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Second-trimester screening for fetal abnormalities
Published in Hung N. Winn, Frank A. Chervenak, Roberto Romero, Clinical Maternal-Fetal Medicine Online, 2021
Jolene C. Muscat, Anthony M. Vintzileos
After the fetal head is evaluated, the fetal facial structures are examined. A range of genetic syndromes and disorders are associated with characteristic facial features, and thorough evaluation of the fetal face can aid in supporting or excluding their diagnosis. Obtaining a combination of coronal, sagittal, and axial views is necessary to complete the facial evaluation. To begin, a fetal profile should be obtained in the sagittal plane (Fig. 5). This allows for proper visualization of the frontal bone, nasal bone, and fetal chin. Absent or shortened nasal bone may indicate fetal aneuploidy and will be discussed later in this chapter. Micrognathia has also been associated with a variety of genetic syndromes and disorders, making characterization of the fetal chin important. The fetal nose and lips should be imaged in coronal plane and the anterior palate should be visualized to exclude cleft lip and palate.
Abnormal Labour
Published in Sanjeewa Padumadasa, Malik Goonewardene, Obstetric Emergencies, 2021
Sanjeewa Padumadasa, Malik Goonewardene
The presenting part may be too large (e.g. macrosomia due to maternal diabetes mellitus or post dates or hydrocephalus), or more commonly, the relative diameters of the presenting part may be increased due to a malposition of the vertex, its attitude, or asynclitism, or a malpresentation. Figure 8.3 shows the relevant diameters of the fetal head. The disparity in the relationship between the fetal head and the maternal pelvis is referred to as cephalopelvic disproportion (CPD), a diagnosis that should be made only during labour.
DRCOG OSCE for Circuit A Answers
Published in Una F. Coales, DRCOG: Practice MCQs and OSCEs: How to Pass First Time three Complete MCQ Practice Exams (180 MCQs) Three Complete OSCE Practice Papers (60 Questions) Detailed Answers and Tips, 2020
The eight requirements that must be satisfied for obstetric forceps instrumental delivery include the following: Adequate analgesia (epidural spinal, pudendal or field block).Empty bladder and rectum.No obvious cephalopelvic disproportion.Fully dilated cervix.No head palpable above the pelvic brim.Membranes must not be intact.Position of the fetal head must be known (occipito-anterior, mento-anterior or the after-coming head in a vaginal breech).Head must be at station 2+ or more.
Extraperitoneal versus transperitoneal cesarean section: a retrospective study
Published in Postgraduate Medicine, 2023
Chao Ji, Meng Chen, Yichen Qin
The traditional method of head delivery requires repeated pressure of the uterine fundus, which increases the pain of puerpera and may increase the rate of surgical complications, indirectly affecting prognosis. A longer time for fetal head delivery leads to a higher risk of complications, such as neonatal asphyxia and amniotic fluid inhalation syndrome caused by external stimulation to the fetus [19]. Therefore, the fetal head should be delivered quickly after uterus incision and the respiratory tract should be fully cleaned. One major difficulty of ECS is the delivery of the fetal head. In this study, no significant impact of ECS was presented on the measurable parameters of the newborn, which might be attributed to the use of obstetric forceps in our hospital for fetal head delivery. The left and right leaves of forceps are, respectively, placed on the left and right sides of the fetal head, and a sufficient and smooth force is used to deliver the head. This approach can effectively shorten the delivery duration of the fetal head.
Maritime Interfacility Transport of Two Laboring Mothers – A Case Report
Published in Prehospital Emergency Care, 2022
J. Corsa, W. Cleek, W. Koons, N. Collins
Enroute, both mothers progressed in their labor, each with asynchronous contractions occurring every 1-2 minutes, with FHT assessments remaining reassuring. Upon entering the Rosario Strait (Figure 3) Mother B reported a sudden increase in pelvic pressure. Repeat cervical examination revealed that Baby B was nearly crowning and significant fetal head movement was noted with each contraction. Mother B was placed supine, assisted in flexing her hips, and encouraged to push with her next set of contractions. Baby B was successfully delivered, with the only complication being a loose nuchal cord that was gently reduced prior to delivery of the anterior shoulder. Baby B entered the world with a vigorous cry, pink coloration, and was promptly placed to mothers chest followed by delayed cord clamping 1 min later. The baby’s AGPAR scores were 10 & 10 at one and five minutes. 10 units of oxytocin was administered and gentle traction was applied to the umbilical cord. The placenta was delivered 20 min later while arriving at Anacortes Harbor.
Post Mortem Diagnosis of Blake's Pouch Cyst: A Presentation of Distended Cyst at Necropsy
Published in Fetal and Pediatric Pathology, 2018
Srividya Sreenivasan, Vishnu Sawant, Joy Ghoshal
A 27-week gestation stillborn female was spontaneously delivered to a 24-year-old primigravida of a nonconsanguineous marriage. An ultrasound at 26 weeks gestation revealed a 21 × 16 mm cyst in the posterior cranial fossa (Figure 1), with lateral ventricular enlargement. The fetal head size was appropriate for gestational age. At autopsy, a thin walled clear fluid-filled 21 × 16 mm cyst was postero-inferior to the cerebellum (Figure 2). During further dissection the cyst spontaneously regressed in size, with an intact cyst wall, suggesting its communication with the 4th ventricle and no overt communication with the subarachnoid space. Blood vessels and choroid plexus were present on the upper part of the cyst wall (Figure 3). Dissection confirmed that the cyst wall was the roof of the 4th ventricle. Histologically, the cyst wall was composed of ependyma with choroid plexus, and no neurons. Both the lateral ventricles were distended with thinning of the cerebral cortex. The third ventricle and aqueduct of Sylvius appeared normal in caliber.