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Biolaw and Bioethics
Published in Roger Brownsword, Technology, Governance and Respect for the Law, 2023
The principal question in Montgomery was whether a pregnant woman who was a diabetic, and whose pregnancy was regarded as high-risk requiring intensive monitoring, should have been informed that there was a risk of shoulder dystocia and given the option of delivery by Caesarean Section. Instead, as the court narrated the story,11 she was not made aware of this particular risk; the risk eventuated during an attempted vaginal delivery that went horribly wrong; and, as a result, the baby was born with severe disabilities. The lower courts, following the Bolam principle, held that the acts of the consultant obstetrician and gynaecologist, who was by her own admission reluctant to steer women towards a Caesarean Section, were sufficiently supported by medical practice. However, the UK Supreme Court, resoundingly rejecting the Bolam test, held that the relationship between clinicians and patients must be rights-respecting rather than paternalistic and that patients have a right to be informed about their options (together with their relative benefits and risks).
Pediatric Imaging in General Radiography
Published in Christopher M. Hayre, William A. S. Cox, General Radiography, 2020
Allen Corrall, Joanna Fairhurst
This is a birth related injury which can occur several ways, most commonly caused by shoulder dystocia where the baby becomes stuck in the birth canal as one of its shoulder lodges on the mother’s pubic bone and during the associated assisted delivery the head (or trunk in breech birth) is pulled causing nerve damage as the neck is stretched (South & Isaacs, 2012). The neonate presents with upper limb paralysis on the affected side (sometimes both) and the X-ray request will often mention lack of tone in the affected arm. The role of X-ray is to exclude a fractured clavicle or humerus as an alternative cause for paresis. Nerve damage sequelae range from full recovery to a permanent degree of paralysis.
Solutions Using Machine Learning for Diabetes
Published in Punit Gupta, Dinesh Kumar Saini, Rohit Verma, Healthcare Solutions Using Machine Learning and Informatics, 2023
Jabar H. Yousif, Kashif Zia, Durgesh Srivastava
Diabetes affects individuals, families, businesses, and society as a whole. Six Arabic countries are among the ten highest globally for the prevalence of diabetes: Egypt, United Arab Emirates (UAE), Bahrain, Kuwait, Oman, and Saudi Arabia. Dietary modifications and physical activities can prevent all types of diabetes. Typically, health care providers treat diabetes with weight management plans, exercise, self-monitoring of blood glucose, and medication if required. Gestational diabetes is associated with several risks, including hypertensive disorder, Cesarean delivery, preterm birth, and infant shoulder dystocia [17].
MR neurography of the brachial plexus in adult and pediatric age groups: evolution, recent advances, and future directions
Published in Expert Review of Medical Devices, 2020
Alexander T. Mazal, Ali Faramarzalian, Jonathan D. Samet, Kevin Gill, Jonathan Cheng, Avneesh Chhabra
Upper plexus injuries are the most commonly encountered form of plexus injury during birth and are often related to fetal macrosomia or shoulder dystocia. Upper trunk injury typically involves the C5-6 nerve roots and classically manifests as Erb’s palsy (Figure 7), which is characterized by a ‘waiter’s tip’ posture with internal rotation of the arm and flexion of the wrist and fingers [58]* (this reference is believed to be of importance to readers because it provides a comprehensive overview of imaging of brachial plexus palsies, particularly those which occur in pediatrics). In breech delivery, failure to deliver the arms alongside the torso before the emergence of the fetal head can lead to hyper-abduction of the upper extremity and subsequent stretching of the eighth cervical and first thoracic roots [59]. Other rare mechanisms of obstetric-related lower plexus injury, including compound arm presentation, have also been described [60].