1,698 results match your criteria Shoulder Dystocia

A Trial of labor after caesarean section with a macrosomic neonate. Is it safe?

Miriam Lopian

Am J Perinatol 2022 Jun 24. Epub 2022 Jun 24.

Objective: To determine whether a trial of labour after caesarean section (TOLAC) with a macrosomic neonate is associated with adverse outcomes. Methods A retrospective cohort study was conducted in a population motivated for TOLAC. Women attempting TOLAC with a neonatal birthweight >4000g were compared to women attempting TOLAC with neonatal birthweights between 3500g-4000g. Read More

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Vacuum-Assisted Delivery Complication Rates Based on Ultrasound-Estimated Fetal Weight.

J Clin Med 2022 Jun 17;11(12). Epub 2022 Jun 17.

Department of Obstetrics and Gynecology, Meir Medical Center, Kfar Saba 4428164, Israel.

This retrospective cohort study investigated the association between ultrasonographic estimated fetal weight (EFW) and adverse maternal and neonatal outcomes after vacuum-assisted delivery (VAD). It included women with singleton pregnancies at 34-41 weeks gestation, who underwent ultrasonographic pre-labor EFW and VAD in an academic institution, over 6 years. Adverse neonatal and maternal outcomes included shoulder dystocia, clavicular fracture, or third- and fourth-degree perineal tears. Read More

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Incidence changes in risk factors associated with the decreasing number of birth-related clavicle fractures in Finland: A nationwide retrospective birth cohort from 2004 to 2017.

Birth 2022 Jun 23. Epub 2022 Jun 23.

Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.

Background: A clavicle fracture is one of the most common birth injuries. The objective of this study was to examine whether the decreased incidence of birth-related clavicle fractures in Finland is because of temporal changes in their predisposing factors.

Methods: For this nationwide population-based study, we used the Finnish Medical Birth Register and the Care Register for Health Care databases. Read More

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Application of magnetic resonance neurography in neonatal brachial plexus injury: A case report and literature review.

Radiol Case Rep 2022 Aug 11;17(8):2859-2862. Epub 2022 Jun 11.

Department of Radiology, Baoding Children's Hospital, Baoding 071051, China.

Neonatal obstetric brachial plexus palsy is common in newborns with fetal macrosomia, especially those who are delivered vaginally with shoulder dystocia or breech delivery. The anatomical structure of brachial plexus in newborns is thin, and it is neither collinear nor coplanar in space; The location, the type and degree of neonatal brachial plexus injury need to be comprehensively judged by clinical history, neurological and imaging examination. Conventional MR imaging is not sufficient to diagnose brachial plexus injury. Read More

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Adverse pregnancy outcomes in non-diabetic patients with an elevated early pregnancy HbA1c.

Am J Perinatol 2022 Jun 16. Epub 2022 Jun 16.

Division of Maternal Fetal Medicine, Maternal Child Health Research Center, University of Pennsylvania Perelman School of Medicine, Philadelphia, United States.

Objective: To evaluate the impact of elevated early HbA1c values on perinatal outcomes in patients without a diagnosis of diabetes or gestational diabetes.

Study Design: This is a retrospective study of patients with a singleton pregnancy who underwent universal HbA1c screening in early pregnancy at an urban tertiary care center between December 1, 2016 and December 31, 2018. Patients with pregestational diabetes (DM) and gestational diabetes (GDM) were excluded from analysis. Read More

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Effects of high fidelity simulation model on midwives' shoulder dystocia management skills: An educational İntervention study.

Niger J Clin Pract 2022 Jun;25(6):773-778

Department of Midwifery, Faculty of Health Sciences, Manisa Celal Bayar University, Manisa, Turkey.

Background: Shoulder dystocia is an emergency and risky situation that most likely directly involves midwives.

Aim: The aim of this study is to determine the effects of simulation training with a high fidelity mannequin on midwives' shoulder dystocia management.

