Evaluation of the labour process with serial transperineal ultrasonography and prediction of the type of birth

2021 ◽  
Vol 49 (1) ◽  
pp. 36-42
Author(s):  
Ayca Nazli Bulut ◽  
Venhar Ceyhan
Keyword(s):  
Vaginal Delivery ◽  
Roc Analysis ◽  
Lithotomy Position ◽  
Delivery Method ◽  
Birth Process ◽  
Labour Process ◽  
Caesarean Section Delivery ◽  
The Relationship ◽  
Type Of Delivery ◽  
Angle Of Progression

AbstractObjectivesThe purpose of this study is to follow the birth process with transperineal ultrasonography (TPU) and predict the delivery method using angle of progression (AOP).MethodsThe study included 134 patients. The AOP was examined with TPU in the lithotomy position applied at 4-h intervals, not at a time of straining or contractions. The relationship was examined between AOP and those who continued with vaginal delivery, and those who underwent caesarean section delivery.ResultsA total of 122 (91%) patients had vaginal delivery and 12 (9%) patients had cesarean delivery. In patients giving vaginal delivery, progress in AOP was observed in every 4-h measurement, but not in patients with cesarean section. In the ROC analysis, if 70% sensitivity and 75% specificity with AOP degree >132.5°, the patient was expected to have vaginal delivery with a probability of 77.5% (95% CI 0.62–0.93; p=0.002).ConclusionsRather than repeating digital examinations, the labour process can be monitored with serial TPU and the type of delivery can be predicted. There is a need for further studies for the measurement of AOP with TPU to become a part of clinical practice in the monitoring of the whole labour process.

Relationship between Thyroglobulin and Tumor Detectabilily with Thallium-201 in Differentiated Thyroid Cancer

2000 ◽  
Vol 39 (01) ◽  
pp. 10-15 ◽  
Author(s):  
S. P. Müller ◽  
Ch. Reiners ◽  
A. Bockisch ◽  
Katja Brandt-Mainz
Keyword(s):  
Thyroid Cancer ◽  
Differentiated Thyroid Cancer ◽  
Roc Analysis ◽  
Tsh Suppression ◽  
Significant Difference ◽  
Test Specificity ◽  
The Relationship ◽  
Tumor Scintigraphy ◽  
Tsh Stimulation

Summary Aim: Tumor scintigraphy with 201-TICI is an established diagnostic method in the follow-up of differentiated thyroid cancer. We investigated the relationship between thyroglobulin (Tg) level and tumor detectability. Subject and methods: We analyzed the scans of 122 patients (66 patients with proven tumor). The patient population was divided into groups with Tg above (N = 33) and below (N = 33) 5 ng/ml under TSH suppression or above (N = 33) and below (N = 33) 50 ng/ml under TSH stimulation. Tumor detectability was compared by ROC-analysis (True-Positive-Fraction test, specificity 90%). Results: There was no significant difference (sensitivity 75% versus 64%; p = 0.55) for patients above and below 5 ng/ml under TSH suppression and a just significant difference (sensitivity 80% versus 58%; p = 0.04) for patients above and below 50 ng/ml under TSH stimulation. In 18 patients from our sample with tumor, Tg under TSH suppression was negative, but 201-TICI-scan was able to detect tumor in 12 patients. Conclusion: Our results demonstrate only a moderate dependence of tumor detectability on Tg level, probably without significant clinical relevance. Even in patients with slight Tg elevation 201-TICI scintigraphy is justified.

scholarly journals POS1456-HPR THE SERUM IRON LEVEL MIGHT BE USEFUL IN DETERMINING THE SEVERITY OF MALNUTRITION IN PATIENTS WITH RHEUMATOID ARTHRITIS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1012.2-1012
Author(s):  
Y. Matsumoto ◽  
Y. Sugioka ◽  
M. Tada ◽  
T. Okano ◽  
K. Mamoto ◽  
...  
Keyword(s):  
Grip Strength ◽  
Serum Iron ◽  
Roc Analysis ◽  
Severe Malnutrition ◽  
Inflammatory Condition ◽  
Research Support ◽  
Chugai Pharmaceutical ◽  
The Relationship ◽  
Nutritional Indicator

