication to Vacuum Assisted Delivery However, anal sphincter approaches 33% VI. Complications See VII. Precautions Vacuum can do as much or more damage as forceps Criteria to discontinue (prevent ) No progress after 3 pulls No baby extraction in 30 minutes after initiation Cup disengages 3 times Significant fetal scalp or maternal VIII. Preparation See IX. Technique Apply Suction cup during contraction Decrease cup pressure to 100 mmHg between contractions No traction until

2018 FP Notebook

94. Neonatal Distress Causes

as above Maternal conditions (or other maternal serious chronic comorbidity) Maternal Other Maternal factors Maternal age <17 years old or over age 38 years old Limited or absent Maternal Fetal Status Oligohydramnios or polyhydramnios (especially if < 1500 g or immature ) Decreased fetal activity VI. Risk Factors: Intrapartum Maternal factors (or other serious infection) Maternal medications ( s, sedation) ( , ) Prolonged or Premature Labor Precipitous Delivery Meconium stained amniotic fluid Fetal (...) Status Malpresentation (e.g. ) VII. References (2016) Manual, 14th ed, p. I-198 Claudius, Behar, Nichols in Herbert (2015) EM:Rap 15(1): 3-4 Spangler, Claudius, Behar and Nicholas in Herbert (2016) EM:Rap 16(9): 11-3 Images: Related links to external sites (from Bing) These images are a random sampling from a Bing search on the term "Neonatal Distress Causes." Click on the image (or right click) to open the source website in a new browser window. Related Studies (from Trip Database) Related Topics

2018 FP Notebook

95. Vaginal Birth After Cesarean: New Insights

). Participants: A non-DHHS, nonadvocate 15-member panel representing the fields of obstetrics and gynecology, urogynecology, maternal and fetal medicine, pediatrics, midwifery, clinical pharmacology, medical ethics, internal medicine, family medicine, perinatal and reproductive psychiatry, anesthesiology, nursing, biostatistics, epidemiology, health care regulation, risk management, and a public representative. In addition, 21 experts from pertinent fields presented data to the panel and conference audience (...) have important risks and benefits and that these risks and benefits differ for the woman and her fetus. This poses a profound ethical dilemma for the woman as well as her caregivers, because benefit for the woman may come at the price of increased risk for the fetus and vice versa. This conundrum is worsened by the general paucity of high-level evidence about both medical and nonmedical factors, which prevents the precise quantification of risks and benefits that might help to make an informed

2010 NIH Consensus Statements

96. Periviable birth. Full Text available with Trip Pro

fetal well-being or fetal malpresentation. Whenever possible, periviable births for which maternal or neonatal intervention is planned should occur in centers that offer expertise in maternal and neonatal care and the needed infrastructure, including intensive care units, to support such services. This document describes newborn outcomes after periviable birth, provides current evidence and recommendations regarding interventions in this setting, and provides an outline for family counseling (...) challenging decisions. Multiple factors have been found to be associated with short-term and long-term outcomes of periviable births in addition to gestational age at birth. These include, but are not limited to, nonmodifiable factors (eg, fetal sex, weight, plurality), potentially modifiable antepartum and intrapartum factors (eg, location of delivery, intent to intervene by cesarean delivery or induction for delivery, administration of antenatal corticosteroids and magnesium sulfate), and postnatal

2016 American Journal of Obstetrics and Gynecology

97. Maternal and Neonatal Outcomes of Attempted Vaginal Compared With Planned Cesarean Delivery in Triplet Gestations. (Abstract)

delivery, including those coded as elective or for fetal malpresentation. Primary maternal outcomes included infection (composite of chorioamnionitis, endometritis, wound separation, and wound infection), blood transfusion, or transfer to the intensive care unit. Primary neonatal outcomes included neonatal asphyxia, mechanical ventilation, and composite neonatal morbidity, consisting of ≥1 of the following: birth injury, 5-minute Apgar <4, arterial pH <7.0 or base excess <-12.0, neonatal asphyxia (...) a multiinstitution obstetric cohort.We performed a retrospective cohort study using data from the Consortium on Safe Labor, identifying triplet pregnancies with delivery at a gestational age ≥28 weeks. Women with a history of cesarean delivery and pregnancies complicated by chromosomal or congenital anomalies, twin-twin transfusion syndrome, or a fetal demise were excluded. The attempted vaginal group included all women with spontaneous or induced labor and excluded all women delivering by prelabor cesarean

2016 American Journal of Obstetrics and Gynecology

98. Use of a portable system with ultrasound and blood tests to improve prenatal controls in rural Guatemala Full Text available with Trip Pro

and urine tests. The information of each pregnancy is registered in a medical exchange tool, and is later reviewed by a gynecology specialist to ensure a correct diagnosis and improve nurses training.No maternal deaths were reported within the intervention group, versus five cases in the control group. Regarding neonatal deaths, official data revealed a 64 % reduction for neonatal mortality. A 37 % prevalence of anemia was detected. Non-urgent referral was recommended to 70 pregnancies, being fetal (...) malpresentation the main reported cause.Impact data on maternal mortality (reduction to zero) and neonatal mortality (NMR was reduced to 36 %) are encouraging, although we are aware of the limitations of the study related to possible biasing and the small sample size. The major reduction of maternal and neonatal mortality provides promising prospects for these low-cost diagnostic procedures, which allow to provide high quality prenatal care in isolated rural communities of developing countries.This research

2016 Reproductive health

99. Repair of Lateral And Mediolateral Episiotomy

: Risk factor of trauma eg; macrosomia, congenital fetal malformations as (exophthalmous major, hydrocephalus, spinal cord teratoma….etc. Instrumental delivery. Primipara refuses to be in the study. Other techniques of episiotomy. Preterm onset of labour. Indication for CS eg; CPD, malposition and malpresentation, fetal distress….etc. Use of epidural analgesics. Factors affecting wound healing eg;DM, corticosteroid therapy, chronic debilitating diseases…etc. Contacts and Locations Go to Information

2016 Clinical Trials

100. Virtual Reality Analgesia in Labor: The VRAIL Pilot Study

risk pregnancy without obstetric complications In first stage of labor for vaginal delivery Desires non-pharmacologic alternative for pain control Exclusion Criteria: Younger than 18 or older than 45 years of age Presence of fetal or placental anomaly High risk pregnancy or anesthetic concerns (BMI>40, difficult airway, hemorrhage, nonreassuring FHR, malpresentation) Current use of pharmacologic analgesia including neuraxial anesthesia Not capable of answering study measures using numeric rating

2016 Clinical Trials

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