Subjects And Methods: This study utilized a quantitative, quasi-experimental research design. Read More

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Operative vaginal delivery: practice patterns and outcomes at a tertiary general hospital.

Singapore Med J 2022 06 16. Epub 2022 Jun 16.

Department of Obstetrics and Gynaecology, Singapore General Hospital, Singapore.

Introduction: There has been a global decrease in operative vaginal deliveries, with a marked shift towards the vacuum extractor. However, little is known about the trends in operative vaginal delivery in Singapore.

Methods: A retrospective study was conducted on all operative vaginal deliveries performed from 2012 to 2017 at Singapore General Hospital (SGH). Read More

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Antenatal Risk Score for Prediction of Shoulder Dystocia with Focus on Fetal Ultrasound Data.

Am J Obstet Gynecol 2022 Jun 10. Epub 2022 Jun 10.

Berlin Center for Diabetes and Pregnancy, Department for Obstetrics and Gynecology, St. Joseph Hospital, Berlin, Germany; Department for Obstetrics, Campus Virchow, Charité, Humboldt University, Berlin, Germany. Electronic address:

Background: Shoulder dystocia (SD) is one of the most threatening complications during delivery and though difficult to predict, the individual risk should be considered when counselling for mode of delivery.

Objective: The aim of the study was to develop and validate a risk score for SD based on fetal ultrasound and maternal data from 15.000 deliveries. Read More

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Selective versus routine use of episiotomy for vaginal births in Shanghai hospitals, China: a comparison of policies.

BMC Pregnancy Childbirth 2022 Jun 11;22(1):475. Epub 2022 Jun 11.

Department of Obstetrics and Gynecology, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, 200092, China.

Background: To assess the effects of policy of selective versus routine episiotomy on mother and baby for women delivering vaginally in Shanghai and whether the hospital type has any effect on the outcomes.

Method: This was a multi-center retrospective cohort study in Shanghai between March 2015 and May 2017. The study population were vaginal births with selective or routine episiotomy (n = 5478) in 20 secondary or tertiary hospitals. Read More

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Evaluation of the Effects on Uninfected Pregnant Women and Their Pregnancy Outcomes During the COVID-19 Pandemic in Beijing, China.

Front Med (Lausanne) 2022 11;9:842826. Epub 2022 May 11.

Beijing Key Laboratory for Genetics of Birth Defects, Beijing Pediatric Research Institute, Beijing, China.

Background: People's lifestyles may have changed during the COVID-19 pandemic, which may have a profound impact on pregnant women and newborns. This study aims to assess the effects of the COVID-19 pandemic on uninfected pregnant women and their newborns, including potential environmental factors.

Methods: We retrospectively analyzed the pregnancy complications of 802 cases in the pandemic group and 802 controls in the pre-pandemic group in a matched nested case-control study, and evaluated the association with sociodemographic features, lifestyles, and other factors in 311 pregnant women with adverse pregnancy outcomes. Read More

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Association Between Low-Dose Aspirin and Development of Gestational Diabetes: A Systematic Review and Meta-Analysis.

J Obstet Gynaecol Can 2022 May 28. Epub 2022 May 28.

Department of Obstetrics and Gynecology, Alpert Medical School, Brown University, Providence, Rhode Island. Electronic address:

Objective: To evaluate the association between the use of low-dose aspirin for preeclampsia prophylaxis and risks of gestational diabetes (primary outcome), neonatal hypoglycemia, macrosomia, large for gestational age, birth trauma, and shoulder dystocia (secondary outcomes).

Data Sources: We searched Ovid MEDLINE, Embase, CINAHL, and Cochrane/CENTRAL for studies published between January 1, 1989, and April 24, 2021.

Study Selection: Randomized controlled trials (RCTs) or cohort studies of any size conducted in any setting were included. Read More

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The Challenges of Treating Glucokinase MODY during Pregnancy: A Review of Maternal and Fetal Outcomes.

