Antenatal Diagnosis of Fetal Intracranial Anomalies

1989 ◽  
Vol 4 (1_suppl) ◽  
pp. S107-S112
Author(s):  
Hossam E. Fadel
Keyword(s):  
Cesarean Section ◽  
Obstetric Care ◽  
Fetal Distress ◽  
Management Options ◽  
Diagnostic Features ◽  
Pathologic Features ◽  
Fetal Malformations ◽  
The Central Nervous System ◽  
Investigational Procedure ◽  
Route Of Delivery

Defects in the central nervous system (CNS) are the most devastating of the various fetal malformations that can be sonographically diagnosed. The sonographer often initiates a decision-making process that presents the patient with difficult options. An accurate and reliable sonographic diagnosis becomes an essential part of this evolving aspect of obstetric care. In this paper, some of the major defects of the CNS that have been diagnosed sonographically are presented with a brief outline of the pathologic features, diagnostic features, the prognosis, as well as management options. Most of these malformations are serious enough so that termination of pregnancy is usually offered if the diagnosis is made prior to the age of viability and, for some malformations (ie, hydranencephaly, alobar holoprosencephaly), even later. Intrauterine treatment, principally ventriculoamniotic shunting, remains an investigational procedure. A diagnosis of a serious or lethal malformation allows the obstetrician to choose not to perform a cesarean section because of fetal distress or dystocia due to macrocephaly in such "doomed" fetuses. On the other hand, cesarean section may be the preferred route of delivery for fetuses with other malformations (eg, meningomyelocele). (J Child Neurol 1989;4:S107-S112).

scholarly journals Features of abdominal delivery in obstetric institutions of level III

2020 ◽  
Vol 27 (2) ◽  
pp. 49-58
Author(s):  
M. V. Galustyan ◽  
I. I. Kutsenko ◽  
I. O. Borovikov
Keyword(s):  
Cesarean Section ◽  
Maternal Care ◽  
Obstetric Care ◽  
Fetal Distress ◽  
Krasnodar Krai ◽  
Clinical Hospital ◽  
Medical Institutions ◽  
Complicated Pregnancy ◽  
Operative Activity ◽  
Abdominal Delivery

Aim. To evaluate and analyse features of abdominal delivery in maternal care institutions (level III) in Krasnodar Krai on the basis of M.S. Robson’ obstetric care criteria (2001) and indicators of cesarean section efficacy.Materials and methods. A retrospective study of archives from two Krasnodar Krai obstetric institutions (level III) (the perinatal centres of the Children’s Regional Clinical Hospital and the Regional Clinical Hospital No. 2) was carried out. The material for analysis was the number of births, surgery activity and perinatal mortality indicators (2017).Results. A comparative analysis of abdominal delivery in two leading perinatal centres of the Region revealed low levels of cesarean section efficacy. The monitoring of obstetric conditions, which had the greatest influence on the growth of abdominal delivery cases, was carried out using M.S. Robson’ system. It was revealed that the largest increase in abdominal delivery was observed in patients included in groups I and V.Conclusion. Despite the fact that the efficacy of abdominal delivery in Krasnodar Krai maternal care institutions (level III) is low, a detailed individualised analysis of indications for the performed surgical labour revealed obstetric practices (uterine scars, fetal distress, anomalies in labour), which increased the level of surgical activity. However, taking into account the specificity of indications for hospitalisation of patients in these medical institutions (severe extragenital pathology, complicated pregnancy), an increase in operative activity and low effectiveness of cesarean section are justified.

THE RELATIONSHIP OF AMNIOTIC FLUID VISCOSITY TO RESPIRATORY DISTRESS IN LAMBS

PEDIATRICS ◽  
1966 ◽  
Vol 38 (5) ◽  
pp. 858-864
Author(s):  
Arthur J. Moss ◽  
Ovidio Rettori ◽  
Norman S. Simmons
Keyword(s):  
Cesarean Section ◽  
Respiratory Distress ◽  
Amniotic Fluid ◽  
Fetal Distress ◽  
In Utero ◽  
Fluid Viscosity ◽  
Lung Expansion ◽  
Relationship Of ◽  
The Relationship ◽  
Length Of Gestation

