Abstract：
OBJECTIVE:We sought to determine the fetal injury rate associated with shoulder dystocia and to determine whether there is a higher rate of brachial plexus injury or bone fracture when fetal manipulation techniques are required for delivery. STUDY DESIGN:A retrospective review of 285 cases of shoulder dystocia that occurred between January 1991 and December 1995 was performed. The type, sequence, and combination of obstetric maneuvers used to relieve the shoulder dystocia were noted. These cases were divided into two groups, as follows: (1) those resolved with McRoberts' maneuver, suprapubic pressure, or proctoepisiotomy or a combination of these and (2) those that required the addition of direct fetal manipulative maneuvers (Woods, posterior arm, or Zavanelli). Fetal injury was defined as the occurrence of brachial plexus palsy, clavicular fracture, humeral fracture, or fetal death caused by asphyxial complications. RESULTS:The fetal injury rate was 24.9% (71/285), including 48 (16.8%) brachial plexus palsies, 27 (9.5%) clavicular fractures, and 12 (4.2%) humeral fractures. Sixteen infants had both nerve injury and bone fracture. Four (8.9%) brachial plexus palsies had documented persistence at 1 year of follow-up. One neonatal death occurred at age 3 months after an episode of hypoxic ischemic encephalopathy. The incidence of bone fracture was not higher when direct fetal manipulation was required: 21 of 127 (16.5%) versus 18 of 158 (11.4%), p = 0.21. The incidence of brachial plexus palsy was also similar in both groups (27/127 vs 21/158, p = 0.1). CONCLUSIONS:Direct fetal manipulation techniques used to alleviate shoulder dystocia are not associated with an increased rate of bone fracture or brachial plexus injury.
journal_name
Am J Obstet Gynecoljournal_title
American journal of obstetrics and gynecologyauthors
Gherman RB,Ouzounian JG,Goodwin TMdoi
10.1016/s0002-9378(98)70312-6subject
Has Abstractpub_date
1998-06-01 00:00:00pages
1126-30issue
6eissn
0002-9378issn
1097-6868pii
S0002-9378(98)70312-6journal_volume
178pub_type
杂志文章abstract：:In the conservative management of premature rupture of the membranes, most patients have oligohydramnios caused by continuous leakage of amniotic fluid. To avoid unfavorable effects of oligohydramnios on fetal development and well-being, we infused physiologic saline solution continuously into the amniotic cavity at a...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/0002-9378(89)90243-3
更新日期：1989-07-01 00:00:00
abstract：BACKGROUND:A growing literature suggests that minority races, particularly Black women, have a lower probability of live birth and higher risk of perinatal complications after autologous assisted reproductive technology. However, questions still remain as to whether these racial disparities have arisen because of assoc...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/j.ajog.2020.09.013
更新日期：2020-09-12 00:00:00
abstract：OBJECTIVES:We sought to determine the types of congenital anomalies affecting infants of women with gestational diabetes mellitus or type 2 diabetes and to examine the relationship between those malformation types and measures of initial glycemia of women at entry into prenatal care with type 2 diabetes or at time of d...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/s0002-9378(00)70217-1
更新日期：2000-02-01 00:00:00
abstract：:A light and electron microscopic study was undertaken of the early phases of cervical squamous metaplasia. A study of areas of columnar epithelium with one row of subcolumnar cells revealed a spectrum of squamous differentiation ranging from cytologically undifferentiation to more characteristically basal type squamou...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/s0002-9378(15)33239-7
更新日期：1980-07-15 00:00:00
abstract：OBJECTIVE:The purpose of this study was to assess the role of fetal nasal bones evaluation in first-trimester screening for trisomy 21 in selected and unselected pregnancies. STUDY DESIGN:Visualization of the nasal bones was attempted in women attending for routine nuchal translucency screening (unselected population,...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/j.ajog.2005.09.008
更新日期：2006-03-01 00:00:00
abstract：:The effect of progesterone on estrogen-induced uterine blood flow was investigated in repeated experiments in seven nonpregnant, oophorectomized ewes with chronically implanted electromagnetic flow probes and catheters inserted into branches of the uterine arteries. Administered alone, progesterone has no effect on ba...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/0002-9378(77)90617-2
更新日期：1977-06-01 00:00:00
abstract：OBJECTIVE:We sought to assess the modern prevalence and risk factors for third- and fourth-degree perineal tears. STUDY DESIGN:The study population comprised 38,252 women who delivered in one medical center, from January 2005 through December 2009, and met the following inclusion criteria: singleton pregnancy, vertex ...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/j.ajog.2010.11.019
