scholarly journals Intrauterine fetal death followed by shoulder dystocia and birth by modified posterior axillary sling method: a case report

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Angel Hoi Wan Kwan ◽  
Annie Shuk Yi Hui ◽  
Jacqueline Ho Sze Lee ◽  
Tak Yeung Leung
Keyword(s):  
Shoulder Dystocia ◽  
Intrauterine Fetal Death ◽  
Fetal Head ◽  
Successful Case ◽  
Posterior Shoulder ◽  
Variable Success ◽  
Pass Through ◽  
Narrow Space ◽  
Rubber Catheter ◽  
The Right

Abstract Background Various manoeuvres such as McRoberts position, suprapubic pressure, rotational methods, posterior arm extraction and all-four position (HELPERR) have been proposed for relieving shoulder dystocia with variable success. Posterior axillary sling method using a rubber catheter was proposed in 2009 but has not been widely used. We modified this method using ribbon gauzes and a long right-angle forceps and report a successful case. Case presentation A 44 years old parity one Chinese woman with a history of a caesarean delivery and poorly controlled type 2 diabetes mellitus was admitted to the Accident and Emergency Department for advanced stage of labour at term. Upon arrival, intrauterine fetal demise was diagnosed with severe asynclitism causing obstruction at the perineum. Episiotomy resulted in birth of the fetal head. The fetal posterior right shoulder, however, remained very high up in the pelvis and HELPERR methods failed to extract the shoulders. We then tied two long ribbon gauzes together, and guided its knot to the anterior aspect of the posterior axilla. By using a long right-angle forceps (24 cm long) to grasp the knot on the posterior side of the axilla and pulling it through, a sling was formed. Traction was then applied through the sling to simultaneously pull and rotate the posterior shoulder. A stillbirth of 3488 g was finally extracted. Conclusions We modified the sling method by using two ribbon gauzes, tied together and a right-angle forceps with several advantages. Compared to a rubber catheter, ribbon gauze with a knot can be easily held between the fingers for easy guidance past the fetal axilla. It is also thin, non-elastic and stiff enough to ensure a good grip for traction. The long and slim design of the right-angle forceps makes it easy to pass through a narrow space and reach the axilla high up in the pelvis. We emphasize simultaneous traction and rotation, so that the shoulders are delivered through the wider oblique pelvic outlet dimension.

scholarly journals The Carit Maneuver: A Novel Approach for the Relief of Shoulder Dystocia—A Case Series

2020 ◽  
Vol 10 (02) ◽  
pp. e133-e138
Author(s):  
Alfredo F Gei ◽  
Jorge Suarez Mastache ◽  
Luis D. Pacheco ◽  
Mariana Villanueva
Keyword(s):  
Cohort Study ◽  
Head And Neck ◽  
Mechanism Of Action ◽  
Case Series ◽  
Shoulder Dystocia ◽  
Fetal Head ◽  
Successful Intervention ◽  
Novel Approach ◽  
Posterior Shoulder ◽  
Maternal And Neonatal Outcomes

Abstract Objective The main purpose of this article is to describe the technique and mechanism of action of a novel intervention for the relief of shoulder dystocia we are labeling Carit maneuver. Methods We report a cohort study of eight cases of shoulder dystocia not relieved by the combination of McRobert's maneuver and suprapubic pressure treated with the Carit maneuver. This intervention involves the use of the fetal head and neck as the grasping point of the fetus to exert a ventral rotation of the fetal trunk, reduce the bi-acromial diameter, and deliver the posterior shoulder by passive displacement.In all these cases, the direction of the original head restitution, direction of exerted rotation, and side and location of delivery of the first shoulder were recorded. Maternal and neonatal outcomes were reviewed and reported. Results In all cases, the Carit rotational maneuver resulted in the delivery of the posterior shoulder in the transverse (4), oblique anterior (2), or direct anterior (2) diameters. No instances of neonatal depression or fetal acidemia were noted in this cohort. Conclusion The Carit maneuver is an original and successful intervention in the management of shoulder dystocia unresponsive to McRobert's maneuver and suprapubic pressure.

