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Umbilical Cord Prolapse

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161. Management of calcium channel blocker overdose in the emergency department

this: Like Loading... Published A simplified approach to the initial assessment and management of emergency department patients with umbilical cord prolapse Share this: Like this: Like Loading... Published A simplified approach to the initial assessment and management of emergency department patients with massive hemoptysis Share this: Like this: Like Loading... Leave a Reply 2 thoughts on “ Management of calcium channel blocker overdose in the emergency department ” Dr. Dani August 4, 2015, Very helpful

2015 First10EM

162. Vasa Previa

previa must be distinguished from funic presentation (prolapse with the umbilical cord between the presenting part and the internal cervical os), in which fetal blood vessels wrapped with Wharton jelly can be seen covering the cervix. In funic presentation, unlike in vasa previa, the umbilical cord moves away from the cervix during ultrasound evaluation; in vasa previa, the cord is fixed in place. Treatment Antenatal monitoring to detect cord compression Cesarean delivery Antenatal management of vasa (...) of Placenta Previa SOCIAL MEDIA Add to Any Platform Loading , MD, Main Line Health System Click here for Patient Education NOTE: This is the Professional Version. CONSUMERS: Topic Resources Vasa previa occurs when membranes that contain fetal blood vessels connecting the umbilical cord and placenta overlie the internal cervical os. Vasa previa can occur on its own (see Figure: ) or with placental abnormalities, such as a velamentous cord insertion. In velamentous cord insertion, vessels from the umbilical

2013 Merck Manual (19th Edition)

163. Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-be

weeks 0 days project EGA. Biospecimen Retention: Samples With DNA Blood serum, blood plasma, maternal deoxyribonucleic acid (DNA), urine supernatant, urine cell pellet, cervico-vaginal fluid, bacterial vaginosis (BV) slide, cord blood (fetal DNA), cord blood serum, placenta, fetal membranes, umbilical cord segment, placenta and umbilical cord, chorionic villi and maternal decidua from clinical chorionic villus sampling (CVS), amniotic fluid supernatant and cell pellet from clinical amniocentesis (...) Premature Rupture of the Membranes (preterm PROM) OR fetal membrane prolapse, regardless of subsequent labor augmentation or cesarean delivery. Indicated preterm birth [ Time Frame: 42 weeks project estimated gestational age or less ] Delivery following induction or cesarean delivery at less than 37 weeks 0 days gestation for one or more conditions that the woman's caregiver determines to threaten the health/life of the mother or fetus. The primary diagnoses associated with indicated preterm birth

2011 Clinical Trials

164. Eating disorder (Full text)

a at birth increase the risk factor for developing either anorexia nervosa or bulimia nervosa. Some of this developmental risk as in the case of placental infarction, maternal anemia and cardiac problems may cause , umbilical cord occlusion or cord prolapse may cause , resulting in cerebral injury, the in the and is highly susceptible to damage as a result of oxygen deprivation which has been shown to contribute to , , and may affect personality traits associated with both eating disorders and comorbid

2012 Wikipedia PubMed abstract

165. Coffin birth

case in which it could be concluded that coffin birth had occurred based on the position of the bodies and the clear attachment of the umbilical cord to the un-expelled placenta. In 2019, the autopsy reports in the case of the in August 2018 revealed that Shanann Watts (who had been 15 weeks pregnant at the time of her murder) had been found in a shallow grave and that the fetus had been expelled from her body, along with the placenta and umbilical cord. [ ] Bioarchaeology [ ] Postmortem fetal (...) of the mother by the umbilical cord. The primary cause of the delivery was the otherwise normal contractions, which had begun before death, and was therefore not related to processes of decomposition. While this is not postmortem fetal extrusion, it may be referred to as a case of postmortem delivery , a term which is applied to a broad range of techniques and phenomena with a resultant delivery of a live infant. In 2008, in Germany, a 23-year-old woman in her third was involved in a motor vehicle accident

2012 Wikipedia

166. Study of Cerebrolysin for Treatment of Infants With History of Neonatal Hypoxic Ischemic Encephalopathy

onset of encephalopathy, and multisystem organ dysfunction with exclusion of other possible causes for findings. Criteria of neonatal asphyxia: Full term neonate more than 36 weeks of gestation pH of 7.0 or less or a base deficit of 16 mmol per liter or more in a sample of umbilical-cord blood or any blood during the first hour after birth. If, during this interval, a pH is between 7.01 and 7.15, a base deficit is between 10 and 15.9 mmol per liter, or a blood gas is not available, additional (...) criteria are required. These includes an acute perinatal event (e.g., late or variable decelerations, cord prolapse, cord rupture, uterine rupture, maternal trauma, hemorrhage, or cardiorespiratory arrest) and either a 10-minute Apgar score of 5 or less or assisted ventilation initiates at birth and continues for at least 10 minutes. Criteria of neonatal encephalopathy according to Sarnat and Sarnat. Presence of one or more signs in at least three of the following six categories: level of consciousness

