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Operative Vaginal Delivery
Published in Vincenzo Berghella, Obstetric Evidence Based Guidelines, 2022
Adeeb Khalifeh, Megan Piacquadio
NeonatalIntracranial hemorrhage rate is increased in OVD, but the absolute risk is low [19].The rates of intracranial hemorrhage and neonatal encephalopathy compared to second-stage CD are similar [19, 20].Cephalohematoma, fetal scalp lacerations, retinal hemorrhages, subgaleal hematoma, and intracranial hemorrhages have been reported in vacuum deliveries.Facial lacerations, facial nerve palsy, and corneal abrasion are more common with forceps delivery.Long-term cognitive outcomes are similar to spontaneous vaginal deliveries [21, 22].Recent data show that the duration of OVD, more specifically vacuum duration, is correlated to a greater risk of adverse neonatal outcomes [23].
Ventouse Delivery
Published in Gowri Dorairajan, Management of Normal and High Risk Labour During Childbirth, 2022
Vacuum is considered safer than forceps if appropriately applied, placing the cup at the flexion point. The risk of maternal injury is lesser with a vacuum if soft tissue entrapment is prevented. Vacuum assistance can cause cephalhematoma and subgaleal bleed.
Neurologic examination of the infant and child
Published in Michael Y. Wang, Andrea L. Strayer, Odette A. Harris, Cathy M. Rosenberg, Praveen V. Mummaneni, Handbook of Neurosurgery, Neurology, and Spinal Medicine for Nurses and Advanced Practice Health Professionals, 2017
Karthik Madhavan, George M. Ghobrial, Stephen S. Burks, Michael Y. Wang
Caput succedaneum and cephalhematoma are often noted during the first visit. Cephalohematoma is a traumatic subperiosteal hematoma that occurs underneath the skin, in the periosteum of the infant’s skull bone. Cephalohematoma does not pose any risk to the brain, as it is extracranial accumulation and is limited at the suture. Caput succedaneum is a neonatal condition involving a serosanguinous, subcutaneous, extraperiosteal fluid collection with poorly defined margins caused by the pressure of the presenting part of the scalp against the dilating cervix; it does not follow the suture lines.
The BD Odon Device™: an update of its current state
Published in Journal of Obstetrics and Gynaecology, 2021
Manuel Gonçalves-Henriques, Pedro Brandão
The vacuum extraction was introduced during the 20th century and has gained popularity over the years. If criteria for applying a vacuum extractor are met, most of the deliveries are successful requiring no other intervention. As disadvantages, it may cause scalp abrasion (1.5–2.5%), foetal cephalohematoma (6–15%) and retinal haemorrhage (up to 29%) and it increases the risk of perineal trauma compared to non-assisted deliveries (Vacca 2006; O’Mahony et al. 2010; Howard and Makhlouf 2016; van den Akker 2019).
Pathologic Skull Fracture in a Near-Term Neonate with Arthrochalasia Type Ehlers-Danlos Syndrome: A Case Report
Published in Fetal and Pediatric Pathology, 2022
Yi Ariel Liu, Chieko Chijiwa, Christopher P. Dunham, Douglas H. Jamieson, Alfonso Solimano, Julianne van Schalkwyk, Millan S. Patel, Anna F. Lee
Autopsy demonstrated a female near term infant, appropriately grown for 36 weeks of gestation. Craniofacial dysmorphic features included hypertelorism, short palpebral fissures, low set posteriorly rotated ears, pointed nose, large anterior fontanelle, and retrognathia. Cephalohematoma was confirmed. The extremities were notable for broad hands with tapered fingers and broad thumbs, bilateral camptodactyly, especially of digits 2-3, and deep creases between toes. The skin covering the extremities was wrinkled and redundant, raising the possibility of cutis laxa (Fig. 1). However, skin biopsy showed nonspecific histology with appropriately distributed elastic fibers on elastin stain. There was no atypical coiling, fragmentation, or clumping of the elastin fibers, and no complete loss of elastin fibers that would be consistent with cutis laxa. Postmortem skeletal survey demonstrated a fracture of the left parietal skull, and bilateral hip dislocations with metaphyseal sclerosis (Fig. 2). Other skeletal survey findings included a vertical skull base and beaded costovertebral joints. Autopsy additionally revealed a fracture at the occipital base of skull. Histologic analysis of the fractures showed fracture-associated hematomas with no bony remodeling, consistent with early fracture repair. Neuropathology examination revealed bilateral acute to subacute periventricular hemorrhages, with concomitant and extensive right frontal lobe hemorrhage extending to the intraventricular and subarachnoid spaces. Subacute hypoxic-ischemic injury with gliosis was also identified, suggestive of an insult sustained in the perinatal period. Brain development was normal for age. Ocular structures were normally formed. Hypoxic-ischemic changes were seen in the liver (as patchy necrosis and cholestasis), and the kidneys, adrenals, and lymph nodes (as petechial hemorrhages). The thymus showed stress-related cortical atrophy. Placental examination disclosed no additional contributory findings.