The viscosity of amniotic fluid was measured in 52 ewes and the results correlated with the postnatal course of the lambs delivered by cesarean section. Viscosity was not related to length of gestation or to the immediate prepartum condition of the ewe, but a definite relationship was found between amniotic fluid viscosity (AFV) and the postnatal course of the fetus. Of 22 lambs considered viable, 9 failed to survive. In 10 of the 13 survivors, AFV was less than 1.6; whereas in the nonsurvivors, AFV varied between 1.6 and 4.4. All of the nonsurvivors experienced respiratory difficulty associated with copious amounts of extremely viscous secretions in the mouth and oropharynx. The substance responsible for the high AFV was a mucoprotein and was detectable in all samples with a viscosity of 1.24 or more but in none with a viscosity below 1.24. The data suggest the possibility that fetal distress may induce qualitative or quantitative alterations of fetal mucous secretions in utero which subsequently could impede lung expansion at birth.

scholarly journals Prelabour Rupture of Membranes: Mode of Delivery and Outcome

2015 ◽  
Vol 3 (2) ◽  
pp. 237-240 ◽  
Author(s):  
Vlora Ademi Ibishi ◽  
Rozalinda Dusan Isjanovska
Keyword(s):  
Cesarean Section ◽  
Mode Of Delivery ◽  
Neonatal Morbidity ◽  
Fetal Distress ◽  
Maternal Complications ◽  
Cephalopelvic Disproportion ◽  
Cesarean Section Delivery ◽  
Clinical Center ◽  
Failed Induction ◽  
The University

BACKGROUND: Pre-labour Rupture of Membranes (PROM) is an important cause of maternal and fetal morbidity and increased rate of cesarean section delivery. AIM: The aim of this study is to investigate the clinical characteristics, PROM-delivery interval, mode of delivery, and early maternal neonatal outcome among pregnant patients presenting with pre-labour rupture of membranes.MATERIAL AND METHODS: This prospective case control study is implemented at the Obstetric and Gynecology Clinic of the University Clinical Center of Kosovo. The study included 100 pregnant patients presenting with prelabour rupture of membranes of which 63 were primigravida and 37 patients were multigravida.RESULTS: The incidence of cesarean section in this study is 28 % and the most common indications for cesarean delivery were fetal distress, malpresentation, cephalopelvic disproportion, and failed induction. The most common maternal complications in this study are chorioamnionitis, retained placenta and postpartum hemorrhage. Neonatal infectious morbidity was present in 16 % of cases.CONCLUSION: PROM is a significant issue for obstetricians and an important cause of maternal and neonatal morbidity and increased rate of cesarean section delivery.

scholarly journals Fetal MRI vs. fetal ultrasound in the diagnosis of pathologies of the central nervous system

2021 ◽  
Vol 31 (Supplement_2) ◽  
Author(s):  
Inês Pimentel ◽  
João Costa ◽  
Óscar Tavares
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Corpus Callosum ◽  
Fetal Mri ◽  
Fetal Ultrasound ◽  
Fetal Malformations ◽  
Fetal Us ◽  
The Central Nervous System ◽  
Common Group ◽  
Magnetic Resonance Imaging Mri

Abstract Background Malformations of the central nervous system (CNS) constitute the 2nd most common group of fetal pathologies, which can be reflected throughout the patient's life. Fetal ultrasound (US), together with fetal magnetic resonance imaging (MRI) are extremely important techniques for the diagnosis of CNS malformations. The objective of this work was to address fetal US and fetal MRI, as well as the benefits of its use in different CNS pathologies and to ascertain which of the techniques presents better results. Methods For this systematic literature review, a search was conducted using databases such as PubMed® and ScienceDirect®, Google Scholar, b-on digital library, in a 10-year period, 2010 to 2020. 60 references were used, which met the inclusion criteria, namely compliance with the defined timeframe and the theme of the work to be addressed. Results As for the results, fetal US is the first-line technique for fetal evaluation, and its objective is to detect possible fetal malformations early, while fetal MRI complements the information collected through fetal US. When there are cases of isolated ventriculomegaly and complete agenesis of the corpus callosum, fetal US can correctly assess the pathology. When it comes to pathologies such as dysgenesis of the corpus callosum and malformations of the posterior fossa, fetal MRI evaluates more effectively in comparison to fetal US. Conclusions In conclusions, to reduce the number of false positives, the techniques should be used together, thus providing a better diagnosis.