2010 Clinical Trials

167. Comparison of transverse and vertical skin incision for emergency cesarean delivery. (Full text)

analysis was limited to emergent procedures, defined as those performed for cord prolapse, abruption, placenta previa with hemorrhage, nonreassuring fetal heart rate tracing, or uterine rupture. Incision-to-delivery intervals, incision-to-closure intervals, and maternal outcomes were compared by skin-incision type (transverse compared with vertical) after stratifying for primary compared with repeat singleton cesarean delivery. Neonatal outcomes were compared by skin-incision type.Of the 37,112 live (...) with 43 minutes, P<.001) and 4 minutes in repeat cesarean deliveries (56 compared with 52 minutes, P<.001). Neonates delivered through a vertical incision were more likely to have an umbilical artery pH of less than 7.0 (10% compared with 7%, P=.02), to be intubated in the delivery room (17% compared with 13%, P=.001), or to be diagnosed with hypoxic ischemic encephalopathy (3% compared with 1%, P<.001).In emergency cesarean deliveries, neonatal delivery occurred more quickly after a vertical skin

2010 Obstetrics and Gynecology PubMed abstract

168. Labor outcomes after Shirodkar cerclage. (Abstract)

was 18.8%, with the majority (9 of 13) being for fetal indications. Two (2.9%) patients had a uterine rupture of an unscarred uterus and 2 (2.9%) patients had an umbilical cord prolapse. Four (5.8%) patients had a cervical laceration requiring repair.Patients with a Shirodkar cerclage placed and removed during the index pregnancy appear to have a higher than expected rate of cesarean delivery for fetal indications and complications associated with significant neonatal morbidity including uterine (...) rupture and cord prolapse.

2009 Journal of Reproductive Medicine

169. Retrospective cohort study of diagnosis-delivery interval with umbilical cord prolapse: the effect of team training. (Abstract)

Retrospective cohort study of diagnosis-delivery interval with umbilical cord prolapse: the effect of team training. To determine whether the introduction of multi-professional simulation training was associated with improvements in the management of cord prolapse, in particular, the diagnosis-delivery interval (DDI).Retrospective cohort study.Large tertiary maternity unit within a University Hospital in the United Kingdom.All cases of cord prolapse with informative case record: 34 pre-training (...) , 28 post-training.Review of hospital notes and software system entries; comparison of quality of management for umbilical cord prolapse pre-training (1993-99) and post-training (2001-07).Diagnosis-delivery interval; proportion of caesarean section (CS) in whom actions were taken to reduce cord compression; type of anaesthesia for CS births; rate of low (<7) 5-minute Apgar scores; rate of admission to neonatal intensive care unit (NICU) (if birthweight >2500 g).After training

2009 BJOG

170. Inducing labour

attempt to induce labour (the timing should depend on the clinical situation and the woman's wishes) caesarean section (refer to 'Caesarean section' [NICE clinical guideline 13]). 1.7.2.4 For women who choose caesarean section after a failed induction, recommendations in 'Caesarean section' (NICE clinical guideline 13) should be followed. 1.7.3 1.7.3 Cord prolapse Cord prolapse 1.7.3.1 T o reduce the likelihood of cord prolapse, which may occur at the time of amniotomy, the following precautions (...) should be taken: Before induction, engagement of the presenting part should be assessed. Obstetricians and midwives should palpate for umbilical cord presentation during the preliminary vaginal examination and avoid dislodging the baby's head. Amniotomy should be avoided if the baby's head is high. 1.7.3.2 Healthcare professionals should always check that there are no signs of a low- lying placental site before membrane sweeping and before induction of labour. 1.7.4 1.7.4 Uterine rupture Uterine

2008 National Institute for Health and Clinical Excellence - Clinical Guidelines

171. Postnatal care up to 8 weeks after birth

and lung sounds abdomen; check shape and palpate to identify any organomegaly; also check condition of umbilical cord genitalia and anus; check for completeness and patency and undescended testes in males Postnatal care up to 8 weeks after birth (CG37) © NICE 2018. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 28 of 63spine; inspect and palpate bony structures and check integrity of the skin skin; note colour and texture as well (...) or medicated wipes be used. The only cleansing agent suggested, where it is needed, is a mild non-perfumed soap. [2006] [2006] 1.4.24 Parents should be advised how to keep the umbilical cord clean and dry and that antiseptics should not be used routinely. [2006] [2006] Thrush Thrush 1.4.25 If thrush is identified in the baby, the breastfeeding woman should be offered information and guidance about relevant hygiene practices. [2006] [2006] 1.4.26 Thrush should be treated with an appropriate antifungal

