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Sample records for delivery apgar scores

  1. Apgar score

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/003402.htm Apgar score To use the sharing features on this page, ... birth. Virginia Apgar, MD (1909-1974) introduced the Apgar score in 1952. How the Test is Performed The ...

  2. Apgar Scores

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    ... Stages Listen Español Text Size Email Print Share Apgar Scores Page Content Article Body As soon as your ... the syringe, but is blue; her one minute Apgar score would be 8—two points off because she ...

  3. Effect of induction-delivery and uterine-delivery on apgar scoring of the newborn.

    Directory of Open Access Journals (Sweden)

    Kamat S

    1991-07-01

    Full Text Available Very short or prolonged induction-delivery interval (i.e. less than 5 minutes or more than 15 minutes and uterine-delivery interval of more than 90 seconds has a definite effect on the apgar scoring of a newborn especially when general anaesthesia is administered as compared to regional anaesthesia for caesarean section.

  4. Preterm birth and cerebral palsy. Predictive value of pregnancy complications, mode of delivery, and Apgar scores

    DEFF Research Database (Denmark)

    Topp, Monica Wedell; Langhoff-Roos, J; Uldall, P

    1997-01-01

    .01), and low Apgar scores at 1 minute (45% vs. 36%, p or = 3 (adjusted OR = 1.53 (95% CI 1.00-2.34), p ... complications preceding preterm birth did not imply a higher risk of cerebral palsy. Delivery by Cesarean section was a prognostic factor for developing cerebral palsy, and the predictive value of Apgar scores was highly limited....

  5. The Apgar Score.

    Science.gov (United States)

    2015-10-01

    The Apgar score provides an accepted and convenient method for reporting the status of the newborn infant immediately after birth and the response to resuscitation if needed. The Apgar score alone cannot be considered as evidence of, or a consequence of, asphyxia; does not predict individual neonatal mortality or neurologic outcome; and should not be used for that purpose. An Apgar score assigned during resuscitation is not equivalent to a score assigned to a spontaneously breathing infant. The American Academy of Pediatrics and the American College of Obstetricians and Gynecologists encourage use of an expanded Apgar score reporting form that accounts for concurrent resuscitative interventions.

  6. Evaluation of a Comprehensive Delivery Room Neonatal Resuscitation and Adaptation Score (NRAS) Compared to the Apgar Score: A Pilot Study.

    Science.gov (United States)

    Jurdi, Shadi R; Jayaram, Archana; Sima, Adam P; Hendricks Muñoz, Karen D

    2015-01-01

    This study evaluated the interrater reliability and perceived importance of components of a developed neonatal adaption score, Neonatal Resuscitation Adaptation Score (NRAS), for evaluation of resuscitation need in the delivery room for extremely premature to term infants. Similar to the Apgar, the NRAS highest score was 10, but greater weight was given to respiratory and cardiovascular parameters. Evaluation of provider (N = 17) perception and scoring pattern was recorded for 5 clinical scenarios of gestational ages 23 to 40 weeks at 1 and 5 minutes and documenting NRAS and Apgar score. Providers assessed the tool twice within a 1-month interval. NRAS showed superior interrater reliability (P Apgar score. These findings identify an objective tool in resuscitation assessment of infants, especially those of smaller gestation age, allowing for greater discrimination of postbirth transition in the delivery room.

  7. Neonatal apgar scores and umbilical blood gas changes in vaginal delivery and cesarean: a comparative study

    Directory of Open Access Journals (Sweden)

    SH. Raafati

    2006-07-01

    Full Text Available Background: Umbilical cord blood gas analysis is a useful method for assessment of oxygenation and acid-base status in neonates. Severe fetal acidemia is associated with increased perinatal mortality and increased risk of subsequent impaired neurological development. Due to high percentage of C/S in our country and the effect of anesthetic medications on umbilical blood gases which can cause neonatal acidosis and hypoxemia, the study of umbilical cord blood gas in vaginal delivery versus cesarean section is mandatory. Methods: In this cross-sectional study one hundred samples were taken from Mostafa Khomeini hospital in summer 2004. The samples were taken immediately of umbilical vein after clamping the umbilical cord and analyzed after 10 minutes. Cases were classified in to 3 groups: vaginal delivery (n=40, elective C/S under general anesthesia (n=35 and C/S under spinal anesthesia (n=25. Duration of anesthesia and its effect on blood gas and infants apgar were assessed. Results: In the first group (vaginal delivery mean blood gase parameters were; pH=7.3064.73, pO2=25.246.87, HCO3=20.562.03, Apgar=8.820.38 and pCO2=41.826.57. In the second group (general anesthesia mean blood gaze parameters were: pH=7.3044.73, pO2=38.7014.02, pCO2=43.265.87, HCO3=21.1113 and apgar score=8.170.7. In the third group (spinal anesthesia mean blood gaze parameters were: pH=7.3014.50, pCO2=44.14.99, HCO3=21.382.15, pO2=26.625.5 and apgar=8.600.62. The apgar scores and pO2 demonstrated significant relationship with type of anesthesia. The apgar score was lower and pO2 was higher in C/S under general anesthesia compared with the other two groups. There was significant relationship between duration of anesthesia and umbilical pO With increasing duration of anesthesia, pO2 was reduced. Between the type of delivery and anesthesia duration with PH, pO2, pCO2 and HCO3 were not meaningful relationship (P<0.05. Conclusion: There

  8. Determinants of low APGAR score among preeclamptic deliveries in Cipto Mangunkusumo Hospital: a retrospective cohort study in 2014

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    Sulaeman A. Susilo

    2015-11-01

    Full Text Available Background: Preeclampsia has great implication on adverse neonatal outcome. Appearance, pulse, grimace, activity, respiration (APGAR score at 1 or 5 minutes is one of the indicators of physiologic maturity of the infant. Therefore, the aim of this study was to know the correlation of APGAR score in preeclamptic deliveries with its risk factors. Methods: This study was a retrospective cohort. Data were collected from January to December 2013 including all preeclamptic women with singleton live pregnancies who delivered their babies in Cipto Mangunkusumo Hospital, Jakarta. The primary outcome was APGAR score. There were some determinants conducted in this study. Binary logistic was used as multivariate analysis to analyze the correlation between APGAR score and risk factors of preeclampsia, data were analyzed using chi square test. Results: Out of 450 preeclamptic women, 446 of them met the inclusion criteria. Low APGAR scores at 1 and 5 minutes were found in 19% (86/446 and 5.4% (24/446 of neonates respectively. Early onset of preeclampsia (adjusted OR = 4.577; 95% CI = 2.147 - 9.757, white blood cell ≥ 15,000/μL (adjusted OR = 3.315; 95% CI = 1.738 – 6.324, HELLP syndrome (adjusted OR = 2.00; 95% CI = 1.38 – 2.91 were independent risk factors for having infant with low APGAR score at 1 minute. Meanwhile, there was no significant risk factors at 5 minutes APGAR score after adjustment.Conclusion: Leukocytosis, early onset preeclampsia, preterm birth, and thrombocytopenia, severity of preeclampsia, and HELLP syndrome are independent risks of having infant born with low APGAR score at 1 minute in preeclamptic deliveries.

  9. Assessment of Variations in Oxidative Stress in Newborns from Caesarian and Normal Delivery Based on Apgar Score.

    Science.gov (United States)

    Sinharay, M; Chakraborty, I; Dasgupta, A; Chakraborty, P

    2017-01-01

    Fetal distress seems to be strongly related to fetal hypoxia, which is known to cause derangement of the balance between pro-oxidant and anti-oxidant factors by depleting the antioxidant reserve and increasing oxidative stress. Reduced Apgar score signify the fetal distress in postpartum period. The current study explores the severity of oxidative stress and nitrosative stress markers along with the antioxidant status in the cord blood of the newborns with low Apgar score (Group 1), fairly low Apgar score (Group 2) and normal Apgar score (Group 3) in both categories born by Cesarean section (CS) and Normal delivery (ND). Cord blood was collected from eighty full terms, mature neonates of both sexes; forty born via ND and 40 delivered by CS. Apgar scores were recorded and they were grouped based on the different levels of the score. Methemoglobin (HbM), RBC glucose-6-phosphate dehydrogenase (G6PD), RBC reduced glutathione (GSH) were measured as markers of oxidative stress, whereas serum nitrate and nitrite levels were assayed as markers of nitrosative stress. The data obtained were analyzed for the level of significance between study variables. One way ANOVA revealed statistically significant difference between the means of HbM (1.48±0.52, 1.03±0.4 and 0.69±0.31 for Group 1, 2 and 3 respectively, pApgar groups. The results suggest that lowest Apgar score ND neonates are exposed to highest oxidative, nitrosative stress and have the poorest antioxidant defense. The CS neonates have the similar fate except the insignificant difference between the nitrosative stresses among the three Apgar score groups signifying that they are better protected against the nitrosative stress than their ND counterparts.

  10. Genetic effect on apgar score

    Directory of Open Access Journals (Sweden)

    Carla Franchi-Pinto

    1999-03-01

    Full Text Available Intraclass correlation coefficients for one- and five-min Apgar scores of 604 twin pairs born at a southeastern Brazilian hospital were calculated, after adjusting these scores for gestational age and sex. The data support a genetic hypothesis only for 1-min Apgar score, probably because it is less affected by the environment than 4 min later, after the newborns have been under the care of a neonatology team. First-born twins exhibited, on average, better clinical conditions than second-born twins. The former showed a significantly lower proportion of Apgar scores under seven than second-born twins, both at 1 min (17.5% vs. 29.8% and at 5 min (7.2% vs. 11.9%. The proportion of children born with "good" Apgar scores was significantly smaller among twins than among 1,522 singletons born at the same hospital. Among the latter, 1- and 5-min Apgar scores under seven were exhibited by 9.2% and 3.4% newborns, respectively.Os coeficientes de correlação intraclasse foram calculados para os índices de Apgar 1 e 5 minutos após o nascimento de 604 pares de gêmeos em uma maternidade do sudeste brasileiro, depois que esses índices foram ajustados para idade gestacional e sexo. Os dados obtidos apoiaram a hipótese genética apenas em relação ao primeiro índice de Apgar, provavelmente porque ele é menos influenciado pelo ambiente do que 4 minutos depois, quando os recém-nascidos já estiveram sob os cuidados de uma equipe de neonatologistas. Os gêmeos nascidos em primeiro lugar apresentaram, em média, melhor estado clínico que os nascidos em segundo lugar, visto que os primeiros mostraram uma proporção de índices de Apgar inferiores a 7 significativamente menor do que os nascidos em segundo lugar, tanto um minuto (17,5% contra 29,8% quanto cinco minutos após o nascimento (7,2% contra 11,9%. A proporção de recém-nascidos com índices de Apgar que indicam bom prognóstico foi significativamente menor nos gêmeos do que em 1.522 conceptos

  11. Committee Opinion No. 644: The Apgar Score.

    Science.gov (United States)

    2015-10-01

    The Apgar score provides an accepted and convenient method for reporting the status of the newborn infant immediately after birth and the response to resuscitation if needed. The Apgar score alone cannot be considered to be evidence of or a consequence of asphyxia, does not predict individual neonatal mortality or neurologic outcome, and should not be used for that purpose. An Apgar score assigned during a resuscitation is not equivalent to a score assigned to a spontaneously breathing infant. The American Academy of Pediatrics and the American College of Obstetricians and Gynecologists encourage use of an expanded Apgar score reporting form that accounts for concurrent resuscitative interventions.

  12. Birth Weight, Apgar Scores, Labor and Delivery Complications and Prenatal Characteristics of Southeast Asian Adolescents and Older Mothers.

    Science.gov (United States)

    Swenson, Ingrid; And Others

    1986-01-01

    Examined 337 adolescents and 876 older mothers who delivered live-born, single infants between 1980-1982. Absence of alcohol and tobacco consumption among Southeast Asian subjects may have contributed to generally favorable Apgar scores, length of gestation, and birth weights. High frequencies of alcohol and tobacco consumption among White…

  13. Relationship of Apgar Scores and Bayley Mental and Motor Scores

    Science.gov (United States)

    Serunian, Sally A.; Broman, Sarah H.

    1975-01-01

    Examined the relationship of newborns' 1-minute Apgar scores to their 8-month Bayley mental and motor scores and to 8-month classifications of their development as normal, suspect, or abnormal. Also investigated relationships between Apgar scores and race, longevity, and birth weight. (JMB)

  14. What Is the Apgar Score?

    Science.gov (United States)

    ... Development Infections Diseases & Conditions Pregnancy & Baby Nutrition & Fitness Emotions & Behavior School & Family Life First Aid & Safety Doctors & ... 2 being the best score: A ppearance (skin color) P ulse (heart rate) G rimace response (reflexes) ...

  15. Proportion and factors associated with low fifth minute Apgar score ...

    African Journals Online (AJOL)

    Proportion and factors associated with low fifth minute Apgar score among ... with low Apgar scores are at an increased risk of perinatal morbidity and mortality. ... of meconium stained liquor, induced/ augmented labor and low birth weight.

  16. Serious adverse neonatal outcomes such as 5-minute Apgar score of zero and seizures or severe neurologic dysfunction are increased in planned home births after cesarean delivery.

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    Grünebaum, Amos; McCullough, Laurence B; Arabin, Birgit; Chervenak, Frank A

    2017-01-01

    The United States is with 37,451 home births in 2014 the country with the largest absolute number of home births among all developed countries. The purpose of this study was to examine the occurrence and risks of a 5-minute Apgar score of zero and neonatal seizures or serious neurologic dysfunction in women with a history of prior cesarean delivery for planned home vaginal birth after cesarean (VBAC), compared to hospital VBAC and hospital birth cesarean deliveries for term normal weight infants in the United States from 2007-2014. We report in this study outcomes of women who had one or more prior cesarean deliveries and included women who had a successful vaginal birth after a trial of labor after cesarean (TOLAC) at home and in the hospital, and a repeat cesarean delivery in the hospital. We excluded preterm births (Apgar score of 0 of 1 in 890 (11.24/10,000, relative risk 9.04, 95% confidence interval 4-20.39, p<.0001) and an incidence of neonatal seizures or severe neurologic dysfunction of 1 in 814 (Incidence: 12.27/10,000, relative risk 11.19, 95% confidence interval 5.13-24.29, p<.0001). Because of the significantly increased neonatal risks, obstetric providers should therefore not offer or perform planned home TOLACs and for those desiring a VBAC should strongly recommend a planned TOLAC in the appropriate hospital setting. We emphasize that this stance should be accompanied by effective efforts to make TOLAC available in the appropriate hospital setting.

  17. Apgar Scores: Examining the Long-term Significance

    OpenAIRE

    Montgomery, Kristen S.

    2000-01-01

    The Apgar scoring system was intended as an evaluative measure of a newborn's condition at birth and of the need for immediate attention. In the most recent past, individuals have unsuccessfully attempted to link Apgar scores with long-term developmental outcomes. This practice is not appropriate, as the Apgar score is currently defined. Expectant parents need to be aware of the limitations of the Apgar score and its appropriate uses.

  18. Effects of LI4 Acupressure on length of delivery time, some of physiologic responseEffects of LI4 Acupressure on Length of Delivery Time, Mothers’ Physiologic Physiologic Responses and Newborn’s Apgar Scores s and Apgar scores in women during of labor

    Directory of Open Access Journals (Sweden)

    azam hamidzade

    2010-01-01

    Full Text Available Introduction: Prolonged labor has been associated with cesarean delivery and low Ph cord blood. Furthermore, hemorrhage and infection, which are strongly associated with long labor, are leading causes of maternal death. Due to the importance of duration of labor, this study investigates the effects of Hego (LI4 acupressure on length of delivery time, mothers’ physiological responses i.e., respiration and pulse rates of mothers, and Apgar scores of newborns. Methods: In this randomized clinical trial study, 100 pregnant women, who were at the beginning of active phase of labor (dilatation 5-3and had referred to Fatemiye educational and research clinic in Shahroud, were randomly assigned to either the LI4 acupressure (n=50 or LI4 touch control (n=50 group. The experimental group received LI4 acupressure at the onset of the active phase for duration of each uterine contraction over a period of 20 minutes but the control group received only LI4 touch. Length of delivery time was calculated in two stages: from 3-5 cm cervical dilation to full cervical dilation and full cervical dilation to the delivery. Pulse and respiration rates were measured before intervention, immediately after intervention, 20, 60 minutes after intervention and then each hour until delivery. One-minute and five-minute Apgar scores were also registered. Results: There were significant differences between the groups in length of delivery time. The total labor (3-5 dilation to delivery was significantly shorter in the LI4 acupressure intervention group (P=0.038. Maternal pulse and respiration rates weren’t significantly different between the groups (P=0.711, P=0.108. There were no significant differences between two groups for neonatal Apgar scores at one and five minutes. (P= 0.2, P= 0.3. Conclusion: These finding showed that LI4 acupressure was effective for shortening the length of delivery time and had no side effects on mothers’ pulse and respiration rate or no

  19. The Molecular Apgar Score: A Key to Unlocking Evolutionary Principles.

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    Torday, John S; Nielsen, Heber C

    2017-01-01

    One of the first "tools" used for systematically evaluating successful newborn transitional physiology at birth was the Apgar Score, devised by Virginia Apgar in 1953. This objective assessment tool allowed clinicians to immediately gauge the relative success of a newborn infant making the transition from the in utero liquid immersive environment to the ex utero gas environment in the delivery room during the first minutes after birth. The scoring system, although eponymous, is generally summarized as an acronym based on Appearance, Pulse, Grimace, Activity, and Respiration, criteria evaluated and scored at 1 and 5 min after birth. This common clinical appraisal is a guide for determining the elements of integrated physiology involved as the infant makes the transition from a "sea water" environment of 3% oxygen to a "land" environment in 21% oxygen. Appearance determines the perfusion of the skin with oxygenated blood-turning it pink; Pulse is the rate of heart beat, reflecting successful oxygen delivery to organs; Grimace, or irritability, is a functional marker for nervous system integration; Activity represents locomotor capacity; and, of course, Respiration represents pulmonary function as well as the successful neuro-feedback-mediated drive to breathe, supplying oxygen by inspiring atmospheric gas. Respiration, locomotion, and metabolism are fundamental processes adapted for vertebrate evolution from a water-based to an atmosphere-based life and are reflected by the Apgar Score. These physiologic processes last underwent major phylogenetic changes during the water-land transition some 300-400 million years ago, during which specific gene duplications occurred that facilitated terrestrial adaptation, in particular the parathyroid hormone-related protein receptor, the β-adrenergic receptor, and the glucocorticoid receptor. All these genetic traits and the gene regulatory networks they comprise represent the foundational substructure of the Apgar Score. As

  20. [Intraoperative crisis and surgical Apgar score].

    Science.gov (United States)

    Oshiro, Masakatsu; Sugahara, Kazuhiro

    2014-03-01

    Intraoperative crisis is an inevitable event to anesthesiologists. The crisis requires effective and coordinated management once it happened but it is difficult to manage the crises properly under extreme stressful situation. Recently, it is reported that the use of surgical crisis checklists is associated with significant improvement in the management of operating-room crises in a high-fidelity simulation study. Careful preoperative evaluation, proper intraoperative management and using intraoperative crisis checklists will be needed for safer perioperative care in the future. Postoperative complication is a serious public health problem. It reduces the quality of life of patients and raises medical cost. Careful management of surgical patients is required according to their postoperative condition for preventing postoperative complications. A 10-point surgical Apgar score, calculated from intraoperative estimated blood loss, lowest mean arterial pressure, and lowest heart rate, is a simple and available scoring system for predicting postoperative complications. It undoubtedly predicts higher than average risk of postoperative complications and death within 30 days of surgery. Surgical Apgar score is a bridge between proper intraoperative and postoperative care. Anesthesiologists should make effort to reduce the postoperative complication and this score is a tool for it.

  1. Evaluation of the Apgar score and its Related Factors in Neonates Born in Hospitals of Yazd

    Directory of Open Access Journals (Sweden)

    R Fallah

    2009-01-01

    Full Text Available Introduction: Newborns should be evaluated immediately after birth and the traditional way of assessing is to use the Apgar score. The aim of this study was to estimate the Apgar score and evaluate the first 24 hour- clinical outcome of babies born at Yazd hospitals. Methods: In a descriptive cross-sectional study, Apgar score was assessed for 462 newborns at the 4 centers of Afshar, Madar, Kargar and Bahman of Yazd. 262 out of 462 babies were born by vaginal delivery and the other 200 babies were delivered by cesarean section. The data was analyzed by using both parametric and non parametric tests. Apgar score of 7 and less was considered as abnormal. Results: In this study, the type of delivery (cesarean section or vaginal delivery, method of anesthesia (epidural or general and gender of newborn had no impact on Apgar score, but prematurity, low birth weight, premature rupture of membranes, inadequate prenatal care and the level of maternal education had influence on reduction of the Apgar score. Those babies who were in good condition and were kept beside their mothers had the highest Apgar score. Conclusion: Apgar score is a useful measure to assess the general condition of the newborns at birth and for the prediction of their morbidity, mortality and neurologic impairment.

  2. Prolonged second stage of labor is associated with low Apgar score.

    Science.gov (United States)

    Altman, Maria; Sandström, Anna; Petersson, Gunnar; Frisell, Thomas; Cnattingius, Sven; Stephansson, Olof

    2015-11-01

    There is no consensus on the effects of a prolonged second stage of labor on neonatal outcomes. In this large Swedish population-based cohort study, our objective was to investigate prolonged second stage and risk of low Apgar score at 5 min. All nulliparous women (n = 32,796) delivering a live born singleton infant in cephalic presentation at ≥37 completed weeks after spontaneous onset of labor between 2008 and 2012 in the counties of Stockholm and Gotland were included. Data were obtained from computerized records. Exposure was time from fully retracted cervix until delivery. Logistic regression analyses were used to estimate crude and adjusted odds ratios (ORs) with 95% confidence intervals (CIs). Adjustments were made for maternal age, height, BMI, smoking, sex, gestational age, sex-specific birth weight for gestational age and head circumference. Epidural analgesia was included in a second model. The primary outcome measure was Apgar score at 5 min Apgar score Apgar score Apgar score.

  3. Conventional versus combined apgar scores in neonatal asphyxia: a prospective study

    Directory of Open Access Journals (Sweden)

    Amir Kamal Hardani

    2015-01-01

    Conclusion: In asphyxiated neonates sensitivity and specificity of combined apgar were more than conventional apgar. With respect to this study, better assessment could be achieved by combined apgar score method instead of conventional Apgar.

  4. Relationship between maternal periodontal disease and Apgar score of newborns

    OpenAIRE

    Shirmohammadi, Adileh; Abdollahifard, Sedigeh; Chitsazi, Mohammad-Taghi; Behlooli, Sepideh

    2012-01-01

    Purpose The aim of this study was to evaluate the relationship between maternal periodontal disease and the health status of newborns using Apgar scores. Methods One hundred pregnant women with periodontal disease were included in the case series and 100 pregnant women without periodontal disease were placed in the control group, respectively. The periodontal parameters of bleeding on probing (BOP), clinical attachment loss (CAL), probing depth (PD), birth weight, and Apgar scores were record...

  5. Maternal exposure to brominated flame retardants and infant Apgar scores.

    Science.gov (United States)

    Terrell, Metrecia L; Hartnett, Kathleen P; Lim, Hyeyeun; Wirth, Julie; Marcus, Michele

    2015-01-01

    Brominated flame retardants (BFRs) and other persistent organic pollutants have been associated with adverse health outcomes in humans and may be particularly toxic to the developing fetus. We investigated the association between in utero polybrominated biphenyl (PBB) and polychlorinated biphenyl (PCB) exposures and infant Apgar scores in a cohort of Michigan residents exposed to PBB through contaminated food after an industrial accident. PBB and PCB concentrations were measured in serum at the time the women were enrolled in the cohort. PBB concentrations were also estimated at the time of conception for each pregnancy using a validated elimination model. Apgar scores, a universal measure of infant health at birth, measured at 1 and 5min, were taken from birth certificates for 613 offspring born to 330 women. Maternal PCB concentrations at enrollment were not associated with below-median Apgar scores in this cohort. However, maternal PBB exposure was associated with a dose-related increase in the odds of a below-median Apgar score at 1min and 5min. Among infants whose mothers had an estimated PBB at conception above the limit of detection of 1 part per billion (ppb) to Apgar score increased with higher maternal PBB at conception. It remains critical that future studies examine possible relationships between in utero exposures to brominated compounds and adverse health outcomes.

