The fetal-pelvic index: a method of identifying fetal-pelvic disproportion in women attempting vaginal birth after previous cesarean delivery
Article Abstract:
The rate of cesarean section has increased since 1970 and has become the most frequently performed major operation in the US. In addition, women who have had a previous cesarean section usually deliver subsequent pregnancies by cesarean section, despite evidence indicating the safety of vaginal delivery. Some studies have shown that vaginal delivery after previous cesarean section is less successful among women with previous pregnancies in which labor failed to progress or who have a narrow birth canal. The adequacy of the size of the birth canal for vaginal delivery may be determined by calculating the fetal-pelvic index, which compares the size of the head and abdomen of the fetus to the size of the mother's pelvis through which the infant passes during vaginal delivery. The accuracy of the fetal-pelvic index in predicting the presence or absence of disproportion between the fetus and maternal pelvis was assessed. In addition, the value of the fetal-pelvic index in predicting the outcome for 65 pregnant women attempting vaginal delivery following previous cesarean section was examined. Vaginal delivery was not successful in 18 women, who then delivered by cesarean section. The fetal-pelvic index was negative (did not indicate disproportion) in 52 women, including 47 who had a successful vaginal delivery. Five women had false-negative results, in which the fetal-pelvic index incorrectly indicated a lack of disproportion. Labor failed to progress in four of five women with false-negative results. In addition, labor failed to progress in all 13 women with a positive fetal-pelvic index, indicating disproportion. Two other methods of determining fetal-pelvic disproportion (X-ray of the pelvis and ultrasonography) were not as accurate in identifying fetal-pelvic disproportion when each method was used alone. These findings suggest that the fetal-pelvic index may serve as a useful measure in determining the success of vaginal delivery in pregnant women who previously delivered by cesarean section. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: American Journal of Obstetrics and Gynecology
Subject: Health
ISSN: 0002-9378
Year: 1991
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Naturally occurring insulin autoantibodies in neonates of normal pregnancies and their relationship to insulinemia and birth weight
Article Abstract:
Antibodies against insulin in fetal cord blood do not appear to come from the mother. Researchers measured glucose, insulin and insulin autoantibodies in blood samples from 70 pregnant women and cord blood samples from their newborn infants. None of the women had diabetes before pregnancy or gestational diabetes during the pregnancy. Blood levels of insulin autoantibodies were substantially higher in the cord blood samples than in the maternal samples. There was no association between cord blood autoantibodies and maternal autoantibodies. Both cord blood and maternal insulin levels were positively associated with birth weight. Fourteen of the babies were extremely large for their gestational age, a condition called macrosomia.
Publication Name: American Journal of Obstetrics and Gynecology
Subject: Health
ISSN: 0002-9378
Year: 1995
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A new questionnaire for urinary in continence in women: Developing and testing
Article Abstract:
The objective of the study is to develop a psychometrically sound, symptom-based questionnaire for urinary incontinence diagnosis in women and to test its reliabity and validity, with incontinence specialists' clinical evaluations as the gold standard. The Questionnaire of the Urinary Incontinence Diagnosis is reliable and able to diagnose stress urinary incontinence in a referral urogynecology patient population with accuracy.
Publication Name: American Journal of Obstetrics and Gynecology
Subject: Health
ISSN: 0002-9378
Year: 2005
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