Int J Environ Res Public Health 2022 05 14;19(10). Epub 2022 May 14.

Diabetes, Endocrinology and Metabolic Disease Institute, Kaplan Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Rehovot 9190401, Israel.

Background: The optimal treatment strategy for the follow-up and management of women with glucokinase maturity-onset diabetes of the young (GCK-MODY)during pregnancy remains unknown. Data regarding maternal and fetal outcomes are lacking.

Aim: This paper summarizes the existing literature regarding the maternal and fetal outcomes of women with glucokinase MODY to guide future treatment strategy. Read More

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Gestational diabetes mellitus and adverse pregnancy outcomes: systematic review and meta-analysis.

BMJ 2022 05 25;377:e067946. Epub 2022 May 25.

Department of Neurosurgery, Xiangya Hospital, Central South University, Changsha, Hunan, China

Objective: To investigate the association between gestational diabetes mellitus and adverse outcomes of pregnancy after adjustment for at least minimal confounding factors.

Design: Systematic review and meta-analysis.

Data Sources: Web of Science, PubMed, Medline, and Cochrane Database of Systematic Reviews, from 1 January 1990 to 1 November 2021. Read More

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Derivation and assessment of a sex-specific fetal growth standard.

J Matern Fetal Neonatal Med 2022 May 22:1-9. Epub 2022 May 22.

Department of Obstetrics and Gynecology, University of Utah Health, Salt Lake City, UT, USA.

Purpose: To derive a prescriptive sex-specific fetal growth standard and assess clinical management and outcomes according to sex-specific growth status.

Materials And Methods: This was a secondary analysis of the Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-Be (nuMoM2b), a prospective observational study of 10,038 nulliparas from eight U.S. Read More

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Evaluation of obstetric management of women with macrosomic foetuses in two Level 3 maternity hospitals in France and identification of predictive factors for obstetric and neonatal complications.

Eur J Obstet Gynecol Reprod Biol 2022 Jul 13;274:34-39. Epub 2022 Apr 13.

CHU REIMS Maison Blanche, 45 Rue Cognacq Jay 51100 Reims, France.

Objective: Foetal macrosomia is associated with high maternal and neonatal morbidity; however, obstetric management of suspected macrosomia has not been well defined. This study aimed to analyse obstetric management in a population of women who delivered macrosomic new-borns and assess maternal and neonatal outcomes and risk factors for complications in such cases.

Study Design: This two-centre retrospective study conducted in France over a 10-year period comprised 1724 women who had delivered macrosomic new-borns (defined as those whose weight was > 90th percentile according to the Association of Users of Computerised Records in Perinatology, Obstetrics, and Gynaecology curve) from 37SA. Read More

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Accuracy of Fetal Biacromial Diameter and Derived Ultrasonographic Parameters to Predict Shoulder Dystocia: A Prospective Observational Study.

Int J Environ Res Public Health 2022 05 9;19(9). Epub 2022 May 9.

Obstetrics and Gynecology Unit, Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", 80128 Naples, Italy.

Background And Objectives: Shoulder dystocia (ShD) is one of most dangerous obstetric complication. The objective of this study was to determine if the ultrasonographic fetal biacromial diameter (BA) and derived parameters could predict ShD in uncomplicated term pregnancies.

Materials And Methods: We conducted a prospective observational study in a tertiary care university hospital from March 2021 to February 2022. Read More

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Effectiveness of Telemedicine in Managing Diabetes in Pregnancy: A Systematic Review and Meta-Analysis.

J Diabetes Sci Technol 2022 May 9:19322968221094626. Epub 2022 May 9.

Department of Health Science and Technology, Aalborg University, Aalborg, Denmark.

Background: Strict monitoring of blood glucose during pregnancy is essential for ensuring optimal maternal and neonatal outcomes. Telemedicine could be a promising solution for supporting diabetes management; however, an updated meta-analysis is warranted. This study assesses the effects of telemedicine solutions for managing gestational and pregestational diabetes. Read More

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Neonatal bilateral adrenal hemorrhage and adrenal insufficiency accompanied by Subgaleal hematoma: a case report with brief review of literature.