  6. Assessment of canine neonatal viability-the Apgar score.

    Science.gov (United States)

    Veronesi, M C

    2016-09-01

    Perinatal mortality is relatively high in dogs, with deaths peaking around the time of birth and during the first week of age. Among the several causes of canine perinatal mortality, whelping is the greatest cause. Therefore, early neonatal assistance at birth should be mandatory with dogs. In comparison with human neonatology, knowledge and technological ability in canine neonatology is tremendously scarce. The Apgar score for the newborn viability assessment at birth represents a feasible method for the prompt recognition of newborns that will need special assistance immediately after birth. The five parameters of the Apgar score were adapted to the canine species by different studies. Advantages and limits, as well as clinical applications, are presented and discussed in further detail. It was concluded that the Apgar score represents the easiest and simplest, non-invasive and reliable method, that could be performed under every clinical and practical condition, for newborn puppies viability evaluations and short-term survival prognosis.

  7. Apgar score is related to development of atopic dermatitis

    DEFF Research Database (Denmark)

    Naeser, Vibeke; Kahr, Niklas; Stensballe, Lone Graff

    2013-01-01

    . We cross-linked with data from the Danish National Birth Registry and performed cotwin control analysis in order to test the impact of birth characteristics on the risk of atopic dermatitis. Results. Apgar score, OR (per unit) = 1.23 (1.06-1.44), P = 0.008, and female sex, OR = 1.31 (1.06-1.61), P....... In this population-based cotwin control study, high Apgar score was a risk factor for atopic dermatitis. This novel finding must be confirmed in subsequent studies....

  8. Surgical Apgar Score Predicts Postoperative Complications in ...

    African Journals Online (AJOL)

    neurotrauma patients by using an effective scoring system can reduce ... complications was 7.04 while for patients with complications was ... their SAS for purposes of risk stratification; high risk. (0-4), medium .... Deep Venous. Thrombosis. 0.

  9. The APGAR rubric for scoring online discussion boards.

    Science.gov (United States)

    Phillippi, Julia C; Schorn, Mavis N; Moore-Davis, Tonia

    2015-05-01

    The World Health Organization has called for a dramatic increase in the number of midwives and supports the use of innovative programs to assist students in achieving midwifery competencies. Online discussion boards are excellent educational tools for stimulating in-depth student engagement. However, complex discussions can be difficult to grade without a well-constructed rubric. The 'discussion-board APGAR' provides clear scoring criteria for discussions of midwifery care. The discussion-board APGAR has 5 components: Application, Professionalism, Group work, Analysis, and Rationale and provides scoring criteria for unacceptable, marginal, and proficient performance. The discussion-board APGAR is based on the Core Competencies for Basic Midwifery Practice in the United States (US), consistent with the International Confederation of Midwives Essential Competencies for Basic Midwifery Practice, and can be adjusted to be congruent with other midwifery standards.

  10. Comparison of the four proposed Apgar scoring systems in the assessment of birth asphyxia and adverse early neurologic outcomes.

    Directory of Open Access Journals (Sweden)

    Hosein Dalili

    Full Text Available To compare the Conventional, Specified, Expanded and Combined Apgar scoring systems in predicting birth asphyxia and the adverse early neurologic outcomes.This prospective cohort study was conducted on 464 admitted neonates. In the delivery room, after delivery the umbilical cord was double clamped and a blood samples was obtained from the umbilical artery for blood gas analysis, meanwhile on the 1- , 5- and 10- minutes Conventional, Specified, Expanded, and Combined Apgar scores were recorded. Then the neonates were followed and intracranial ultrasound imaging was performed, and the following information were recorded: the occurrence of birth asphyxia, hypoxic Ischemic Encephalopathy (HIE, intraventricular hemorrhage (IVH, and neonatal seizure.The Combined-Apgar score had the highest sensitivity (97% and specificity (99% in predicting birth asphyxia, followed by the Specified-Apgar score that was also highly sensitive (95% and specific (97%. The Expanded-Apgar score was highly specific (95% but not sensitive (67% and the Conventional-Apgar score had the lowest sensitivity (81% and low specificity (81% in predicting birth asphyxia. When adjusted for gestational age, only the low 5-minute Combined-Apgar score was independently associated with the occurrence of HIE (B = 1.61, P = 0.02 and IVH (B = 2.8, P = 0.01.The newly proposed Combined-Apgar score is highly sensitive and specific in predicting birth asphyxia and also is a good predictor of the occurrence of HIE and IVH in asphyxiated neonates.

  11. [The 100th anniversary of the birthday of Virginia Apgar. In honor of the developer of the Apgar score].

    Science.gov (United States)

    Brandt, L; Brandt, K

    2009-05-01

    The 7th of June 2009 marks the 100th anniversary of the birthday of the American anaesthesiologist Virginia Apgar. The Apgar score for evaluation of the newborn created by her in 1952 and later named after her is one of the most popular and most often used medical scoring systems.

  12. Apgar score after induction of anesthesia for canine cesarean section with alfaxalone versus propofol.

    Science.gov (United States)

    Doebeli, A; Michel, E; Bettschart, R; Hartnack, S; Reichler, I M

    2013-11-01

    The effects of alfaxalone and propofol on neonatal vitality were studied in 22 bitches and 81 puppies after their use as anesthetic induction agents for emergency cesarean section. After assessment that surgery was indicated, bitches were randomly allocated to receive alfaxalone 1 to 2 mg/kg body weight or propofol 2 to 6 mg/kg body weight for anesthetic induction. Both drugs were administered intravenously to effect to allow endotracheal intubation, and anesthesia was maintained with isoflurane in oxygen. Neonatal vitality was assessed using a modified Apgar score that took into account heart rate, respiratory effort, reflex irritability, motility, and mucous membrane color (maximum score = 10); scores were assigned at 5, 15, and 60 minutes after delivery. Neither the number of puppies delivered nor the proportion of surviving puppies up to 3 months after delivery differed between groups. Anesthetic induction drug and time of scoring were associated with the Apgar score, but delivery time was not. Apgar scores in the alfaxalone group were greater than those in the propofol group at 5, 15, and 60 minutes after delivery; the overall estimated score difference between the groups was 3.3 (confidence interval 95%: 1.6-4.9; P < 0.001). In conclusion, both alfaxalone and propofol can be safely used for induction of anesthesia in bitches undergoing emergency cesarean section. Although puppy survival was similar after the use of these drugs, alfaxalone was associated with better neonatal vitality during the first 60 minutes after delivery.

  13. Late umbilical cord clamping, neonatal hematocrit and Apgar scores: a randomized controlled trial.

    Science.gov (United States)

    Salari, Z; Rezapour, M; Khalili, N

    2014-01-01

    Based on current evidence, there is a little agreement on the best timing for after birth umbilical cord clamping. This study was designed to compare the impact of using two different times for cord clamping on hematocrit concentration and Apgar scores of the neonate. Fifty-six healthy full-term vaginally born neonates were allocated to early (10 seconds after delivery) and late (3 minutes after delivery) umbilical cord clamping groups in this randomized clinical trial. We recorded the length of the 3rd stage of labor and Apgar score at 5 minutes. Infant's hematocrit was measured at 2 and 18 hours of age. Neonatal hematocrit differed between the two groups. Late cord clamping group had greater hematocrit at 2 hours (45.5 ± 4 vs. 49.5 ± 4.4, P = 0.0003) and 18 hours (47.7 ± 5.5 vs. 52.9 ± 4.3, P = 0.0002). Apgar scores at 5 minutes (9.3 ± 0.6 vs. 9.4 ± 0.6, p = 0.5) and duration of delivery 3rd stage (10.2 ± 3.7 min vs. 8.9 ± 5 min, P = 0.2) did not differ between early and late cord clamping groups respectively. Late cord clamping leads to a significant increase in the hematocrit of the neonate but it does not have effects on Apgar score and duration of the 3rd stage of labor.

  14. Risk factors of incomplete Apgar score and umbilical cord blood gas analysis: a retrospective observational study.

    Science.gov (United States)

    van Tetering, Anne A C; van de Ven, Joost; Fransen, Annemarie F; Dieleman, Jeanne P; van Runnard Heimel, Pieter J; Oei, S Guid

    2017-11-01

    To investigate whether incomplete umbilical cord blood gas (UCBG) analysis occurs more often than the incomplete reporting of the Apgar score, and risk factors associated with the incomplete values. A total of 8824 infants born alive after 26 weeks' gestation between January 2009 and April 2013 were included. We extracted data on five-minute Apgar score, UCBG analysis, gestational age, mode of delivery, time of delivery and multiple pregnancy. Univariate and multivariable logistic regression analyses were performed. Five-minute Apgar score was incomplete in 15 cases (0.2%) and UCBG analysis in 1960 cases (22.2%), p < 0.05. Incomplete UCBG analysis was significantly more likely to occur in situations with Apgar score below seven (Odds ratio (OR) 1.68, 95% CI;1.29-2.19), gestational age between 26 to 27 6/7 and 28 to 31 6/7 weeks (OR 3.14, 95% CI; 2.13-4.62 and OR 1.91, 95% CI; 1.57-2.32), cesarean section (OR 1.31, 95% CI; 1.11-1.55), and multiple pregnancy (OR 2.02, 95% CI; 1.69-2.43). Deliveries during night time had a lower risk of incomplete UCBG analysis (OR 0.78, 95% CI; 0.69-0.88). Measuring five-minute Apgar score generated less incomplete data compared with UCBG analysis. The risk factors associated with incomplete UCBG analysis were noted. Study outcomes with UCBG analysis as neonatal assessment tool should be interpreted with caution.

  15. Then & Now: Research Pays Off for All Americans / Dr. Virginia Apgar: Keeping Score at Baby's First Cry | NIH ...

    Science.gov (United States)

    ... Research Pays Off for All Americans Dr. Virginia Apgar: Keeping Score at Baby's First Cry Past Issues / Winter 2010 ... evaluated your physical condition and gave you an Apgar score. The score is named for Dr. Virginia Apgar ( ...

  16. The 5-minute Apgar score: survival and short-term outcomes in extremely low-birth-weight infants.

    Science.gov (United States)

    Phalen, Ann Gibbons; Kirkby, Sharon; Dysart, Kevin

    2012-01-01

    The Apgar score is a standardized tool for evaluating newborns in the delivery room. Despite its long history and widespread use, debate remains over its reliability of predicting neonatal outcomes, especially in extremely low-birth-weight premature infants. The aim of the study was to examine the relationship between the 5-minute Apgar score of extremely low-birth-weight infants, as it relates to survival and morbidities associated with prematurity and length of hospital stay. A retrospective query of the Alere neonatal database from 2001 to 2011 examined all infants less than 32 weeks' gestation and less than 1000-g birth weight. The 5-minute Apgar score was divided into 2 groups, score of 4 or greater or less than 4. The study compared results of the 5-minute Apgar score and associated morbidities in surviving infants. Statistical analyses included chi-square, Fisher exact test, t test, and multivariate regression. The sample consisted of 3898 infants with an 86.4% (n = 3366) survival rate. Controlling for gestational age and birth weight, surviving infants with a 5-minute Apgar score of less than 4 were more likely to demonstrate nonintact survival. Infants with a low 5-minute Apgar score have greater risk for mortality and morbidities associated with prematurity.

  17. Neonatal viability evaluation by Apgar score in puppies delivered by cesarean section in two brachycephalic breeds (English and French bulldog).

    Science.gov (United States)

    Batista, M; Moreno, C; Vilar, J; Golding, M; Brito, C; Santana, M; Alamo, D

    2014-05-01

    This study tried to define neonatal viability after cesarean section in brachycephalic breeds and the efficacy of an adapted Apgar test to assess newborn survival. Data from 44 cesarean sections and 302 puppies were included. Before surgery (59-61 days after ovulation), an ultrasound evaluation defined the fetal biparietal diameter (BPD). Immediately after the uterine delivery, the pups were evaluated to detect birth defects and then, a modified Apgar score (range: 0-10) was used to define neonatal health at 5min (Apgar 1) and 60min (Apgar 2) after neonatal delivery; puppies were classified into three categories: critical neonates (score: 0-3), moderate viability neonates (score: 4-6) and normal viability neonates (score: 7-10). Mean (±SEM) value of BPD was 30.8±0.1mm and 28.9±0.1mm in English and French Bull-Dog fetus, respectively. The incidence of spontaneous neonatal mortality (4.98%, 14/281) and birth defects (6.95%) were not influenced by the sex; however, congenital anomalies and neonatal mortality were higher (pApgar 1, the percentage of critical neonates, moderate viability neonates and normal viability neonates were 20.5%, 46.3% and 33.1% respectively; sixty minutes after birth, the critical neonates only represented 10.3% of the total puppies. Almost all neonates (238/239) showing moderate or normal viability at Apgar 1, survived for the first 24h after birth. The results of the study showed a direct relationship (pApgar score and neonatal viability. Therefore, the routine performance of the Apgar score would appear to be essential in the assessment of the status of brachycephalic breed puppies.

  18. Apgar score is related to development of atopic dermatitis

    DEFF Research Database (Denmark)

    Naeser, Vibeke; Kahr, Niklas; Stensballe, Lone Graff

    2013-01-01

    Aim. To study the impact of birth characteristics on the risk of atopic dermatitis in a twin population. Methods. In a population-based questionnaire study of 10,809 twins, 3-9 years of age, from the Danish Twin Registry, we identified 907 twin pairs discordant for parent-reported atopic dermatitis....... We cross-linked with data from the Danish National Birth Registry and performed cotwin control analysis in order to test the impact of birth characteristics on the risk of atopic dermatitis. Results. Apgar score, OR (per unit) = 1.23 (1.06-1.44), P = 0.008, and female sex, OR = 1.31 (1.06-1.61), P...... = 0.012, were risk factors for atopic dermatitis in cotwin control analysis, whereas birth anthropometric factors were not significantly related to disease development. Risk estimates in monozygotic and dizygotic twins were not significantly different for the identified risk factors. Conclusions...

  19. Surgical apgar score predicts early complication in transfemoral amputees

    DEFF Research Database (Denmark)

    Wied, Christian; Foss, Nicolai Bang; Kristensen, Morten T

    2016-01-01

    AIM: To assess whether the surgical apgar score (SAS) is a prognostic tool capable of identifying patients at risk of major complications following lower extremity amputations surgery. METHODS: This was a single-center, retrospective observational cohort study conducted between January 2013...... and April 2015. All patients who had either a primary transtibial amputation (TTA) or transfemoral amputation (TFA) conducted at our institution during the study period were assessed for inclusion. All TTA patients underwent a standardized one-stage operative procedure (ad modum Persson amputation......) performed approximately 10 cm below the knee joint. All TTA procedures were performed with sagittal flaps. TFA procedures were performed in one stage with amputation approximately 10 cm above the knee joint, performed with anterior/posterior flaps. Trained residents or senior consultants performed...

  20. Preterm Birth: A Prominent Risk Factor for Low Apgar Scores

    Directory of Open Access Journals (Sweden)

    Maria Svenvik

    2015-01-01

    Full Text Available Objective. To determine predictive risk factors for Apgar scores < 7 at 5 minutes at two hospitals providing tertiary care and secondary care, respectively. Methods. A retrospective registry cohort study of 21126 births (2006–2010 using data from digital medical records. Risk factors were analyzed by logistic regression analyses. Results.  AS5min⁡<7 was multivariately associated with the following: preterm birth; gestational week 32 + 0–36 + 6, OR=3.9 (95% CI 2.9–5.3; week 28 + 0–31 + 6, OR=8 (5–12; week < 28 + 0, OR=15 (8–29; postterm birth, OR=2.0 (1.7–2.3; multiple pregnancy, OR=3.53 (1.79–6.96; previous cesarean section, OR=3.67 (2.31–5.81; BMI 25–29, OR=1.30 (1.09–1.55; BMI≥30  OR=1.70 (1.20–2.41; nonnormal CTG at admission, OR=1.98 (1.48–2.66. ≥1-para was associated with a decreased risk for AS5min⁡<7, OR=0.34 (0.25–0.47. In the univariate logistic regression analysis AS5min⁡<7 was associated with tertiary level care, OR=1.48 (1.17–1.87; however, in the multivariate analysis there was no significant difference. Conclusion. A number of partially preventable risk factors were identified, preterm birth being the most evident. Further, no significant difference between the two hospital levels regarding the risk for low Apgar scores was detected.

  1. Maternal depression, antidepressant use in pregnancy and Apgar scores in infants

    DEFF Research Database (Denmark)

    Jensen, Hans Mørch; Grøn, Randi; Lidegaard, Øjvind

    2013-01-01

    Use of antidepressants during pregnancy has been associated with a low Apgar score in infants but a contribution from the underlying depressive disorder might influence this association.......Use of antidepressants during pregnancy has been associated with a low Apgar score in infants but a contribution from the underlying depressive disorder might influence this association....

  2. Obstetrical complications and Apgar score in subjects at risk of psychosis.

    Science.gov (United States)

    Kotlicka-Antczak, Magdalena; Pawełczyk, Agnieszka; Rabe-Jabłońska, Jolanta; Smigielski, Janusz; Pawełczyk, Tomasz

    2014-01-01

    The objective of the study was to identify associations between a history of obstetrical complications (OCs) and the future development of symptoms indicating risk of psychosis (At Risk Mental State - ARMS). The frequency of OCs was assessed in 66 ARMS subjects, 50 subjects with the first episode of schizophrenia (FES) and 50 healthy controls. Obstetrical data was obtained from medical documentation and evaluated with the Lewis and Murray Scale. Definite OCs, according to the Lewis and Murray Scale, occurred significantly more frequently in the ARMS group compared to the controls (χ(2) = 7.79, p = 0.005; OR = 4.20, 95% CI = 1.46-12.11), as well as in the FES subjects compared to the controls (χ(2) = 8.39, p = 0.004; OR = 4.64, 95% CI = 1.56-13.20). Apgar scores in the first (Apgar 1) and the fifth minute after birth (Apgar 5) were significantly lower in the FES subjects compared to the controls (for Apgar 1 score Z = 4.439, p Apgar 5 score Z = 5.250, p Apgar 5 scores compared to the healthy controls (Z = 3.458, p = 0.0016). The results indicate that OCs and low Apgar 5 score should be considered important factors in identifying subjects at risk of developing psychosis.

  3. The Relationship of Apgar Scores to Neonatal Survival and Later Development: A Review. Interim Report No. 19.

    Science.gov (United States)

    Rubin, Rosalyn A.; And Others

    This paper presents a review of the literature concerning the infant Apgar scoring system and its relationship to later mental and motor development. Since 1952, the Apgar scoring system has provided a viable means of assessing the infant's immediate postnatal condition. Researchers have demonstrated that while the 1-minute Apgar score is a useful…

  4. Child Abuse: Its Relationship to Birthweight, Apgar Score, and Developmental Testing.

    Science.gov (United States)

    Goldson, Edward; And Others

    1978-01-01

    The relationship of child abuse to birthweight, five-minute Apgar score, and performance on the Bayley Scales of Infant Development was studied in 75 low socioeconomic infants (ages 2-30 months). Journal availability: see EC 111 042. (Author)

  5. (IgG) Density and Apgar Score in Normal Term Pregnancy

    African Journals Online (AJOL)

    AFRICAN JOURNALS ONLINE (AJOL) · Journals · Advanced Search · USING AJOL ... Ex-vivo, term placenta of forty euthyroid mothers, the maternal serum, and cord blood ... Keywords: APGAR score, IgG density, Term placenta, Cord blood ...

  6. [Fetal distress: Information provided by lactate levels and antioxidant status, compared with the Apgar score].

    Science.gov (United States)

    Abessolo, Felix Ovono; Ngou, J P J F Ngou-Mve; Meye, J F; Yangou, Jf Moutsinga; Lemamy, G J J F; Ngou-Milama, E J F

    2009-01-01

    The multitude of criteria used to assess fetal distress and the subjective character of the Apgar score led us to compare the information it provides with that from measurements of lactate and two principal antioxidant enzymes superoxide dismutase (SOD) and glutathione peroxidase (GPx). We measured plasma lactates, SOD, and GPX from the umbilical cord blood of live-born children whose mothers had had at least three prenatal consultations. The correlation of these measurements with the 5-minute Apgar score was tested with the Spearman correlation coefficient. Lactate levels were correlated with the baby's blood glucose (r=0.212; p=0.0084), and GPx activity (r=0.179; p=0.0061), the Apgar score (r=0.258; p=0.001) and the mother's blood glucose (r=0.167; p=0.035). GPx was correlated not only with the lactate level but also with birth weight (r=0.205; p=0.000) and height (r=0.316; p=0.0056), while SOD was correlated only with the mother's blood glucose (r=0.161; p=0.046). In multivariate analysis, followed by stepwise analysis, lactate was the main variable associated with the Apgar score. It thus seems better able to replace the Apgar score than the antioxidant enzyme levels. GPx was higher in children of high birth weight and may make them better able to combat the free radicals due to anoxia or hypoxia.

  7. Comparing Propofol with Sodium Thiopental on Neonatal Apgar Score after Elective Cesarean Section

    Directory of Open Access Journals (Sweden)

    Mohammad Mehdi Dadras

    2013-04-01

    Full Text Available Background: The Apgar score (Appearance, Pulse, Grimace, Activity, and Respiration of newborn babies immediately after birth is a determining factor involved with mortality of newborns after birth. Regarding the disagreement on advantages and possible disadvantages of propofol rather thiopental in the available references, the study was triggered with the aim of analyzing effects of two mentioned drugs on babies’ apgar score, mothers’ nausea, vomit and time necessary for mothers’ recovery. Materials and Methods: In this double-blind clinical trial, a total of 230 healthy women who were volunteered to undertake cesarean operation were selected and then divided randomly into two equal groups using statistical blocking. One group was treated by propofol while other one was treated by thiopental. The prescribed drugs for both groups were identical except the anesthesia induction drug. Babies’ Apgar score 1 and 5 minutes after birth and recovery period, mothers’ nausea and vomiting after operation were recorded. Results: Apgar score I minute 1 (p=0.041 and apgar score in minute 5 (p=0.034 for propofol group were meaningfully higher than those for thiopental group. Recovery time from anesthesia was not different meaningfully in two groups (p=0.67. Statistical analysis of nausea and vomit in both groups showed that they are lower in propofol group rather thiopental group (p=0.028.Conclusion: It seems that in cesarean operations, after sufficient fluid therapy, propofol can be a proper drug to achieve anesthesia. Moreover it exerts less impact on cesarean babies’ apgar and stimulates lower levels of nausea and vomiting in mothers.

  8. Variability in Apgar Score Assignment among Clinicians: Role of a Simple Clarification.

    Science.gov (United States)

    Gupta, Sabhya; Natarajan, Girija; Gupta, Dhruv; Karnati, Sreenivas; Dwaihy, Meghan; Wang, Bo; Chawla, Sanjay

    2017-01-01

    Objective We aimed to evaluate variability in Apgar score (AS) assignment among health care providers (HCPs) and to evaluate whether a simple clarification improves accuracy and consistency of AS assignment. Study Design An electronic questionnaire survey was provided to pediatric residents, nurse practitioners, neonatal fellows, and faculty in level III neonatal intensive care unit and major academic centers in the United State to assign AS for three clinical scenarios. Next, we provided a simple clarification on various components of AS. After review of clarification, responders were asked to provide AS for the same scenarios. We also sought the opinion of responders on the subjectivity of five components of AS. Results A total of 107 responses were collected. Correct assignment before and after clarification improved significantly: heart rate (78 vs. 90%, p = 0.02), reflex (63 vs.75%, p = 0.06), and breathing (82 vs. 96%, p = 0.003). Correct scoring for color and tone were 86 and 67%, respectively. Interobserver agreement improved significantly after clarification. Conclusion There was variability among HCPs for AS assignment, with improvement in correct response as well as consistency after a simple clarification. Availability of this clarification, along with the AS table in delivery room, will improve the correct assignment and consistency of AS for high-risk infants. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  9. Association between maternal obesity and offspring Apgar score or cord pH: a systematic review and meta-analysis.