Background:The Global Leadership Initiative on Malnutrition (GLIM) criteria, the first international criteria for diagnosis of malnutrition, was released in 2018 [1]. Patients with rheumatoid arthritis (RA) are thought to be prone to malnutrition due to decreased food intake and increased muscle catabolism caused by chronic inflammation or pain. However, there has been no report to assess the nutritional status of RA patients in accordance with the GLIM criteria. In addition, commonly used blood nutrient indicators such as albumin might not be appropriate as nutritional indicators for RA because these values are affected by inflammation.Objectives:This study aims to examine the rates of malnutrition in RA patients according to GLIM criteria, and the relationship between blood nutrient indicators and the severity of malnutrition.Methods:In this study, we conducted a cross-sectional survey of 135 female RA patients in 2020. According to the GLIM criteria, patients were considered to be malnourished if patients had one of the following phenotypic: (1) low body mass index, (2) non-volitional weight loss, (3) reduced muscle mass, and one of the following etiologic: (1) reduced food intake or assimilation, (2) disease burden/inflammatory condition. Reduced muscle mass was evaluated by measuring calf circumference, and inflammatory condition was evaluated by Disease Activity Score (DAS) 28. In accordance with the GLIM criteria, the severity of malnutrition was judged as three levels: no problem, moderate, and severe malnutrition. Albumin, transthyretin, transferrin, retinol binding protein, zinc, iron, ceruloplasmin, and total cholesterol were assessed as blood nutrition indicators. Also grip strength was assessed. We compared each nutritional indicator among the three groups according to the severity of malnutrition using age-adjusted analysis of covariance, and examined the relationship between each nutritional indicator and the severity of malnutrition using receiver operating characteristic (ROC) analysis.Results:In RA patients, 20% were classified as severe malnutrition, and 40% were moderate or more. Serum iron levels were significantly lower in the severe malnutrition group compared to the no problem group (p = 0.001). In ROC analysis, serum iron, zinc, albumin, and grip strength (area under curve; AUC; 0.680, 0.696, 0.636, 0.790, respectively) were significant parameters for classification of moderate and severe malnutrition. Serum iron and grip strength (AUC for respective parameters were 0.741, 0.747) were significant parameters for classification of severe malnutrition.Conclusion:Evaluation based on the GLIM criteria showed that about 40% of RA patients were under moderate or severe malnutrition. It was suggested that serum iron and grip strength might be useful to predict the severity of malnutrition.References:[1]Cederholm T, Jensen GL, Correia MITD, Gonzalez MC, Fukushima R, Higashiguchi T, et al. GLIM criteria for the diagnosis of malnutrition – A consensus report from the global clinical nutrition community. Clinical Nutrition 2019; 38: 1-9.Acknowledgements:We thank to Tomoko Nakatsuka, and the Center for Drug & Food Clinical Evaluation, Osaka City University Hospital, for management and collection of the study data. We also thank to study participants.Disclosure of Interests:Yoshinari Matsumoto Grant/research support from: Yamada Research Grant, Yuko Sugioka: None declared, Masahiro Tada: None declared, Tadasi Okano Speakers bureau: AbbVie, Asahikasei, Astellas Pharma Inc, Ayumi Pharmaceutical, Bristol-Myers Squibb, Chugai Pharmaceutical, Daiich Sankyo, Eisai, Janssen, Lilly, Mitsubishi Tanabe Pharma Corporation, Novartis Pharma, Ono Pharmaceutical, Pfizer, Sanofi, Takeda Pharmaceutical, Teijin Pharma and UCB, Grant/research support from: AbbVie, Eisai, Mitsubishi Tanabe Pharma Corporation and Nipponkayaku, Kenji Mamoto: None declared, Kentaro Inui Speakers bureau: Daiichi Sankyo Co. Ltd., Mitsubishi Tanabe Pharma, Janssen Pharmaceutical K.K., Astellas Pharma Inc., Takeda Pharmaceutical Co. Ltd., Ono Pharmaceutical Co. Ltd., Abbvie GK, Pfizer Inc., Eisai Co., Ltd., Chugai Pharmaceutical Co., Ltd, Grant/research support from: anssen Pharmaceutical K.K., Astellas Pharma Inc., Sanofi K.K., Abbvie GK, Takeda Pharmaceutical Co. Ltd., QOL RD Co. Ltd., Mitsubishi Tanabe Pharma, Ono Pharmaceutical Co. Ltd., Eisai Co., Ltd., Daiki Habu: None declared, Tatsuya Koike Speakers bureau: AbbVie, Astellas Pharma Inc, Bristol-Myers Squibb, Chugai Pharmaceutical, Eisai, Janssen, Lilly, Mitsubishi Tanabe Pharma Corporation, MSD, Ono Pharmaceutical, Pfizer, Roche, Takeda Pharmaceutical, Teijin Pharma, and UCB, Grant/research support from: AbbVie, Astellas Pharma Inc, Bristol-Myers Squibb, Chugai Pharmaceutical, Eisai, Janssen, Lilly, Mitsubishi Tanabe Pharma Corporation, MSD, Ono Pharmaceutical, Pfizer, Roche, Takeda Pharmaceutical, Teijin Pharma, and UCB

