scholarly journals Is routine X-ray pelvimetry of value to decide on mode of delivery for women with labor dystocia?

2021 ◽  
Vol 48 (2) ◽  
pp. 317
Keyword(s):  
Mode Of Delivery ◽  
X Ray ◽  
Labor Dystocia

scholarly journals Is routine X-ray pelvimetry of value to decide on mode of delivery for women with labor dystocia?

2020 ◽  
Author(s):  
Kaori Kawakami ◽  
Yuria Tanaka ◽  
Yuji Ikeda ◽  
Atsushi Komatsu ◽  
Osamu Kobayashi ◽  
...  
Keyword(s):  
Odds Ratio ◽  
Mode Of Delivery ◽  
Transverse Diameter ◽  
Maternal Height ◽  
Maternal Weight ◽  
Cephalopelvic Disproportion ◽  
X Ray ◽  
Cesarean Section Delivery ◽  
Labor Dystocia ◽  
Independent Variable

Abstract Background: X-ray pelvimetry is used for evaluation of pelvic inlet generally to diagnose cephalopelvic disproportion (CPD) or contracted inlet. Cesarean section delivery (C/S) is often performed for labor dystocia without CPD or contracted inlet. Here, we examined whether X-ray pelvimetry is useful to decide on mode of delivery in women with dystocia.Method: A total of 1118 pregnant women received X-ray pelvimetry before or during labor. Overall, 205 women with cesarean deliveries for indications except for dystocia were excluded. The remaining 913 women undergoing induction/augmentation were retrospectively investigated. Obstetrical and maternal variables were analyzed by univariate, multivariate or ROC analysis.Results: Among 913 women, 37 (4%), including three with contracted inlet and seven with CPD, gave birth by C/S, whereas 876 gave birth by vaginal delivery. Low maternal height, older age, small obstetrical conjugate, large weight and infant head size were significantly associated with risk of C/S for dystocia. Multivariate analysis revealed that the obstetrical conjugate was an independent variable for risk of C/S. The area under the ROC curve (AUC) and the optimal cut-off values, respectively, were as follows: obstetrical conjugate: 0.68 and 11.7 cm (odds ratio=4.27), transverse diameter: 0.59 and 11.4 cm (odds ratio=1.82), maternal height: 0.70 and 155.5 cm (odds ratio=4.33), and maternal weight before pregnancy: 0.55 and 49.7 kg (odds ratio=1.98).Conclusion: The obstetrical conjugate was an independent variable associated with risk of C/S for dystocia. Additionally, maternal height was comparable to the conjugate in term of diagnostic ability. Our data suggested that routine X-ray pelvimetry was not beneficial to identify women at risk of C/S for dystocia.

Predicting the Mode of Delivery by Angle of Progression (AOP) before the Onset of Labor by Transperineal Ultrasound in Nulliparous Women

2020 ◽  
Vol 16 (1) ◽  
pp. 39-45 ◽  
Author(s):  
Priyanka Shankerappa Minajagi ◽  
Sujatha Bagepalli Srinivas ◽  
Shripad Hebbar
Keyword(s):  
Caesarean Section ◽  
Mode Of Delivery ◽  
Antenatal Clinic ◽  
Transperineal Ultrasound ◽  
Multivariable Logistic Regression Analysis ◽  
Fetal Head ◽  
Labor Dystocia ◽  
Nulliparous Women ◽  
Fetal Position ◽  
Angle Of Progression

Background: Prediction of the mode of delivery is crucial for better labour outcome. Recent studies suggest that the angle of progression (AOP), measured using transperineal ultrasound, can substantially aid the assessment of fetal head descent during labor, thereby predicting the mode of delivery. Objective: To assess the ability of the AOP measured by transperineal ultrasound to predict the mode of delivery in nulliparous women before the onset of labor. Methods: A prospective observational study was conducted at our hospital, of nulliparous women who had presented to the antenatal clinic at ≥ 38 weeks of gestation but not in labor. AOP was measured using transperineal ultrasonography and compared among the women having Caesarean section (CS) due to labor dystocia and vaginal delivery (VD). Various other confounding factors which increase the risk of caesarean section were analyzed. Results: Among total 120 nulliparous women, the mean AOP was narrower in patients undergoing CS (n = 28) compared to those with VD (n = 92) (91.6 ± 6.1° vs. 100.7 ± 6.9°; P < 0.01). Multivariable logistic regression analysis revealed that narrow AOP values (OR 3.66; P < 0.001; 95% CI 1.7- 14.5) and occiput-posterior fetal position (OR 1.63; P = 0.04; 95% CI 1.0-7.5) were the independent risk factors for CS. An AOP ≥ 96° (calculated from the ROC curve) was associated with VD in 95% (76/80) of women and an AOP < 96° was observed among 60% (24/40) of women who underwent CS. Conclusion: Narrow AOP (< 96°) and occiput-posterior fetal position are at higher risk for CS due to labor dystocia. AOP measured at the antenatal period could accurately predict the mode of delivery, thereby modifying labor outcome.