    Science.gov (United States)

    Zhu, Tingting; Tang, Jun; Zhao, Fengyan; Qu, Yi; Mu, Dezhi

    2015-12-22

    Previous results are inconsistent regarding the association between maternal obesity and Apgar score or cord pH in humans. The aim of this study was to investigate the association between maternal pre-pregnancy and pregnancy body mass index (BMI) and infant Apgar score or cord pH. We conducted a systematic review of studies published in English before 20 August 2015 using PubMed, EMBASE, and Cochrane Library. Eleven cohort studies with a total of 2,586,265 participants finally met our inclusion criteria. Pooled results revealed the following factors associated with Apgar score Apgar score <7 at 1 minute. There was no association between maternal BMI and neonatal cord pH. Thus, this study suggests that maternal overweight and obesity affect baby's condition immediately after birth in general. More studies are needed to confirm these results and detect the influence of variables across studies.

  10. Apgar Score Is Related to Development of Atopic Dermatitis: Cotwin Control Study

    Directory of Open Access Journals (Sweden)

    Vibeke Naeser

    2013-01-01

    Full Text Available Aim. To study the impact of birth characteristics on the risk of atopic dermatitis in a twin population. Methods. In a population-based questionnaire study of 10,809 twins, 3–9 years of age, from the Danish Twin Registry, we identified 907 twin pairs discordant for parent-reported atopic dermatitis. We cross-linked with data from the Danish National Birth Registry and performed cotwin control analysis in order to test the impact of birth characteristics on the risk of atopic dermatitis. Results. Apgar score, OR (per unit = 1.23 (1.06–1.44, P=0.008, and female sex, OR = 1.31 (1.06–1.61, P=0.012, were risk factors for atopic dermatitis in cotwin control analysis, whereas birth anthropometric factors were not significantly related to disease development. Risk estimates in monozygotic and dizygotic twins were not significantly different for the identified risk factors. Conclusions. In this population-based cotwin control study, high Apgar score was a risk factor for atopic dermatitis. This novel finding must be confirmed in subsequent studies.

  11. Combining the ASA Physical Classification System and Continuous Intraoperative Surgical Apgar Score Measurement in Predicting Postoperative Risk.

    Science.gov (United States)

    Jering, Monika Zdenka; Marolen, Khensani N; Shotwell, Matthew S; Denton, Jason N; Sandberg, Warren S; Ehrenfeld, Jesse Menachem

    2015-11-01

    The surgical Apgar score predicts major 30-day postoperative complications using data assessed at the end of surgery. We hypothesized that evaluating the surgical Apgar score continuously during surgery may identify patients at high risk for postoperative complications. We retrospectively identified general, vascular, and general oncology patients at Vanderbilt University Medical Center. Logistic regression methods were used to construct a series of predictive models in order to continuously estimate the risk of major postoperative complications, and to alert care providers during surgery should the risk exceed a given threshold. Area under the receiver operating characteristic curve (AUROC) was used to evaluate the discriminative ability of a model utilizing a continuously measured surgical Apgar score relative to models that use only preoperative clinical factors or continuously monitored individual constituents of the surgical Apgar score (i.e. heart rate, blood pressure, and blood loss). AUROC estimates were validated internally using a bootstrap method. 4,728 patients were included. Combining the ASA PS classification with continuously measured surgical Apgar score demonstrated improved discriminative ability (AUROC 0.80) in the pooled cohort compared to ASA (0.73) and the surgical Apgar score alone (0.74). To optimize the tradeoff between inadequate and excessive alerting with future real-time notifications, we recommend a threshold probability of 0.24. Continuous assessment of the surgical Apgar score is predictive for major postoperative complications. In the future, real-time notifications might allow for detection and mitigation of changes in a patient's accumulating risk of complications during a surgical procedure.

  12. Correlation of Apgar Score with Asphyxial Hepatic Injury and Mortality in Newborns: A Prospective Observational Study from India

    Directory of Open Access Journals (Sweden)

    Deepak Sharma

    2016-01-01

    Full Text Available Objective The objective of this study is to determine the correlation of Apgar score with asphyxial hepatic injury and neonatal mortality in moderately and severely asphyxiated newborns. Material and Methods This is a secondary analysis of our prospective observational case-controlled study. Sixteen neonates with severe birth asphyxia (five-minute Apgar ≤3 were compared with either 54 moderate asphyxia neonates (five-minute Apgar >3 or 30 normal neonates. Liver function tests were measured on postnatal days 1, 3, and 10 in the study and control groups. Neonatal mortality was observed in the study and control population. Results Correlation of Apgar score in severely asphyxiated neonates compared with normal Apgar score neonates and moderately asphyxiated neonates for deranged hepatic function showed significant correlation (odds ratio [OR] 4.88, 95% CI 3.26–5.84, P = 0.01 and OR 2.46, 95% CI 1.94–3.32, P = 0.02, respectively. There was a significant increase in serum lactate dehydrogenase (LDH and total bilirubin on day 1 and serum LDH at age of 10th postnatal life in severely asphyxiated neonates when compared to moderately asphyxiated neonates, whereas there was a significant decrease in total bilirubin and serum albumin on day 3 in severely asphyxiated neonates. There was a significant increase in serum alanine transaminase, serum LDH, and total bilirubin on day 1, serum aspartate transaminase, serum LDH, and total bilirubin on day 3, and International Normalized Ratio on day 10 of postnatal life when severely asphyxiated neonates were compared with normal neonates. There was a significant reduction in total protein and serum albumin on day 1 and direct bilirubin on day 3 in severely asphyxiated neonates when compared with normal neonates. There was a significant increase in neonatal mortality in severely asphyxiated neonates when compared to the other two groups. Correlation of Apgar score in severely asphyxiated neonates compared with

  13. Comparison of Growth Parameters, Apgar score, the Blood Zinc, Magnesium, Calcium and Phosphor between Gestational Diabetic and Non-Gestational Diabetic Pregnant Women: a Prospective Cohort Study

    Directory of Open Access Journals (Sweden)

    Mohammad Keshvari-Delavar

    2016-05-01

    Full Text Available Background: Due to little attention to the combined effect of diabetes and pregnancy on mother an infant’s microelements in literatures. This study aimed to compare newborns growth parameters, Apgar score, the cord blood zinc, magnesium, calcium and phosphor between pregnant women with and without gestational diabetes mellitus. Materials and Methods: This prospective cohort study was conducted in Hamadan city, Iran, during 2013-14. Gestational diabetes considered as exposure and 20 women with gestational diabetes were individually matched with the 20 non-diabetic pregnant women in terms of the variables age, number of pregnancies, and type of delivery were included in this study. The cord blood and mother vein blood samples were taken immediately after delivery. Results: The mean of newborn's head circumference was 34.85±0.9 cm and 33.90±0.97 cm in mothers with gestational diabetes and non- diabetic mothers respectively (P

  14. Impact of Prenatal Cognitive-Behavioral Stress Management Intervention on Maternal Anxiety and Depression and Newborns’ Apgar Scores

    Directory of Open Access Journals (Sweden)

    Mahsa Karamoozian

    2015-06-01

    Full Text Available Background: Motherhood is a transformative and pleasing experience in a woman’s life. However, given the physical and psychological changes, it can induce a degree of stress and anxiety in mothers. The aim of the present study was to evaluate the effects of cognitive-behavioral stress management (CBSM on maternal anxiety and depression during pregnancy and newborns’ Apgar scores. Methods: This semi-experimental study was performed by applying a pretest-posttest control-group design. Overall, 30 primiparous mothers were selected among women referring to health clinics of Kerman, Iran, using convenience sampling. Subjects were randomly allocated to experimental and control groups. Data were collected, using Pregnancy-Related Anxiety Questionnaire and Edinburgh Postnatal Depression Questionnaire. After completing the pretest, the experimental group was subjected to 12 sessions of CBSM training; posttest data were collected after the intervention. Multivariate analysis of covariance was performed, using SPSS version 16. P-value < 0.05 was considered statistically significant. Results: The obtained results revealed a significant decrement in the average posttest scores of anxiety and depression in the experimental group, compared to pretest scores and the control group. Moreover, differences in 1- and 5-minute Apgar scores between the two groups were statistically significant. These findings indicated the effectiveness of CBSM during pregnancy in reducing maternal anxiety and depression. Conclusion: Pregnant women can benefit from psychological interventions such as CBSM in medical and health care centers.

  15. Prevention of misunderstanding of Apgar score%应防止对Apgar评分的误解

    Institute of Scientific and Technical Information of China (English)

    陈自励

    2001-01-01

    @@Apgar V 1953年提出的Apgar评分至今仍是国际公认的在产房评价新生儿最简捷实用的方法[1]。正确的认识和应用可充分发挥它的作用和价值;如果误解,则会带来不少弊端,是当前值得注意的一种倾向。

  16. Prediction of Outcome After Emergency High-Risk Intra-abdominal Surgery Using the Surgical Apgar Score

    DEFF Research Database (Denmark)

    Cihoric, Mirjana; Toft Tengberg, Line; Bay-Nielsen, Morten

    2016-01-01

    BACKGROUND: With current literature quoting mortality rates up to 45%, emergency high-risk abdominal surgery has, compared with elective surgery, a significantly greater risk of death and major complications. The Surgical Apgar Score (SAS) is predictive of outcome in elective surgery, but has never...... been validated exclusively in an emergency setting. METHODS: A consecutive prospective single-center cohort study of 355 adults undergoing emergency high-risk abdominal surgery between June 2013 and May 2014 is presented. The primary outcome measure was 30-day mortality. Secondary outcome measures were...... the incidence of both outcomes. Area under the curve was used to demonstrate the scores' discriminatory power. RESULTS: One hundred eighty-one (51.0%) patients developed minor or no complications. The overall incidence of major complications was 32.7% and the overall death rate was 16.3%. Risk of major...

  17. Impact of systemic inflammatory response syndrome and surgical Apgar score on post-operative acute kidney injury.

    Science.gov (United States)

    Toyonaga, Y; Asayama, K; Maehara, Y

    2017-08-28

    Surgical Apgar Score (SAS) is relatively weakly associated with post-operative outcomes in emergency surgery, compared with elective surgery. A combination of systemic inflammatory response syndrome (SIRS) and SAS may be useful for prediction of poor outcomes after emergency surgery. A retrospective study was conducted in patients who underwent emergency abdominal or cerebral surgery from January 2005 to December 2010. AKI was diagnosed using Acute Kidney Injury Network criteria for 2 days after surgery. Pre-operative SIRS was defined as SIRS score ≥ 2. Patients were divided into those with SAS ≥ 5 and SIRS (OR 1.9, 95% CI: 1.2-2.9, P SIRS and SAS SIRS and SAS SIRS and SAS SIRS and SAS are independently associated with post-operative AKI. Simultaneous use of pre-operative SIRS and SAS may improve prediction of poor post-operative outcomes. © 2017 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  18. 21 CFR 880.2930 - Apgar timer.

    Science.gov (United States)

    2010-04-01

    ... Apgar timer. (a) Identification. The Apgar timer is a device intended to alert a health care provider to take the Apgar score of a newborn infant. (b) Classification. Class I (general controls). The device is... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Apgar timer. 880.2930 Section 880.2930 Food...

  19. Neonatal APGAR Score in the Prevention of Iodine Deficiency Disorder%新生儿APGAR评分在碘缺乏病防治中的应用

    Institute of Scientific and Technical Information of China (English)

    程丽梅; 杨小静; 谷霞; 齐小雪; 叶红; 罗琳; 刘佩; 李津蜀

    2013-01-01

    Objective To explore the effect of newborn APGAR score method in prevention of Iodine Deficiency Disorder (IDD) Methods With of length and breadth research method,100 neonates were measures APGAR score,height and weight every 5 years after the popularization of iodine containing salt,and were compared with the thyroid enlargement rate.Results After 15 years' iodine supplementation,the neonatal APGAR score weight increased respectively 0.08,0.3,0.29 and 99.8 g.The neonatal APGAR score at 5 and 10 minutes among years had statistically significant differences; low APGAR score was not detected; 5 and 10 minutes APGAR scores had considerable relation with swollen.Conclusion The neonatal APGAR score method can be applied to evaluate the effect of the prevention and control effect of IDD,yet further improvement is needed.%目的 探索新生儿APGAR评分法在评价碘缺乏病(IDD)防治效果中的作用.方法 采用纵横结合研究,在实施全民补碘后,每5年对同一所医院随机调查100例新生儿APGAR评分、身高、体重等指标,并与同期儿童甲状腺肿大率相比较.结果 补碘后15年,新生儿APGAR评分和体重分别增加了0.08、0.3、0.29和99.8 9;其中,新生儿5 min、10 minAPGAR评分在年度之间差异具有统计学意义;低APGAR评分未检出;5 min、10 min APGAR评分与甲肿率有较好的相关性.结论 新生儿APGAR评分可用于IDD防治效果评价,但需进一步研究.

  20. Bloqueio combinado para analgesia de parto: a adição de sufentanil ao anestésico local influencia o apgar dos recém-nascidos? Bloqueo combinado para analgesia de parto: ¿la adición de sufentanil al anestésico local influye en el apgar de los reciÿn nacidos? Combined spinal-epidural for labor analgesia: does the addition of sufentanil to the local anesthetic influence apgar scores of the newborns?

    Directory of Open Access Journals (Sweden)

    Domingos Dias Cicarelli

    2007-06-01

    Universidade de São Paulo (USP y evaluar si la utilización de sufentanil asociado al anestésico local en el BC altera el Apgar de los recién nacidos. MÉTODO: Se analizaron las fichas de anestesia en que se realizaron BC para la analgesia de parto durante 12 meses en el Hospital Universitario de la USP. Se registraron el uso y la dosis de sufentanil, la vía de parto utilizada y las puntuaciones de Apgar del 1°, 5° y 10° minutos de los recién nacidos. RESULTADOS: De los 635 BC evaluados, 307 utilizaron sufentanil y anestésico local (Grupo SUF y 328, solo anestésico local (Grupo AL. Ciento veinte y siete (20% fueron realizados a través de la técnica de aguja por dentro de aguja y los otros 508 (80% realizados por la técnica dos punciones. No se verificó diferencia entre el Apgar de los grupos estudiados en el 1°, 5° y 10° minutos. CONCLUSIONES: El sufentanil utilizado en el bloqueo combinado no alteró el Apgar de los recién nacidos.BACKGROUND AND OBJECTIVES: Combined spinal-epidural (CSE is a very common obstetric technique. However, the literature does not present a standardization regarding the technique, doses, and anesthetics used, besides there is also the controversy about the possibility that the addition of opioids to the local anesthetic causes fetal bradycardia and affects its vitality. The aim of this study was to identify the techniques and anesthetics used in the Anesthesiology Service of the Hospital Universitário of Universidade de São Paulo (USP and determine whether the use of sufentanil associated with the local anesthetic affects Apgar scores of newborns. METHODS: The anesthesiology charts of patients submitted to CSE for labor analgesia over a 12-month period at the Hospital Universitário of USP were analyzed. The use and dose of sufentanil, the type of delivery, and Apgar scores in the 1st, 5th, and 10th minutes were recorded. RESULTS: Of the 635 CSE analyzed, 307 used sufentanil and local anesthetic (SUF Group and 328 only local

  1. Re-evaluation of Apgar score:introduction of policy statements of the Apgar score by American Academy of Pediatrics and American College of Obstetricians and Gynecologists%Apgar评分的再评价——美国儿科学会和妇产科学会“Apgar评分”最新声明简介

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    李茂军; 吴青; 阳倩; 唐彬秩; 陈昌辉

    2016-01-01

    自1952年以来,Apgar评分作为一种被广泛接受的简便方法,一直用于评估新生儿出生后状态及对复苏的反应.但在很多情况下,Apgar评分被用来不恰当地预测新生儿特定的神经系统不良结果.2015年10月美国儿科学会(APP)和美国妇产科学会(ACOG)更新了《Apgar评分》的政策声明.声明指出,Apgar评分的局限性决定了不宜单独使用Apgar评分诊断窒息;不能预测个体的病死率和神经系统不良结果;鼓励使用扩展的Apgar评分表,以便解释同期复苏的干预效果.%As a widely accepted and convenient method,the Apgar score has been applied to assess the status of the newborn infants and the response to resuscitation since 1952.But the Apgar score has also been used inappropriately in infants to predict specific neurologic outcomes in many cases."The Apgar Score" produced by American Academy of Pediatrics(AAP) in collaboration with American College of Obstetricians and Gynecologists(ACOG),updated policy statements of the Apgar score in October 2015.The Apgar score has limitations,and it is not appropriate to use it alone to establish the diagnosis of asphyxia;the method does not predict individual neonatal mortality or neurologic outcome.AAP/ACOG encourages the use of an expanded Apgar score reporting form that accounts for concurrent resuscitation interventions.

  2. Propensity score matching with clustered data. An application to the estimation of the impact of caesarean section on the Apgar score.

    Science.gov (United States)

    Arpino, Bruno; Cannas, Massimo

    2016-05-30

    This article focuses on the implementation of propensity score matching for clustered data. Different approaches to reduce bias due to cluster-level confounders are considered and compared using Monte Carlo simulations. We investigated methods that exploit the clustered structure of the data in two ways: in the estimation of the propensity score model (through the inclusion of fixed or random effects) or in the implementation of the matching algorithm. In addition to a pure within-cluster matching, we also assessed the performance of a new approach, 'preferential' within-cluster matching. This approach first searches for control units to be matched to treated units within the same cluster. If matching is not possible within-cluster, then the algorithm searches in other clusters. All considered approaches successfully reduced the bias due to the omission of a cluster-level confounder. The preferential within-cluster matching approach, combining the advantages of within-cluster and between-cluster matching, showed a relatively good performance both in the presence of big and small clusters, and it was often the best method. An important advantage of this approach is that it reduces the number of unmatched units as compared with a pure within-cluster matching. We applied these methods to the estimation of the effect of caesarean section on the Apgar score using birth register data. Copyright © 2016 John Wiley & Sons, Ltd.

  3. 索兰纳斯及其对Apgar评分法的贡献%Contribution of Soranus of Ephesus on Apgar Score

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    袁岳沙; 曾凡芝

    2001-01-01

    索兰纳斯是古罗马时期的著名妇产科医生,是妇产科学、儿科学等学科的先驱之一。他的关于新生儿成熟度的评估标准还鲜为人知。在对索兰纳斯和Apgar的新生儿评估系统的比较分析中,可见索兰纳斯对Apgar评分法的贡献。%Soranus of Ephesus was a famous gynecological physician in Roman times and one of the pioneers of gynecology, pediatrics and so on. The contribution of Soranus on Apgar score was researched by comparing Soranus critical and Apgar score of evaluation system of newborn infant.

  4. An Influence of Birth Weight, Gestational Age, and Apgar Score on Pattern Visual Evoked Potentials in Children with History of Prematurity

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    Marta Michalczuk

    2015-01-01

    Full Text Available Purpose. The objective of our study was to examine a possible influence of gestational age, birth weight, and Apgar score on amplitudes and latencies of P100 wave in preterm born school-age children. Materials and Methods. We examined the following group of school-age children: 28 with history of prematurity (mean age 10.56 ± 1.66 years and 25 born at term (mean age 11.2 ± 1.94 years. The monocular PVEP was performed in all children. Results. The P100 wave amplitudes and latencies significantly differ between preterm born school-age children and those born at term. There was an essential positive linear correlation of the P100 wave amplitudes with birth weight, gestational age, and Apgar score. There were the negative linear correlations of P100 latencies in 15-minute stimulation from O1 and Oz electrode with Apgar score and O1 and O2 electrode with gestational age. Conclusions. PVEP responses vary in preterm born children in comparison to term. Low birth weight, early gestational age, and poor baseline output seem to be the predicting factors for the developmental rate of a brain function in children with history of prematurity. Further investigations are necessary to determine perinatal factors that can affect the modified visual system function in preterm born children.

  5. 新生儿出生评分计时器在新生儿评分中的效果%Effect of neonatal score timer in Apgar score of neonates

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    阮利红; 马彦玲; 唐玉秋; 田敬霞

    2013-01-01

    Objective: To research the effect of neonatal score timer in Apgar score of neonates. Methods: Timing of crying time of 1 100 neonates was conducted, the neonates with one munite Apgar score > 7 received timing score by single blind method, a statistical analysis was carried out Results: A total of 1 068 neonates were found with one minute Apgar score > 7, the mean crying time was (23. 82 ± 12. 55) seconds, the crying time of 92. 13% of the neonates was 40 seconds or less than 40 seconds. The mean time of primary one minute Apgar score was (64. 22 ± 12.43) seconds; compared with that of 60 seconds, there was statistically significant difference (P < 0. 05 ) . Thirty - two neonates were found with one minute Apgar score ≤ 7, resuscitation was conducted according to the principal of neonatal resuscitation guidance, the telling time of timer was once 30 seconds. Resuscitation was completed successfully in 32 neonates. Conclusion: Neonatal Apgar score timer is convenient and accurate, which improve the accuracy of Apgar score and is helpful to rescue of neonates with asphyxia.%目的:研究新生儿出生评分计时器在新生儿评分中的效果.方法:对1 100例新生儿进行啼哭时间计时,对1 min Apgar评分>7分的新生儿进行单盲法计时评分,进行统计学分析.结果:1 min Apgar评分>7分的新生儿有1 068例,啼哭时间平均为(23.82±12.55)s,在≤40 s啼哭的新生儿占92.13%.原始1min Apgar评分时间平均为(64.22±12.43)s;与60s做比较差异有统计学意义(P<0.05).1 min Apgar评分≤7分者32例,采用新生儿复苏指南原则进行复苏,计时器报时1次/30 s.32例均复苏成功.结论:新生儿出生评分计时器使用简便,计时准确,提升了Apgar评分的准确性,利于对窒息新生儿的抢救.

  6. Awareness and apgar score in elective Cesarean section under general anesthesia with propofol or Isoflurane: A prospective, randomized, double-blinded clinical trial study

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    Somayeh Khanjani

    2014-01-01

    Full Text Available Background: Awareness is a postoperative recall of events experienced under general anesthesia. In this study, we compared the incidence of awareness between two routine methods used, inhalation (Isoflurane and intravenous protocol (Propofol, in elective Cesarean section, and also evaluated the effect of these two different methods on the apgar score of newborns. Materials and Methods: In this prospective, clinical trial study, 90 pregnant women candidates for elective Cesarean section were randomly enrolled, after taking written consent. Induction of anesthesia in both groups was provided by propofol and succinylcholine in the same manner, and maintenance of anesthesia in Group 1 was provided by propofol 100 μg/kg/minute and in Group 2 with isoflurane 1 MAC, to maintain the bispectral index (BIS between 45 and 60. Blood pressure, heart rate, electrocardiography (ECG, and also Etco2 and o2sat were recorded throughout the surgery and finally analyzed and compared. Results: From 90 patients, four cases of confirmed awareness were found in the propofol group and three cases in the Isoflurane group (8/9% vs. 6/7%, but the apgar scores were comparable between the two groups. Meanwhile there were no significant differences between the two groups in basic information, neonatal apgar scores, hemodynamic changes, and BIS, Electromyography (EMG, and signal quality index (SQI values. Conclusion: According to the patient′s state, diagnosis of the anesthesiologist, and other criteria like price and its availability, we could use these drugs in general anesthesia during Cesarean section, although it is recommended that more studies be done to compare the effect of these two drugs in larger groups.

  7. Awareness and apgar score in elective Cesarean section under general anesthesia with propofol or Isoflurane: A prospective, randomized, double-blinded clinical trial study.

    Science.gov (United States)

    Khanjani, Somayeh; Naghibi, Khosrou; Azarnoush, Hamed

    2014-01-01

    Awareness is a postoperative recall of events experienced under general anesthesia. In this study, we compared the incidence of awareness between two routine methods used, inhalation (Isoflurane) and intravenous protocol (Propofol), in elective Cesarean section, and also evaluated the effect of these two different methods on the apgar score of newborns. In this prospective, clinical trial study, 90 pregnant women candidates for elective Cesarean section were randomly enrolled, after taking written consent. Induction of anesthesia in both groups was provided by propofol and succinylcholine in the same manner, and maintenance of anesthesia in Group 1 was provided by propofol 100 μg/kg/minute and in Group 2 with isoflurane 1 MAC, to maintain the bispectral index (BIS) between 45 and 60. Blood pressure, heart rate, electrocardiography (ECG), and also Etco2 and o2sat were recorded throughout the surgery and finally analyzed and compared. From 90 patients, four cases of confirmed awareness were found in the propofol group and three cases in the Isoflurane group (8/9% vs. 6/7%), but the apgar scores were comparable between the two groups. Meanwhile there were no significant differences between the two groups in basic information, neonatal apgar scores, hemodynamic changes, and BIS, Electromyography (EMG), and signal quality index (SQI) values. According to the patient's state, diagnosis of the anesthesiologist, and other criteria like price and its availability, we could use these drugs in general anesthesia during Cesarean section, although it is recommended that more studies be done to compare the effect of these two drugs in larger groups.

