Correlation of intrapartum translabial ultrasound parameters with computed tomographic 3D reconstruction of the female pelvis

2016 ◽  
Vol 44 (5) ◽  
Author(s):  
Robert Armbrust ◽  
Wolfgang Henrich ◽  
Larry Hinkson ◽  
Christian Grieser ◽  
Jan-Peter Siedentopf
Keyword(s):  
Correlation Coefficient ◽  
Body Height ◽  
Parallel Line ◽  
Translabial Ultrasound ◽  
Vaginal Examination ◽  
Female Pelvis ◽  
Fetal Head ◽  
Second Stage Of Labor ◽  
Computed Tomographic ◽  
The Mean

AbstractIntrapartum translabial ultrasound [ITU] can be an objective, reproducible and more reliable method than digital vaginal examination when evaluating fetal head position and station in prolonged second stage of labor. However, two-dimensional (2D) ultrasound is not sufficient to demonstrate the ischial spines and other important “landmarks” of the female pelvis. Therefore, the purpose of this study was to evaluate the distance of the interspinous plane as a parallel line to the infrapubic line in 2D ITU with the help of 3D computed tomography and digital reconstruction.Mean distance between the infrapubic plane and the tip of the ischiadic spine was 32.35 (±4.46) mm. The mean height was 166 (±7) cm; the mean weight was 67.5 (±18.4) kg. Body height and the measured distance were significantly correlated (P=0.025; correlation coefficient of 0.5), whereas body weight was not (P=0.37; correlation coefficient of –0.214).With the present results, clinicians were enabled to transfer the reproducible measurements of the “head station” by ITU to the widespread but observer-depending vaginal examination. Furthermore, ITU can be verified as an objective method in comparison to subjective palpation with the ability to optimize the evaluation of the head station according to bony structures as landmarks in a standardized application.

scholarly journals Intrapartum ultrasound use in clinical practice as a predictor of delivery mode during prolonged second stage of labor

2021 ◽  
Author(s):  
tamar katzir ◽  
Yoav Brezinov ◽  
Ella Kharish ◽  
Shira Hadad ◽  
Edi Vaisbuch ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Real Life ◽  
Vacuum Extraction ◽  
Delivery Mode ◽  
Fetal Head ◽  
Second Stage Of Labor ◽  
Second Stage ◽  
Nulliparous Women ◽  
The Mean ◽  
Time To Delivery

Abstract Purpose To determine the validity of Intrapartum ultrasound (IPUS), and particularly the angle of progression (AOP), in predicting delivery mode when measured in real-life clinical practice among women with protracted second stages of labor. Methods Using electronic medical records, nulliparous women with a second stage of labor of ≥ 3hours ("prolonged") and a documented AOP measurement during the second stage were identified. The ability of a single AOP measurement in "prolonged" second stage to predict a vaginal delivery (VD) was assessed. Fetal head descend, measured by AOP change/hour (calculated from serial measurements) was compared between women who delivered vaginally and those who had a cesarean delivery (CD) for arrest of descent. Results Of the 191 women who met the inclusion criteria, 62 (32.5%) delivered spontaneously, 96 (50.2%) had a vacuum extraction (VE) and 33 (17.3%) had a CD. The mean AOP was wider among women who had VD (spontaneous or VE) compared to those who had CD (153º±19 vs. 133º±17, p < 0.001). Wider AOPs were associated with higher rates of VD and an AOP ≥ 127º was associated with a VD rate of 88.6% (148/167). Among the 87 women who had more than one AOP measurement, the mean AOP change per hour was higher in the VD group than in the CD group (15.1º±11.4º vs. 6.2º±6.3º, p < 0.001). Conclusion Ultrasound assessed fetal head station in nulliparous women with a protracted second stage of labor can be an accurate and objective additive tool in predicting mode and interval time to delivery in real-life clinical practice.

