The relation between head circumference and mid pelvic circumference: A simple index for cephalo-pelvic disproportion evaluation

2021 ◽  
Author(s):  
Gad Liberty ◽  
Ofer Gemer ◽  
Irena Siyanov ◽  
Eyal Y. Anteby ◽  
Alona Apter ◽  
...  
Keyword(s):  
Head Circumference ◽  
Odds Ratio ◽  
Proof Of Concept ◽  
Fetal Head ◽  
Simple Index ◽  
Bony Pelvis ◽  
Cesarean Deliveries ◽  
Simple Tool ◽  
Vaginal Deliveries ◽  
Concept Evaluation

Introduction: Cephalo-pelvic-disproportion (CPD) is one of the most common obstetric complications. Since CPD is the disproportion between the fetal head and maternal bony pelvis, evaluation of the head-circumference (HC) relative to maternal bony pelvis may be a useful adjunct to pre-labor CPD evaluation. The aim of the present study was a proof-of-concept evaluation of the ratio between HC to pelvic circumference (PC) as a predictor of CPD. Methods: Of 11,822 deliveries, 104 cases that underwent an abdomino-pelvic CT for any medical indication and who underwent normal vaginal deliveries (NVD) (n=84) or cesarean deliveries (CD) due to CPD (n=20) were included retrospectively. Maternal pelvis dimensions were reconstructed and neonatal HC, as a proxy for fetal HC, were measured. The correlation between cases of CPD and Cephalo-Pelvic Circumference Index (CPCI), which represents the ratio between the HC and PC in percent (HC/PC *100) was evaluated. Results: The mid-pelvis cephalo-pelvic circumference index (MP-CPCI) was larger in CD groups as compared to the NVD group: 103±11 vs. 97±8% respectively (p=0.0003). In logistic regression analysis, the MP-CPCI was found to be independently associated with CD due to CPD: each 1% increase in MP-CPCI increased the likelihood of CD for CPD by 11% (aOR 1.11, CI 95% 1.03-1.19, p=0.004). The adjusted odds ratio for CD due to CPD increased incrementally as the MP-CPCI increased, from 3.56 (95%CI, 1.01-12.6) at MP-CPCI of 100, to 5.6 (95%CI, 1.63-19.45) at 105, 21.44 (95%CI, 3.05-150.84) at 110, and 28.88 (95%CI, 2.3-362.27) at MP-CPCI of 115 Conclusions: The MP-CPCI, representing the relative dimensions of the fetal HC and maternal PC, is a simple tool that can potentially distinguish between parturients at lower and higher risk of CPD. Prospective randomized studies are required to evaluate the feasibility of prenatal pelvimetry and MP-CPCI to predict the risk of CPD during labor.

EFFECTS OF INONIZING RADIATION CAUSED HEAT STRESS ON THE HUMAN BODY FOR STANDARD ISO 7243

2013 ◽  
pp. 47-57
Author(s):  
Van Trong Le ◽  
Thi Tuyet Mai Nguyen ◽  
Thi Xuan Duyen Nguyen ◽  
Ba Luan Nguyen ◽  
Tuyen Pham ◽  
...  
Keyword(s):  
Heat Stress ◽  
Risk Assessments ◽  
Management Systems ◽  
Temperature Index ◽  
Wet Bulb Globe Temperature ◽  
Simple Index ◽  
Simple Tool ◽  
Results Management ◽  
Globe Temperature ◽  
Hot Environments

Objectives: Presents heat stress Standard ISO 7243, which is based upon the wet bulb globe temperature index (WBGT), and considers its suitability for use worldwide. Materials and Methods: The WBGT index are considered and how it is used in ISO 7243 and across the world as a simple index for monitoring and assessing hot environments. Results: Management systems, involving risk assessments, that take account of context and culture, are required to ensure successful use of the standard and global applicability. For use outdoors, a WBGT equation that includes solar absorptivity is recommended. A ‘clothed WBGT’ is proposed to account for the effects of clothing. Conclusion: ISO 7243 is a simple tool to assess the heat stress and may be applicated worldwide.

scholarly journals Laparoscopic augmented reality registration for oncological resection site repair

2021 ◽  
Author(s):  
Fabian Joeres ◽  
Tonia Mielke ◽  
Christian Hansen
Keyword(s):  
Augmented Reality ◽  
Time Pressure ◽  
Tumour Resection ◽  
Anatomical Landmarks ◽  
Proof Of Concept ◽  
Registration Accuracy ◽  
Target Registration Error ◽  
Concept Evaluation ◽  
Navigation Support ◽  
Challenges And Opportunities