  8. 脐动脉血气分析与Apgar评分联合应用临床价值研究%Clinical Values of Umbilical Cord Artery Blood Gas Analysis Combined with Apgar Score

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    张萍; 赵丽丽; 李海囡

    2011-01-01

    Objective To explore the relationship hetween umbilical cord artery blood gas analysis and Apgar score and to evaluate the clinical significance of their combination. Methods Results of umbilical cord artery blood gas analysis and Apgar scores were obtained immediately after delivery in 184 normal term infants with the outcomes of these neonates followed-up. Results The average value of pH in the distress group was ( 7.25 ± 0.21 ) and was ( 7.29±0.04 ) in the non - distress group. Percentage of neonates with umbilical artery pH < 7.2, <7.1 , < 7.0 were 30.36%, 23.21%, 16.07% in the distress group and were 14.06%, 10.16%, 5.47% in the non - distress group ( P<0.05 ) . Among the neonates with Apgar scores≤7, percentage of individuals with pH value below boundary ( 7.2, 7.1 or 7.0 ) was higher than in those with Apgar scores > 7 (P<0.05 ). Among the neonates with Apgar score≤7, sensitivity and specificity were 58.82% and 57.14% when pH <7.2,55.88% and 73.08% when pH < 7.1, and were 35.29% and 75.00% when pH < 7.0. With the decrease of umhilical blood pH, incidence rate of hypoxic ischemic encephalopathy and pathologic jaundice increased. Conclusion Combination of Apgar score and umbilical cord gas analysis reflects the hypoxic and ischemic status of the fetus more objectively and sensitively and might be able to play an important role in predicting the immediate and long - term prognosis of the neonate.%目的 探讨脐动脉血气分析与Apgar评分的关系及二者联合应用的临床意义.方法 对184例足月新生儿出生即进行脐动脉血气分析、Apgar评分,并追踪新生儿结局.结果 宫内窘迫组脐动脉血pH值为(7.25±0.21),无宫内窘迫组pH值为(7.29±0.04).宫内窘迫组pH<7.2占30.36%,<7.1占23.21%,<7.0占16.07%;无宫内窘迫组pH<7.2占14.06%,<7.1占10.16%,<7.0占5.47%,两组比较差异均有统计学意义(P<0.05).分别以7.2、7.1、7.0

  9. Discussion on Correlation Between Cord Around Neck S/D Value in Third Trimester and Apgar Score%妊娠晚期脐带绕颈S/D值与Apgar评分的相关性探讨

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    侯立业; 叶德福; 张桃桃; 李佳; 刘娟

    2012-01-01

      Objective :To evaluate the correlation between the third trimester around the neck umbilical cord of fetal umbilical artery S/D value and neonatal Apgar score,to provide health security for perinatal babies.Methods :Selection pregnant women which were found that umbilical cord around the neck in hengli people’s hospital. To analyze the correlation between the third trimester around the neck umbilical cord of fetal umbilical artery S/D value and neonatal Apgar score. Results :All 803 cases of umbilical cord around the neck of pregnant women,there were 89 cases (11.08%) umbilical artery S/D value ≥ 3.0,including Apgar score <7 person in 3 patients (3.37%);there were 714 cases (88.92%) umbilical artery S/D value <3.0,including Apgar score <7 person in 3 patients (0.42%). Umbilical artery S/D value ≥ 3.0,the incidence of neonatal asphyxia is obviously higher than that of the umbilical artery S/D value <3.0(P<0.001),the difference was statistically significance. Conclusion :Measuring the third trimester umbilical cord around the neck fetal umbilical artery S/D value,can effectively predict neonatal Apgar score,and to provide a powerful security perinatal newborn.%  目的:评估妊娠晚期脐带绕颈的胎儿脐动脉 S/D 值与新生儿 Apgar 评分的相关性,为围生期新生儿提供健康保障.方法:选择在笔者所在医院住院待产孕妇,经超声检查发现脐带绕颈者,测脐动脉 S/D 值,与产后新生儿 Apgar 评分对比分析,研究 S/D 值与新生儿 Apgar 评分的相关性.结果:803例脐带绕颈的孕妇,脐动脉 S/D 值≥3.0者89例(11.08%),其中 Apgar 评分<7者3例(3.37%);脐动脉 S/D 值<3.0者714例(88.92%),其中 Apgar 评分<7者3例(0.42%).脐动脉 S/D 值≥3.0者新生儿窒息的发生率明显高于脐动脉 S/D 值<3.0者,差异有统计学意义(P<0.001).结论:测量妊娠晚期脐带绕颈胎儿脐动脉 S/D 值,可以有效预测新生儿 Apgar 评分情况,为

  10. Association of heart rate variability with 5-minute Apgar score in neonates with severe asphyxia%重度窒息新生儿5分钟Apgar评分的心率变异性分析

    Institute of Scientific and Technical Information of China (English)

    王瑾; 李丽; 阚亚楠; 梁宏伟; 陈家菲

    2013-01-01

    目的探讨重度窒息新生儿5 min Apgar评分与心率变异性(HRV)的关系。方法入选103例出生后1 min Apgar评分为0~3分的重度窒息新生儿,根据出生后5 min Apgar评分分组,>7分为A组(n=50),≤7分B组(n=53);同时以40例1、5 min Apgar评分均>7分的足月新生儿作为对照组;三组新生儿均于出生后第3天行24 h动态心电图检查,并分析其HRV变化。结果 B组较对照组及A组HRV时域指标PNN50、rMSSD、SDSD降低,SDNN、SDANN升高,差异均有统计学意义(P0.05)。结论新生儿窒息损伤自主神经功能,5 min Apgar评分联合HRV时域参数可作为重度窒息新生儿自主神经功能损伤及预后的无创判断指标。%Objective To explore the relationship between 5-minute Apgar score and heart rate variability (HRV) in severely asphyxiated neonates. Methods A total of 103 severely asphyxiated neonates with 1-minute Apgar score of 0 to 3 points were selected. They were divided into Group A (>7 points, n=50) and Group B (≤7 points, n=53) based on 5-minute Apgar score. Meanwhile, 40 full-term neonates with 1-and 5-minute Apgar score greater than 7 points were selected as control group. 24-hour dynamic electrocardiogram was performed and HRV was analyzed on the third day after birth in three groups. Results PNN50, rMSSD, SDSD were decreased and SDNN, SDANN were increased in group B as compared with group A and control group (P0.05). Conclusions Neonatal asphyxia can cause damage to autonomic nervous system. 5-minute Apgar score and HRV can be joint-ly used as a non-invasive index in autonomic nervous damage and its prognosis in asphyxiated newborns.

  11. 脐血血气分析与胎儿Apgar评分监测缺氧的相关性研究%Study on correlation between umbilical cord blood gas analysis and Apgar scores in monitoring fetal hypoxia

    Institute of Scientific and Technical Information of China (English)

    杨燕

    2013-01-01

    Objective To study the correlation of umbilical cord blood gas analysis and Apgar scores in monitoring fetal hypoxia.Methods 180 cases of bom from March 2011 to March 2012 in our hospital,with the legislation collected cord blood samples for blood gas analysis,and two groups according to the results of fetal Apgar scores,were divided into experimental and control groups.The 90 cases of experimental group had fetal Apgar score ≤7 points,the 90 cases of control group had fetal Apgar score ≥8 points.combining with cord blood research blood gas analysis and fetal Apgar scores,we monitored the two groups of children with hypoxia and statistical analysis.Reaults The experimental group's fetal Apgar score ≤7 Pa02,HC03-,pH values were significantly lower than those of the control group (P<0.05),fetal PaC02 values of the experimental group,BE negative values were significantly higher than those in the control group (P<0.05).Concluaions Umbilical cord blood gas analysis for monitoring fetal Apgrscores neonatal hypoxia.can improve the neonatal diagnostic accuracy,and improve perinatal survival rate.in the control group (P<0.05).Conclusion umbilical cord blood gas analysis to monitor fetal Apgar scores neonatal hypoxia can improve the the neonatal diagnostic accuracy,and improve perinatal survival.%目的 研究脐血血气分析与胎儿Apgar评分监测缺氧的相关性.方法 选择2011年3月至2012年3月我院180例新生儿出生后,立采集脐血血样进行血气分析,并根据胎儿Apgar评分结果,分为实验组和对照组两组.实验组90例胎儿Apgar评分≤7分,对照组90例胎儿Apgar评分≥8分,结合研究脐血血气分析与胎儿Apgar评分情况,监测两组患儿缺氧情况,并进行统计分析.结果 Apgar评分≤7分的实验组胎儿的PaO2、HCO3-、pH值均明显低于Apgar评分≥8分的对照组胎儿(P<0.05),实验组胎儿的PaCO2值、BE负值均明显高于对照组(P<0.05).结论 脐血血气分析与胎

  12. 早产儿Apgar评分与脐动脉血气值相关性44例分析%Correlation between Apgar Score and Umbilical Artery Blood Gas Values of Premature Infant:Analysis on 44 Cases

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    杨静波; 隋广涛

    2011-01-01

    [Objective] To study the correlation between Apgar score and blood gas analysis among premature infant, so as to guide the clinical diagnosis and treatment of asphyxia in premature infants. [ Methods ] By using i-STAT blood gas analyzer, the blood gas analysis was conducted in umbilical arterial blood of 44 premature infants and 36 full-term infants at 1 and 5 minutes after birth, and correlation between the results and Aptgar score was analyzed. [ Results ] The blood pH in the premature infant group and the full-term infant group was 7.24 ± 0.04 and 7.22 ± 0.04, respectively. In the premature infant group, there were 13 infants whose l-min Apgar score was ≤7, which accounted for 29.5%, there were 7 infants whose 5-min Apg ar score was ≤7, which accounted for 15.9%. In the full-term infant group, there were 3 infants whose l-min and 5-min Apgar score was ≤7, which accounted for 8. 3%. [ Conclusion ] Apgar score should be combined with umbilical artery blood gas values in diagnosis of asphyxia in premature infants, and the umbilical artery blood gas values is more important.%目的:研究早产儿生后Apgar评分与血气分析的相关性,以指导临床对早产儿窒息的诊断及处理.方法:用i-STAT型血气分析仪对44例早产儿及36例足月儿生后1、5 min脐动脉血进行血气分析,并与Apgar评分进行相关分析.结果:血pH值:早产儿组为7.24±0.04,足月儿组为7.22±0.04.Apgar评分:早产儿组1 min Apgar评分≤7分的有13名,占总数的29.5%;5 min Apgar评分47分的有7名,占总数的15.9%;足月儿1 min和5 min Apgar评分≤7分的共有3名,占总数的8.3%.结论:诊断早产儿窒息时应将Apgar评分与脐动脉血气值相结合,且以脐动脉血气结果为主.

  13. Low Apgar scores at 5 minutes in a low risk population: maternal and obstetrical factors and postnatal outcome Baixos índices de Apgar no quinto minuto de vida em população de baixo risco: fatores maternos e obstétricos e resultados pós-natais

    Directory of Open Access Journals (Sweden)

    Eugenia Maria Assunção Salustiano

    2012-10-01

    Full Text Available OBJECTIVE: To evaluate the association between Apgar scores of less than seven at five minutes (AS5min 7 at 5 minutes who were randomly selected by a computer program. The main outcomes were neonatal death, newborn respiratory distress, need for orotracheal intubation and neonatal intensive care unit (NICU, and hypoxic-ischemic-encephalopathy. RESULTS: After multiple regression analysis, repeated late decelerations on cardiotocography (OR: 2.4; 95% CI: 1.4-4.1 and prolonged second stage of labor (OR: 3.3; 95% CI: 1.3-8.3 were associated with AS5min 0.05. CONCLUSION: Repeated late decelerations and prolonged second stage of labor in the low-risk population are predictors of AS5min OBJETIVO: Avaliar a associação entre índice de Apgar menor que sete no 5º minuto, os fatores pré-natais e resultados pós-natais. MÉTODOS: Trata-se de estudo retrospectivo com 27.252 recém-nascidos em maternidade escola com população de baixo risco obstétrico, de janeiro de 2003 a dezembro de 2010. Prontuários de todos os casos com índice de Apgar 7 no 5º minuto, escolhidos ao acaso, foram revisados. Os principais desfechos estudados foram: óbito neonatal, insuficiência respiratória neonatal, necessidade de intubação orotraqueal e de unidade terapia intensiva (UTI neonatal e encefalopatia hipóxico-isquêmica. RESULTADOS: Após análise de regressão múltipla, desacelerações tardias (DIP II (OR: 2,4; IC95%: 1,4-4,1 e período expulsivo prolongado (OR: 3,3; IC 95%: 1,3-8,3 se associaram com Apgar < 7 no 5º minuto; assim como com insuficiência respiratória ao nascimento (OR: 3,0; IC 95%: 1,3-6,9, intubação traqueal (OR: 2,5; IC 95%: 1,2-4,8, necessidade de UTI neonatal (OR: 9,5; IC 95%: 6,7-16,8 e encefalopatia hipóxico-isquêmica (OR: 14,1; IC 95%: 3,6-54,7. Nenhuma outra variável prénatal se associou com Apgar < 7 no 5º minuto (p < 0,05. CONCLUSÃO: DIP II e período expulsivo prolongado estão associados com Apgar < 7 no 5º minuto em

  14. Correlation of plasma D-dimer, T lymphocyte subsets, CRP level with Apgar score of neonates in pregnant women with pregnancy-induced hypertension during perinatal period%妊高征孕妇围生期血浆D-二聚体、T细胞亚群及CRP水平与胎儿Apgar评分的相关性

    Institute of Scientific and Technical Information of China (English)

    钟晓红

    2014-01-01

    Objective It is to explore the correlation of plasma D -dimer ( D-D) , T lymphocyte subsets , CRP level with Apgar score of neonates in pregnant women with pregnancy-induced hypertension ( PIH) during perinatal period .Methods 120 pregnant women with PIH were selected as observation group , and 60 healthy pregnant women were selected as control group . Plasma D-D, CD4 +and CD8 +T cell lymphocyte subsets and CRP level of the two groups were detected before and 3d after delivery , and Apgar scores of neonates were recorded after delivery .By applying Pearson correlation analysis , the correlation of plasma D-dimer, T lymphocyte subsets proportion , CRP level and Apgar score of neonates was analyzed .Besides, the correlation of D-dimer, CD4+/CD8 +, CRP index, and Apgar score of neonates was analyzed by multiple logistic regression analysis.Results There was no statistical difference in plasma D -D, CD4+/CD8 +and CRP before and 3d after delivery in control group (P>0.05), while observation group’s plasma D-D and CRP decreased (P<0.05), and CD4 +/CD8 +in-creased (P<0.05).By comparison, D-dimer, CRP, and CD4 +/CD8 +before and 3d after delivery in observation group were all higher than those in control group (P<0.05).By Pearson correlation, it showed that D -dimer, CD4 +/CD8+, CRP and Apgar score of neonates were both negative correlation with each other (P<0.05).By multiple logistic regression a-nalysis, D-dimer and CD4 +/CD8 +are independent forecast factors for Apgar score of neonates (OR=0.673, P=0.032;OR=0.543, P=0.026).Conclusion Plasma D-dimer, T lymphocyte subsets and CRP in pregnant women with PIH during perinatal period have clinical value for assessment of Apgar score of neonates .%目的:探讨妊娠高血压综合征孕妇围生期血浆D-二聚体( D-dimer )、T细胞亚群、C反应蛋白( CRP)与胎儿Apgar评分的相关性。方法选取妊高征孕妇120例设为观察组;另选取同期孕检的健康孕妇60例设为对照组。检测2

  15. Clinical study of umbilical artery blood gas analysis and Apgar score in evaluation of neonatal asphyxia%脐动脉血气分析和Apgar评分评估新生儿窒息的临床探讨

    Institute of Scientific and Technical Information of China (English)

    余燕红; 陈影; 陈少君

    2014-01-01

    目的:探讨脐动脉血气分析及Apgar评分在评估新生儿窒息中的临床意义。方法选择2012年3月~2013年3月广东省肇庆市第二人民医院分娩的84例新生儿作为研究对象,其中34例窒息新生儿为观察组,50例正常新生儿为对照组。分析两组新生儿出生时Apgar评分及脐动脉血血气分析与脏器损伤的关系,脐动脉血pH值与出生1 min Apgar评分的关系。结果观察组中,pH值<7.2者占38.2%,对照组中pH值<7.2者占16.0%,脐动脉血pH值较低的患儿,Apgar评分也较低,同时窒息的发生率较高,差异均有统计学意义(P<0.05)。结论评估新生儿窒息不能没有血气分析的结果,脐动脉血气分析比Apgar评分对评估新生儿窒息更具客观性,两者结合,能反映胎儿宫内缺氧缺血程度,为临床正确及时诊断新生儿窒息提供可靠的科学依据。%Objective To discuss the clinical significance of umbilical artery blood gas analysis and Apgar score in e-valuation of clinical significance in newborns with asphyxia. Methods 84 newborns from March 2012 to March 2013 in the Second People's Hospital of Zhaoqing City in Guangdong Province were selected as study objects, of which 34 newborns with asphyxia were as observation group, and 50 normal newborns were as control group. The relation be-tween the Apgar score at the time of birth, umbilical artery blood gas analysis and visceral injury, and the relation be-tween umbilical arterial pH and Apgar score in 1 min after birth were analyzed. Results In the asphyxia group, new-borns with pH <7.2 accounted for 38.2%, and in the control group, newborns with pH <7.2 accounted for 16.0%, um-bilical artery blood pH value was lower in children who with low Apgar score, at the same time, the rate of asphyxia neonatorum was higher, the differentese were statistically significant (P< 0.05) . Conclusion Assessment of neonatal asphyxia can not be done without blood gas analysis

  16. Meconium stained amniotic fluid neonatal umbilical arterial blood gas value of Apgar score and clinical observation%羊水胎粪污染新生儿脐动脉血气pH值与Apgar评分临床观察

    Institute of Scientific and Technical Information of China (English)

    高建国; 孙庆霞; 于普丽; 宋燕玲; 胡美莲

    2014-01-01

    Objective To explore the relationship between meconium stained amniotic fluid and the degree of asphyxia of newborn hypoxia. Methods Umbilical arterial blood gas analysis and Apgar score were pH value detection method of meconium stained amniotic fluid 1 degrees in 160 cases, 135 cases of meconium stained amniotic fluidⅡ°Ⅲ°, meconium stained amniotic fluid of 189 cases of newborn. Results the difference of umbilical artery blood gas index pH value and Apgar score significantly, and the amniotic fluid meconium pollution degree and umbilical artery blood gas index pH value and Apgar score proportional relationship, namely, the more serious pollution of neonatal asphyxia hypoxic severity. Conclusion Meconium stained amniotic fluid and the degree of asphyxia of newborn anoxic degree, and the problem of Neonatology, obstetrics, puts forward positive prevention interventions.%目的:探讨羊水胎粪污染程度与新生儿窒息缺氧的相关性。方法对羊水胎粪污染Ⅰ度160例、羊水胎粪污染Ⅱ度135例、羊水胎粪污染Ⅲ度189例新生儿的脐动脉血气pH值及Apgar评分结果进行分析。结果3组脐动脉血血气指标pH值及Apgar评分差异显著,且羊水胎粪污染程度与脐动脉血血气指标pH值及Apgar评分成正比关系,即污染程度越严重新生儿窒息缺氧程度越重。结论羊水胎粪污染程度与新生儿窒息缺氧的程度有密切联系,产科、新生儿科应积极给予预防干预措施。

  17. Breech delivery at term in Denmark, 1982-92

    DEFF Research Database (Denmark)

    Krebs, L; Langhoff-Roos, J

    1999-01-01

    The aim of the study was to determine the influence of intended mode of delivery on neonatal outcome in term breech delivery and to identify risk factors at intended vaginal delivery. Based on register data on all deliveries of non-malformed, singleton fetuses in breech presentation at term (n = 19......,476) in Denmark, 1982-92, a review of medical records of all (n = 218) cases with Apgar score risk of low Apgar score than elective Caesarean section....... Low Apgar score was correlated with duration of second stage of labour, but not with age, parity, birthweight, induction, augmentation or duration of first stage of labour. In conclusion, a pre-labour decision on vaginal delivery was associated with a 15-fold increase in low Apgar score. Prediction...

  18. CT值联合Apgar评分与新生儿缺氧缺血性脑病严重程度相关性研究%Correlation Study of CT Value Joint Apgar Score and Severity of Neonatal Hypoxic Ischemic Encephalopathy

    Institute of Scientific and Technical Information of China (English)

    黄宏亮

    2015-01-01

    目的:研究CT值联合Apgar评分与新生儿缺氧缺血性脑病(HIE)严重程度的相关性.方法:选取2014年1月-2015年4月本院收治的HIE患儿200例,临床分度轻度组108例,中度组65例,重度组27例,测定各组CT值与Apgar评分.结果:三组患者的CT值与Apgar评分比较差异具有统计学意义(P<0.05).结论:CT值、Apgar评分与HIE临床分度关系密切,两者联用可较准确判定HIE的严重程度.%Objective:To study the correlation between CT score and Apgar score and the severity of neonatal hypoxic ischemic encephalopathy (HIE).Method:From January 2014 to April 2015,200 patients with HIE were selected, 108 cases of clinical index mild group,65 cases of moderate group,27 cases of severe group,and the CT score and Apgar score were determined.Result:The difference of CT score and Apgar score between the three groups was statistically significant (P<0.05).Conclusion:CT score and Apgar score are closely related with clinical classification of HIE, and the severity of HIE is more accurate than that of the two.

  19. Virginia Apgar and string music

    OpenAIRE

    2011-01-01

    Virginia Apgar (1909-1974) is one of the most recognized American doctors, worldwide known by his contribution as the developer of the "Apgar test" a method used for the evaluation of newborns all over the world. She had many interests. She was anesthesiologist, a brilliant teacher and researcher, but she also loved lecture, basketball, fishing, golf, philately, and music. She played violin and cello and she interpreted that instruments in various chamber groups. Being motivated by one of her...

  20. Using the Bologna Score to assess normal delivery healthcare

    Directory of Open Access Journals (Sweden)

    Isaiane da Silva Carvalho

    Full Text Available Abstract OBJECTIVE Describing the obstetric care provided in public maternity hospitals during normal labour using the Bologna Score in the city of Natal, Northeastern Brazil. METHOD A quantitative cross-sectional study conducted with 314 puerperal women. Data collection was carried out consecutively during the months of March to July 2014. RESULTS Prenatal care was provided to 95.9% of the mothers, beginning around the 1st trimester of pregnancy (72.3% and having seven or more consultations (51%. Spontaneous vaginal delivery was planned for 88.2% women. All laboring women were assisted by a health professional, mostly by a physician (80.6%, and none of them obtained 5 points on the Bologna Score due to the small percentage of births in non-supine position (0.3% and absence of a partogram (2.2%. A higher number of episiotomies were observed among primiparous women (75.5%. CONCLUSION The score obtained using the Bologna Index was low. Thus, it is necessary to improve and readjust the existing obstetrical model.