scholarly journals Epidural analgesia at trial of labor after cesarean (TOLAC): a significant adjunct to successful vaginal birth after cesarean (VBAC)

2018 ◽  
Vol 46 (3) ◽  
pp. 261-269 ◽  
Author(s):  
Sorina Grisaru-Granovsky ◽  
Maayan Bas-Lando ◽  
Lior Drukker ◽  
Fred Haouzi ◽  
Rivka Farkash ◽  
...  
Keyword(s):  
Epidural Analgesia ◽  
Uterine Rupture ◽  
Mode Of Delivery ◽  
Similar Rate ◽  
Vaginal Birth ◽  
Neonatal Outcomes ◽  
Vaginal Birth After Cesarean ◽  
Trial Of Labor ◽  
Labor Dystocia ◽  
Significant Covariates

Abstract Introduction: Epidural analgesia has been considered a risk factor for labor dystocia at trial of labor after cesarean (TOLAC) and uterine rupture. We evaluated the association between exposure to epidural during TOLAC and mode of delivery and maternal-neonatal outcomes. Materials and methods: A single center retrospective study of women that consented to TOLAC within a strict protocol between 2006 and 2013. Epidural “users” were compared to “non-users”. Primary outcome was the mode of delivery: repeat in-labor cesarean or vaginal birth after cesarean (VBAC). Secondary outcomes were maternal/neonatal morbidities. Univariate/multivariate analyses for associations between epidural and mode of delivery were adjusted for significant covariates/mediators. Results: Of a total of 105,471 births registered, 9464 (9.0%) were eligible for TOLAC; 7149 (75.5%) women consented to TOLAC, among which 4081 (57.1%) had epidural analgesia. The in labor cesarean rate was significantly lower for the epidural “users” 8.7% vs. “non-users” 11.8%, P<0.0001, with a parallel increased rate of instrumental delivery. Uterine rupture rates were comparable: 0.4% and 0.29%, respectively (P=0.31). The adjusted multivariate model showed that epidural “users” were more likely to experience a VBAC, odds ratio (OR) 4.58 [3.67; 5.70]; P<0.0001 with a similar rate of adverse maternal-neonatal outcomes. Conclusion: Epidural analgesia at TOLAC may emerge as a safe and significant adjunct for VBAC.

Space and Time Distribution of Hard X-Ray Emission in a Loop at the Beginning of a Flare

1994 ◽  
Vol 144 ◽  
pp. 275-277
Author(s):  
M. Karlický ◽  
J. C. Hénoux
Keyword(s):  
Time Distribution ◽  
Electron Bombardment ◽  
Spatial Evolution ◽  
Superthermal Electrons ◽  
Flare Loop ◽  
X Ray ◽  
Superthermal Electron ◽  
Flare Loops ◽  
Chromospheric Evaporation ◽  
Temporal And Spatial

AbstractUsing a new ID hybrid model of the electron bombardment in flare loops, we study not only the evolution of densities, plasma velocities and temperatures in the loop, but also the temporal and spatial evolution of hard X-ray emission. In the present paper a continuous bombardment by electrons isotropically accelerated at the top of flare loop with a power-law injection distribution function is considered. The computations include the effects of the return-current that reduces significantly the depth of the chromospheric layer which is evaporated. The present modelling is made with superthermal electron parameters corresponding to the classical resistivity regime for an input energy flux of superthermal electrons of 109erg cm−2s−1. It was found that due to the electron bombardment the two chromospheric evaporation waves are generated at both feet of the loop and they propagate up to the top, where they collide and cause temporary density and hard X-ray enhancements.

Some Problems in Understanding the Solar Corona

1994 ◽  
Vol 144 ◽  
pp. 1-9
Author(s):  
A. H. Gabriel
Keyword(s):  
Solar Corona ◽  
Solar Atmosphere ◽  
Theoretical Modelling ◽  
Total System ◽  
Major Advance ◽  
X Ray ◽  
Proper Perspective ◽  
Space Observations

The development of the physics of the solar atmosphere during the last 50 years has been greatly influenced by the increasing capability of observations made from space. Access to images and spectra of the hotter plasma in the UV, XUV and X-ray regions provided a major advance over the few coronal forbidden lines seen in the visible and enabled the cooler chromospheric and photospheric plasma to be seen in its proper perspective, as part of a total system. In this way space observations have stimulated new and important advances, not only in space but also in ground-based observations and theoretical modelling, so that today we find a well-balanced harmony between the three techniques.