更新日期：2011-04-01 00:00:00
abstract：:An analysis of the medical records of 103 women with Crohn's disease points up the following observations. There is a slight increase in spontaneous abortions and a substantial degree of subfertility. The obstetric experience is the same as in the normal obstetric population and the effects of the disease on pregnancy...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/0002-9378(78)90664-6
更新日期：1978-05-15 00:00:00
abstract：OBJECTIVE:We sought to compare our 5-year program of fragile X screening of high-risk gravid women with our program of fragile X testing of affected individuals (probands). STUDY DESIGN:All women referred to the prenatal genetics clinic from 1994 to 1998 who had a family history of unspecified mental retardation or le...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/s0002-9378(99)70302-9
更新日期：1999-10-01 00:00:00
abstract：OBJECTIVE:Our purpose was to quantitatively assess the effects of oxytocin on membrane properties in the pregnant human myometrium. STUDY DESIGN:Specimens were obtained from the lower uterine segment during cesarean section at term. Electrical activity was recorded from individual cells by a conventional microelectrod...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/s0002-9378(97)70465-4
更新日期：1997-07-01 00:00:00
abstract：:The known effect of progesterone on carbohydrate metabolism prompted a study of some of the hepatic "lipogenic" and "gluconeogenic" enzymes in rats treated with progesterone. Several enzymes providing lipid precursors (phosphofructokinase, malic enzyme, glucose-6-phosphate dehydrogenase, and citrate cleavage enzyme) s...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/0002-9378(77)90732-3
更新日期：1977-09-15 00:00:00
abstract：:To determine whether hormone analysis could be used for accurate determination of fetal sex, we measured testosterone (T) and follicle-stimulating hormone (FSH) in 130 amniotic fluid samples at midgestation. The mean unconjugated T in amniotic fluid of 73 patients carrying male fetuses was 202 pg. per milliliter (95 p...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/0002-9378(77)90034-5
更新日期：1977-07-01 00:00:00
abstract：:The biophysical profile has proved to be a valuable tool for the assessment of fetal well-being, independent of gestational age. Magnesium sulfate is commonly used as a tocolytic agent, yet relatively little is known about its effects on the biophysical activities of the fetus. To investigate the effects of magnesium ...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/0002-9378(89)90399-2
更新日期：1989-09-01 00:00:00
abstract：OBJECTIVE:Conventional diagnosis of bacterial vaginosis contains some controversial points. To understand accurately the relationship between clinical stages and the microbiotas, the intravaginal microbial flora was analyzed by the clone library method. STUDY DESIGN:Vaginal fluid samples from 31 patients were examined...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/j.ajog.2011.04.018
更新日期：2011-09-01 00:00:00
abstract：:In vivo proton magnetic resonance spectroscopy of human fetal brain was performed in the third trimester of pregnancy. Spectra were obtained showing signals assigned to cerebral compounds such as N-acetylaspartate, creatine, and cholines. Relative signal intensities were similar to those observed in neonatal brain spe...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/s0002-9378(94)70111-3
更新日期：1994-04-01 00:00:00
abstract：OBJECTIVE:The purpose of this study was to determine whether plasma from women with severe preeclampsia stimulates the production of endothelial cell interleukin-6 production and whether vitamin E could inhibit this process. STUDY DESIGN:Human umbilical vein endothelial cells were cultured in the presence of 5% plasma...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1067/mob.2003.134
更新日期：2003-03-01 00:00:00
abstract：:The catecholamine metabolites HMPG and VMA have been determined in samples of amniotic fluid in 38 uncomplicated pregnancies, seven cases of IUGR, and six cases of diabetes. A successive increase of HMPG and VMA was found toward the end of the pregnancy. HMPG and particularly the HMPG/VMA ratio were significantly high...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/0002-9378(80)90639-0
更新日期：1980-04-15 00:00:00
abstract：:A letter is written in response to a report by Drs. Beric, Kupresanin, and Hulka (Am. J, Obslet Gynecol. 114: 273, 1972) which stated that the Karman catheter is not suitable for terminating pregnancies beyond Week 6 of pregnancy. The use of a Karman catheter in terminating pregnancies of 7-10 weeks resulted in 47% t...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/0002-9378(73)91070-3
更新日期：1973-05-15 00:00:00