  1. Using the Bologna Score to assess normal delivery healthcare.

    Science.gov (United States)

    Carvalho, Isaiane da Silva; Brito, Rosineide Santana de

    2016-01-01

    Describing the obstetric care provided in public maternity hospitals during normal labour using the Bologna Score in the city of Natal, Northeastern Brazil. A quantitative cross-sectional study conducted with 314 puerperal women. Data collection was carried out consecutively during the months of March to July 2014. Prenatal care was provided to 95.9% of the mothers, beginning around the 1st trimester of pregnancy (72.3%) and having seven or more consultations (51%). Spontaneous vaginal delivery was planned for 88.2% women. All laboring women were assisted by a health professional, mostly by a physician (80.6%), and none of them obtained 5 points on the Bologna Score due to the small percentage of births in non-supine position (0.3%) and absence of a partogram (2.2%). A higher number of episiotomies were observed among primiparous women (75.5%). The score obtained using the Bologna Index was low. Thus, it is necessary to improve and readjust the existing obstetrical model. Descrever a assistência obstétrica prestada em maternidades públicas municipais durante o parto normal na cidade de Natal, Nordeste do Brasil, com uso do Índice de Bologna. Estudo transversal com abordagem quantitativa, desenvolvido com 314 puérperas. A coleta de dados processou-se de forma consecutiva durante os meses de março a julho de 2014. A assistência pré-natal foi prestada a 95,9% das puérperas, com início em torno do 1º trimestre de gestação (72,3%) e realização de sete ou mais consultas (51%). O parto vaginal espontâneo foi planejado para 88,2% mulheres. Todas as parturientes foram assistidas por um profissional de saúde, especialmente pelo médico (80,6%) e nenhuma obteve 5 pontos no Índice de Bologna em virtude dos baixos percentuais de partos em posição não supina (0,3%) e ausência do partograma (2,2%). Houve maior número de episiotomias em primíparas (75,5%). A pontuação obtida por meio do Índice de Bologna foi baixa. Desse modo, é preciso melhorar e

  2. [Virginia Apgar and her scale].

    Science.gov (United States)

    van Gijn, Jan; Gijselhart, Joost P

    2012-01-01

    Virginia Apgar (1909-1974), born in New Jersey, managed to continue medical school despite the financial crisis of 1929, continued for a brief time in surgery and subsequently became one of the first specialists in anaesthesiology. In 1949 she was appointed to a professorship, the first woman to reach this rank at Columbia University in New York. She then dedicated herself to obstetric anaesthesiology and devised the well known scale for the initial assessment of newborn babies, according to 5 criteria. From 1959 she worked for the National Foundation for Infantile Paralysis (now March of Dimes), to expand its activities from prevention of poliomyelitis to other aspects of preventive child care, such as rubella vaccination and testing for rhesus antagonism. She remained single; in her private life she enjoyed fly fishing, took lessons in aviation and was an accomplished violinist.

  3. Revisiting the mode of delivery and outcome of singleton breech ...

    African Journals Online (AJOL)

    Assisted vaginal breech delivery was associated wilh high rate of low Apgar score (score <7) at the 5th minute ... There was no difference in terms of birth injury, neonatal death and maternal morbidities between those that had assisted vaginal ...

  4. Breech at term--mode of delivery? A register-based study

    DEFF Research Database (Denmark)

    1995-01-01

    . Register-based cohort study of all (n = 15718) singleton term breech deliveries of non-malformed infants in Denmark 1982-1990. Process and outcome measures: mode of delivery, gestational age, birth weight, congenital malformations, intrapartum death, Apgar scores and early neonatal death. RESULTS. A total...... of 3247 (20.7%) term infants were delivered vaginally, 7106 (45.3%) by elective and 5356 (34.1%) by emergency cesarean section. Infants delivered vaginally and by emergency cesarean section had significantly higher rates of mortality (intrapartum and early neonatal death) and morbidity (low Apgar scores......) when compared to those delivered by elective cesarean section. In vaginal deliveries, parity was not correlated with outcome, but infants with a birth weight above 4000 grams had significantly higher rates of low Apgar scores. CONCLUSIONS. Register data on singleton term breech deliveries imply...

  5. 新生儿缺氧缺血性脑病颅脑MRI-Apgar评分、血清NSE相关性研究%Study on brain MRI and its relations to Apgar scores, serum level of NSE in patients with neonatal hypoxic ischemic encephalopathy

    Institute of Scientific and Technical Information of China (English)

    丁燕霞; 李晓春

    2011-01-01

    Objective To invastigate the change of cerebral MRI of neonatal Hypoxic Is-chemic Encephalopathy(HIE), and the relation between the serum neuron - specific enolase(NSE) and Apgar scores. Methods One hundred HIE cases were chosen as experimental group, including 50 preterm cases and 50 term neonates. Based the degree of MRI, the subjects in the experimental group were classified into HIE mild and HIE moderate and severe. Another forty normal ones were chosen as control group. Blood samples were collected in all the research objects for NSE detecting. MRI was performed 3~7 days after birth in the experimental group. Results In full term neonates and preterm neonates, as the aggravation of the degrees of MRI, the serum NSE levels got increased and Apgar scores got decreased. Compared with the control group and the HIE mild group, the NSE levels in the HIE moderate and severe group had significant differences. However, the differences between the mild HIE group and the control group was insignificant. Differences of 5 min Apgar score between any two groups were significant. Conclusion Serum NSE level and Apgar score can be used as the early objective markers for evaluating the prognosis of brain damage in hypoxic is-chemic encephalopathy, and they are concordance with the cerebral MRI degrees. We can perform early diagnosis and evaluation of HIE by utilizing the two indexes.%目的 探讨新生儿缺氧缺血性脑病(HIE)颅脑磁共振成像(MRI)改变与血清神经元特异性烯醇化酶(NSE)及新生儿评分(Apgar评分)之间的关系.方法 选取HIE患儿100例(早产儿50例,足月儿50例)为实验组,依据颅脑MRI表现程度分为轻度HIE和中重度HIE组;另选同期非HIE新生儿40例为对照组,均在其生后行Apgar评分、检测血清NSE浓度,并于生后3~7 d行颅脑MRI检查.结果 HIE足月儿和早产儿随着MRI表现程度加重,血清NSE值逐渐增高,Apgar评分逐渐降低.中重度组与轻度组、对照组相比NSE水平

  6. Time between skin incision and delivery during cesarean.

    Science.gov (United States)

    Rossouw, Jana N; Hall, David; Harvey, Justin

    2013-04-01

    To investigate factors influencing skin incision-to-delivery time (including sub-divisions thereof) and the effect of these surgical intervals on immediate neonatal outcome. A prospective cohort analysis was conducted of all women undergoing cesarean delivery at Tygerberg Hospital, Cape Town, South Africa, from May 24 to November 2, 2010. Three surgical intervals were evaluated: skin incision to myometrium, myometrium to delivery, and skin incision to delivery. Neonatal outcome was assessed by the 5-minute Apgar score. Of 1120 cesarean deliveries recorded during the study period, 77.2% were emergency procedures, which were performed more quickly at all surgical planes (Pdelivery time was significantly extended among repeat procedures (Pdeliveries. Repeat procedures, adhesions, and obesity prolonged the time taken for cesarean delivery. Nevertheless, the effect of these factors on the 5-minute Apgar score was minimal. Copyright © 2013 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  7. A Labor and Delivery Patient Classification System Based on Direct Nursing Care Time

    Science.gov (United States)

    1991-08-01

    determine apgar score , label cord blood, clamp umbilical cord, stabilize neonate’s temperature, and complete identification of neonate. PL-form general...second practical exercise, based on a different written patient scenario, was returned to the nurse researchers. The researchers scored the exercise to...Bolton, L. B. (no date). Determinants of nursing care. Labor and Delivery. An obstetrical acuity scoring system for labor and delivery. Los Angeles, CA

  8. Agressividade e índice de Apgar

    OpenAIRE

    2010-01-01

    A agressividade é o comportamento que surge transversalmente como queixa isolada ou a par de outras queixas na maioria das crianças com e sem doença, que procuram apoio em saúde mental infantil. Nessas crianças, e a partir da recolha dos dados anamnesicos, tem-se verificado a constância de registo, no Livro do Bebé, de Índice de Apgar ≤ 9 ao primeiro minuto. Este estudo exploratório pretendeu analisar a hipótese teórica de que o Índice de Apgar abaixo de 10 ao primeiro minut...

  9. Breech at term--mode of delivery?

    DEFF Research Database (Denmark)

    Krebs, L; Langhoff-Roos, J; Weber, T

    1995-01-01

    : Register-based cohort study of all (n = 15718) singleton term breech deliveries of non-malformed infants in Denmark 1982-1990. Process and outcome measures: mode of delivery, gestational age, birth weight, congenital malformations, intrapartum death, Apgar scores and early neonatal death. RESULTS: A total...... of 3247 (20.7%) term infants were delivered vaginally, 7106 (45.3%) by elective and 5356 (34.1%) by emergency cesarean section. Infants delivered vaginally and by emergency cesarean section had significantly higher rates of mortality (intrapartum and early neonatal death) and morbidity (low Apgar scores......BACKGROUND: The present study was designed to determine neonatal mortality and morbidity in non-malformed singleton term infants delivered in breech presentation and identify a possible correlation between outcome on the one hand and mode of delivery, parity and birth weight on the other. METHODS...

  10. Tentativa de suicidio y apgar familiar modificado

    Directory of Open Access Journals (Sweden)

    Bárbara de la C Santos Céspedes

    1997-08-01

    Full Text Available Se estudian 50 pacientes con tentativa de suicidio durante 1993 en el área de salud del Policlínico "Josué País García" del Centro Urbano "Abel Santamaría" de Santiago de Cuba, mediante el Apgar familiar modificado, instrumento que mide el grado de funcionamiento familiar, adaptado después de estudios pilotos en la misma población. Las categorías adaptación, relación, desarrollo, efecto y convivencia, así como el resultado general del Apgar, demostraron que la dinámica familiar de las personas investigadas fue significativamente desfavorable, hallazgos que se validaron por las técnicas estadísticas convencionales. Este trabajo propone la investigación del fenómeno del suicidio con la perspectiva del enfoque sistémico de la familia y el individuo, modelo que se escapa a la tradición médica, el cual se considera importante como instrumento para los médicos de la familia.50 patients who attempted suicide in 1993 at the health area of the "Josué País García" Polyclinic from the "Abel Santamaría" Urban Center, in Santiago de Cuba, were studied by using the modified family Apgar, a tool that measures the family functioning degree, adaptation, relation, development, effect, and living together categories, as well as the Apgar's general result, showed that the family dynamics of the persons investigated was significantly unfavourable. These findings were validated by the conventional statistical techniques. This paper recommends the investigation of the sucide phenomenon with the perspective of the systemic approach of the family and the individual, a model hat escapes as an important tool for family physicians.

  11. El apgar familiar en ancianos conviventes

    Directory of Open Access Journals (Sweden)

    Orlando Díaz Tabares

    1998-12-01

    Full Text Available Con el objetivo de determinar el comportamiento del Apgar familiar en ancianos conviventes, no institucionalizados y sin alteraciones de la esfera cognoscitiva, pertenecientes a dos consultorios médicos de la familia, ubicados en la comunidad rural del policlínico docente de San Cristóbal, durante el año 1995 se realizó un estudio retrospectivo, longitudinal y descriptivo, mediante la aplicación de un modelo de encuesta a los 70 ancianos que conformaron el universo de estudio. Los resultados fueron procesados estadísticamente utilizando el método Chi cuadrado mediante un sistema computarizado, y se consideró significativo todo valor asociado a una probabilidad menor que 0,05. Resultó estadísticamente notable la percepción de funcionabilidad familiar en los ancianos pertenecientes a familias nucleadas. Existió correspondencia muy significativa entre la evaluación de funcionabilidad que el anciano otorgó a su familia y la detectada por el investigador. No se comprobó relación estadísticamente significativa entre el Apgar familiar y la edad de los ancianos, el vínculo laboral actual y el comportamiento de las funciones asignadas y asumidas por ellosA retrospective, longitudinal and descriptive study was conducted to determine the behavior of family Apgar among noninstitutionalized, living together aged patients who had no alternations of the cognitive sphere and who received medical attention at two family physician’s offices located in the rural community of the Teaching Polyclinic of San Cristóbal, during 1995, 70 elderly patients were surveyed and the results were statistically processed using the Chi square method by a computerized system. Every value associated to a probability under 0.05 was considered as significant. The perception of family functionability in the elderly from nucleated families was statistically remarkable. There was a very important correspondence between the evaluation of functionability granted by

  12. Frequency of neonatal complications after premature delivery

    Directory of Open Access Journals (Sweden)

    Gordana Grgić

    2013-04-01

    Full Text Available Introduction: Preterm delivery is the delivery before 37 weeks of gestation are completed. The incidence of preterm birth ranges from 5 to 15%. Aims of the study were to determine the average body weight, Apgar score after one and five minutes, and the frequency of the most common complications in preterminfants.Methods: The study involved a total of 631 newborns, of whom 331 were born prematurely Aims of this study were to (24th-37th gestational weeks-experimental group, while 300 infants were born in time (37-42 weeks of gestation-control group.Results: Average body weight of prematurely born infants was 2382 grams, while the average Apgar score in this group after the fi rst minute was 7.32 and 7.79 after the fifth minute. The incidence of respiratory distress syndrome was 50%, intracranial hemorrhage, 28.1% and 4.8% of sepsis. Respiratory distresssyndrome was more common in infants born before 32 weeks of gestation. Mortality of premature infants is present in 9.1% and is higher than that of infants born at term.Conclusions: Birth body weight and Apgar scores was lower in preterm infants. Respiratory distress syndrome is the most common fetal complication of prematurity. Intracranial hemorrhage is the second most common complication of prematurity. Mortality of premature infants is higher than the mortality of infants born at term birth.

  13. Breech at term--mode of delivery? A register-based study

    DEFF Research Database (Denmark)

    1995-01-01

    . Register-based cohort study of all (n = 15718) singleton term breech deliveries of non-malformed infants in Denmark 1982-1990. Process and outcome measures: mode of delivery, gestational age, birth weight, congenital malformations, intrapartum death, Apgar scores and early neonatal death. RESULTS. A total...... of 3247 (20.7%) term infants were delivered vaginally, 7106 (45.3%) by elective and 5356 (34.1%) by emergency cesarean section. Infants delivered vaginally and by emergency cesarean section had significantly higher rates of mortality (intrapartum and early neonatal death) and morbidity (low Apgar scores......BACKGROUND. The present study was designed to determine neonatal mortality and morbidity in non-malformed singleton term infants delivered in breech presentation and identify a possible correlation between outcome on the one hand and mode of delivery, parity and birth weight on the other. METHODS...

  14. Perbandingan antara Sevofluran dan Enfluran terhadap Kontraksi Uterus, Jumlah Perdarahan, dan Skor APGAR pada Seksio Sesarea Elektif

    Directory of Open Access Journals (Sweden)

    RR. Pramada Resvita

    2015-04-01

    Full Text Available Different volatile agents with different physicochemical properties affect uterine contraction, amount of bleeding, and APGAR score in different ways. The objective of this study was to evaluate the effects of different volatile agents, i.e., sevoflurane and enflurane, on uterine contraction, amount of bleeding, and APGAR score. A randomized controlled trial (RCT was conducted on 36 patients undergoing elective caesarean section. These patients were randomly divided into two groups, group I (sevoflurane and group II (enflurane. The data were analyzed using t-test, Mann-Whitney, and fisher exact tests. The result of this study showed that there was a significant difference in the strength of uterine contraction among the sevoflurane group and the enflurane group (p<0.05 and also a significant difference in the amount of bleeding among the two groups (p<0.05, with better results seen ion the sevoflurane group. However, there was no significant difference found oin the APGAR score among the two groups. It is concluded in this study that sevoflurane gives better results in terms of uterine contraction with less bleeding compared to the enflurane group. No difference is found in the APGAR score in sevoflurane and enflurane groups.

  15. Twin-to-twin delivery time: neonatal outcome of the second twin.

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    Schneuber, Susanne; Magnet, Eva; Haas, Josef; Giuliani, Albrecht; Freidl, Thomas; Lang, Uwe; Bjelic-Radisic, Vesna

    2011-12-01

    To examine the effect of twin-to-twin delivery time (TTDT) on neonatal outcome. We evaluated twin deliveries >34 weeks of gestation. Twin pregnancies with both twins delivered by cesarean section and pregnancies with antenatal complications were excluded. We analyzed TTDT and neonatal outcomes of the second twin (umbilical arterial pH value (pH(art)), Apgar scores at 1, 5 and 10 minutes, need for intensive care). The study population was divided into two homogenous groups based on the mode of delivery: (A) vertex presentation and vaginal delivery of both twins, (B) vertex presentation and vaginal or vaginal operative delivery of twin I, breech or transverse presentation and vaginal breech delivery or cesarean section (CS) of twin II. A total of 207 twin pairs were included in our study. In Group A (n = 151) there were no significant correlations between TTDT and pH(art) or Apgar scores at 1,5 and 10 minutes of twin II (p = .156; 0.861; 0.151 and 0.384, respectively). In Group B (n = 56), the mean pH(art) of twin II was inversely correlated to TTDT, but not significantly (p = .417). TTDT was inversely related to 1-min and 5-min Apgar scores, but not significantly (p = .330; p = .138, respectively). The 10-min Apgar score showed no correlation with TTDT (p = .638). Increasing TTDT was not associated with adverse fetal outcome. Expectant management of the second twin appears possible and elapsed time alone does not appear to be an indication for intervention.

  16. Clinical Significances of Using Fetal Heart Rate Monitoring,Apgar Score and Umbilical Arterial Blood Gas Analysis to Assess Perinatal Asphyxia%胎心监护、Apgar评分及脐动脉血气分析评估围生儿窒息的临床意义

    Institute of Scientific and Technical Information of China (English)

    苏晋琼; 朱小瑜; 王晨虹; 杨传忠

    2010-01-01

    目的 探讨胎心率、Apgar评分及脐动脉血气分析在围生儿窒息评估中的意义.方法 收集本院胎心率<90次·min-1、持续时间>1 min、重复出现5次以上、儿科医师提前到场接生、电子胎心监护(EFM)异常的73例足月儿为EFM异常组.对照组为同期分娩胎心监护正常,按EFM异常组胎龄、体质量、分娩方式、Apgar分值及高危因素等配对的73例新生儿.观察2组不同Apgar评分新生儿脐动脉血气变化.结果 EFM异常组血气pH、碳酸氢根(HCO3-)、碱剩余(BE)较对照组显著降低(Pa<0.05,0.01).EFM异常组1 min Apgar8~10分患儿血HCO3-、BE均较对照组降低(Pa<0.05).EFM异常组Apgar 1~7分患儿血pH、HCO3-、BE较对照组降低(Pa<0.05,0.01).EFM异常组Apgar 1~3分、4~7分、9~10分三者间血气pH、Pa(CO2)、HCO3-、BE比较,差异有统计学意义(Pa<0.05,0.01);Apgar4~7分患儿血气pH、pa(CO2)、HCO3-、BE与Apgar 8分患儿一致,差异均无统计学意义(Pa>0.05);Apgar评分8分患儿血pH、HCO3-、BE均较Apgar 9~10分患儿降低(Pa<0.05).对照组不同Apgar评分组间血气比较,差异均无统计学意义(Pa>0.05).结论 胎心率持续减速对胎儿窘迫有预警作用;胎心率、Apgar评分及脐动脉血气3种方法组合应用,对准确评估围生儿窒息具有重要意义.

  17. Transverse arrest: a review of outcomes of rotational forceps and cesarean delivery at a single center.

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    Leo; Odibo; Ling; Rodis; Borgida; Campbell

    1998-07-01

    Objective: To assess whether Kielland forceps rotational delivery causes a significant increase in maternal or perinatal morbidity in comparison with cesarean delivery in the clinical situation of transverse arrest. Rotational forceps delivery has been reported to have unacceptably high maternal and neonatal complication rates when compared with either spontaneous vaginal delivery or non-rotational forceps delivery. Clinically, however, we considered the more relevant comparison between Kielland rotational forceps delivery and cesarean delivery as these are generally the two modes of delivery for the fetus in transverse arrest.Study Design: The charts of all the mothers delivered by Kielland forceps or cesarean delivery for the main indication of transverse arrest between July 1995 and June 1996 were reviewed. The following were evaluated: Apgar scores at 1 and 5 minutes, cord pH, birth weight, neonatal superficial facial laceration or bruising, bone or nerve injuries, maternal injuries, 3rd and 4th degree perineal or vaginal lacerations, post-partum fever. Statistical analysis was by chi(2) (for Apgar scores), two-tailed Fisher Exact test (for post-partum fever), and t test (for birth weight and cord pH). A P value cesarean deliveries were performed. One-minute Apgar scores of less than or equal to 7 were noted in 11.5% and 6.7% of the forceps and cesarean section groups, respectively (P = NS); mean arterial cord pH was 7.26 for both groups; no cases of post-partum fever were noted in the forceps versus 16% in the cesarean group (P cesarean group, respectively (P cesarean delivery.No significant difference in cord pH and Apgar scores were noted between the two groups. The birth weight was greater and post-partum fever was more common in the cesarean section group. Neonatal facial bruising, temporary facial nerve palsy, and maternal perineal and vaginal lacerations were more common in the forceps groups. This study suggests that rotational forceps may be a

  18. Mode of delivery has an independent impact on neonatal condition at birth.

    Science.gov (United States)

    Prior, Tomas; Kumar, Sailesh

    2014-10-01

    Current intra-partum monitoring techniques are often criticized for their poor specificity, with their performance frequently evaluated using measures of the neonatal condition at birth as a surrogate marker for intra-partum fetal compromise. However, these measures may potentially be influenced by a multitude of other factors, including the mode of delivery itself. This study aimed to investigate the impact of mode of delivery on neonatal condition at birth. This prospective observational study, undertaken at a tertiary referral maternity unit in London, UK, included 604 'low risk' women recruited prior to delivery. Commonly assessed neonatal outcome variables (Apgar score at 1 and 5min, umbilical artery pH and base excess, neonatal unit admission, and a composite neonatal outcome score) were used to compare the condition at birth between babies born by different modes of delivery, using one-way ANOVA and chi-squared testing. Infants born by instrumental delivery for presumed fetal compromise had the poorest condition at birth (mean composite score=1.20), whereas those born by Cesarean section for presumed fetal compromise had a better condition at birth (mean composite score=0.64) (p=surrogate marker of intra-partum fetal compromise. When evaluating the efficacy of intra-partum monitoring techniques, the isolated use of Apgar scores, umbilical artery acidosis and neonatal unit admission should be discouraged. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  19. Effects of epidural anesthesia on I and II delivery stage and on a newborn

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    Čutura Neđo

    2009-01-01

    Full Text Available Background/Aim. Epidural anesthesia (EA is the most efficient method of pain reduction and its total elimination during delivery. The aim of this study was to establish an influence of EA on the first and the second part of delivery process, frequency of vacuum extractor and forceps appliance, and the effect of EA on the newborn. Methods. A total of 360 patients with EA were analyzed at delivery and 1 130 controls without EA. Both groups had vaginal delivery. In both groups deliveries were stimulated by 10 IU of oxytocin in 500 mL of crystalloid solvent, with 15-20 drops per minute. As anaesthetic, Bupivacain (0,25% or 0, 125% was used by the 18 G catheters Braun and Wigon. Level of application was L2-L3 part of spine. Results. The results of this study indicate that deliveries with EA were shorter in duration, but also had much more vacuum extractor and forceps appliance (over 2.5 times than those without EA. Apgar score was significantly higher in the experimental group with multiple deliveries. However, there was no significant deference between average Apgar score of newborns of patients with EA and that of newborns of patients without EA. Conclusion. Application of EA decreases duration of delivery, and has no any adverse effects on newborns.

  20. Newborns from deliveries with epidural anaesthesia

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    Avramović Lidija

    2010-01-01

    Full Text Available Introduction. The use of epidural anaesthesia in delivery with the purpose to reduce pain and fear in a pregnant woman has the influence on the physiological status of the woman in childbirth and the course of delivery. From the epidural space of the pregnant woman, one part of free anaesthetic comes in the foetal circulation through the mother's circulation and placenta and connects with the foetal proteins. A lower value of albumins and serum proteins in the foetal circulation give bigger free fraction of anaesthetic which is accumulated in the foetal liver, brain and heart full of blood. Objective. The aim of the study was to examine the influence of epidural anaesthesia on the newborn. Methods. Retrospective study of 6,398 documents of newborns was performed in our Clinic of Gynaecology and Obstetrics 'Narodni front' during 2006. The first group was made of 455 newborns from deliveries with epidural anaesthesia and the second was the control group of 5,943 remaining newborns. In both groups we analysed the following: sex, week of gestation, weight, Apgar score, measure of care and resuscitation, perinatal morbidity and then the obtained results were compared. Results. Most of deliveries were vaginal without obstetric intervention (86.6%. The number of deliveries finished with vacuum extractor (4.6% was statistically significantly bigger in the group with epidural anaesthesia than in the control group. Most of the newborns in the first group were born on time (96.5% in 39.0±1.0 week of gestation and with foetal weight 3448±412 grammes. There was no statistical significance in Apgar score between both groups. Epidural anaesthesia does not increase the degree of the newborn's injury. Lower pH of blood was found in the newborns from deliveries with vacuum extractor or operated on (the Ceasarean section. Conclusion. Application of epidural anaesthesia decreases duration of delivery and has no adverse effects on the newborn and hypoxic

  1. Delayed interval delivery after intrauterine infection and immature birth of twin 1--a case report and literature review.