2006 National Institute for Health and Clinical Excellence - Clinical Guidelines

172. Fetal Health Surveillance: Antepartum & Intrapartum Consensus Guideline

to prompt delivery, depending upon the overall clinical situation. (III-C) Recommendation 13: Fetal Scalp Blood Sampling 1. Where facilities and expertise exist, fetal scalp blood sampling for assessment of fetal acid–base status is recommended in women with “atypical/abnormal” fetal heart tracings at gestations > 34 weeks when delivery is not imminent, or if digital fetal scalp stimulation does not result in an acceleratory fetal heart rate response. (III-C) Recommendation 14: Umbilical Cord Blood (...) Gases 1. Ideally, cord blood sampling of both umbilical arterial and umbilical venous blood is recommended for ALL births, for quality assurance and improvement purposes. If only one sample is possible, it should preferably be arterial. (III-B) 2. When risk factors for adverse perinatal outcome exist, or when intervention for fetal indications occurs, sampling of arterial and venous cord gases is strongly recommended. (I-insufficient evidence. See Table 1). Recommendation 15: Fetal Pulse Oximetry 1

2008 British Columbia Perinatal Health Program

173. Birth imminent (normal delivery and delivery complications)

the receiving hospital. 2 When placing the Alert Call Control will advise you of the local arrangements for units receiving distressed neonates where this is not the Obstetric Unit. 2. Maternal Seizures Refer to Pregnancy Induced Hypertension (including pre-eclampsia) Birth Imminent (normal delivery and delivery complications) Page 4 of 9 October 2006 Obstetrics and Gynaecological Emergencies Obstetrics & Gynaecological Emergencies3. Prolapsed Umbilical Cord This is an EXTREME EMERGENCY that requires (...) rather than the baby’s head. Cord prolapse is more common with a breech presentation (refer to note 3 – prolapsed umbilical cord). In the case of a known breech presentation the mother should be transported to the BOOKED OBSTETRIC UNIT unless birth is in progress. The mother should be constantly re-assessed en-route and the appropriate action taken should the circumstances change. If birth is in progress treat as for a normal delivery except for the following points: ? If the mother is on the bed

2006 Joint Royal Colleges Ambulance Liaison Committee

174. Obstetrics/Gynaecology - birth imminent-normal delivery/delivery complications

the receiving hospital. 2 When placing the Alert Call Control will advise you of the local arrangements for units receiving distressed neonates where this is not the Obstetric Unit. 2. Maternal Seizures Refer to Pregnancy Induced Hypertension (including pre-eclampsia) Birth Imminent (normal delivery and delivery complications) Page 4 of 9 October 2006 Obstetrics and Gynaecological Emergencies Obstetrics & Gynaecological Emergencies3. Prolapsed Umbilical Cord This is an EXTREME EMERGENCY that requires (...) rather than the baby’s head. Cord prolapse is more common with a breech presentation (refer to note 3 – prolapsed umbilical cord). In the case of a known breech presentation the mother should be transported to the BOOKED OBSTETRIC UNIT unless birth is in progress. The mother should be constantly re-assessed en-route and the appropriate action taken should the circumstances change. If birth is in progress treat as for a normal delivery except for the following points: ? If the mother is on the bed

2007 Joint Royal Colleges Ambulance Liaison Committee

175. N-acetylcysteine in Intra-amniotic Infection/Inflammation

: up to 30 days ] early and late neonatal sepsis maternal and umbilical cord plasma antioxidant capacity [ Time Frame: up to 1 day ] plasma antioxidant capacity maternal and umbilical cord plasma N-acetylcysteine levels [ Time Frame: up to 1 day ] N-acetylcysteine levels umbilical cord levels of inflammatory cytokine concentrations [ Time Frame: up to 1 day ] pannel of pro and anti inflammatory cytokines funisitis grades [ Time Frame: up to 1 day ] histology maternal and umbilical cord blood (...) heart failure, history of asthma), maternal infection (HIV, hepatitis B or C), cord prolapse, known fetal malformation, allergic reactions to N-acetylcysteine, preeclampsia 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 ClinicalTrials.gov identifier (NCT number): NCT00397735 Locations Layout