BMC Pediatr 2022 05 5;22(1):248. Epub 2022 May 5.

Department of Family Medicine, Ziaeian Hospital, Tehran University of Medical Sciences, Tehran, Iran.

Background: Neonatal adrenal hemorrhage (NAH) is an almost infrequent phenomenon (0.2-0.55%). Read More

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Human shoulder development is adapted to obstetrical constraints.

Proc Natl Acad Sci U S A 2022 04 11;119(16):e2114935119. Epub 2022 Apr 11.

Laboratory of Physical Anthropology, Graduate School of Science, Kyoto University, 606-8502 Kyoto, Japan.

In humans, obstetrical difficulties arise from the large head and broad shoulders of the neonate relative to the maternal birth canal. Various characteristics of human cranial development, such as the relatively small head of neonates compared with adults and the delayed fusion of the metopic suture, have been suggested to reflect developmental adaptations to obstetrical constraints. On the other hand, it remains unknown whether the shoulders of humans also exhibit developmental features reflecting obstetrical adaptation. Read More

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Brachial Plexus Birth Injuries.

Orthop Clin North Am 2022 Apr 5;53(2):167-177. Epub 2022 Mar 5.

Department of Orthopaedics, The Ohio State University Wexner Medical Center, 700 Children's Drive, T2E- A2700, Columbus, OH 43205, USA; Department of Orthopedic Surgery, Nationwide Children's Hopsital, Columbus, OH, USA. Electronic address:

Brachial plexus birth injuries (BPBIs) are typically traction type injuries to the newborn that occur during the delivery process. Although the incidence of these injuries has overall decreased from 1.5 to around 0. Read More

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Association of Glyburide and Subcutaneous Insulin With Perinatal Complications Among Women With Gestational Diabetes.

JAMA Netw Open 2022 03 1;5(3):e225026. Epub 2022 Mar 1.

Division of Research, Kaiser Permanente Northern California, Oakland.

Importance: Nearly 30% of individuals with gestational diabetes (GDM) do not achieve glycemic control with lifestyle modification alone and require medication treatment. Oral agents, such as glyburide, have several advantages over insulin for the treatment of GDM, including greater patient acceptance; however, the effectiveness of glyburide for the treatment of GDM remains controversial.

Objective: To compare the perinatal and neonatal outcomes associated with glyburide vs insulin using causal inference methods in a clinical setting with information on glycemic control. Read More

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Does predelivery BMI really matter in pregnancy?

Ginekol Pol 2022 Mar 24. Epub 2022 Mar 24.

Department of Perinatology and Gynecology, Poznan University od Medical Sciences, Poland.

Objectives: The aim of the study was to compare the perinatal outcome between the normal weight, overweight and obese pregnant women who delivered in the third-level center of reference. Moreover, the objective was to analyze the usefulness of predelivery body mass index (BMI) in prediction of preterm delivery, prolonged second stage of labor, instrumental vaginal delivery, cesarean section, fetal macrosomia, dystocia and newborn acidosis.

Material And Methods: The retrospective study included 2104 patients, divided into three groups, with BMI between 18. Read More

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Screening for late-onset gestational diabetes: Are there any clinical benefits?

BJOG 2022 Mar 19. Epub 2022 Mar 19.

Academic Department of Obstetrics and Gynaecology, Chelsea and Westminster Hospital, London, UK.

Objective: To determine whether screening for gestational diabetes mellitus (GDM) in the third trimester and managing those who are screen positive on a diabetes pathway affects obstetric and neonatal outcomes.

Design: Retrospective study of prospectively collected data.

Setting: London Teaching Hospital. Read More

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Is sonographic measurement of head-perineum distance useful to predict obstetrical anal sphincter injury in case of vacuum delivery?

Int J Gynaecol Obstet 2022 Mar 8. Epub 2022 Mar 8.