    Science.gov (United States)

    de Jong, M W; Pinas, I M; van Eijck, J

    1995-11-01

    We report a case of delayed interval delivery in a twin pregnancy complicated by rupture of membranes, intrauterine infection and birth of one twin at 21 weeks gestation. Tocolysis combined with antibiotics and corticosteroids successfully prolonged pregnancy for 73 days, allowing the second twin to mature and reach viability. At 31.5 weeks gestation, a 1890 g healthy male neonate was born with good Apgar scores. His postnatal course was uneventful. A literature review of several other cases of delayed interval delivery is presented. When multifetal pregnancies are complicated by immature birth of one fetus, delayed interval delivery may offer survival chances and favourable outcome for the remaining fetus(es).

  2. A STUDY OF HYPERBARIC BUPIVACAINE VERSUS ISOBARIC ROPIVACAINE FOR ELECTIVE CAESAREAN DELIVERIES

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    Radha Ramana

    2016-05-01

    Full Text Available OBJECTIVE Is to compare the anaesthetic effects of intrathecal administration of hyperbaric Bupivacaine 10 mg with isobaric Ropivacaine 15 mg for elective caesarean delivery. METHOD 100 parturients of ASA 1 and II posted for elective caesarean delivery were randomly divided into 2 groups of 50 each: Group A received intrathecal 0.5% Hyperbaric Bupivacaine 10 mg and Group B received intrathecal 0.75% isobaric Ropivacaine 15 mg. Time of onset and regression of sensory and motor blocks, haemodynamics, time of first complaint of pain, neonatal APGAR and side-effects were evaluated. RESULTS Ropivacaine group has significantly slower onset of sensory analgesia at T6 (4.45±0.03 in Ropivacaine group as against 2.38±0.36 in Bupivacaine group, p 0.05. There was no difference in the haemodynamics and neonatal APGAR. Neither of the groups had any significant intraoperative or postoperative complications. CONCLUSION Intrathecal Isobaric Ropivacaine 15 mg provides effective spinal anaesthesia for caesarean delivery. It has slower onset, shorter motor block, early sensory regression and similar postoperative analgesia and APGAR scores as compared to 10 mg of 0.5% hyperbaric bupivacaine. The shorter duration of motor block can facilitate early ambulation and makes Ropivacaine a good alternative for elective caesarean deliveries.

  3. Cesarean delivery rates and obstetric culture - an Italian register-based study.

    Science.gov (United States)

    Plevani, Cristina; Incerti, Maddalena; Del Sorbo, Davide; Pintucci, Armando; Vergani, Patrizia; Merlino, Luca; Locatelli, Anna

    2017-03-01

    Cesarean delivery rates are rising due to multiple factors, including less use of operative vaginal delivery and vaginal birth after cesarean delivery, which often reflect local obstetric practices. Objectives of the study were to analyze the relations between cesarean delivery, these practices, and perinatal outcomes. We included all deliveries in the 72 hospitals of Lombardia, a region in northern Italy, during the year 2013. The delivery certificate was used as data source. Pearson's correlation coefficient and logistic regression were used for statistical analysis. We included 87 896 deliveries. The number of deliveries per hospital ranged from 140 to 6123. The rate of cesarean delivery was 28.3% (range 9.9-86.4%), operative vaginal delivery 4.7% (range 0.2-10.0%), and vaginal birth after cesarean 17.3% (range 0-79.2%). We found a significant inverse correlation between rates of overall cesarean delivery and operative vaginal delivery (r = -0.25, p = 0.04). The correlation between rate of overall cesarean delivery and vaginal birth after cesarean was also inverse and significant (r = -0.57, p cesarean delivery rate and the rates of Apgar score at 5 min cesarean delivery, could reduce the rising cesarean delivery rate. This will require a change in obstetric culture, continuing education of healthcare providers, and leadership. © 2016 Nordic Federation of Societies of Obstetrics and Gynecology.

  4. A comparison of labor outcome with oxytocin and spontaneous delivery in low risk pregnant women

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    parvin Asti

    2015-02-01

    Full Text Available Background: Medical interventions in labor have been common in recent years. Oxytocin is amongst them which is used to speed delivery. Unfortunately the indiscriminate administration of it could lead to maternal and infant complications. The aim of this study was to compare labor outcome with oxytocin and spontaneous delivery in low risk pregnant women. Materials and Methods: In this descriptive – comparative study, 395 women with single fetus, cephalic presentation, normal delivery, in the active phase of labor were selected. 197 of the cases, as Oxytocin group, received oxytocin by physician,s order during their labor and 198 of the samples, as the second group, had spontaneous vaginal delivery. In both groups, some of the maternal and neonatal outcomes including: maternal morbidity , Apgar score at minutes one and five, admitted in neonatal intensive care unit and were studied.Data were analyzed using SPSS 16, t-test, Chi-square and Mann Whitney tests. Results: The findings showed that oxytocin significantly increased rates of episiotomy, laceration, post partum hemorrhage, hospitalization of neonate in intensive care unit and reduction of Apgar score at minutes one and five that were statistically significant (p <0.05. Conclusion: The results showed that the acceleration of delivery is not a safe method and increases the rate of maternal and infant complications. Therefore, it should be used in the case of medical necessities.

  5. Obstetrical approach in breech presentation delivery

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    G. Grgić

    2007-02-01

    Full Text Available Although it is accompanied by a higher number of intrapartal complications and a higher rate of prenatal mortality and morbidity the breech presentation is not considered to be an unfavourable presentation for delivery. However, delivery with the breech presentation requires a detailed and very careful approach in assessment of the way delivery is to be conducted and a serious approach of an obstetrician when making a final decision. This often results in a high rate of caesarean sections in certain institutions which has been up to 80-100% of all the breech presentations.The objective of this retrospective study was to establish incidence of deliveries of the breech presentations and to determine a way of completing delivery depending on a parity of mother and a condition of the newborn at delivery in the five-year period. The results have shown that breech presentation occurred in 4.69% of the total number of deliveries. There was no statistically significant difference in the way the delivery had been completed neither in the condition of newborns as a result of the way the delivery was completed. 50.75% of deliveries were completed with cesarean section and 49.25% of women delivered the breech presentation vaginally. An average Apgar score for those delivered vaginally was 8.05 and 7.52 for babies delivered naturally. Breech presentation requires a serious prepartal analysis of delivery factors based on which a significant number of deliveries can be conducted vaginally with a satisfactory condition of newborns at delivery.

  6. Comparison of three prenatal risk scores in a series of low-risk pregnancies.

    Science.gov (United States)

    Kelly, R B; Acheson, L S; Zyzanski, S J

    1988-01-01

    Three prepartum obstetrical risk-scoring methods (Goodwin, Halliday, Hobel) were retrospectively applied to a consecutive series of 795 singleton pregnancies. The study population was low risk overall, with a perinatal mortality rate of 11 per 1000 and a primary cesarean section rate of 9.7%. The predictive ability of the scores was tested for individual outcomes as well as for a "combined measure" designed to group outcomes of clinical interest. Outcome variables examined included labor arrests, need for augmentation of labor, fetal heartrate abnormalities during labor, selection of or transfer to a more intensive level of care, indicated forceps delivery, cesarean section, resuscitation, Apgar scores, permanent injury, and perinatal deaths. Along with expected differences in sensitivity and specificity, there were differences among the three scores in performance as measured by positive and negative predictive value. Goodwin's system performed somewhat better overall. All three systems performed better in multiparous than in primiparous patients, but primiparas experienced more adverse outcomes.

  7. The Effect of the Time of Injection of Intrathecal Analgesia on the Length of Early and Advanced Labor

    Science.gov (United States)

    2007-11-02

    coding Delivry type of delivery, see below for coding Apgar 1 = first minute apgar score ( number from zero to ten) Apgar 5 = five minute apgar score ...DATABASE SPREADSHEET Case # Age Race Weight Height Gest Stage 1 Stage 2 Total Anesth Delivry Med Apgar 1 Apgar 5 Bweigh Igender Anespr Obstpro Gravida Para

  8. Los cincuenta años del puntaje APGAR

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    Alfredo Jácome Roca

    2003-08-01

    Full Text Available

    Perfil biográfico de una mujer extraordinaria.

    Algún día del año 1949,un grupo de médicos y alumnos se encontraba tomando el desayuno en la cafetería del Hospital Columbia-Presbyterian en NuevaYork, cuando un estudiante (quien rotaba por anestesia comentó que hacía falta desarrollar un sistema de valoración del recién nacido.

    La anestesióloga Virginia Apgar, quien se encontraba entre los concurrentes, respondió: “Eso es fácil, se puede hacer de la siguiente manera”; y acto seguido cogió de la mesa un pedazo de papel y escribió los cinco temas de lo que más adelante se convertiría en el famoso puntaje de evaluación del neonato que conocemos como el “Apgar”. Se levantó entonces y se fue al servicio de obstetricia para ensayar de inmediato la escala de valoración que acababa de ocurrírsele.

    En 1952, hace cincuenta años, presentaría sus experiencias en un congreso internacional de anestesiología.

    Esta anécdota fue contada en 1980 por el médico Richard Patterson, presente en el famoso desayuno; hace parte del material biogràfico de Selma Harrison Calmes, profesora de anestesiología en la Universidad de California en Los Ángeles (UCLA, sobre su colega Ginny Apgar. Calmes es la principal biógrafa de esta sobresaliente, valerosa y peculiar mujer.

    Para entender la importancia de lo realizado por Apgar, es necesario ponerse en el contexto de aquella época. Nacida en 1909 en Westfield, Nueva Jersey, tuvo un padre aficionado a la electricidad, las ondas radiales y la astronomía, por lo que ella creció al lado de un telescopio y un laboratorio, instalados en el sótano. Estuvo entonces en temprano contacto con la ciencia y además con la práctica médica, pues un hermano murió a los tres años de tuberculosis y otro visitaba frecuentemente al médico por un eczema crónico, hechos que quizá influyeron en su determinación de seguir la carrera de medicina cuando

  9. [Apgar status, blood gases and acid base balance of neonates after caesarean sections, using either thiopentone or ketamine for induction of anaesthesia (author's transl)].

    Science.gov (United States)

    Traub, E; Knoche, E; Dick, W; Völschow, E

    1977-04-01

    Apgar status and acid base balance of 206 neonates, delivered by caesarean section under general anaesthesia, were investigated in order to compare the possible effects of either thiopentone- or ketamine-induction on the postpartum adaption. Several other criteria were recorded also, for instance, a possible neonatal asphyxia, the induction-delivery-interval, the maternal age, the administration of other than anaesthetic drugs etc. There were not correlations between the Apgar status and the induction-delivery interval in either groups. The number of neonates within the 3 Apgar-classes, and the asphyxiated neonates, were equally distributed in the thiopentone- and ketamine-groups. There was no correlation between maternal ages and either the thiopentone- or ketamin-babies, but a marked correlation with the number of depressed newborns. Those neonates, who were suspected to be hypoxic before anaesthesia showed a more depressed post-partum respiration after thiopentone- than after ketamine-induction. On the other hand it seems to be that neonatal respiration and total Apgar status was more depressed if the "ketamin mothers" were treated with sedatives, hypnotics and/or analgesics before caesarean section. The blood gas values and the acid base parameters did not show a statistically significant difference between the pH of the thiopentone- and the ketamine-neonates. These differences can be explained as the combination of the nonsignificant changes in PCO2 and standard-bicarbonate values. As far as can be judged from the above mentioned criteria it may be deduced that ketamine or thiopentone can equally well be used for inducation of anaesthesia for caesarean section.

  10. Among perinatal factors, only the Apgar score is associated with specific language impairment

    NARCIS (Netherlands)

    Diepeveen, F.B.; Kroon, M.L. De; Dusseldorp, E.; Snik, A.F.M.

    2013-01-01

    AIM: The purpose of this study was to assess the relation of perinatal risk factors with later development of specific language impairment (SLI). METHOD: In a case-control study, 179 children attending special needs schools for SLI were matched with non-affected children attending mainstream schools

  11. Among perinatal factors, only the Apgar score is associated with specific language impairment

    NARCIS (Netherlands)

    Diepeveen, F.B.; Kroon, M.L. de; Dusseldorp, E.; Snik, A.F.

    2013-01-01

    The purpose of this study was to assess the relation of perinatal risk factors with later development of specific language impairment (SLI). METHOD: In a case-control study, 179 children attending special needs schools for SLI were matched with non-affected children attending mainstream schools. Bot

  12. Perinatal Outcome of Second Twin with Respect to Mode of Delivery: An Observational Study

    Science.gov (United States)

    Nadkarni, Trupti K

    2016-01-01

    Introduction With the advent of assisted reproductive techniques, multi-fetal pregnancies are on the rise. While caesarean section is the defined mode of delivery for triplets and higher order pregnancies, the picture for twin delivery is not so clear. While a trial for vaginal delivery is attempted, the second twin is considered vulnerable to complications. Whether this translates into worsened perinatal outcomes is not well defined. Aim To study the perinatal outcome and to identify the various factors influencing the perinatal outcome of second twin with respect to mode of delivery. Materials and Methods Data was collected from hospital birth records regarding the mode of delivery of viable twins (period of gestation >28 weeks) and outcome of second twin with respect to APGAR scores, NICU stay, neonatal morbidity and mortality, over a period of 12 months. Results Of the 93 pairs of twins delivered, in 21(22.6%) pregnancies both twins were delivered vaginally, in 70(75.2%) pregnancies both were delivered by caesarean section and in 2 (1.8%) pregnancies 1st twin was delivered by vaginal route and 2nd by caesarean. In the vaginal delivery group, 85.7% times both twins were in vertex position. In the caesarean group, vertex/non-vertex (38.57%) was the most common presentation followed by non-vertex /non-vertex (25.71%) and vertex/vertex (24.28%). Comparing the perinatal outcome of second twin in both groups, the odds for APGAR score ≤7 was 3.385 times (OR-3.384, 95% CI 1.2099- 9.4684, p=0.02) in the vaginal group compared to the caesarean group. There was no association (OR-1.054, 95% CI 0.3344- 3.3268, p=0.9) between neonatal morbidity of second twin compared to mode of delivery. All 3 perinatal deaths were in the vaginal group (all between 28-32 weeks of gestation). Conclusion There is an increased preference for caesarean delivery in twin pregnancies except in cases where both the twins are in vertex position and not associated with any other maternal or fetal

  13. Uterine rupture with attempted vaginal birth after cesarean delivery: decision-to-delivery time and neonatal outcome.

    Science.gov (United States)

    Holmgren, Calla; Scott, James R; Porter, T Flint; Esplin, M Sean; Bardsley, Tyler

    2012-04-01

    To estimate the time from the diagnosis of uterine rupture to delivery that would prevent adverse neonatal sequelae. Cases of uterine rupture from January 1, 2000, to December 31, 2009, were identified in nine hospitals in the Intermountain Health Care system and at the University of Utah. Maternal demographics, labor characteristics, and neonatal outcomes were obtained. Primary adverse outcome was abnormal umbilical artery pH level less than 7.0 or 5-minute Apgar score less than 7. Adverse secondary outcome included fetal or neonatal death and neonatal neurologic injury attributed to uterine rupture. Thirty-six cases of uterine rupture occurred during 11,195 trials of labor after cesarean delivery. Signs of uterine rupture were fetal (n=24), maternal (n=8), or a combination of maternal and fetal (n=3). In one case, uterine rupture was not suspected. Mean time to delivery from the onset of symptoms or signs for the primary adverse outcome group (n=13) was 23.3 (±10.8) minutes compared with 16.0 (±7.7) minutes for those without an adverse outcome (P=.02). No neonate delivered in fewer than 18 minutes had an umbilical pH level below 7.0. Three neonates delivered at more than 30 minutes met criteria for an adverse secondary outcome. The frequency of uterine rupture was 0.32% in patients attempting a trial of labor after cesarean delivery. Neonates delivered within 18 minutes after a suspected uterine rupture had normal umbilical pH levels or 5-minute Apgar scores greater than 7. Poor long-term outcome occurred in three neonates with a decision-to-delivery time longer than 30 minutes. II.

  14. Combined spinal-epidural analgesia in labour: its effects on delivery outcome

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    Suneet Kaur Sra Charanjit Singh

    2016-06-01

    Full Text Available ABSTRACT BACKGROUND AND OBJECTIVES: Combined spinal-epidural (CSE has become an increasingly popular alternative to traditional labour epidural due to its rapid onset and reliable analgesia provided. This was a prospective, convenient sampling study to determine the effects of CSE analgesia on labour outcome. METHODS: One hundred and ten healthy primigravida parturients with a singleton pregnancy of ≥37 weeks gestation and in the active phase of labour were studied. They were enrolled to the CSE (n = 55 or Non-CSE (n = 55 group based on whether they consented to CSE analgesia. Non-CSE parturients were offered other methods of labour analgesia. The duration of the first and second stage of labour, rate of instrumental vaginal delivery and emergency cesarean section, and Apgar scores were compared. RESULTS: The mean duration of the first and second stage of labour was not significantly different between both groups. Instrumental delivery rates between the groups were not significantly different (CSE group, 11% versus Non-CSE group, 16%. The slightly higher incidence of cesarean section in the CSE group (16% versus 15% in the Non-CSE group was not statistically significant. Neonatal outcome in terms of Apgar score of less than 7 at 1 and 5 min was similar in both groups. CONCLUSION: There were no significant differences in the duration of labour, rate of instrumental vaginal delivery and emergency cesarean section, and neonatal outcome in parturients who received compared to those who did not receive CSE for labour analgesia.

  15. Fatores perinatais associados a recém-nascidos de termo com pH<7,1 na artéria umbilical e índice de Apgar <7,0 no 5º minuto Perinatal factors associated with pH<7.1 in umbilical artery and Apgar 5 min <7.0 in term newborn

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    Patrícia de Moraes De Zorzi

    2012-08-01

    Full Text Available OBJETIVO: Avaliar os fatores perinatais associados a recém-nascidos de termo com pHPURPOSE: To assess perinatal factors associated with term newborns with pH<7.1 in the umbilical artery and 5th min Apgar score<7,0. METHODS: Retrospective case-control study carried out after reviewing the medical records of all births from September/1998 to March/2008, that occurred at the General Hospital of Caxias do Sul. The inclusion criterion was term newborns who presented a 5th min Apgar score <7.0 and umbilical artery pH<7.10. In the univariate analysis, we used the Student's t-test and the Mann-Whitney test for continuous variables, the c² test for dichotomous variables and risk estimation by the odds ratio (OR. The level of significance was set at p<0.05. RESULTS: Of a total of 15,495 consecutive births, 25 term neonates (0.16% had pH<7.1 in the umbilical artery and a 5th min Apgar score <7.0. Breech presentation (OR=12.9, p<0.005, cesarean section (OR=3.5, p<0.01 and modified intrapartum cardiotocography (OR=7.8, p<0.02 presented a significant association with the acidosis event. Among the fetal characteristics, need for hospitalization in the neonatal intensive care unit (OR=79.7, p <0.0001, need for resuscitation (OR=12.2, p <0.0001 and base deficit were associated with the event (15.0 versus -4.5, p<0.0001. CONCLUSION: Low Apgar score at the 5th min of life associated with pH<7.1 in the umbilical artery can predict adverse neonatal outcomes.

  16. Introduction of Asthma APGAR tools improve asthma management in primary care practices.

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    Yawn, Barbara P; Bertram, Susan; Wollan, Peter

    2008-08-31

    Primary care asthma management is often not compatible with national evidence-based guidelines. The objective of this study was to assess the feasibility and impact of the Asthma APGAR tools to enhance implementation of asthma guideline-compatible management in primary care practices. Twenty-four primary care practices across the US. This is a mixed methods study. Quantitative data were used to assess changes in guideline recommended asthma management including use of daily controller therapy, planned care visits, and education and information documentation before and after implementation of the Asthma APGAR. Qualitative data from focus group sessions were used to assess health care professional and patient perceived usability and value of the Asthma APGAR tools during office visits for asthma. Implementing the Asthma APGAR tools in the 24 practices was associated with enhanced asthma visit-related medical record documentation including significant increases in recording of activity limitations due to asthma and asthma symptom frequency, asthma medication nonadherence, asthma triggers, and the patients' perceived response to therapy (p < 0.01 for each item). Some care processes also increased significantly including assessment of inhaler technique and prescribing of daily controller therapy among patients with persistent asthma. Focus groups of patients and of clinical staff reported that the Asthma APGAR tools were easy to use, "made sense" and "improved care" was given and received. The Asthma APGAR tools are feasible to implement in primary care practices and their implementation is associated with increased guideline-compliant asthma management.

  17. Comparing the Asthma APGAR system and the Asthma Control Test™ in a multicenter primary care sample.

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    Rank, Matthew A; Bertram, Susan; Wollan, Peter; Yawn, Roy A; Yawn, Barbara P

    2014-07-01

    To compare asthma control assessment using the Asthma APGAR system, a tool developed by primary care clinicians, in a multicenter primary care sample with the Asthma Control Test (ACT™)/Childhood Asthma Control Test (CACT™), a tool developed by asthma specialists. This is a substudy of a multicenter, randomized, controlled pragmatic trial that tests the effectiveness of the Asthma APGAR system in primary care practices. As part of the study, enrolled patients completed both the ACT™/CACT™ and the Asthma APGAR system between March 1, 2011, and December 31, 2011. Kappa and McNemar statistics were used to compare the results of questionnaires. Of the 468 patients in our sample, 306 (65%) were classified as not controlled by the ACT™/CACT™ or the Asthma APGAR system. The overall agreement was 84.4%, with a kappa value of .68 (substantial agreement) and a McNemar test P value of .35 (suggesting no significant difference in the direction of disagreement). Of those with poor control as defined by the Asthma APGAR system, 23.8% (73) had no controller medications and 76.5% (234) were seldom or sometimes able to avoid identified triggers for their asthma. Of those who stated that they had been prescribed controller medications, 116 of 332 (35%) stated that they did not use the controller medication on a daily basis. The Asthma APGAR system and the ACT™/CACT™ similarly assess asthma control in a multicenter primary care-based sample. The Asthma APGAR system identified an "actionable item" in more than 75% (234) of the individuals with poor asthma control, thus linking an assessment of poor asthma control with a management strategy. Copyright © 2014 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

  18. MODE OF DELIVERY AND FOETAL OUTCOME IN MECONIUM-STAINED LIQUOR: A RETROSPECTIVE STUDY

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    Anitha Narasimhaiah

    2016-08-01

    Full Text Available AIMS AND OBJECTIVES To study the incidence of MSL, mode of delivery and foetal outcome in women with MSL in labour. MATERIALS AND METHODS A retrospective study was conducted from January 2014 to December 2015 on patients admitted in labour room of Dr. B. R. Ambedkar Medical College and Hospital and assessed for MSL, mode of delivery and foetal outcome. RESULTS Out of the 1661 deliveries 195 (11.73 % were complicated with MSL. Chi square test was applied to analyse Grades of meconium and APGAR score at 95 % confidence and p value of < 0.05 was obtained which was statistically significant. CONCLUSION MSL alone is not an indication for Caesarean Section and is not associated with adverse neonatal outcome. Increase in the grades of MSL is associated with more adverse outcome.