scholarly journals A Novel Radiographic Measurement Method for the Evaluation of Metatarsophalangeal Joint Dislocation of the Lesser Toe in Patients with Rheumatoid Arthritis

2021 ◽  
Vol 18 (14) ◽  
pp. 7520
Author(s):  
Hideki Ohashi ◽  
Keiichiro Nishida ◽  
Yoshihisa Nasu ◽  
Kenta Saiga ◽  
Ryuichi Nakahara ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Roc Analysis ◽  
Metatarsophalangeal Joint ◽  
Metatarsal Head ◽  
Radiographic Measurement ◽  
Joint Dislocation ◽  
Severity Grading ◽  
Grade 3 ◽  
The Relationship ◽  
Mtp Joints

Dorsal dislocation of metatarsophalangeal (MTP) joints of the lesser toe frequently occurs in patients with rheumatoid arthritis (RA), and may cause painful and uncomfortable plantar callosities and ulceration. The current study examined the reliability and clinical relevance of a novel radiographic parameter (the MTP overlap distance [MOD]) in evaluating the severity of MTP joint dislocation. The subjects of the current study were 147 RA patients (276 feet; 1104 toes). MOD, defined as the overlap distance of the metatarsal head and the proximal end of the phalanx, was measured on plain radiographs. The relationship between the MOD and clinical complaints (forefoot pain and/or callosity formation) was analyzed to create a severity grading system. As a result, toes with callosities had a significantly larger MOD. ROC analysis revealed that the MOD had a high AUC for predicting an asymptomatic foot (−0.70) and callosities (0.89). MOD grades were defined as follows: grade 1, 0 ≤ MOD < 5 mm; grade 2, 5 ≤ MOD < 10 mm; and grade 3, MOD ≥ 10 mm. The intra- and inter-observer reliability of the MOD grade had high reproducibility. Furthermore, the MOD and MOD grade improved significantly after joint-preserving surgeries for lesser toe deformities. Our results suggest that MOD and MOD grade might be useful tools for the evaluation of deformities of the lesser toe and the effect of surgical intervention for MTP joints in patients with RA.

scholarly journals Prediction of vaginal delivery with transperineal ultrasound in women induced with dinoprostone beyond 40 weeks of gestation

2018 ◽  
Vol 7 (8) ◽  
pp. 2998
Author(s):  
Hale Göksever Çelik ◽  
Engin Çelik ◽  
Gökhan Yıldırım
Keyword(s):  
Pregnant Women ◽  
Vaginal Delivery ◽  
Prospective Observational Study ◽  
Transperineal Ultrasound ◽  
Direct Visualization ◽  
Fetal Head ◽  
Nulliparous Women ◽  
Multiparous Women ◽  
High Possibility ◽  
Angle Of Progression