2006 Clinical Trials

176. Comparison of obstetric outcomes between on-call and patients' own obstetricians. (Full text)

and 2001 at the Royal Victoria Hospital in Montréal. We excluded breech deliveries, elective cesarean sections and deliveries with placenta previa or prolapse of the umbilical cord. Logistic regression analysis was used to compare obstetric outcomes (e.g., cesarean delivery, instrumental vaginal delivery and episiotomy) between the regular-care and on-call obstetricians after adjustment for potential confounders.A total of 28,332 eligible deliveries were attended by 26 obstetricians: 21,779 (76.9

2007 Canadian Medical Association Journal PubMed abstract

177. Predictions for the decision-to-delivery interval for emergency cesarean sections in Norway. (Abstract)

interval variation was at patient level, not between departments. Several significant decision-to-delivery interval predictors were identified: 1. abruptio placentae (-54 min), umbilical cord prolapse (-37 min), and fetal stress (-35 min); 2. general anesthesia (versus regional) (-15 min), 3. cesarean sections performed during night-time (-10 min), 4. seniority of the surgeon (-6 min), and 5. cervical opening (for each cm: -6 min).The variance in the decision-to-delivery interval was mainly explained (...) by the different nature of the cesarean sections. The most important predictors, which all acted to reduce decision-to-delivery interval, were the three indications abruptio placentae, cord prolapse, and fetal stress. Sections performed during night-time had significantly reduced decision-to-delivery interval. The size of the maternal units as measured by number of deliveries per year was not a significant predictor.

2006 Acta Obstetricia et Gynecologica Scandinavica

178. Decision-to-incision times and maternal and infant outcomes. (Abstract)

procedures were defined as those performed for umbilical cord prolapse, placental abruption, placenta previa with hemorrhage, nonreassuring fetal heart rate pattern, or uterine rupture. Detailed information regarding maternal and neonatal outcomes, including the interval from the decision time to perform cesarean delivery to the actual skin incision, was collected.Of the 11,481 primary cesarean deliveries, 2,808 were performed for an emergency indication. Of these, 1,814 (65%) began within 30 minutes (...) of the decision to operate. Maternal complication rates, including endometritis, wound infection, and operative injury, were not related to the decision-to-incision interval. Measures of newborn compromise including umbilical artery pH less than 7 and intubation in the delivery room were significantly greater when the cesarean delivery was commenced within 30 minutes, likely attesting to the need for expedited delivery. Of the infants with indications for an emergency cesarean delivery who were delivered more

2006 Obstetrics and Gynecology

179. In situ Malone antegrade continence enema in 127 patients: a 6-year experience. (Abstract)

males. Average patient age at the time of surgery was 9.6 years (range 2.9 to 28.4). Diagnoses included myelomeningocele in 116 cases, lipomeningocele in 6, spinal cord injury in 2, posterior urethral valves in 1, sacral agenesis in 1 and functional constipation in 1.Cecal plication/imbrication was performed in 100 patients, appendix intussusception and imbrication in 24, and creation of tenia flaps in 3. The abdominal stoma was umbilical in 50 cases, right lower quadrant in 74 and periumbilical (...) in 3. Concomitant genitourinary reconstruction was performed in 87% of patients. Mean followup was 26.9 months (range 0.7 to 68.1). Fecal continence was reported by 91% of the patients. Thirteen stomal revisions (stenosis 10, prolapse 2 and leakage 1) were required in 11 patients. Major complications included a cecal volvulus requiring a right hemicolectomy in 1 patient, small bowel obstruction in 2, and shunt infection and/or malfunction in 2. Four patients have elected to no longer use the MACE

2004 Journal of Urology

180. Expectant management of preterm premature rupture of membranes and nonvertex presentation: what are the risks? (Abstract)

with vertex presentations (control group) comprised the 2 study groups. All patients that met the study admission criteria were treated in a similar manner at 1 of 3 level-III hospitals. The gestational ages at delivery of all patients were between 23-34 weeks, and the gestational ages between case and control patients were matched for gestational age.A statistically significant (P = .03) higher incidence of a prolapsed umbilical cord was found in the study group (n = 8; 10.8%) relative to the control (...) group (n = 1; 1.4%). More infants in the study group had low 5-minute Apgar scores (<5) and/or low cord pH (<7.20; n = 25 [33.8%]) than in the control group (n = 12 [16.2%]; P = .02). Five infants with breech presentations underwent a precipitous unplanned vaginal delivery. Significant morbidity was not detected in these 5 infants.After transfer to an antenatal ward, patients with PPROM with nonvertex presentations appear to have a significantly higher risk for prolapsed umbilical cords, lower Apgar

2007 American Journal of Obstetrics and Gynecology

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