Larval and juvenile development of the Iceland cockle Ciliatocardium ciliatum (Fabricius, 1780) (Bivalvia: Cardiidae)

2020 ◽  
Vol 324 (2) ◽  
pp. 242-251
Author(s):  
L.P. Flyachinskaya ◽  
P.A. Lezin
Keyword(s):  
Lateral Position ◽  
Larval Shell ◽  
Subtidal Zone ◽  
Larval Stages ◽  
Posterior Shoulder ◽  
Blade Shape ◽  
The Right ◽  
Lateral Structures ◽  
Juvenile Development ◽  
Concentric Structure

The paper considers the development of Ciliatocardium ciliatum from the stage of straight hinge to juvenile. In the White Sea the spawning of C. ciliatum begins at the end of June, larvae at different stages of development occur in plankton until the end of September. The earliest of the larvae found had shell lengths of 123–130 µm. The paper first examined the anatomy and structure of the larval shell of C. ciliatum. During the development, the main stages of organogenesis were described and special attention was paid to the formation of the digestive and muscular systems. The digestive system begins to function when the larva reaches a size of 170–180 µm. The digestive gland has a two-blade shape and is shifted to the right side. The foot is formed at a size of 230 µm, the gill rudiments appear when the larva reaches 270 µm. The development of the larval shell and larval hinge of the mollusc is considered in detail. The development of the larval shell of C. ciliatum is similar to the development of other family members. Throughout all the larval stages, the shell has a rounded shape with a low umbos, and the prodissoconch II has a clearly visible concentric structure. The C. ciliatum larval hinge is characterized by weak differentiation and the absence of pronounced cardinal teeth typical for other Cardiidae. However, the lateral structures of the castle – ridges and flanges – are well developed. The ligament begins to form at a size of 240–250 µm and occupies a lateral position. The settlement of the cockle takes place in September in the subtidal zone. After the metamorphosis, a large radial sculpture is formed on the dissoconch and a number of small spikes are formed at the rib of the posterior shoulder.

scholarly journals A successful case of biological invasion: the fish Cichla piquiti, an Amazonian species introduced into the Pantanal, Brazil

2008 ◽  
Vol 68 (4) ◽  
pp. 799-805 ◽  
Author(s):  
EK. Resende ◽  
DKS. Marques ◽  
LKSG. Ferreira
Keyword(s):  
National Park ◽  
Reproductive Period ◽  
Distribution Area ◽  
Left Bank ◽  
Amazonian Fish ◽  
Paraguay River ◽  
Turbid Waters ◽  
Successful Case ◽  
The Right ◽  
Flooded Areas

The "tucunaré", Cichla piquiti, an exotic Amazonian fish has become established along the left bank of the Paraguay River in the Pantanal. It was introduced by escaping from culture ponds in the Upper Piquiri River and spread downstream, along the lateral flooded areas of that river, continuing through the clear waters of the left bank of the Paraguay River and reaching south as far as the Paraguai Mirim and Negrinho rivers. Adult spawners have been found in the region, meaning that it is a self-sustained population. Reproduction occurs in the period of low waters. They were found feeding on fishes of lentic environments belonging to the families Characidae, Cichlidae and Loricariidae. Until the end of 2004, its distribution was restricted to the left bank of the Paraguay River, but in March 2005, some specimens were found on the right bank, raising a question for the future: what will be the distribution area of the tucunaré in the Pantanal? Information about its dispersion is increasing: it is known to be in the Tuiuiú Lake, Pantanal National Park and in the Bolivian Pantanal, all of them on the right bank of the Paraguay River. The hypothesis that the "tucunaré" could not cross turbid waters, such as in the Paraguay River, was refuted by these recent findings. Possibly, the tucunaré's capacity to lay more than one batch of eggs in a reproductive period, as well as its care of eggs and young, lead them to establish themselves successfully in new environments, as has been observed in the Pantanal and other localities.