The Effect of Redesigning of Childbirth Room on Mothers’ Satisfaction

2020 ◽  
Vol 17 ◽  
Author(s):  
Fatemeh Mohseni ◽  
Marzieh Kargar Jahromi ◽  
Mojdeh Hassanzadeh
Keyword(s):  
Intervention Group ◽  
Maternity Hospital ◽  
Health Care Team ◽  
Control Group ◽  
Fars Province ◽  
Vaginal Examination ◽  
Fetal Head ◽  
Level Of Satisfaction ◽  
Quasi Experimental ◽  
The Mean

Background: Since women refer to the maternity hospital, they undergo vaginal examination for investigation of cervical dilation, cervical effacement, fetal head position, and amniotic membrane status. In this way, the health care team can monitor the delivery process and make proper decisions based on the women’s conditions. However, this can cause discomfort and dissatisfaction among women. One of the main goals of health systems is moving towards increasing patient satisfaction. This study aimed to assess the effect of redesigning of childbirth room on mothers’ satisfaction. Methods: This quasi-experimental study was conducted on 128 term pregnant women (37-42 weeks of gestation) referred to the maternity ward of Amir-Al-Momenin hospital, Gerash, Fars province, Iran. The participants were divided into two groups of 64. In the control group, women were examined vaginally in the previous childbirth room (without a new design) and in the intervention group, women were examined in a room with a new design. One day after delivery, satisfaction was evaluated in both groups using a valid and reliable researcher-made questionnaire. Results: The results of comparing the mean rank of satisfaction and the mean satisfaction score, one day after delivery, between the two groups showed that in the intervention group there was a higher level of satisfaction than the control group. Results showed that pregnant women’s satisfaction with vaginal examination in the intervention group was higher than control group one day after childbirth. Conclusion: The results indicated that redesigning of childbirth room, patient centric care, and privacy, could improve the pregnant women’s satisfaction with vaginal examination.

scholarly journals Diagnosis of station and rotation of the fetal head in the second stage of labor with intrapartum translabial ultrasound

2009 ◽  
Vol 33 (3) ◽  
pp. 331-336 ◽  
Author(s):  
T. Ghi ◽  
A. Farina ◽  
A. Pedrazzi ◽  
N. Rizzo ◽  
G. Pelusi ◽  
...  
Keyword(s):  
Translabial Ultrasound ◽  
Fetal Head ◽  
Second Stage Of Labor ◽  
Second Stage

THE EFFECT OF ALTERATION OF THYROXINE BINDING CAPACITY ON THE DIALYZABLE AND ABSOLUTE FRACTIONS OF TRIIODOTHYRONINE IN CIRCULATION

1973 ◽  
Vol 72 (2) ◽  
pp. 265-271 ◽  
Author(s):  
J. H. Dussault ◽  
D. A. Fisher ◽  
J. T. Nicoloff ◽  
V. V. Row ◽  
R. Volpe
Keyword(s):  
Correlation Coefficient ◽  
Inverse Relationship ◽  
Binding Capacity ◽  
Hormone Concentration ◽  
Thyroxine Binding Globulin ◽  
Serum Thyroxine ◽  
A Value ◽  
The Mean ◽  
Male Subjects ◽  
Female Subjects

ABSTRACT In order to determine the effect of alterations in binding capacity of thyroxine binding globulin (TBG) on triiodothyronine (T3) metabolism, studies were conducted in 10 patients with idiopathically low (7 subjects) or elevated (3 subjects) TBG levels and 10 subjects given norethandrolone (7 male subjects) or oestrogen (3 female subjects). Measurements of serum thyroxine (T4) concentration, maximal T4 binding capacity, serum T3 concentration and per cent dialyzable T3 were conducted. Serum T3 was measured both by chemical and radioimmunoassay methods. In patients with idiopathically low TBG, the mean serum T4 concentration was low (2.4 μg/100 ml), the mean serum T3 level low (55 ng/100 ml), the mean per cent dialyzable T3 increased (0.52%), and the calculated free T3 concentration normal (186 pg/100 ml). In patients with idiopathically high TBG levels the mean T4 concentration was high (10.3 μg/100 ml), the mean T3 level slightly elevated (127 ng/100 ml), the% dialyzable T3 low (0.10%) and the calculated free T3 concentration low normal (123 pg/100 ml). The correlation coefficient between the per cent dialyzable T3 and maximal TBG binding capacity in the 20 subjects was 0.68, a value significant at the P < 0.01 level. Thus, alterations in binding capacity of TBG seem to influence T3 and T4 metabolism similarly; the inverse relationship between the % of dialyzable hormone and total hormone concentration tends to keep the absolue levels of free hormones stable.