Background: Digital cervical evaluation has been used to determine the likelihood of vaginal delivery which is considered by many women to be non-tolerable. Recently, transperineal ultrasound allowing direct visualization of the fetal skull has been using for the prediction of labor route. Authors aimed to study whether measurements on transperineal ultrasound are predictive for vaginal delivery in pregnant women induced with dinoprostone at 40.0-42.0 gestational weeks.Methods: A total of 55 pregnant women at 40.0-42.0 gestational weeks were enrolled in this prospective observational study. All participated women were examined before the induction with dinoprostone to measure the head-perineum distance (HPD), the head-pubis distance and the angle of progression of fetal head (AOP).Results: The greater AOP, the shorter HPD and the head-pubis distance were associated with vaginal delivery in the nulliparous women. The HPD and the head-pubis distance were shorter, whereas the AOP was greater in the multiparous women giving birth by vaginal route.Conclusions: Transperineal ultrasound can be applied at the beginning of labor to predict whether vaginal delivery will occur or not. As shown in our study, the pregnant women with shorter HPD and wider AOP might have a high possibility to achieve vaginal delivery.

scholarly journals Luaran persalinan gemeli di RSUP Prof. Dr. R. D Kandou Periode 1 Januari 2014 – 31 Desember 2015

e-CliniC ◽  
2016 ◽  
Vol 4 (2) ◽  
Author(s):  
Yoel B. Parlindungan ◽  
Freddy W. Wagey ◽  
Maya Mewengkang
Keyword(s):  
Vaginal Delivery ◽  
Descriptive Study ◽  
Multiple Pregnancies ◽  
Delivery Method ◽  
Mortality And Morbidity ◽  
Delivery Outcome ◽  
Research Show ◽  
Duration Of Gestation

Abstract: Multiple pregnancies are pregnancy more than one fetuses. Multiple pregnancies increase seventy percent lately and effected on mortality and morbidity of maternal also fetal. This research is retrospective descriptive study with the purpose is outcome of twins’ delivery in RSUP Prof. DR. R. D Kandou from January 1st 2014 until December 31st 2015. The result of this research show 60 events of twins’ labor from 5038 labors (0.012%), most founded on mother age 21 – 25 years old with primiparas. The twins’ outcome shows the most presentations are cephalic-cephalic with vaginal delivery method. The most duration of gestation is 34 – 37 weeks shows prematurity is high. Female infants dominated. Birthweight show most 2000 – 2499 g on first infants and 2500 – 2999 g on second infants with 6-8 score of apgar.Keywords: twins’ delivery outcome, number of incidence. Abstrak: Kehamilan multijanin adalah kehamilan dengan jumlah janin lebih dari satu. Kehamilan kembar meningkat tujuh puluh persen saat ini dan meningkatkan angka mortalitas maupun morbiditas baik maternal maupun fetal. Penelitian ini menggunakan metode retrospektif deskriptif dengan tujuan untuk melihat luaran persalinan gemeli di RSUP Prof. DR. R. D Kandou periode 1 Januari 2014 – 31 Desember 2015. Hasil pengumpulan data dan penelitian menunjukan terdapat 60 kejadian persalinan gemeli dari 5038 persalinan (0.012%), paling banyak ditemukan pada ibu usia 21 – 25 tahun dengan primipara. Luaran bayi ditemukan presentasi bayi paling banyak adalah kepala-kepala, dengan metode persalinan spontan pervaginam. Usia kehamilan terbanyak adalah 34 – 37 minggu yang menunjukan tingginya prematuritas. Bayi perempuan mendominasi. Berat lahir terbanyak adalah 2000 – 2499 g pada bayi 1 dan 2500 – 2999 g pada bayi 2 dengan apgar skor terbanyak 6-8. Kata kunci: luaran persalinan kembar, angka kejadian.

scholarly journals The Assessment of Intrapartum Transperineal Ultrasonographic Parameters for their Effectiveness in Evaluation of Progress of Labor and Prediction of Mode of Delivery in Egyptian Women