scholarly journals Visual Estimation of Force Applied During Simulated Deliveries Complicated by Shoulder Dystocia

2018 ◽  
Vol 08 (04) ◽  
pp. e206-e211
Author(s):  
Margaret Walters ◽  
Allison Eubanks ◽  
Elizabeth Weissbrod ◽  
John Fischer ◽  
Barton Staat ◽  
...  
Keyword(s):  
Study Design ◽  
Pubic Symphysis ◽  
Shoulder Dystocia ◽  
Objective Measurement ◽  
Excessive Force ◽  
Visual Estimation ◽  
Average Amount ◽  
Fetal Head

Background Shoulder dystocia occurs when the fetal head delivers, but the shoulder is lodged behind the pubic symphysis. Training for these emergency deliveries is not optimized, and litigation can occur around a shoulder dystocia delivery. Objective Evaluate the ability of an outside observer to visually estimate the amount of traction applied to the fetal head during simulated deliveries complicated by shoulder dystocia. Study Design Simulated deliveries with an objective measurement of traction were randomly organized for estimation of traction applied. Videos show providers applying a “normal” (75 N) and “excessive” (150 N) amount of force in both a “calm” and “stressed” delivery. Results Fifty participants rated the amount of force applied. Observers estimated traction, on a scale from 1 to 5, higher in the 150-N deliveries as compared with 75-N deliveries (“calm” environment: 3.1 vs. 2.8, p < 0.001; and “stressed” environment: 3.2 vs. 2.8, p < 0.001). Only 15% of observers rated force “above average” or “excessive” in a “calm” environment, as opposed to 30% of observers in the “stressed” environment. Conclusion Observers are not able to determine when “excessive force” is used and are twice as likely to overestimate the force applied to a fetal head when an average amount of force is used and the delivery environment is stressful. Precis Observers are unable to determine when excessive traction is applied to the fetal head during simulated deliveries complicated by shoulder dystocia.

Temporary Erb-Duchenne Palsy Without Shoulder Dystocia or Traction to the Fetal Head

2005 ◽  
Vol 106 (5, Part 1) ◽  
pp. 1110 ◽  
Author(s):  
Robert H. Allen ◽  
Edith D. Gurewitsch
Keyword(s):  
Shoulder Dystocia ◽  
Fetal Head

scholarly journals Anatomical and Morphometric Study of Optic Foramen in North Indian Population

2019 ◽  
Vol 08 (02) ◽  
pp. 053-056 ◽  
Author(s):  
Ajay Kumar ◽  
Alok Tripathi ◽  
Shilpi Jain ◽  
Satyam Khare ◽  
Ram Kumar Kaushik ◽  
...  
Keyword(s):  
Temporal Bone ◽  
Middle Cranial Fossa ◽  
Optic Canal ◽  
Morphometric Study ◽  
P Value ◽  
Transverse Diameter ◽  
Petrous Temporal Bone ◽  
Pass Through ◽  
Human Skulls ◽  
The Right

Abstract Introduction Optic canal connects orbit to middle cranial fossa. Optic nerve and ophthalmic artery pass through this canal. The aim of the present study is to make morphometric and anatomical observations of endocranial opening of optic canal. Materials and Methods The observations were conducted on 30 dry adult human skulls. The observations were made on shape, margins, confluence, septations, dimensions, and distance of optic foramen from apex of petrous temporal bone. Result and Statistical Analysis On morphometric observation, transverse diameter (TD) was 6.00 mm and 6.15 mm on the left and the right side, respectively. The vertical diameter (VD) was 5.14 mm on the left side and 4.82 mm on the right side. The distance of optic foramen to apex of petrous temporal bone was 21.84 mm on the left side and 21.90 mm on the right side. The mean, standard deviation, range, and p value were measured by using SPSS software version 19.00. Conclusion In the present study we attempt to provide a comprehensive anatomical and morphometric data of optic foramen that may help ophthalmologists and neurosurgeons during surgery.

