Abstract:
OBJECTIVE:A depressed skull fracture is an inward buckling of the calvarial bones and is referred to as a "ping-pong" fracture. This study aimed to look at differences between "spontaneous" and "instrument-associated" depressed skull fractures. STUDY DESIGN:This retrospective, case-control analysis included every neonate who was admitted with a depressed skull fracture between 1990 and 2000. Cases after a spontaneous vaginal delivery, elective cesarean delivery, or cesarean delivery that was performed during labor without previous instrument use were classified as "spontaneous" (n = 18 cases). Cases after a delivery in which forceps or a vacuum cup had been used either successfully or unsuccessfully were classified as "instrument-associated" (n = 50 cases). Continuous data were analyzed with 2-tailed unpaired t tests; chi 2 analysis was used for nominal data. A probability value of <.05 was considered statistically significant. RESULTS:Fifty depressed skull fractures were associated with an instrument delivery, and 18 depressed skull fractures were classified as "spontaneous." The only obstetric parameter that differed significantly between the 2 groups was the length of the active phase. Among the 68 neonates, 15 neonates underwent prolonged second stage, forceps or manual head rotation, or forceps use during elective cesarean delivery. All "instrument-associated" cases were caused by forceps application or sequential instrument use; depressed skull fractures never occurred after isolated vacuum extraction. Every type of forceps was involved. Intracranial lesions were significantly more frequent in the instrument-associated group (30% vs 0%; P = .02). Two infants sustained persistent severe motor disabilities. CONCLUSION:Depressed skull fractures occur in the setting of spontaneous and operative deliveries, although the incidence is higher in the latter case. Depressed skull fractures that are associated with instrumental deliveries are significantly more likely to be associated with intracranial lesions. Persistent disabilities are rare.
journal_name
Am J Obstet Gynecoljournal_title
American journal of obstetrics and gynecologyauthors
Dupuis O,Silveira R,Dupont C,Mottolese C,Kahn P,Dittmar A,Rudigoz RCdoi
10.1016/j.ajog.2004.06.035subject
Has Abstractpub_date
2005-01-01 00:00:00pages
165-70issue
1eissn
0002-9378issn
1097-6868pii
S0002937804006350journal_volume
192pub_type
杂志文章,多中心研究abstract::The intrauterine pressure data obtained from oxytocin-treated patients in dysfunctional labor, managed by a specific oxytocin regimen and a computer-defined goal of uterine activity, are analyzed. Questions asked concern the efficacy of the computer diagnosis of hypocontractility, the quantity of uterine activity need...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(83)91189-4
更新日期:1983-03-01 00:00:00
abstract::Compliance difficulties are more common among oral contraceptive users than is generally appreciated. Inconsistent use and method discontinuation are estimated to account for approximately 20% of the annual 3.5 million annual unintended pregnancies in the United States. In the past research focused on adolescents, for...
journal_title:American journal of obstetrics and gynecology
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doi:10.1016/s0002-9378(99)70718-0
更新日期:1999-02-01 00:00:00
abstract:OBJECTIVE:The objective of the study was to determine whether an individualized growth standard (IS) improves the identification of preterm small-for-gestational-age (SGA) neonates at risk of developing moderate/severe cerebral palsy (CP) or death. STUDY DESIGN:This study was a secondary analysis of data from a random...
journal_title:American journal of obstetrics and gynecology
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更新日期:2013-10-01 00:00:00
abstract:OBJECTIVE:We examined the effect of interferon gamma on proliferation and epidermal growth factor receptor expression in ovarian cancer cell lines and normal ovarian epithelial cells. STUDY DESIGN:The tritiated thymidine incorporation assay was used to assess the effect of interferon gamma on proliferation. Scatchard ...
journal_title:American journal of obstetrics and gynecology
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doi:10.1016/0002-9378(92)91790-h
更新日期:1992-12-01 00:00:00
abstract:OBJECTIVE:The objective of the study was to assess whether implementation of a statewide initiative was associated with changes in perinatal human immunodeficiency virus (HIV) testing practices. STUDY DESIGN:This was an observational cohort study of all 1,141,799 women who delivered in Illinois birthing hospitals over...
journal_title:American journal of obstetrics and gynecology
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更新日期:2012-11-01 00:00:00
abstract::Immunoglobulins G, M, and A were found in varying concentrations in four different human fetal anatomic compartments of 17 fetuses in the absence of apparent infection. The highest levels were noted in the thoracic cavity. ...
journal_title:American journal of obstetrics and gynecology
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doi:10.1016/s0002-9378(88)80146-7
更新日期:1988-10-01 00:00:00
abstract::One hundred incidental appendectomies were performed in patients undergoing operative laparoscopy (videolaseroscopy) for evaluating and treating various major diseases of the reproductive organs. Except for a fever resolving within 24 hours in one case and mild periumbilical ecchymosis, there were no intraoperative or...
journal_title:American journal of obstetrics and gynecology
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更新日期:1991-09-01 00:00:00
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journal_title:American journal of obstetrics and gynecology
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更新日期:2007-06-01 00:00:00
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pub_type: 杂志文章
doi:10.1016/0002-9378(91)90503-j
更新日期:1991-03-01 00:00:00
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更新日期:2020-12-09 00:00:00
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journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章,评审
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更新日期:1985-06-15 00:00:00
abstract::Fifty-five ewes with chronically catheterized singleton gestations were studied to assess changes in basal concentrations of fetal catecholamines with increasing gestational age. All pregnancies were time dated, and measurements of catecholamines were conducted at least 5 days after placement of fetal catheters when f...
journal_title:American journal of obstetrics and gynecology
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更新日期:2007-01-01 00:00:00
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更新日期:2011-11-01 00:00:00
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doi:10.1016/s0002-9378(98)70498-3
更新日期:1998-04-01 00:00:00
abstract::A placental lesion associated with elevated maternal serum alpha-fetoprotein level and a positive Kleihauer-Betke test is reported. Serial ultrasonograms showed a progressive increase in the echogenicity of the lesion that corresponded to a large intervillous thrombosis after delivery. This case illustrates the import...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
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journal_title:American journal of obstetrics and gynecology
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更新日期:2020-10-08 00:00:00
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journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章,多中心研究
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doi:10.1016/0002-9378(93)90679-d
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更新日期:1999-02-01 00:00:00
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journal_title:American journal of obstetrics and gynecology
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更新日期:1978-07-01 00:00:00
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journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2005.09.001
更新日期:2006-03-01 00:00:00
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更新日期:1994-07-01 00:00:00
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journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
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更新日期:1994-12-01 00:00:00
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journal_title:American journal of obstetrics and gynecology
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更新日期:1989-01-01 00:00:00
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pub_type: 杂志文章
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更新日期:1991-05-01 00:00:00
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journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
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更新日期:1993-10-01 00:00:00
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journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章,多中心研究
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更新日期:2013-06-01 00:00:00