Translabial ultrasound in the second stage of labor

Choonpa Igaku ◽  
2016 ◽  
Vol 43 (3) ◽  
pp. 457-465
Author(s):  
Koichi KOBAYASHI ◽  
Miki GOTO ◽  
Ken SAKAMAKI
Keyword(s):  
Translabial Ultrasound ◽  
Second Stage Of Labor ◽  
Second Stage

The Comparison of Intrapartum Sonographic Signs and Digital Examination in Fetus with Cephalic Presentation

2020 ◽  
Vol 103 (11) ◽  
pp. 1178-1184
Keyword(s):  
Pregnant Women ◽  
Cross Sectional Study ◽  
Head Position ◽  
Vaginal Examination ◽  
Fetal Head ◽  
Cross Sectional ◽  
Percent Agreement ◽  
Anterior Position ◽  
Fetal Head Position ◽  
Digital Vaginal Examination

Objective: The agreement of fetal head position examined by digital vaginal examination (DVE) and intrapartum sonographic signs (ISS) in pregnant women during labor. Materials and Methods: A cross-sectional study was conducted. Two hundred eight-term singleton pregnant women attending labor at Ramathibodi Hospital, Thailand with the fetal cephalic presentation, cervical dilatation of 4 to 8 cm, station –2 or below and no contraindication for DVE were enrolled. The DVE evaluating fetal head position was performed by the third-year obstetrical residents. After DVE, ISS via transabdominal ultrasound for determining fetal head position was obtained immediately by the first researcher. The DVE report and the ultrasonographic images of ISS were recorded separately. The fetal head position based on ISS was designated by the second researcher blinded to the DVE result. The agreement of DVE and ISS for determining fetal head position was analyzed. Results: Two hundred eight pregnant women were analyzed. The fetal head position detected by DVE was consistent with that of ISS at 41.3% (p<0.001). The most percent agreement was observed in the fetus with left occiput anterior position at 72.7% (p<0.001). The lowest percent agreement was found in the direct occiput posterior at 14.3% (p=0.243). Parity, gestational age, current body mass index, epidural analgesia, cervical effacement, caput succedaneum, molding, and station did not significantly affect the discrepancy between DVE and ISS. Conclusion: The agreement between DVE and ISS for evaluating the fetal head position was low. The ISS might be considered for evaluating the fetal head position. Keywords: Fetal head position, Intrapartum sonographic sign, Digital vaginal examination

Observation of the Pulp Chamber of Maxillary First Premolars: A Micro-computed Tomographic Study

2020 ◽  
Vol 16 (3) ◽  
pp. 224-230
Author(s):  
Gozde Serindere ◽  
Ceren Aktuna Belgin ◽  
Kaan Orhan
Keyword(s):  
Root Canal ◽  
Age Groups ◽  
Slice Thickness ◽  
Micro Ct ◽  
Micro Computed Tomography ◽  
Pulp Chamber ◽  
Anatomical Structures ◽  
Computed Tomographic ◽  
The Mean ◽  
Chamber Floor

Background: There are a few studies about the evaluation of maxillary first premolars internal structure with micro-computed tomography (micro-CT). The aim of this study was to assess morphological features of the pulp chamber in maxillary first premolar teeth using micro- CT. Methods: Extracted 15 maxillary first premolar teeth were selected from the patients who were in different age groups. The distance between the pulp orifices, the diameter of the pulp and the width of the pulp chamber floor were measured on the micro-CT images with the slice thickness of 13.6 µm. The number of root canal orifices and the presence of isthmus were evaluated. Results: The mean diameter of orifices was 0.73 mm on the buccal side while it was 0.61 mm on palatinal side. The mean distance between pulp orifices was 2.84 mm. The mean angle between pulp orifices was -21.53°. The mean height of pulp orifices on the buccal side was 4.32 mm while the mean height of pulp orifices on the palatinal side was 3.56 mm. The most observed shape of root canal orifices was flattened ribbon. No isthmus was found in specimens. Conclusion: Minor anatomical structures can be evaluated in more detail with micro-CT. The observation of the pulp cavity was analyzed using micro-CT.

scholarly journals Effect of Posterior Tibial Slope Change on Postoperative Range of Motion and Clinical Outcomes after Posterior Cruciate-Substituting Total Knee Arthroplasty