scholarly journals Analysis of Cesarean Sections using Robson’s Ten Group Classification System

2021 ◽  
Vol 37 (2) ◽  
Author(s):  
Rashida Parveen ◽  
Mehnaz Khakwani ◽  
Anum Naz ◽  
Rabia Bhatti
Keyword(s):  
Cesarean Section ◽  
Classification System ◽  
Fetal Distress ◽  
Group Classification ◽  
Care Hospital ◽  
Cesarean Sections ◽  
Previous Cesarean Section ◽  
Group 10 ◽  
Group 5 ◽  
Previous Cesarean

Objective: To analyze trends of CSs and evaluating them according to Robson’s Ten Groups Classification System (TGCS) at a leading government tertiary care hospital of South Punjab, Pakistan. Methods: This cross-sectional study was conducted at Department of Obstetrics and Gynaecology, Nishtar Medical University Hospital, Multan Pakistan, from October 2019 to March 2020.The study population included a total of 167 women who underwent CS in the hospital during the specified study period. For each case, we collected data regarding maternal characteristics and pregnancy-related information. The dependent variable was Robson classification group. Results: Overall, mean age was 26.53+5.1 years. Majority of the women, 116 (69.5%) belonged to urban areas of residence, 74 (44.3%) gestational aged between 37-42 years while 108 (64.7%) had history of cesarean section. Most of the patients, 85 (50.9%) turned out to be from TGCS Group-10. Group-5 and Group-1 were the 2nd and 3rd most common group, accounted for 24 (14.4%) and 19 (11.4%) cases respectively. Previous cesarean section (20.4%) and fetal distress (19.8%) were found to be most common indications leading to cesarean section. Conclusion: As per Robson’s Ten-Group Classification, Group-10 and Group-5 were found to be the most contributing among deliveries done. Previous cesarean section and fetal distress were the most common indications of cesarean section. doi: https://doi.org/10.12669/pjms.37.2.3823 How to cite this:Parveen R, Khakwani M, Naz A, Bhatti R. Analysis of Cesarean Sections using Robson’s Ten Group Classification System. Pak J Med Sci. 2021;37(2):---------. doi: https://doi.org/10.12669/pjms.37.2.3823 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Primary Hemangioblastoma of Kidney with Molecular Analyses by Next Generation Sequencing: A Case Report and Review of the Literature

2021 ◽  
Author(s):  
Xintong Wang ◽  
George K Haines ◽  
Jane Houldsworth ◽  
Qiusheng Si
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Renal Cell ◽  
Pathological Examination ◽  
Molecular Evidence ◽  
Pathologic Features ◽  
Eosinophilic Cytoplasm ◽  
The Central Nervous System ◽  
Positive Immunostaining ◽  
Vhl Disease

Abstract Background: Hemangioblastoma is an indolent mesenchymal tumor most frequently occurring in the central nervous system (CNS), but can also arise extraneuraxially, as part of von Hippel-Lindau (VHL) disease or in sporadic cases. Extraneuraxial hemangioblastomas (EH) occur outside the central nervous system. It includes tumors arising from the nervous paraneuraxial structures and visceral organs. Sporadic hemangioblastoma of the kidney, a rare subset of EH, is an under-recognized renal neoplasm. There have been only 25 cases described to date in the English language literature. We report herein one additional case in a patient without VHL disease.Case presentation: A 61 year old male presenting with gross hematuria was found to have a 3.5 cm renal mass at the lateral mid to lower pole of the left kidney on computed tomography urogram. Patient underwent a partial nephrectomy for the mass. The pathological examination showed a well-circumscribed non-encapsulated tumor composed of sheets of large polygonal cells traversed by a rich vascular network. The tumor cells showed clear to eosinophilic cytoplasm and overall bland nuclei. The diagnosis of hemangioblastoma was confirmed by positive immunostaining for alpha-inhibin, S100, neuron-specific enolase, PAX8, and negative staining for epithelial membrane antigen, HMB-45, and Melan-A. VHL gene mutation was not detected in this tumor. The diagnosis of sporadic renal hemangioblastoma was made.Conclusion: Sporadic renal hemangioblastoma (RH) is a rare subset of EH. We report herein one such case in a patient without clinical or molecular evidence of VHL disease. We reviewed the literature to better understand the clinical, radiological and pathologic features of this neoplasm. From our review cases and the present case, we have found that the majority of RHs showed a positive immunostaining for PAX8, which supports the idea that the immunoprofiles of EH can vary depending on sites of origin. Diagnosis of renal hemangioblastoma is challenging because of its rarity and overlapping microscopic and immunophenotypic features with renal cell tumor, especially with clear cell renal cell carcinoma. However, accurate diagnosis is necessary, since RH is clinically benign and correct recognition of this pathological entity is important to avoid unnecessary over treatment.