scholarly journals A Rare Case of Contralateral Diaphragm Paralysis following Birth Injury with Brachial Plexus Palsy: A Case Report and Review of the Literature

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Audra J. Reiter ◽  
Yazan K. Rizeq ◽  
Benjamin T. Many ◽  
Jonathan C. Vacek ◽  
Fizan Abdullah ◽  
...  
Keyword(s):  
Brachial Plexus ◽  
Vaginal Delivery ◽  
Phrenic Nerve ◽  
Muscle Tone ◽  
Work Of Breathing ◽  
Shoulder Dystocia ◽  
Brachial Plexus Palsy ◽  
Birth Injury ◽  
Diaphragm Paralysis ◽  
The Right

Clinical History. A 4.4 kg male was born to a 25-year-old, G2P1, nondiabetic woman at 39 and 5/7 weeks. Delivery was complicated by shoulder dystocia requiring forceps-assisted vaginal delivery, resulting in left arm Erb’s palsy secondary to left brachial plexus injury. He was born with low muscle tone and bradycardia and subsequently required intubation for poor respiratory effort. He was extubated on day one of life but continued to be tachypneic and have borderline oxygen saturation, requiring intensive care. Chest radiographs demonstrated a progressive clearing of his lung fields, consistent with presumptively diagnosed meconium aspiration. However, a persistent elevation of the right hemidiaphragm was noted, and his tachypnea and increased work of breathing continued. Focused ultrasound of the diaphragm was performed, confirming decreased motion of the right hemidiaphragm. Following a multidisciplinary discussion, thoracoscopic right diaphragm plication was performed on the 33rd day of life. He was extubated postoperatively and subsequently weaned to room air with a notable decrease in tachypnea over 48 hours. He was discharged on postoperative day 12 and continues to thrive at 6 months of age without respiratory embarrassment. Purpose. Ipsilateral phrenic nerve injury with diaphragm paralysis from shoulder dystocia during vaginal delivery is a recognized phenomenon. Herein, we present a case of contralateral diaphragm paralysis in order to draw attention to the clinician that this discordance is possible. Key Points. According to Raimbault et al., clinical management of newborns who experience birth injury is a multidisciplinary effort. According to Fitting and Grassino, though most cases of phrenic nerve injuries are ipsilateral to shoulder dystocia brachial plexus palsy, contralateral occurrence is possible and should be considered. According to Waters, diaphragm plication is a safe and effective operation.

scholarly journals Management of Shoulder Dislocation by Prakash Method

2021 ◽  
Vol 8 (1) ◽  
pp. 21-24
Author(s):  
Ihsan Ullah ◽  
Samir Khan Kabir ◽  
Khalid . ◽  
Mohammad Inaam ◽  
Gul Hassan ◽  
...  
Keyword(s):  
Success Rate ◽  
Shoulder Dislocation ◽  
Recurrent Dislocation ◽  
Study Data ◽  
Posterior Shoulder ◽  
Fracture Dislocations ◽  
History Of ◽  
The Right ◽  
First Time ◽  
Anterior Posterior

OBJECTIVES: The objective of the study is to evaluate the effectiveness and safety of shoulder reduction developed by Prakash. METHODOLOGY: This descriptive study was carried out at Rehman Medical and Surgical Center District Buner and Naseer Teaching Hospital Peshawar from June 2017 to December 2019. All patients with a history of trauma to either shoulder were subjected to anterior-posterior shoulder radiograph. Those having shoulder dislocation were enrolled in the study. Data including age, gender, previous dislocation history, duration of dislocation and associated fracture, and fracture type were recorded in patient case sheet. Patients having recurrent dislocation, polytrauma, low GCS, fracture-dislocations, and more than a week history of dislocation were excluded from the study. RESULTS: This study was performed on 30 patients. The mean age of the patients was 36.46±11.58 years. Among them, 83.3% (n=25) were male and 16.7% (n=5) were female. While dislocation occurred on the right shoulder in 63.3% (n=19) and in 36.7% (n=11) on the left side. All the patients have dislocation for the first time. The reduction was performed using Prakash’s method. The success rate was 90% (n=27) and 10% (n=3) the reduction failed, which was then reduced under anesthesia using the Hippocratic method. CONCLUSION: The Prakash's method for reducing anterior shoulder dislocation requires minimum assistance with no anesthesia, it is safe, less time consuming, has a high success rate, less pain, and has minimal complications.  