  19. Effects of hospital delivery during off-hours on perinatal outcome in several subgroups: a retrospective cohort study

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    Gijsen Ronald

    2012-09-01

    Full Text Available Abstract Background Studies have demonstrated a higher risk of adverse outcomes among infants born or admitted during off-hours, as compared to office hours, leading to questions about quality of care provide during off-hours (weekend, evening or night. We aim to determine the relationship between off-hours delivery and adverse perinatal outcomes for subgroups of hospital births. Methods This retrospective cohort study was based on data from the Netherlands Perinatal Registry, a countrywide registry that covers 99% of all hospital births in the Netherlands. Data of 449,714 infants, born at 28 completed weeks or later, in the period 2003 through 2007 were used. Infants with a high a priori risk of morbidity or mortality were excluded. Outcome measures were intrapartum and early neonatal mortality, a low Apgar score (5 minute score of 0–6, and a composite adverse perinatal outcome measure (mortality, low Apgar score, severe birth trauma, admission to a neonatal intensive care unit. Results Evening and night-time deliveries that involved induction or augmentation of labour, or an emergency caesarean section, were associated with an increased risk of an adverse perinatal outcome when compared to similar daytime deliveries. Weekend deliveries were not associated with an increased risk when compared to weekday deliveries. It was estimated that each year, between 126 and 141 cases with an adverse perinatal outcomes could be attributed to this evening and night effect. Of these, 21 (15-16% are intrapartum or early neonatal death. Among the 3100 infants in the study population who experience an adverse outcome each year, death accounted for only 5% (165 of these outcomes. Conclusion This study shows that for infants whose mothers require obstetric interventions during labour and delivery, birth in the evening or at night, are at an increased risk of an adverse perinatal outcomes.

  20. A cross-sectional study exploring the incidence of and indications for second-stage cesarean delivery over three decades.

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    Pearson, Greg A; MacKenzie, Ian Z

    2017-09-01

    To observe the incidence of, indications for, and complications associated with second-stage cesarean delivery in 10-year intervals over 30 years. The present analysis of prospectively collected data compared cesarean deliveries during 1976, 1986, 1996, and 2006 at John Radcliffe Hospital in Oxford, UK (n=3222). Pregnancy, delivery, and neonatal details were reviewed. The proportion of deliveries by cesarean in the second stage of labor increased from 0.5% (22/4464) in 1976 to 2.1% (124/5998) in 2006 (Pcesarean deliveries during the second stage because of failed instrumental delivery also increased over the study period from 59.1% (13/22) in 1976 to 71.0% (88/124) in 2006. Compared with cesareans at other stages, uterine trauma (Pcesarean delivery. Neonates delivered by second-stage cesarean had lower Apgar scores (Pcesarean earlier in labor. A trend towards an increase in neonatal trauma with second-stage cesarean compared with cesarean delivery before labor or during the first stage did not reach statistical significance. The proportion of deliveries by cesarean in the second stage of labor increased; these deliveries were associated with greater maternal and neonatal morbidity, but were not influenced by the indication for cesarean. © 2017 International Federation of Gynecology and Obstetrics.

  1. Effects of epidural lidocaine analgesia on labor and delivery: A randomized, prospective, controlled trial

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    Nafisi Shahram

    2006-12-01

    Full Text Available Abstract Background Whether epidural analgesia for labor prolongs the active-first and second labor stages and increases the risk of vacuum-assisted delivery is a controversial topic. Our study was conducted to answer the question: does lumbar epidural analgesia with lidocaine affect the progress of labor in our obstetric population? Method 395 healthy, nulliparous women, at term, presented in spontaneous labor with a singleton vertex presentation. These patients were randomized to receive analgesia either, epidural with bolus doses of 1% lidocaine or intravenous, with meperidine 25 to 50 mg when their cervix was dilated to 4 centimeters. The duration of the active-first and second stages of labor and the neonatal apgar scores were recorded, in each patient. The total number of vacuum-assisted and cesarean deliveries were also measured. Results 197 women were randomized to the epidural group. 198 women were randomized to the single-dose intravenous meperidine group. There was no statistical difference in rates of vacuum-assisted delivery rate. Cesarean deliveries, as a consequence of fetal bradycardia or dystocia, did not differ significantly between the groups. Differences in the duration of the active-first and the second stages of labor were not statistically significant. The number of newborns with 1-min and 5-min Apgar scores less than 7, did not differ significantly between both analgesia groups. Conclusion Epidural analgesia with 1% lidocaine does not prolong the active-first and second stages of labor and does not increase vacuum-assisted or cesarean delivery rate.

  2. Decision-to-Delivery Time and Perinatal Complications in Emergency Cesarean Section.

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    Heller, Günther; Bauer, Erik; Schill, Stefanie; Thomas, Teresa; Louwen, Frank; Wolff, Friedrich; Misselwitz, Björn; Schmidt, Stephan; Veit, Christof

    2017-09-04

    A decision-to-delivery interval (DDI) of no more than 20 minutes has long been considered a requirement for cesarean sections, even though there have hardly been any studies on this topic. We retrospectively investigated data relevant to DDI for emergency cesarean sections performed for the most common indications, namely, suspected and documented fetal asphyxia. We analyzed data on emergency in-hospital cesarean sections in the period 2008-2015. Low 5- and 10-minute Apgar scores (a scheme with points awarded for breathing, heart rate, muscle tone, skin coloration, and the elicitability of reflexes) were the primary endpoints; acid-base status in arterial cord blood and in-hospital neonatal death were the secondary endpoints. The raw analysis was supplemented by an analysis adjusted for various factors including gestational age, maternal age, and obstetrical presentation. Data from 39 291 neonates were included. The DDI was up to 10 minutes in 64.6% of cases, from 11 to 20 minutes in 34.3%, and over 20 minutes in 1.1%. Low Apgar scores were less common in children whose emergency cesarean sections were performed within 10 minutes or within 20 minutes. For example, the adjusted odds ratio for a 10-minute Apgar score below 4 was 0.49 (95% confidence interval [0.25; 0.96] when a DDI of more than 20 minutes was used as the reference criterion. This is the largest population-based, risk-adjusted analysis to be carried out on this topic to date. It reveals, for the first time, an association between DDI of 20 minutes or less and the avoidance of outcomes that are dangerous to the child. As it is not possible to predict such obstetrical emergencies in advance, it seems reasonable to ensure the availability of caredelivery structures that make it possible for emergency cesarean sections to be performed within 20 minutes of the decision to do so.

  3. Term twin birth - impact of mode of delivery on outcome.

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    Ylilehto, Elina; Palomäki, Outi; Huhtala, Heini; Uotila, Jukka

    2017-05-01

    The main aims of this study were to compare maternal and neonatal outcomes in term twin birth according to the planned mode of delivery and to study the effects of chorionicity and inter-twin delivery time on neonatal outcome. A single-center cohort study of 495 women with twin deliveries at ≥37(+0) weeks of gestation. Term twin deliveries were divided into a trial of labor group (TOL, 69.3%) and a planned cesarean section (CS) group (30.7%). The primary outcomes were maternal and neonatal morbidity. 80.8% of women attempting TOL achieved vaginal birth. In the TOL group, mothers had less bleeding [median 500 mL (range 150-2700 mL) vs. 950 mL (range 150-3500 mL), p delivery time exceeded 30 min. TOL is a good option for women with twin pregnancy at term, regardless of chorionicity. Active management of labor for the second twin is important, also in DC births. Maternal outcomes were more favorable with TOL and although low Apgar scores and low umbilical blood pH may be more frequent after TOL - especially with the second twin - serious neonatal morbidity is rare and does not differ from that after planned CS. © 2017 Nordic Federation of Societies of Obstetrics and Gynecology.

  4. Effect of psychoprophylaxis (Lamaze preparation) on labor and delivery in primiparas.

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    Scott, J R; Rose, N B

    1976-05-27

    To investigate whether "prepared-childbirth" courses offer measurable physical advantages, we compared the labor and delivery characteristics of 129 primiparas who had completed ante-partum Lamaze-training psychoprophylaxis classes with an equal number of matched controls who had not. The former were given narcotics less frequently during labor (P less than 0.001), received conduction anesthesia less often (P less than 0.001), and had a higher frequency of spontaneous vaginal deliveries (P less than 0.001) than the control patients. However, these differences had no apparent effects on the length of labor, number or type of maternal complications, frequency of fetal distress, mean Apgar scored, or neonatal problems.

  5. Assisted vaginal deliveries in mothers admitted as public or private patients in Western Australia.

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    Kristjana Einarsdóttir

    Full Text Available BACKGROUND: Mothers delivering as private patients in Australia have a high rate of assisted deliveries, which could lead to adverse infant outcomes in this group of patients. We investigated whether the risk of adverse infant outcomes after assisted deliveries was different for mothers admitted as public or private patients for delivery, when compared with unassisted deliveries. METHODS AND FINDINGS: We included 158,241 vaginal, singleton, term birth admissions in our study where the infant was live born and without birth defects. The study population was identified from statutory birth and hospital data collections held by the Western Australian (WA Department of Health. We estimated odds ratios and confidence intervals using logistic regression models adjusted for a range of maternal demographic, pregnancy and birth characteristics. Interaction was assessed by including interaction terms in the models. Outcomes included low Apgar scores at five minutes (< 7, neonatal resuscitation and special care admission. Mothers delivering as private patients had an increased risk of assisted vaginal delivery compared with public patients (adjusted OR 1.74, 95% CI  =  1.68-1.80. Compared with unassisted vaginal deliveries, assisted deliveries were associated with increased risk of Apgar scores at five minutes below 7 (OR 1.25, 1.08-1.45, neonatal resuscitation (OR  =  1.69, 1.42-2.00 and admission to special care nursery (OR  =  1.64, 1.53-1.76. The increased risk of neonatal resuscitation was higher for mothers admitted as private patients for delivery (OR  =  2.13 than public patients (OR  = 1 .55, p(interaction  =  0.03. CONCLUSIONS: Our results suggested that the high risk of neonatal resuscitation following assisted vaginal deliveries compared to unassisted is higher in private patients than public patients. Whether this phenomenon is due to the twofold higher rate of assisted vaginal deliveries in this group of patients or a

  6. Effects of remifentanil on cardiovascular and bispectral index responses to endotracheal intubation in severe pre-eclamptic patients undergoing Caesarean delivery under general anaesthesia.

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    Yoo, K Y; Jeong, C W; Park, B Y; Kim, S J; Jeong, S T; Shin, M H; Lee, J

    2009-06-01

    We examined the effects of remifentanil on cardiovascular and bispectral index (BIS) responses to tracheal intubation and neonatal outcomes in pre-eclamptic patients undergoing Caesarean delivery under general anaesthesia. Forty-two women with severe pre-eclampsia were randomly assigned to receive either remifentanil 1 microg kg(-1) (n=21) or saline (n=21) over 30 s before induction of anaesthesia using thiopentone 4 mg kg(-1) and suxamethonium 1.5 mg kg(-1). Mean arterial pressure (MAP), heart rate (HR) and BIS values as well as plasma catecholamine concentrations were measured. Neonatal effects were assessed using Apgar scores and umbilical cord blood gas analysis. Induction with thiopentone caused a reduction in MAP and BIS in both remifentanil and control groups. Following the tracheal intubation MAP and HR increased in both groups, the magnitude of which was lower in the remifentanil group. BIS values also increased, of which magnitude did not differ between the groups. Norepinephrine concentrations increased significantly following the intubation in the control, while remained unaltered in the remifentanil group. The neonatal Apgar scores at 1 min were significantly lower in the remifentanil group than in the control. However, Apgar scores at 5 min, and umbilical artery and vein blood gas values were similar between the groups. These results suggest that a single bolus of 1 microg kg(-1) remifentanil effectively attenuates haemodynamic but not BIS responses to tracheal intubation in pre-eclamptic patients undergoing Caesarean delivery under general anaesthesia. However, its use was associated with maternal hypotension and neonatal respiratory depression requiring resuscitation.

  7. Studies on the incidence of intracranial haemorrhages and their relation to the delivery by using the cranial computer-tomography (CT) in full-term newborns

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    Brockerhoff, P.; Brand, M.; Ludwig, B.

    1981-09-01

    The cranial computer-tomography is a new non-invasive method for the diagnosis of perinatal intracranial haemorrhage. Among 80 neonates, who were examined by CT after delivery at term between the 3. and 5. day of life, there were 43 newborns without any neurological symptom. These were examined voluntarily with the permission of their parents. A significant correlation between the CT-finding of an intracranial haemorrhage and the neurological observations was found, whereas there was no relation to the mode of delivery. Parity, birth weight, Apgar-score, cord blood-pH did not correspond to the CT-findings. An extremely short duration of the second stage of labor in spontaneous delivery seems to increase the risk of perinatal intracranial haemorrhage.

  8. [Delivery during time of shift change is not a risk factor for obstetric complication: a historical cohort study].

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    Reichman, Orna; Samueloff, Arnon; Gdansky, Efraim; Yekel, Yael; Calderon-Margalit, Ronit

    2015-03-01

    The time of shift change is a unique time because the continuity of routine care is interrupted. The association between delivery during time of shift change and obstetric complications has not been evaluated. We hypothesized that delivery during time of shift change is at risk for obstetric complications. A historical cohort study was performed of all women with a singleton pregnancy undergoing a trial of labor at term during 2006-2010. Data was extracted from a computerized database that is continuously updated during Labor. The hour of delivery was divided into two categories: "morning shift" (09:30-15:00) and "time of shift change" which was defined 30 minutes prior to and 90 minutes past the official time of shift change, which occurs twice daily at 07:30 and 15:30. Multivariate logistic regression models were implemented to estimate the association between deliveries during "time of shift change" compared to "morning weekdays", with instrumental delivery (primary outcome) and prolonged second stage, unplanned cesarean section, postpartum hemorrhage, 5 minutes Apgar score deliveries were included in the cohort. No statistical difference in instrumental vaginal delivery was documented for women delivering during "time of shift change compared to morning shift weekdays (OR = 0.96, 95% CI: 0.83- 1.11, p = 0.605). None of the secondary outcomes were found at risk for women delivering during "time of shift change". Delivery during "time of shift change" does not pose additional risk for obstetric complications.

  9. 瘢痕子宫再次妊娠阴道分娩25例临床分析%Clinical analysis of 25 scarred uterus re-pregnancy by vaginal delivery cases

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    谢文燕; 付秀虹; 崔利娜; 白爱红

    2015-01-01

    ObjectiveTo investigate feasibility and safety of scarred uterus re-pregnancy by vaginal delivery.MethodsThere were 25 pregnant women with scarred uterus re-pregnancy by vaginal delivery as observation group, and another 30 pregnant women with non-scarred uterus re-pregnancy by vaginal delivery at the same period as control group. All patients had natural labor, and their labor time, intrapartum bleeding volume, neonatal Apgar score, neonatal weight, episiotomy rate, and hospital stay were compared.ResultsThe differences of labor time, intrapartum bleeding volume, neonatal Apgar score, and hospital stay between the two groups had no statistical significance (P>0.05). The observation group had lower neonatal weight and higher episiotomy rate than the control group, and their difference had statistical significance (P0.05);观察组的新生儿体重低于对照组,会阴侧切率高于对照组,差异有统计学意义(P<0.05)。结论在严密监护,具备随时抢救、手术的条件下,符合阴道试产条件的瘢痕子宫孕妇可行阴道分娩。

  10. OUTCOME OF INSTRUMENTAL VAGINAL DELIVERIES IN REFERRED CASES

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    Prameela

    2015-03-01

    Full Text Available INTRODUCTION: Instrumental vaginal deliveries are important procedures. Performed in indicated cases and attending to the well laid criterias will reduce the fetal and maternal morbidity. These assisted instrumental vaginal deliveries help in reducing the caesarean sec tion rate. AIMS AND OBJECTIVES: To determine the incidence and indications of instrumental vaginal deliveries. To know the maternal and fetal outcome in ventouse (vaccum assisted vaginal delivery and forceps deliveries. MATERIAL AND METHOD: This was a retrospective study carried between 01/06/2014 to 31/08/2014 at Cheluvamba Hospital, Mysore Medical College and Research Institute. The hospital records of all the referred patients who had ventouse (vaccum assisted vaginal delivery and forcep s deliveries were obtained and data on age, parity, referral and type of procedure performed, APGAR score and complications were entered into a proforma and analyzed. RESULT: During the period under review there were total of 3385 deliveries, LSCS 843 case s(24.9%, Total instrumental vaginal deliveries 110 cases(3.2%. 33 Ventouse (vaccum assisted vaginal delivery deliveries(0.9%, 57 Low forceps deliveries(1.68% and 20 Outlet forceps deliveries(0.59%.Most common indication for instrumental deliveries be ing fetal distress(62 cases , Prolonged second stage of labour and maternal exhaustion (36 cases.Cut short 2 nd stage of labour - previous LSCS(8cases and Eclampsia(2cases, RHD(1case, Sickle cell anemia with avascular necrosis femur neck(1case.Number of alive babies(103 babies, Perinatal mortality 7cases(0.20%, 8 babies required NICU admission for 3 - 4 days, 1 baby had subdural hematoma, 2 babies had forceps mark. Complications like vaginal tear (4 cases, episiotomy extension (18 cases. CONCLUSION: Ve ntouse and forceps remains appropriate tool in the armamentarium of the modern obstetrician. The major factor which determines the safety of the instrument is the operator rather than the

  11. [Combined spinal-epidural analgesia in labour: its effects on delivery outcome].

    Science.gov (United States)

    Singh, Suneet Kaur Sra Charanjit; Yahya, Nurlia; Misiran, Karis; Masdar, Azlina; Nor, Nadia Md; Yee, Lee Choon

    2016-01-01

    Combined spinal-epidural (CSE) has become an increasingly popular alternative to traditional labour epidural due to its rapid onset and reliable analgesia provided. This was a prospective, convenient sampling study to determine the effects of CSE analgesia on labour outcome. One hundred and ten healthy primigravida parturients with a singleton pregnancy of ≥37 weeks gestation and in the active phase of labour were studied. They were enrolled to the CSE (n=55) or Non-CSE (n=55) group based on whether they consented to CSE analgesia. Non-CSE parturients were offered other methods of labour analgesia. The duration of the first and second stage of labour, rate of instrumental vaginal delivery and emergency cesarean section, and Apgar scores were compared. The mean duration of the first and second stage of labour was not significantly different between both groups. Instrumental delivery rates between the groups were not significantly different (CSE group, 11% versus Non-CSE group, 16%). The slightly higher incidence of cesarean section in the CSE group (16% versus 15% in the Non-CSE group) was not statistically significant. Neonatal outcome in terms of Apgar score of less than 7 at 1 and 5min was similar in both groups. There were no significant differences in the duration of labour, rate of instrumental vaginal delivery and emergency cesarean section, and neonatal outcome in parturients who received compared to those who did not receive CSE for labour analgesia. Copyright © 2014 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.

  12. Combined spinal-epidural analgesia in labour: its effects on delivery outcome.

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    Singh, Suneet Kaur Sra Charanjit; Yahya, Nurlia; Misiran, Karis; Masdar, Azlina; Nor, Nadia Md; Yee, Lee Choon

    2016-01-01

    Combined spinal-epidural (CSE) has become an increasingly popular alternative to traditional labour epidural due to its rapid onset and reliable analgesia provided. This was a prospective, convenient sampling study to determine the effects of CSE analgesia on labour outcome. One hundred and ten healthy primigravida parturients with a singleton pregnancy of ≥37 weeks gestation and in the active phase of labour were studied. They were enrolled to the CSE (n=55) or Non-CSE (n=55) group based on whether they consented to CSE analgesia. Non-CSE parturients were offered other methods of labour analgesia. The duration of the first and second stage of labour, rate of instrumental vaginal delivery and emergency cesarean section, and Apgar scores were compared. The mean duration of the first and second stage of labour was not significantly different between both groups. Instrumental delivery rates between the groups were not significantly different (CSE group, 11% versus Non-CSE group, 16%). The slightly higher incidence of cesarean section in the CSE group (16% versus 15% in the Non-CSE group) was not statistically significant. Neonatal outcome in terms of Apgar score of less than 7 at 1 and 5min was similar in both groups. There were no significant differences in the duration of labour, rate of instrumental vaginal delivery and emergency cesarean section, and neonatal outcome in parturients who received compared to those who did not receive CSE for labour analgesia. Copyright © 2014 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. All rights reserved.

  13. Influence of family APGAR and self efficacy on quality of life of patients with chronic renal failure%家庭关怀度与自我效能感对慢性肾衰竭病人生活质量的影响

    Institute of Scientific and Technical Information of China (English)

    陈静

    2016-01-01

    [目的]探讨家庭关怀度和自我效能感对慢性肾衰竭病人生活质量的影响。[方法]采用家庭关怀度问卷(APGAR)、一般自我效能感量表(GSES)和生活质量综合评定问卷(GQOLI)对66例肾功能衰竭病人进行评估。根据 APGAR 评分将病人分为家庭关怀度差组和家庭关怀度好组,比较两组病人的生活质量。根据 GSES评分将病人分为高自我效能组和低自我效能组,比较两组病人的生活质量。[结果]家庭关怀度好组病人的 GQOLI总分及躯体功能、心理功能、社会功能3个维度评分均高于家庭关怀度差组(t=4.18、12.26、8.78、10.46,P<0.01),而低自我效能组病人的总分及躯体功能、心理功能、社会功能3个维度评分明显低于高自我效能组(t=4.79、11.96、7.78、10.86,P<0.01)。[结论]家庭关怀度与自我效能感对慢性肾衰竭病人的生活质量具有重要影响。%Objective:To probe into the influence of family APGAR and self efficacy on the quality of life of pa-tients with chronic renal failure.Methods:A total of 6 6 patients with chronic renal failure were evaluated by family APGAR (APGAR questionnaire),general self efficacy scale (GSES)and general questionnaire of quali-ty of life (GQOLI).According to the APGAR score,the patients were divided into the poor family APGAR group and the good family APGAR group,then to compare patients'quality of life between both groups.Accord-ing to the GSES score,patients were divided into the high self efficacy group and the low self efficacy group, then to compare patients'quality of life between both groups.Results:The total GQOLI score and dimensions scores including physical function,psychological function,social function in good family APGAR group were higher than those in poor family APGAR group(t=4.18,12.26,8.78,4.18,P<0.01).The total score and di-mensions scores including physical function,psychological function,social function in low self efficacy group were

  14. Effect of preoperative administration of intravenous paracetamol during cesarean surgery on hemodynamic variables relative to intubation, postoperative pain and neonatal apgar.

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    Ayatollahi, Vida; Faghihi, Safa; Behdad, Shokoufeh; Heiranizadeh, Najmeh; Baghianimoghadam, Behnam

    2014-09-01

    Selection of anesthetic drugs for cesarean section requires many considerations. Anesthetic drugs for this purpose must prevent hemodynamic stress due to tracheal intubation, while inducing neonatal complications. This study was conducted to determine the effects of paracetamol given before induction of anesthesia on cardiovascular responses to tracheal intubation and postoperative pain in the mother, and on neonatal Apgar score. This double-blind randomized placebo-controlled trial included 60 women in ASA I, without underlying diseases and fetal distress, who were candidates for elective cesarean section under general anesthesia. Patients were divided into two groups of 30 patients. Patients in the paracetamol group received 1 g intravenous (IV) paracetamol 20 min before the operation, while those in the placebo group received 1 cc normal saline at the same time. In both groups, anesthesia was induced by sodium thiopental and succinylcholine. Maternal systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP) and heart rate (HR) were measured before and immediately upon induction of anesthesia, and at first and fifth minute after tracheal intubation. Neonatal effects were assessed by Apgar score. Postoperative pain was assessed by use of the visual analog scale (VAS). The dose of analgesic used and the time of the first analgesic request by patients postoperatively were recorded. The SBP, DBP, MAP and HR were controlled significantly better in paracetamol group than in placebo group (P neonates did not differ between the groups. The VAS pain score was significantly lower in paracetamol group than in placebo group at all measuring times (P pain postoperatively (P pain management without considerable neonatal complications in women undergoing cesarean section in general anesthesia.