White-Light Coronal Structures: Streamers and CMEs

1994 ◽  
Vol 144 ◽  
pp. 82
Author(s):  
E. Hildner
Keyword(s):  
Emission Line ◽  
Electron Density ◽  
White Light ◽  
Coronal Mass Ejections ◽  
X Rays ◽  
Solar Cycles ◽  
Temperature Function ◽  
X Ray ◽  
Eclipse Observations ◽  
Coronal Structures

AbstractOver the last twenty years, orbiting coronagraphs have vastly increased the amount of observational material for the whitelight corona. Spanning almost two solar cycles, and augmented by ground-based K-coronameter, emission-line, and eclipse observations, these data allow us to assess,inter alia: the typical and atypical behavior of the corona; how the corona evolves on time scales from minutes to a decade; and (in some respects) the relation between photospheric, coronal, and interplanetary features. This talk will review recent results on these three topics. A remark or two will attempt to relate the whitelight corona between 1.5 and 6 R⊙to the corona seen at lower altitudes in soft X-rays (e.g., with Yohkoh). The whitelight emission depends only on integrated electron density independent of temperature, whereas the soft X-ray emission depends upon the integral of electron density squared times a temperature function. The properties of coronal mass ejections (CMEs) will be reviewed briefly and their relationships to other solar and interplanetary phenomena will be noted.

Iron K-Line Emission from X-Ray Binaries

1988 ◽  
Vol 102 ◽  
pp. 47-50
Author(s):  
K. Masai ◽  
S. Hayakawa ◽  
F. Nagase
Keyword(s):  
Accretion Disk ◽  
Radiative Recombination ◽  
Characteristic Temperature ◽  
Line Emission ◽  
Ionization Front ◽  
Continuum Radiation ◽  
X Ray ◽  
Low Mass ◽  
X Ray Binaries

AbstractEmission mechanisms of the iron Kα-lines in X-ray binaries are discussed in relation with the characteristic temperature Txof continuum radiation thereof. The 6.7 keV line is ascribed to radiative recombination followed by cascades in a corona of ∼ 100 eV formed above the accretion disk. This mechanism is attained for Tx≲ 10 keV as observed for low mass X-ray binaries. The 6.4 keV line observed for binary X-ray pulsars with Tx&gt; 10 keV is likely due to fluorescence outside the He II ionization front.

Diagnostics of Gold Laser Plasmas

1988 ◽  
Vol 102 ◽  
pp. 357-360
Author(s):  
J.C. Gauthier ◽  
J.P. Geindre ◽  
P. Monier ◽  
C. Chenais-Popovics ◽  
N. Tragin ◽  
...  
Keyword(s):  
Experimental Results ◽  
Pure Gold ◽  
Electronic Temperature ◽  
X Ray ◽  
Laser Plasmas ◽  
Collisional Radiative Model ◽  
Radiative Model

AbstractIn order to achieve a nickel-like X ray laser scheme we need a tool to determine the parameters which characterise the high-Z plasma. The aim of this work is to study gold laser plasmas and to compare experimental results to a collisional-radiative model which describes nickel-like ions. The electronic temperature and density are measured by the emission of an aluminium tracer. They are compared to the predictions of the nickel-like model for pure gold. The results show that the density and temperature can be estimated in a pure gold plasma.

Axial Observation of X-Ray Spectra from a Beam-Foil Source

1988 ◽  
Vol 102 ◽  
pp. 339-342
Author(s):  
J.M. Laming ◽  
J.D. Silver ◽  
R. Barnsley ◽  
J. Dunn ◽  
K.D. Evans ◽  
...  
Keyword(s):  
Spectral Resolution ◽  
Heavy Ion ◽  
Ion Beams ◽  
Beam Axis ◽  
Doppler Broadening ◽  
X Ray ◽  
Beam Foil

AbstractNew observations of x-ray spectra from foil-excited heavy ion beams are reported. By observing the target in a direction along the beam axis, an improvement in spectral resolution, δλ/λ, by about a factor of two is achieved, due to the reduced Doppler broadening in this geometry.

Observed and Theoretical Spectra in the 10–100Å Interval

1988 ◽  
Vol 102 ◽  
pp. 259-261
Author(s):  
W.A. Brown ◽  
M.E. Bruner ◽  
L.W. Acton
Keyword(s):  
Sounding Rocket ◽  
Full Spectrum ◽  
X Ray

AbstractThe soft x-ray spectra recorded in two sounding rocket flights in 1982 and 1985 are compared with with predicted spectra. The poster presents the processed densitometer trace of the full spectrum together with the new spectrum from the 1985 experiment. This note compares the intensities of the lines with predictions.

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