abstract：:Fetal heart rate (FHR) is influenced by the central nervous system, cardiac automatism, biochemical factors, etc. Changes in FHR were correlated with the anatomic defect in autopsy material from 20 anencephalic infants, and, on this basis, the following hypotheses were formed, subject to later experimental proof. (1) ...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/0002-9378(84)90199-6
更新日期：1984-05-15 00:00:00
abstract：:The accuracy of clinical diagnosis for pelvic inflammatory disease was determined in 95 women who presented with pelvic pain to primary care physicians and then were referred to gynecologists. Laparoscopy or laparotomy with endometrial biopsy and fimbrial minibiopsy revealed that prevalence of pelvic inflammatory was ...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/0002-9378(91)90639-9
更新日期：1991-01-01 00:00:00
abstract：:Late in 1995 and early 1996, 4 epidemiologic studies were published that resulted in a crude mean weighted relative risk of approximately 2 when third-generation oral contraceptives were compared with second-generation oral contraceptives as risk factors for venous thromboembolism. This article reviews empirical evide...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章,评审
doi：10.1053/ob.1998.v179.a93059
更新日期：1998-09-01 00:00:00
abstract：:Ovaries from six women with normal menstrual cycles, a follicle wall biopsy specimen from a gonadotropin-stimulated preovulatory ovary, and a corpus luteum of pregnancy were examined by immunohistochemistry for the presence of immunoreactive renin and angiotensin II. Both antisera densely stained thecal and stromal ce...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/0002-9378(89)90077-x
更新日期：1989-01-01 00:00:00
abstract：OBJECTIVE:The purpose of this study was to investigate temporal correlations between maternal serum placenta growth factor levels and placental perfusion in early human pregnancies. STUDY DESIGN:Systolic umbilical artery Doppler blood flow velocity indices at fetal and placental insertion sites were measured between 7...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/j.ajog.2006.01.012
更新日期：2006-06-01 00:00:00
abstract：OBJECTIVE:The objective of this study was to determine the minimum threshold level at which maximum anatomic prolapse predicts bothersome pelvic floor symptoms. STUDY DESIGN:We performed a cross-sectional study of women older than 40 years undergoing gynecologic and urogynecologic examinations using Pelvic Organ Prola...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/j.ajog.2008.07.028
更新日期：2008-12-01 00:00:00
abstract：:Different perspectives toward symptoms of urogenital aging exist among postmenopausal women, influenced by social and cultural factors, but one constant is that women rarely feel able to discuss urogenital problems freely--with their physicians, husbands, or friends. European women >55 years old were brought up to pri...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章,评审
doi：10.1016/s0002-9378(98)70556-3
更新日期：1998-05-01 00:00:00
abstract：OBJECTIVE:This study was undertaken to clone and express a recombinant human zona pellucida protein 3 and to characterize its biologic activities as a sperm ligand and an inducer of the acrosome reaction. STUDY DESIGN:Human ovarian teratocarcinoma (PA-1) cells were transfected with an expression vector containing huma...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1067/mob.2001.113849
更新日期：2001-04-01 00:00:00
abstract：OBJECTIVE:The objective of this study was to assess the reliability and validity of an objective structured assessment of technical skills (OSATS) for repair of fourth-degree obstetric lacerations on a surgical model. STUDY DESIGN:Three blinded judges reviewed recordings of 20 junior and 20 senior obstetrics-gynecolog...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/j.ajog.2008.07.054
更新日期：2008-12-01 00:00:00
abstract：OBJECTIVE:We sought to characterize reports to the Vaccine Adverse Event Reporting System (VAERS) of pregnant women who received tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis vaccine (Tdap). STUDY DESIGN:We searched VAERS for reports of pregnant women who received Tdap from Jan. 1, 2005, through J...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/j.ajog.2012.05.006
更新日期：2012-07-01 00:00:00
abstract：BACKGROUND:Although consensus guidelines on the management of cardiovascular disease in pregnancy reserve cesarean delivery for obstetric indications, there is a paucity of data to support this approach. OBJECTIVE:The objective of the study was to compare cardiovascular and obstetric morbidity in women with cardiovasc...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/j.ajog.2019.07.019
更新日期：2020-01-01 00:00:00
abstract：:Neonatal mortality in Colorado in the 3-year period 1977-1979 has been analyzed by means of standardized neonatal mortality ratios derived from birth weight-specific mortality for every obstetric facility. The standardized neonatal mortality ratios adjusted for the percentage of neonatal deaths due to untreatable diso...
journal_title：American journal of obstetrics and gynecology
pub_type： 杂志文章
doi：10.1016/s0002-9378(84)90447-2
更新日期：1984-04-15 00:00:00