2021 ◽  
Vol 9 (B) ◽  
pp. 1037-1043
Author(s):  
Gamal Abdelsameea Ibrahim ◽  
Ahmed Soliman Nasr ◽  
Fatma Atta ◽  
Mohamed Reda ◽  
Hend Abdelghany ◽  
...  
Keyword(s):  
Vaginal Delivery ◽  
Ultrasound Examination ◽  
Mode Of Delivery ◽  
Transperineal Ultrasound ◽  
Ultrasound Measurement ◽  
Vaginal Examination ◽  
Fetal Head ◽  
Prolonged Labor ◽  
Digital Vaginal Examination ◽  
Angle Of Progression

Introduction: High fetal head station has been associated with prolonged labor and delivery outcomes. Although clinical assessment of fetal head station is both subjective and unreliable, women with prolonged labor are subjected to multiple digital vaginal examinations. The use of ultrasound has been proposed to aid in the management of labor since 1990s. Ultrasound examination is more accurate and reproducible than clinical examination in the diagnosis of fetal head station and in the prediction of arrest of labor. Ultrasound examination can, to some extent, distinguish those women destined for spontaneous vaginal delivery and those destined for operative delivery and  may predict the outcome of instrumental vaginal delivery. Such a technique has the potential to reduce the frequency of intrusive internal examinations and associated infection and could be useful in allowing the assessment of women in whom digital VE is traumatic or contra-indicated. Intrapartum ultrasound not only provides objective and quantitative data in labor, but also helps to make more reliable clinical decisions aiming to improve obstetric outcomes of both the mother and fetus as a supplementary tool for active management. Aim of the work: This study aims at assessing the value of intrapartum transperineal ultrasonography as a quantitative and objective tool in the evaluation of progress of labor and prediction of mode of delivery. Subjects: This study was a prospective observational study conducted on 600 primiparous women in active first stage of labor admitted to Kasr Al Ainy maternity hospital from January 2017 to June 2018. The studied population was divided into two groups. Group A of 300 women with normal progress of labor and group B of 300 women with prolonged 1st stage of labor. Methods: Fetal head station(FHS) was assessed clinically by digital vaginal examination (dVE) and sonographically by transperineal ultrasound measurement of  head perineal distance (HPD) and angle of progression (AOP). Intrapartum care of the patient continued as normal based only on digital vaginal examinations using the modified WHO partogram. (1). Statistical analysis was targeted towards assessing the potential of the intrapartum ultrasonography in the evaluation of progress of labor and prediction of mode of delivery. Results: All studied parameters for assessment of FHS (dVE, HPD, and AOP) significantly corelated with each other and with both progress of labor and mode of delivery with P value (<0.001). The highest sensitivity for prediction of progress of labor is observed using dVE (83%), the highest specificity is observed using AOP (78.3%). The highest sensitivity for prediction mode of delivery is for combined HPD & AOP (97.7%) while the highest specificity is for AOP (81%). When combining both HPD and AOP for prediction of mode of delivery, the assessment of both parameters was found to have a high sensitivity of 97.7% and a high positive predictive value of 86.63%. Conclusion: Intrapartum ultrasound examination is a valuable tool in the prediction of progress of labor and mode of delivery. The assessment of fetal head station by transperineal ultrasound measurement of HPD and AOP is much more informative of the progress of labor and the mode of delivery than digital assessment of fetal head station. Keywords: Labor, intrapartum ultrasound, Angle of progression, Head perineal distance, fetal head station, digital vaginal examination.