Department of Gynecology and Obstetrics, Poissy-Saint Germain Hospital, Poissy, France.

Objective: Determine if head-perineum distance (HPD) measurement before vacuum extraction (VE) was predictive of an obstetric anal sphincter injury (OASIS) occurrence.

Methods: Retrospective, bicentric (Lille and Poissy, France) cohort study conducted from January 2019 to June 2020. All VE in singleton pregnancies of ≥34 weeks were included. Read More

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Association of change in haemoglobin A1c with adverse perinatal outcomes in women with pregestational diabetes.

Diabet Med 2022 Jul 8;39(7):e14822. Epub 2022 Mar 8.

Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, The Ohio State University, Columbus, Ohio, USA.

Aims: To determine whether a net decline in glycosylated haemoglobin (HbA ) from early to late pregnancy is associated with lower risk of adverse perinatal outcomes at delivery among women with pregestational diabetes.

Methods: A retrospective analysis from 2012 to 2016 at a tertiary care centre. The exposure was the net change in HbA from early (<20 weeks gestation) to late pregnancy (≥20 weeks gestation). Read More

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Fetal Growth Biometry as Predictors of Shoulder Dystocia in a Low-Risk Obstetrical Population.

Am J Perinatol 2022 Mar 3. Epub 2022 Mar 3.

Epidemiology Branch, DIPHR, National Institute of Child Health and Human Development, Bethesda, United States.

Objective: To evaluate fetal biometrics as predictors of shoulder dystocia in a low-risk obstetrical population.

Study Design: Participants were enrolled as part of a U.S. Read More

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Fear of childbirth postpartum and its correlation with post-traumatic stress symptoms and quality of life among women with birth complications - a cross-sectional study.

Arch Womens Ment Health 2022 04 1;25(2):485-491. Epub 2022 Mar 1.

Department of Obstetrics and Gynecology in Norrköping, and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.

The primary aim of the study was to analyze differences in post-traumatic stress symptoms (PTSS) and quality of life (QoL) between women with and without severe fear of childbirth postpartum (PP FOC). The secondary aims were to analyze the correlation between PP FOC and PTSS, and PP FOC and QoL, in women undergoing complicated childbirth. This cross-sectional study was conducted in South-East Sweden. Read More

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Antenatal maternal hypoglycemia in women with gestational diabetes mellitus and neonatal outcomes.

J Perinatol 2022 Feb 22. Epub 2022 Feb 22.

Department of Obstetrics and Gynecology, Medical College of Wisconsin, 9200W. Wisconsin Ave, Milwaukee, WI, 53226, USA.

Objective: To examine the prevalence of antenatal maternal hypoglycemia after initiation of pharmacotherapy for gestational diabetes mellitus (GDMA2) and its association with pregnancy outcomes.

Study Design: Retrospective cohort of GDMA2 women receiving either insulin or oral hypoglycemic agents. Composite neonatal outcome included macrosomia, jaundice, respiratory distress syndrome, large for gestational age, shoulder dystocia, birth trauma, 5-minute Apgar < 7, and neonatal hypoglycemia, and was compared between women with and without hypoglycemia using bivariate and multivariate analyses. Read More

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February 2022

Shoulder dystocia: Updating some medico-legal issues.

Med Leg J 2022 Mar 14;90(1):13-16. Epub 2022 Feb 14.

Department of Obstetrics and Gynaecology; Department of Orthopaedics, University of Malta, Trauma and Sport Medicine.

Shoulder dystocia, or shoulder entrapment at birth, is an obstetrician's nightmare, which not infrequently leads to court litigation with complaints of serious foetal and/or maternal damage. Increasingly, retrospective management scrutiny is extending well beyond second stage birth mechanics and involving all case file entries, history taking, ultrasound scan measurements and haematology profile results, etc. The article highlights some medico-legal issues including the influence of the ruling on patient disclosure and subsequent management. Read More

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