2021 ◽  
Author(s):  
O-Sung Lee ◽  
Jangyun Lee ◽  
Myung Chul Lee ◽  
Hyuk-Soo Han
Keyword(s):  
Total Knee Arthroplasty ◽  
Range Of Motion ◽  
Correlation Coefficient ◽  
Knee Arthroplasty ◽  
Tibial Slope ◽  
Posterior Tibial Slope ◽  
Posterior Tibial ◽  
Clinical Scores ◽  
Total Knee ◽  
The Mean

AbstractThe posterior tibial slope (PTS) is usually adjusted by less than 5 degrees, without considering its individual difference, during posterior cruciate-substituting (PS) total knee arthroplasty (TKA). The effect of these individual changes of PTS would be important because clinical results depending on postoperative PTS were reported conflictingly. We investigated the effect of the change in PTS on the postoperative range of motion (ROM) and clinical scores after PS TKA. We retrospectively reviewed 164 knees from 107 patients who underwent PS TKA with a 2-year follow-up. We analyzed the preoperative and postoperative PTS, ROM, visual analog scale pain scale, Western Ontario and McMaster University Index (WOMAC), Hospital for Special Surgery Knee Score, Knee Society Score, and Forgotten Joint Score (FJS). The association of the absolute change in PTS with ROM and clinical scores was analyzed using correlation analysis and multiple regression analysis. As a result, the mean PTS and mean ROM changed from 9.6 ±  3.4 and 120.1 ±  15.4 degrees preoperatively to 2.0 ±  1.3 and 128.4 ±  9.3 degrees postoperatively, and the mean PTS change was 7.6 ±  3.5 degrees. The PTS change had no statistically significant association with the postoperative ROM and clinical scoring systems, although it did have a weak positive correlation with WOMAC function, No 10 (difficulty in rising from sitting) (correlation coefficient = 0.342, p = 0.041), and moderate positive correlation with the FJS, No. 6 (awareness when climbing stairs) (correlation coefficient = 0.470, p = 0.001). The authors concluded that the amount of change in PTS did not affect the postoperative ROM and clinical scores, although proximal tibial resection with a constant target of PTS resulted in individually different changes in the PTS after PS TKA,

A comparison of spleen size measured by ultrasound in a random population sample and a matched sample of patients at a university hospital, and the determination of normal values and influencing factors

2021 ◽  
Author(s):  
Theresa Schranz ◽  
Jochen Klaus ◽  
Wolfgang Kratzer ◽  
Julian Schmidberger ◽  
Melanie Güthle
Keyword(s):  
Normal Values ◽  
Population Sample ◽  
Body Height ◽  
University Hospital ◽  
Spleen Size ◽  
The Mean ◽  
Random Population Sample ◽  
Hospital Sample

Abstract Objectives This study aimed to compare spleen sizes in a hospital and a population sample using ultrasound and define normal values and factors influencing spleen size. Methods Both samples’ spleen sizes (n = 1520) were measured using ultrasound under the same conditions. Blood counts and other laboratory parameters were determined under the same conditions in both samples. Results In the hospital sample (n = 760), the mean spleen size was 114.7 mm, and in the population sample (n = 760), it was 99.1 mm. In both, spleen size in men was significantly higher than in women (p < 0.0001) and influenced by body height, weight, and BMI (body mass index) (p < 0.0001). In the hospital sample, there was a correlation with higher values for ALT (p = 0.0160), AST (p = 0.0394), AP (p = 0.0482), and ferritin (p = 0.0008) and lower values for HDL (p = 0.0091) and thrombocytes (p < 0.0001). In the multivariate analysis, higher values for AP (p = 0.0059) and lower values for hemoglobin (p = 0.0014) and thrombocytes (p = 0.0001) were found. Stratified for sex (men, women), spleen size increased with higher values for ALT (p = 0.0116, p = 0.0113), AST (p = 0.0014, p = 0.0113), and AP (p = 0.0001, p = 0.0012), and with lower values of hemoglobin (p = 0.0057, p = 0.0016), thrombocytes (p < 0.0001, p = 0.0003), and albumin (p = 0.0029, p = 0.0432). In women, there was a discordant correlation with red blood cells (p = 0.0005) and a concordant correlation with GGT (p = 0.0241), and in men discordant correlations with cholesterol (p = 0.0010) and HDL (p = 0.0404). Conclusions The already proven impact of anthropometric data on spleen size was confirmed. The role of laboratory values should be further analyzed.

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