Abstract Purpose Resection site repair during laparoscopic oncological surgery (e.g. laparoscopic partial nephrectomy) poses some unique challenges and opportunities for augmented reality (AR) navigation support. This work introduces an AR registration workflow that addresses the time pressure that is present during resection site repair. Methods We propose a two-step registration process: the AR content is registered as accurately as possible prior to the tumour resection (the primary registration). This accurate registration is used to apply artificial fiducials to the physical organ and the virtual model. After the resection, these fiducials can be used for rapid re-registration (the secondary registration). We tested this pipeline in a simulated-use study with $$N=18$$ N = 18 participants. We compared the registration accuracy and speed for our method and for landmark-based registration as a reference. Results Acquisition of and, thereby, registration with the artificial fiducials were significantly faster than the initial use of anatomical landmarks. Our method also had a trend to be more accurate in cases in which the primary registration was successful. The accuracy loss between the elaborate primary registration and the rapid secondary registration could be quantified with a mean target registration error increase of 2.35 mm. Conclusion This work introduces a registration pipeline for AR navigation support during laparoscopic resection site repair and provides a successful proof-of-concept evaluation thereof. Our results indicate that the concept is better suited than landmark-based registration during this phase, but further work is required to demonstrate clinical suitability and applicability.

scholarly journals Pregnancy outcomes in women with preexisting thyroid diseases: a French cohort study

2020 ◽  
pp. 1-10
Author(s):  
Marion Lecorguillé ◽  
Juliane Léger ◽  
Anne Forhan ◽  
Marie Cheminat ◽  
Marie-Noëlle Dufourg ◽  
...  
Keyword(s):  
Thyroid Hormone ◽  
Gestational Diabetes ◽  
Head Circumference ◽  
Thyroid Diseases ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Fetal Head ◽  
History Of ◽  
Multivariable Regression ◽  
Multivariable Regression Models

Abstract Women with thyroid diseases at the beginning of pregnancy may have suboptimal thyroid hormone levels because of potential difficulties in compensating for the physiological thyroid hormone changes occurring in pregnancy. Our objective was to study the association between preexisting thyroid diseases, pregnancy complications, and neonatal anthropometry. In total, 16,395 women from the ELFE French longitudinal birth cohort were included, and 273 declared pre-pregnancy thyroid diseases. Associations were investigated with multivariable regression models, with adjustment for relevant potential confounders. Body mass index (BMI) was additionally adjusted for in a second stage. As compared with other women, women with pre-pregnancy thyroid diseases were more frequently obese (19.6% vs. 9.8%) and had greater odds of gestational diabetes development (odds ratio [OR] = 1.58 [95% confidence interval [CI] 1.08, 2.30]) or had undergone treatment for infertility (OR = 1.57 [95% CI 1.07, 2.31]). After adjustment for BMI, the association with gestational diabetes was no longer significant (OR = 1.27 [95% CI 0.86, 1.88]). After excluding women with another medical history, those with pre-pregnancy thyroid diseases had increased odds of premature rupture of membranes (OR = 1.51 [95% CI 1.01, 2.25]). Children born from mothers with hypothyroidism before conception due to a disease or as a potential side effect of treatment had a smaller head circumference at birth than other children (β = −0.23 [95% CI −0.44, −0.01] cm). In conclusion, pre-pregnancy thyroid diseases were associated with risk of infertility treatment, gestational diabetes, and premature rupture of membranes. The association between history of hypothyroidism and moderate adverse effects on fetal head circumference growth needs replication.

scholarly journals Maternal bisphenol urine concentrations, fetal growth and adverse birth outcomes: A population-based prospective cohort

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Chalana M. Sol ◽  
Charissa van Zwol - Janssens ◽  
Elise M. Philips ◽  
Alexandros G. Asimakopoulos ◽  
Maria-Pilar Martinez-Moral ◽  
...  
Keyword(s):  
Birth Outcomes ◽  
Fetal Growth ◽  
Head Circumference ◽  
Lower Risk ◽  
First Trimester ◽  
Population Based ◽  
Third Trimester ◽  
Bisphenol S ◽  
Fetal Head ◽  
Urine Concentrations