Variation of IgG N-linked glycosylation profile in diabetic retinopathy

2020 ◽  
Author(s):  
Zhiyuan Wu ◽  
Huiying Pan ◽  
Di Liu ◽  
Di Zhou ◽  
Haibin Li ◽  
...  
Keyword(s):  
Diabetic Retinopathy ◽  
Roc Analysis ◽  
Cross Validation ◽  
Underlying Mechanism ◽  
Brier Score ◽  
Glycosylation Profile ◽  
Inflammatory Status ◽  
Relationship Of ◽  
The Relationship ◽  
Igg Glycosylation

Abstract Background: The relationship of IgG glycosylation with diabetes and diabetic nephropathy has been reported, while its role in diabetic retinopathy (DR) remained unclear. We aimed to investigate and validate the association of IgG glycosylation with DR. Methods: We analyzed the IgG N-linked glycosylation profile and identified the specific panel in the discovery population using binary logistics model. Findings were validated in the replication population. The discriminative capacity of IgG glycosylation panel was explored by ROC analysis using cross validation and Brier score. Multiple sensitive analyses were performed on the whole population. Results: 2 IgG glycans (GP15, GP20) and 2 derived traits (IGP32, IGP54) were identified and validated significantly associated with DR (P<0.05), and the adjusted OR were 0.676, 0.671, 1.770, 0.681 in combined population, respectively. The glycosylation panel achieved an average AUC of 0.67 and 0.60 in the discovery and replication population. The association was independent of blood pressure, glucose and lipids, thus improving the ROC and Brier score when the panel added. In addition, the results remained consistent when the controls were re-defined and 1:3 re-matched. Conclusions: IgG glycosylation profile reflecting a pro-inflammatory status were associated with DR. The variation of IgG glycome deserves more attention in the aggravation of diabetes and the underlying mechanism warrants further research.

scholarly journals The influence of type of delivery, skin-to-skin contact and maternal nationality on breastfeeding rates at hospital discharge in a baby-friendly hospital in Italy

2019 ◽  
Vol 41 (1) ◽  
Author(s):  
Mauro Cinquetti ◽  
Anna Maria Colombari ◽  
Emanuela Battisti ◽  
Pierpaolo Marchetti ◽  
Giorgio Piacentini
Keyword(s):  
Cesarean Section ◽  
Hospital Discharge ◽  
Vaginal Delivery ◽  
Large Population ◽  
Positive Association ◽  
Skin Contact ◽  
Breastfeeding Practices ◽  
Foreign Nationality ◽  
Skin To Skin ◽  
Type Of Delivery

The aim of this epidemiological study is to evaluate how type of delivery, skin-to-skin contact and maternal nationality influence breastfeeding practices of newborns at discharge in a large population of babies born in the Baby-Friendly Hospital of San Bonifacio, Verona, Italy. Data were collected for all healthy newborns consecutively born over a period of three years, regarding type of delivery, feeding at hospital discharge, skin-to-skin procedure, and for a smaller group maternal nationality was recorded as well. The rate of exclusive breastfeeding in a group of 6017 newborns was 82.1%, higher among babies born by vaginal delivery than in those born by cesarean section (84.9% vs 65%; P<0.001). It was higher in those who had skin-to-skin contact than in those who did not, in both vaginal delivery (85.3% vs 69.2%; P<0.001) and cesarean section (67.7% vs 55.1%; P=0.009). Also, it was found to be higher in babies born to immigrant mothers than in those born to Italian mothers (89.9% vs 79.5%). Vaginal delivery, skin-to-skin contact and maternal foreign nationality have a positive association with breastfeeding at hospital discharge.

scholarly journals What Does Influence the Neonatal Microbiome?

Nutrients ◽  
2020 ◽  
Vol 12 (8) ◽  
pp. 2472
Author(s):  
Francisco J. Pérez-Cano
Keyword(s):  
Dietary Pattern ◽  
Current Knowledge ◽  
Antibiotic Usage ◽  
Maternal Factors ◽  
Feeding Type ◽  
New Research ◽  
The Relationship ◽  
Type Of Delivery

This editorial aims to provide a concise summary of the factors involved in the dynamics of microbiome establishment and maturation. At the same time, it briefly updates the current knowledge and opens new questions in this regard. Many factors act as drivers of the microbiota’s development at both pre- and post-natal levels (e.g., maternal factors, antibiotic usage, type of delivery, dietary pattern, post-natal feeding type, etc.). However, it is interesting to research into its real impact, the relationship between these external modulators, and how to modulate them. The are great opportunities for new research in the field.

Sign in / Sign up

Export Citation Format

Share Document