scholarly journals The Right of a Defense Attorney to Visit as a Prerequisite for the Effective Defense Case Strategy Development during the Preliminary Investigation

2021 ◽  
Vol 16 (10) ◽  
pp. 135-143
Author(s):  
T. I. Khvenko
Keyword(s):  
Preliminary Investigation ◽  
Defense Attorney ◽  
Strategy Development ◽  
Successful Case ◽  
Legitimate Interests ◽  
The Right ◽  
Future Work ◽  
Practical Recommendations

The development and implementation of a successful case strategy is one of the priority tasks for a attorney in the course of a preliminary investigation. The paper examines the question of what factors favorably influence the formation of a successful case strategy by the defense attorney at the stage of preliminary investigation. The author argues that the right of a defender to visit his client as provided by the legislator is a prerequisite for an attorney to build up an effective position to protect the rights and legitimate interests of the client, in accordance with which the content of his future work is determined. The paper also examines the problem of the lack of appropriate conditions provided for by law for organizing a meeting between an attorney and his client in the investigation and inquiry bodies, and offers practical recommendations to strengthen the guarantees of the independence of an attorney during a preliminary investigation.

Variations in the Structure of the Jugular Foramen of Human Skull

2013 ◽  
Vol 10 (2) ◽  
pp. 45-49 ◽  
Author(s):  
SM Akram Hossain ◽  
SM Moshadeq Hossain ◽  
Fakhrul Amin Mohammad Hasanul Banna
Keyword(s):  
Internal Jugular Vein ◽  
Jugular Vein ◽  
Jugular Foramen ◽  
Jugular Bulb ◽  
Cross Sectional ◽  
Medical College ◽  
Geographical Variations ◽  
Pass Through ◽  
The Right ◽  
Study Type

Context: The jugular foramen is one of the most fascinating foramen present at the base of the skull attracting the imagination of many Anatomists worldwide as many important structures pass through it, and amongst them the intriguing structure is the internal jugular vein. The shape and size of the jugular foramen is related to the size of the internal jugular vein and the presence or absence of a prominent superior bulb. As most of the textbooks of Anatomy describe that the right jugular foramen is usually larger than the left jugular foramen. Henceforth the present study was undertaken in 55 skulls from the dept. of Anatomy. Measurements were taken with the help of sliding vernier caliper. Study type: Cross-sectional descriptive type. Place and period of study: Department of Anatomy, Rajshahi Medical College, Rajshahi and Pabna Medical College, Pabna from April 2010 to June 2011. Materials and Methods: Total fifty five (55) human adult skulls were collected from the Anatomy department of Rajshahi Medical College, Rajshahi and Pabna Medical College, Pabna at different times of the study period. The study was conducted to observe variations in the structure of the jugular foramen of the human’s skull. Result: Out of 55 skulls (110 foramina) studied, the presence of dome indicating the presence of jugular bulb was found bilaterally in 100% of cases. 58.18% of cases showed that the size of right foramina were larger than the left foramina whereas 20% of cases showed that right foramina were equal to the left and in 21.82% of cases the left foramina were larger than the right side foramina. An important observation in the present study was the presence of either complete or partial septation in the jugular foramen. Conclusion: The findings of the study reveals that there are some differences among some parameters. The variations are might be due to the geographical variations of the skeletons. It needs further study with larger sample size from different geographical areas of Bangladesh. DOI: http://dx.doi.org/10.3329/bja.v10i2.17281 Bangladesh Journal of Anatomy, July 2012, Vol. 10 No. 2 pp 45-49

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