Abstract Background Exposure to bisphenols may affect fetal growth and development. The trimester-specific effects of bisphenols on repeated measures of fetal growth remain unknown. Our objective was to assess the associations of maternal bisphenol urine concentrations with fetal growth measures and birth outcomes and identify potential critical exposure periods. Methods In a population-based prospective cohort study among 1379 pregnant women, we measured maternal bisphenol A, S and F urine concentrations in the first, second and third trimester. Fetal head circumference, length and weight were measured in the second and third trimester by ultrasound and at birth. Results An interquartile range increase in maternal pregnancy-averaged bisphenol S concentrations was associated with larger fetal head circumference (difference 0.18 (95% confidence interval (CI) 0.01 to 0.34) standard deviation scores (SDS), p-value< 0.05) across pregnancy. When focusing on specific critical exposure periods, any detection of first trimester bisphenol S was associated with larger second and third trimester fetal head circumference (difference 0.15 (95% CI 0.05 to 0.26) and 0.12 (95% CI 0.02 to 0.23) SDS, respectively) and fetal weight (difference 0.12 (95% CI 0.02 to 0.22) and 0.16 (95% CI 0.06 to 0.26) SDS, respectively). The other bisphenols were not consistently associated with fetal growth outcomes. Any detection of bisphenol S and bisphenol F in first trimester was also associated with a lower risk of being born small size for gestational age (Odds Ratio 0.56 (95% CI 0.38 to 0.74) and 0.55 (95% CI 0.36 to 0.85), respectively). Bisphenols were not associated with risk of preterm birth. Conclusions Higher maternal bisphenol S urine concentrations, especially in the first trimester, seem to be related with larger fetal head circumference, higher weight and a lower risk of being small size for gestational age at birth.

Prenatal Sonographic Head Circumference and Cerebral Ventricle Width Measurements Before and After Open Fetal Myelomeningocele Repair – Prediction of Shunting During the First Year of Life

2018 ◽  
Vol 41 (05) ◽  
pp. 544-549 ◽  
Author(s):  
Ladina Vonzun ◽  
Franziska Maria Winder ◽  
Martin Meuli ◽  
Ueli Moerlen ◽  
Luca Mazzone ◽  
...  
Keyword(s):  
Head Circumference ◽  
Predictive Accuracy ◽  
False Positive Rate ◽  
Roc Curves ◽  
First Year ◽  
Fetal Head ◽  
Fetal Diagnosis ◽  
Before And After ◽  
Width Measurements ◽  
First Year Of Life

Abstract Purpose The aim of this study was to describe the sonographic evolution of fetal head circumference (HC) and width of the posterior horn of the lateral ventricle (Vp) after open fetal myelomeningocele (fMMC) repair and to assess whether pre- or postoperative measurements are helpful to predict the need for shunting during the first year of life. Patients & Methods All 30 children older than one year by January 2017 who previously had fMMC repair at the Zurich Center for Fetal Diagnosis and Therapy were included. Sonographic evolution of fetal HC and Vp before and after fMMC repair was assessed and compared between the non-shunted (N = 16) and the shunted group (N = 14). ROC curves were generated for the fetal HC Z-score and Vp in order to show their predictive accuracy for the need for shunting until 1 year of age. Results HC was not an independent factor for predicting shunting. However, the need for shunting was directly dependent on the preoperative Vp as well as the Vp before delivery. A Vp > 10 mm at evaluation for fMMC repair or > 15 mm before delivery identifies 100 % of the infants needing shunt placement at a false-positive rate of 44 % and 25 %, respectively. All fetuses with a Vp > 15 mm at first evaluation received a shunt. Conclusion Fetuses demonstrating a Vp of > 15 mm before in utero MMC repair are extremely likely to develop hydrocephalus requiring a shunt during the first year of life. This compelling piece of evidence must be appropriately integrated into prenatal counseling.

scholarly journals Sonographic large fetal head circumference and risk of cesarean delivery

2018 ◽  
Vol 218 (3) ◽  
pp. 339.e1-339.e7 ◽  
Author(s):  
Michal Lipschuetz ◽  
Sarah M. Cohen ◽  
Ariel Israel ◽  
Joel Baron ◽  
Shay Porat ◽  
...  
Keyword(s):  
Cesarean Delivery ◽  
Head Circumference ◽  
Fetal Head

scholarly journals Development of a Simple Index to Measure Overuse of Diagnostic Testing at the Hospital Level Using Administrative Data