The analysis of cases of abdominal delivery acute fetal hypoxia

2017 ◽  
pp. 28-31
Author(s):  
Yu.P. Vdovichenko ◽  
◽  
N.P. Goncharuk ◽  
Ye.Yu. Gurzhenko ◽  
◽  
...  
Keyword(s):  
Cesarean Section ◽  
Acute Hypoxia ◽  
Fetal Distress ◽  
Positive Trend ◽  
Cesarean Sections ◽  
Fetal Hypoxia ◽  
Vitro Fertilization ◽  
Surgical Interventions ◽  
Abdominal Delivery

The objective: was to study the level of abdominal delivery, its structure according to indications from the fetus, the effect of cesarean sections on perinatal losses in acute fetal hypoxia. Patients and methods. The study was conducted on the basis of the Kyiv City Maternity Hospital №1 for the period from 2001 to 2011. The frequency of cesarean sections was studied and analyzed, the percentage of urgent and planned operations was established, the structure of cesarean sections according to the indications from the fetus was determined, the frequency of cesarean sections in acute hypoxia Fetus, perinatal losses were studied, an analysis of the dependence of perinatal losses on the frequency of cesarean sections during fetal distress was carried out. The analysis used the history of delivery of women giving birth, which culminated in cesarean section. Results. In analyzing the structure of cesarean sections, the fetal indications are as follows: fetal hypoxia, confirmed by objective methods, in the absence of conditions for urgent delivery per vias naturales; Pelvic presentation of the fetus at a mass of more than 3700 g; in vitro fertilization; incorrect position of the fetus after the outflow of amniotic fluid. The conclusion. An increase in the frequency of cesarean sections was noted. Attention is drawn to the positive trend of decreasing the frequency of urgent surgical interventions. The expected decrease in the number of perinatal losses with an increase in the level of caesarean sections due to fetal distress has not been confirmed. Key words: cesarean section, acute fetal hypoxia, cardiotocographic monitoring.

Role of the audit of delivery methods for optimizing the indications for cesarean section and reducing its frequency in clinical practice

2021 ◽  
Vol 20 (2) ◽  
pp. 44-49
Author(s):  
A.A. Churganova ◽  
◽  
M.Kh. Gurzhikhanova ◽  
F.N. Alieva ◽  
S.I. Fedorina ◽  
...  
Keyword(s):  
Cesarean Section ◽  
Fetal Distress ◽  
Labour Induction ◽  
Efficiency Coefficient ◽  
Delivery Methods ◽  
Robson Classification ◽  
Perinatal Center ◽  
Level 3 ◽  
Narrow Pelvis

Objective. To analyze the frequency of indications for cesarean section (CS) and optimize obstetric tactics on the example of a level 3 perinatal center. Materials and methods. We performed retrospective analysis of 7,672 deliveries. Results. The indications for CS included abnormal labour (150; 6.3%), fetal distress (120; 5%), placental abruption (60; 3%), and narrow pelvis (34; 1.4%). Most often (23%) CS was performed in patients with CS scars. Conclusion. The most important step towards reducing the proportion of CS is the change of the approaches to the use of labour induction methods and assessment of the fetus condition. It is extremely important to develop a comprehensive strategy for choosing an optimal delivery method in women with post-CS scars, as well as to perform thorough analysis of the indications for planned and emergency CS. Key words: caesarean section, Robson classification, efficiency coefficient

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