2021 ◽  
Vol 16 (2) ◽  
pp. 77-83 ◽  
Author(s):  
Michael I Ellenbogen ◽  
Laura Prichett ◽  
Pamela T Johnson ◽  
Daniel J Brotman
Keyword(s):  
Administrative Data ◽  
Internal Consistency ◽  
Odds Ratio ◽  
Diagnostic Testing ◽  
Temporal Stability ◽  
County Level ◽  
Hospital Level ◽  
Physician Reimbursement ◽  
Simple Index ◽  
Cost Metrics

OBJECTIVE: We developed a diagnostic overuse index that identifies hospitals with high levels of diagnostic intensity by comparing negative diagnostic testing rates for common diagnoses. METHODS: We prospectively identified candidate overuse metrics, each defined by the percentage of patients with a particular diagnosis who underwent a potentially unnecessary diagnostic test. We used data from seven states participating in the State Inpatient Databases. Candidate metrics were tested for temporal stability and internal consistency. Using mixed-effects ordinal regression and adjusting for regional and hospital characteristics, we compared results of our index with three Dartmouth health service area-level utilization metrics and three Medicare county-level cost metrics. RESULTS: The index was comprised of five metrics with good temporal stability and internal consistency. It correlated with five of the six prespecified overuse measures. Among the Dartmouth metrics, our index correlated most closely with physician reimbursement, with an odds ratio of 2.02 (95% CI, 1.11-3.66) of being in a higher tertile of the overuse index when comparing tertiles 3 and 1 of this Dartmouth metric. Among the Medicare county-level metrics, our index correlated most closely with standardized costs of procedures per capita, with an odds ratio of 2.03 (95% CI, 1.21-3.39) of being in a higher overuse index tertile when comparing tertiles 3 and 1 of this metric. CONCLUSIONS: We developed a novel overuse index that is preliminary in nature. This index is derived from readily available administrative data and shows some promise for measuring overuse of diagnostic testing at the hospital level.

scholarly journals Accuracy of ultrasonic fetal weight estimation using head and abdominal circumference and femur length

2005 ◽  
Vol 58 (11-12) ◽  
pp. 548-552 ◽  
Author(s):  
Ljiljana Mladenovic-Segedi ◽  
Dimitrije Segedi
Keyword(s):  
Birth Weight ◽  
Head Circumference ◽  
Fetal Weight ◽  
Abdominal Circumference ◽  
Weight Estimation ◽  
Fetal Head ◽  
Total Body Mass ◽  
Femur Length ◽  
Fetal Weight Estimation ◽  
Gynecology And Obstetrics

Introduction Former investigations have shown that the accuracy of fetal weight estimation is significantly higher if several ultrasonic fe?tal parameters are measured, because the total body mass depends on the size of fetal head, abdominal circumference and femur length. The aim of this investigation was to establish the best regression model, that is a number of combinations of fetal parameters providing the most accurate fetal weight estimation in utero in our population. Material and methods This prospective study was carried out at the Gynecology and Obstetrics Clinic of the Clinical Center Novi Sad. It included 270 pregnant women with singleton pregnancies within 72 hours of delivery who underwent ultrasound measurements of the biparietal diameter (BPD), head circumference (HC), ab?dominal circumference (AC) and femur length (FL). Results In regard to fetal weight estimation formulas, the deviation was lowest using regression models that simultaneously analyzed four fetal parameters (0.55%) with SD ?7.61%. In these models the estimates of fetal weights were within ?5% of actual birth weight in 48.89%, and within ?10% of actual birth weight in 81.48%. Good results were also obtained using AC, FL measurements (0.92% ? 8.20) as well as using AC, HC, FL measurements (-1.45% ? 7.81). In our sample the combination of AC and FL model gave better results in fetal weight estimation (0.92 ? 8.20%) than the one using BPD and AC (2.97 ? 8.83%). Furthermore, the model using parameters AC, HC and FL showed a lower error in accuracy (-1.45 ? 7.81%) than the model using BPD, AC and FL (2.51 ? 7.82%). Conclusion This investigation has confirmed that the accuracy of fetal weight estimation increases with the number of measured ultra?sonic fetal parameters. In our population the greatest accuracy was obtained using BPD, HC, AC and FL model. In cases when fast estimation of fetal weight is needed, AC, HC, FL model may be appropriate, but if fetal head circumference cannot be measured (amnion rupture and/or fetal head already in the pelvis) the AC, FL model should be used.

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