  15. Cooperation of delivery modes between misoprostol and oxytocin induced labor in patients with low-Bishop-score pregnancy%米索前列醇与催产素用于晚期妊娠低宫颈评分引产分娩方式的比较

    Institute of Scientific and Technical Information of China (English)

    尹学琼

    2014-01-01

    目的:探讨小剂量米索前列醇阴道给药以及催产素对低宫颈评分患者的引产结局。方法:回顾性分析我院2012年3月至2013年2月产科低宫颈评分待产孕妇200例(米索前列醇组100例,A组;催产素组100例,B组)两组,比较两组剖宫产率、引产安全性、引产效果及新生儿情况。结果:两组年龄,孕周,产次及宫颈评分差异无统计学意义(P>0.05)。A 组引产成功率明显高于B组(P<0.01)、剖宫产率低于B组(P<0.01)。两组头位难产、羊水污染率及新生儿Apgar评分差异无统计学意义(P>0.05)。结论:相对于催产素引产,对于低宫颈评分患者采用小剂量米索前列醇阴道给药引产方法安全有效,对控制剖宫产起到积极作用。%Objective :To compare the induced efficacy of virginal Misoprostol administration (at a low dose) with oxytocin administration in low Bishop score patients .Methods:200 hospitalized pregnant women with low-Bishop-scores (from March 2012 to February 2013) were collected (100 patients in misoprostol group revived virginal Misoprostol administration and 100 patients in oxytocin group recived regular oxytocin administration ) and retrospective analyzed .The success rate ,Time from induction to delivery ,First stage of labor ,Second stage of la-bor ,Postpartum hemorrhage in 2h ,Cesarean section rate ,Fetal distress ,Stasis active rate ,Contamination of amni-otic fluid and Apgar scores were compared between groups by using SPSS19 .0 .Results :Ages ,pregnant weeks , pregnant times and Bishop-scores were similar than those in both groups (P>0 .05) .The success rate of induction of labor in group A was significantly higher than those in group B (P0 .05) .Conclusion:Compared with oxytocin ,vaginal misoprostol (at a low dose) induced labor is more likely effective and safe for cervical ripening and artificial labor ,and no additional advantage is observed .

  16. Decision-to-Delivery Time Intervals in Emergency Caesarean Section Cases: Repeated cross-sectional study from Oman.

    Science.gov (United States)

    Tashfeen, Kaukab; Patel, Malini; Hamdi, Ilham M; Al-Busaidi, Ibrahim H A; Al-Yarubi, Mansour N

    2017-02-01

    In cases of fetal intolerance to labour, meeting the standard decision-to-delivery time interval (DDI) of ≤30 minutes is challenging. This study aimed to assess DDIs in emergency Caesarean section (CS) cases to identify factors causing DDI delays and the impact of a delayed DDI on perinatal outcomes. This repeated cross-sectional study included all emergency CS procedures performed due to acute fetal distress, antepartum haemorrhage or umbilical cord prolapse at the Nizwa Hospital, Nizwa, Oman. Three audit cycles of three months each were conducted between April 2011 and June 2013, including an initial retrospective cycle and two prospective cycles following the implementation of improvement strategies to address factors causing DDI delays. Poor perinatal outcomes were defined as Apgar scores of 60 minutes was significantly associated with poor neonatal outcomes in terms of increased SCBU admissions and low Apgar scores (P <0.001 each). Factors causing DDI delays included obtaining consent for the CS procedure, a lack of operating theatre availability and moving patients to the operating theatre. The identification of factors causing DDI delays may provide opportunities to improve perinatal outcomes.

  17. Decision-to-Delivery Time Intervals in Emergency Caesarean Section Cases; Repeated cross-sectional study from Oman

    Directory of Open Access Journals (Sweden)

    Kaukab Tashfeen

    2017-03-01

    Full Text Available Objectives: In cases of fetal intolerance to labour, meeting the standard decision-to-delivery time interval (DDI of ≤30 minutes is challenging. This study aimed to assess DDIs in emergency Caesarean section (CS cases to identify factors causing DDI delays and the impact of a delayed DDI on perinatal outcomes. Methods: This repeated cross-sectional study included all emergency CS procedures performed due to acute fetal distress, antepartum haemorrhage or umbilical cord prolapse at the Nizwa Hospital, Nizwa, Oman. Three audit cycles of three months each were conducted between April 2011 and June 2013, including an initial retrospective cycle and two prospective cycles following the implementation of improvement strategies to address factors causing DDI delays. Poor perinatal outcomes were defined as Apgar scores of 60 minutes was significantly associated with poor neonatal outcomes in terms of increased SCBU admissions and low Apgar scores (P <0.001 each. Factors causing DDI delays included obtaining consent for the CS procedure, a lack of operating theatre availability and moving patients to the operating theatre. Conclusion: The identification of factors causing DDI delays may provide opportunities to improve perinatal outcomes.

  18. Long-term outcome in term breech infants with low Apgar score--a population-based follow-up

    DEFF Research Database (Denmark)

    Krebs, L; Langhoff-Roos, J; Thorngren-Jerneck, K

    2001-01-01

    and 218 controls. RESULTS: Four cases (4.6%) and one control (0.5%) had cerebral palsy. In infants without cerebral palsy, speech/language problems were more frequent than controls (10.6 versus 3.2%) (P=0.02). There were no differences in rates of deficits in attention, motor control and perception (DAMP...

  19. [Mode of delivery, postnatal condition and neonatal outcome in preterm infants].

    Science.gov (United States)

    Ruckhäberle, K E; Viehweg, B; Schlegel, C; Vogtmann, C; Böttcher, H; Schürer, K; Ruckhäberle, B; Weissbach, R; Wolff, C

    1979-01-01

    There were under examination 578 preterm infants of two groups--28. up to 31. and 32. up to 36. week of gestation--after birth of vertex as well as breech prevention. Postnatal condition and neonatal outcome were put into relation to the mode of delivery. We compared Apgar-Score (one and five minute value), morbidity on respiratory distress syndrom as well as rate of survival and neonatal mortality in spontaneous delivery with and without episiotomia, with specula delivery, Shute-forceps and vacuum extraction of vertex presentation as well as with breech presentation after vaginal delivery and primary Caesarean section. In respect of the management of the second stage of labour it is our opinion that prophylactic additional measures in preterm delivery of vertex presentation after 32 weeks of gestation are not necessary and that this question should be examined in a larger study of much more cases. But we were able to demonstrate that up to 32. week of gestation well-timed episiotomia of optimal size is necessary. Our good experiences in breech presentation between 31. and 35. week of gestation treated by obligate Caesarean section have to prove true in future.

  20. [Impact of the instrumental vaginal delivery on pain perception at two months].

    Science.gov (United States)

    Weslinck, N; De Jonckheere, J; Storme, L; Logier, R; Appel, M; Thomas, D; Rakza, T

    2014-06-01

    Although instrumental vaginal delivery reduces the risk of neonatal mortality, it increases the risk of specific morbidity including prolonged neonatal discomfort. Previous studies suggest that neonatal exposure to acute pain could have long-term effects on the pain response later in life. The aim of the study was to investigate whether instrumental vaginal delivery may alter the response to a noxious stimulus at the age of two months. Newborn infants were enrolled in this prospective observational study after parental consent. A group of children born by instrumental vaginal delivery (group 2) were compared to matched controls born by vaginal delivery (group 1). Pain was assessed in each newborn infant between two and four hours after birth using the scale of pain and discomfort of the newborn baby (EDIN). These children were reassessed for pain response to immunizations (Infanrix(®) and Prevenar(®)) at two months of age using the DAN scale. Thirteen children were enrolled in this study, six in group 1 and seven in group 2. Gestational age, birth weight, Apgar score, and umbilical arterial blood were similar in both groups. The EDIN measured between H2 and H4 was significantly higher in group 2 (median, 4 [IQ, 3] versus 0 [3.25], Pdelivery causes discomfort after birth and increases the pain response to immunization at the age of two months. This study supports the hypothesis that instrumental vaginal delivery may alter pain perception later in life. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  1. Does delivery volume of family physicians predict maternal and newborn outcome?

    Energy Technology Data Exchange (ETDEWEB)

    Klein, M.C. [Children' s and Women' s Health Centre, Dept. of Family Practice, Vancouver, British Columbia (Canada); Univ. of British Columbia, Dept. of Family Practice, Vancouver, British Columbia (Canada); Spence, A. [Children' s and Women' s Health Centre, Dept. of Family Practice, Vancouver, British Columbia (Canada); Kaczorowski, J. [McMaster Univ., Depts. of Family Medicine and of Clinical Epidemiology and Biostatistics, Hamilton, Ontario (Canada); Kelly, A. [Children' s and Women' s Health Centre, Dept. of Family Practice, Vancouver, British Columbia (Canada); Univ. of British Columbia, Dept. of Health Care and Epidemiology, Vancouver, British Columbia (Canada); Grzybowski, S. [Univ. of British Columbia, Dept. of Family Practice, Vancouver, British Columbia (Canada)

    2002-05-01

    The number of births attended by individual family physicians who practice intrapartum care varies. We wanted to determine if the practice-volume relations that have been shown in other fields of medical practice also exist in maternity care practice by family doctors. For the period April 1997 to August 1998, we analyzed all singleton births at a major maternity teaching hospital for which the family physician was the responsible physician. Physicians were grouped into 3 categories on the basis of the number of births they attended each year: fewer than 12, 12 to 24, and 25 or more. Physicians with a low volume of deliveries (72 physicians, 549 births), those with a medium volume of deliveries (34 physicians, 871 births) and those with a high volume of deliveries (46 physicians, 3024 births) were compared in terms of maternal and newborn outcomes. The main outcome measures were maternal morbidity, 5-minute Apgar score and admission of the baby to the neonatal intensive care unit or special care unit. Secondary outcomes were obstetric procedures and consultation patterns. There was no difference among the 3 volume cohorts in terms of rates of maternal complications of delivery, 5-minute Apgar scores of less than 7 or admissions to the neonatal intensive care unit or the special care unit, either before or after adjustment for parity, pregnancy-induced hypertension, diabetes, ethnicity, lone parent status, maternal age, gestational age, newborn birth weight and newborn head circumference at birth. High-and medium-volume family physicians consulted with obstetricians less often than low-volume family physicians (adjusted odds ratio [OR] 0.586 [95% confidence interval, CI, 0.479-0.718] and 0.739 [95% Cl 0.583-0.935] respectively). High-and medium-volume family physicians transferred the delivery to an obstetrician less often than low-volume family physicians (adjusted OR 0.668 [95% CI 0.542-0.823] and 0.776 [95% Cl 0.607-0.992] respectively). Inductions were performed

  2. A ‘busy day’ effect on perinatal complications of delivery on weekends: a retrospective cohort study

    Science.gov (United States)

    Snowden, Jonathan M; Kozhimannil, Katy Backes; Muoto, Ifeoma; Caughey, Aaron B; McConnell, K John

    2017-01-01

    Objective To evaluate whether busy days on a labour and delivery unit are associated with maternal and neonatal complications of childbirth in California hospitals, accounting for weekday/weekend births. Design This is a population-based retrospective cohort study. Setting Linked vital statistics/patient discharge data for California births between 2009 and 2010 from the Office of Statewide Health Planning and Development. Participants All singleton, cephalic, non-anomalous California births between 2009 and 2010 (N=724 967). Main outcomes The key exposure was high daily obstetric volume, defined as giving birth on a day when the number of births exceeded the hospital-specific 75th percentile of daily delivery volume. Outcomes were a range of maternal and neonatal complications. Results Several maternal and neonatal complications were increased on high-volume days and weekends following adjustment for maternal demographics, annual hospital birth volume and teaching hospital status. For example, compared with low-volume weekdays, the odds of Apgar <7 on low-volume weekend days and high-volume weekend days were 11% (adjusted OR (aOR) 1.11, CI 1.03 to 1.21) and 29% higher (aOR 1.29, CI 1.10 to 1.52), respectively. High volume was associated with increased odds of neonatal seizures on weekdays (aOR 1.33, CI 1.01 to 1.71) and haemorrhage on weekends (aOR 1.11, CI 1.01 to 1.22). After accounting for between-hospital variation, weekend delivery remained significantly associated with increased odds of Apgar score <7, neonatal intensive care unit admission, prolonged maternal length of stay and the odds of neonatal seizures remained increased on high-volume weekdays. Conclusions Our findings suggest that weekend delivery is a consistent risk factor for a range of perinatal complications and there may be variability in how well hospitals handle surges in volume. PMID:27472947

  3. 宫颈Bishop评分与地诺前列酮计划分娩效果的临床观察%Clinical observation on cervical Bishop score and the effect of dinoprostone for programed delivery

    Institute of Scientific and Technical Information of China (English)

    鲁泽春; 周玲; 杜建新; 张文颖; 王莉; 牛玉静

    2012-01-01

    Objective: To explore cervical Bishop score, clinical efficacy of dinoprostone used for programed delivery of full term pregnancy, and the correlation with maternal and infantile safety. Methods: A total of 181 full term pregnant women (cervical Bishop score ≤6, with indications of vaginal delivery, without contraindications of programed delivery, without severe medical complications, single pregnancy , head position) were selected, then they were treated with placing dinoprostone vaginal suppository into vagina to promote cervical repining , intravenous drip of oxytocin was applied if failed. All the pregnant women were divided into different groups according to initial cervical Bishop score and cervical scores before and after treatment with dinoprostone. The cervical Bishop scores, the degrees of uterine contraction , the interval times from treatment to in labor, the conditions of delivery, vaginal delivery rates, the effects on fetuses and neonates, and the amounts of postpartum hemorrhage in different groups were compared. Results; The successful rate of programed delivery and vaginal delivery rate in high initial cervical Bishop score group were statistically significantly higher than those in low initial cervical Bishop score group (P<0.05) . The successful rate of programed delivery and vaginal delivery rate in the pregnant women with large change of cervical Bishop score before and after treatment with dinoprostone were statistically significantly higher than those in the pregnant women with small change of cervical Bishop score before and after treatment with dinoprostone (P<0.05) . The incidences of amniotic fluid pollution and neonatal asphyxia in low initial cervical Bishop score group and the pregnant women with small change of cervical Bishop score before and after treatment with dinoprostone were statistically significantly higher than those in high initial cervical Bishop score group and the pregnant women with large change of cervical Bishop

  4. Comparing the painlessness effects of spinal (sufentanil and epidural(bupivacaine plus lidocaine analgesic methods in labour and delivery

    Directory of Open Access Journals (Sweden)

    A. Shafiee

    2006-01-01

    Full Text Available Background and purpose: This study was designed in order to compare the effects of spinal and epidural analgesia on labour and also several maternal and fetal factors in vaginal delivery.Materials and Methods: The study was a randomized clinical trail and participatnts were 120 gravid 1 and gravid 2 women in the active phase of delivery, admitted to the labour room of Fatemieh Hospital in Hamedan in 1381-1382.Sixty patients were randomly divided into two groups of 30, analgesia was induced by single spinal sufentanil injection in one group and, bupivacaine plus lidocaine injection in the other group.Maternal vital signs and pain score were recorded (VAS at 1, 5, 15 and 30 minutes after administration of analgesia and every 30 minutes thereafter. Fetal heart rate every 15 minutes, vaginal examination every hour, urinary output every 4 hours after delivery and the incidence of headache and back pain, one week after delivery were the variables under study.Results: Both groups were matched regarding demographic, gravida and Parity factors. There was no significant difference between groups regarding pain score, (based on VAS,duration of the first and second delivery phase, the incidence of fetal distress, meconium excretion, apgar scores at 1 and 5 minutes after delivery, abnormal laboar, operative or assisted delivery. Average analgesic duration was longer in spinal analgesia than single epidural injection analgesia.Conclusion: Considering the difficulty of the technique, the need for anaestheticianHs supervision and injection repeatition in epidural analgesia, it seems that spinal analgesia is a suitable replacement which is more practical, less expensive, easy to perform and induces a desirable analgesia.

  5. Vaginal delivery versus cesarean section for term breech delivery

    Directory of Open Access Journals (Sweden)

    Babović Ivana

    2010-01-01

    Full Text Available Background/Aim. The optimal method of delivery for breech presentation at term still remains a matter of controversy. This is probably due to the fact that the skills of vaginal breech delivery are being lost. The aim of this study was to examine risk factors: mother's age, parity, labor's duration, estimated neonatal birth weight for the mode of breech presentation delivery at term as well as the influence of the delivery mode on neonatal outcome. Methods. A retrospective study of 401 terms (more than 37 week's gestation breech deliveries at the Institute of Gynecology and Obstetrics, Belgrade, from 2007 to 2008 was made. The following groups with respect to mode of delivery were included: the group I - vaginal delivery (VD in 139 patients; the group II - urgent cesarean section (UCS in 128 patients; and the group III - elective cesarean section (ECS in 134 patients. Mother's age, parity, duration of VD, neonatal birth weight (BW, the Apgar score at 5th minute, and duration of stay in a neonatal intensive care unit (NICU vere determined. Neonatal mortality and major neonatal morbidity were compared according to the route of delivery. Fetuses and neonates with hemolytic disease and fetal and neonatal anomalies were excluded from the study. For statistical analyses we performed Student's t test, χ2 likelihood ratio, Kruskall-Wallis test, Mann Whitney test, and ANOVA. Results. The mean age of patients in the group I was 28.29 ± 4.97 years, in the group II 29.68 ± 5.92 years and in the group III 30.06 ± 5.41 years. Difference in mother's age between the group I and III was significant (p = 0.022. In the group III there were 73.9% nuliparous similarly to the gropu II (73.4%. We performed ECS in 54.6% of the nuliparous older than 35 years, and 54.4% multiparous younger than 35 years were delivered by VD. The use of oxytocin for stimulation of vaginal labor was not associated with its duration (p = 0.706. Lowset maneuver was performed in 88.5% of

  6. 新生儿缺氧缺血性脑病脑实质CT值与Apgar评分的相关性研究%Stud y on the relation between CT value of hypoxie-ischemic encephalopathy and Apgar about the newborn

    Institute of Scientific and Technical Information of China (English)

    朱裕; 陈任政; 李旭军; 曾纪莲; 刘红宣

    2015-01-01

    Objective To study on the relation between the CT values on the newborn hypoxie-ischemic encephal-opathy (HIE) and Apgar score, which can provide reference value on treatment of the newborn and predict the prognosis. Methods Randomly sampled 62 newborn with HIE had Apgar score in our hospital and to analyze their 64 multi-detector helical CT imaging, and used the statistical software to find out the relation between the CT value and Apgar score. Results ① White matter of premature infant was more sensitive than that of mature infant, while gray matter of mature infant was more sensitive than that of premature infant. The CT value was more sensitive than Apgar score. ② The Apgar of premature infant or mature infant and the difference between gray matter and the CT value of Pons was positive corr-elation (r=0.675).③CT value was more sensitive than Apgar score. Conclusion CT examination can be more sensitive on diagnosis of HIE exactly and quickly. In addition, the report of CT examination can tell the degree of brain damage by providing specific data.%目的:探讨新生儿缺氧缺血性脑病(HIE)脑实质CT值与Apgar评分的相关性,为患儿的治疗及预后提供参考数据。方法随机抽取我院62例经过Apgar评分的HIE患儿,通过回顾性分析64排螺旋CT扫描的图像,选取特定的部位,测量CT值,利用统计软件,发现Apgar评分与CT值之间的联系。结果①早产儿脑白质损害较足月儿更敏感,足月儿脑灰质损害较早产儿更敏感;②出生10 min早产儿、足月儿Apgar评分分别和灰质与桥脑CT值之差(D)呈正相关(r=0.675);③CT值较Apgar评分更敏感。结论 CT检查能及时、准确、快捷诊断HIE,并能判断脑损害的严重程度,且敏感性高于临床Apgar评分,可以提供客观的具体参考数据。

  7. Resultados neonatais no parto vaginal espontâneo comparados aos dos partos com fórcipe de Simpson-Braun em primíparas Neonatal outcome of spontaneous deliveries as compared to Simpson-Braun forceps deliveries in nulliparous women

    Directory of Open Access Journals (Sweden)

    Belmiro Gonçalves Pereira

    2004-02-01

    Full Text Available OBJETIVO: comparar os resultados neonatais dos partos vaginais espontâneos ou assistidos com fórcipe de Simpson-Braun em nulíparas. MÉTODO: em estudo de corte retrospectivo foram avaliados dois grupos de primíparas atendidas no Centro Obstétrico do CAISM/UNICAMP, que tiveram parto vaginal sob analgesia epidural. O grupo fórcipe foi formado por 119 pacientes que tiveram parto a fórcipe de Simpson-Braun, e o grupo normal por 114 casos de parto vaginal espontâneo. Foram estudadas as variáveis neonatais imediatas como o estado do líquido amniótico e os índices de Apgar, assim como a evolução neonatal nos primeiros dias de vida. Para análise estatística foram utilizados os testes c², exato de Fisher e t de Student para comparação de médias e considerada significativa a diferença correspondente a pPURPOSE: to compare maternal and neonatal outcomes between spontaneous vaginal and Simpson-Braun forceps deliveries in nulliparous women. METHOD: a retrospective study including two groups of nulliparous women, who had vaginal delivery under peridural anesthesia in the obstetric unit of the CAISM-UNICAMP: the forceps group included 119 women who had Simpson-Braun forceps delivery, and the normal group included 114 women who delivered spontaneously. Neonatal outcomes, such as Apgar score and the evolution in the first days of life, were studied. Data were compared in both groups and, for statistical analysis, c² test, Fisher exact, and Student t tests were used. The differences were considered significant when p<0.05. RESULTS: the indications for Simpson-Braun forceps delivery were maternal-fetal relief (90 cases and abbreviation of the expulsive period (29 cases. In the forceps group there were 8 cases (6.7% of vaginal injuries; a similar result was observed in the normal group. The number of hospitalization days for the parturient and the newborns was identical, 2.4 days. The newborns in the two groups had similar Apgar scores

  8. Optimal timing for term delivery of twin pregnancies: a population-based study.

    Science.gov (United States)

    Vilchez, Gustavo A; Dai, Jing; Hoyos, Luis R; Chelliah, Anushka; Bahado-Singh, Ray; Sokol, Robert J

    2015-04-01

    The objective of this study was to examine the risk of adverse neonatal outcomes after twin delivery according to gestational age. The U.S. Natality Database from 2007 to 2010 was reviewed. Inclusion criteria were twin deliveries and gestational age of 37 to 42 weeks. Exclusion criteria were congenital anomalies and missing/incomplete data. Cases were subdivided by gestational age into early term, term, and late term. Singleton pregnancies matched by delivery time and location were selected as controls. Outcome variables included were low Apgar score, assisted ventilation, neonatal intensive care unit admission, surfactant/antibiotic use, seizures, and birth injury. Logistic regression analysis was used to calculate adjusted odds ratios according to gestational age and plurality, using singleton term as reference. A total of 220,169 twin and 270,540 singleton deliveries were identified. The risk of adverse neonatal outcomes for twins was higher than for singletons. For twins, the distribution of the risks of the composite of adverse neonatal outcomes was linear, being the lowest at early term and the highest at late term, whereas the distribution for singletons was u-shaped being lowest at term compared with early and late term. Twins are at higher risk of suboptimal neonatal outcomes than singletons, but do better when delivered at early term rather than term or late term. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  9. Effect of epidural anesthesia using ropivacaine combined with remifentanil on delivery

    Institute of Scientific and Technical Information of China (English)

    Wen Cheng

    2016-01-01

    Objective:Tostudy the ropivacaine combined with remifentanil on analgesic effect and safety of painless labor requirements of maternal epidural anesthesia.Methods:Hospital obstetrics and gynecology scheduled for painless delivery of maternal were selected. 80 cases (analgesic group, the use of ropivacaine epidural analgesia with remifentanil), did not use any analgesia 80 cases of childbirth women as controls group, two groups of mothers underwent index difference childbirth pain were observed during childbirth, birth outcomes and other health care workers with the help of the same group under midwifery.Results:VAS score between T0 time analgesia group and the control group was not statistically significant; in the analgesic, T4, T5, T6 moments analgesia group VAS scores were significantly lower than T1, T2, T3 in the control group. Significantly lower than the control group the first stage of labor analgesia group, significantly longer than the second stage of labor analgesia group control group, two groups of maternal third stage of labor was no significant difference. Mode of delivery between the two groups, birth weight, the first and second 1 min, 5 min Apgar scores were not significantly different.Conclusion: Ropivacaine remifentanil requirements for painless childbirth maternal epidural anesthesia can significantly reduce maternal childbirth pain without causing adverse effects on childbirth and newborns.

  10. 新生儿窒息后脑损伤与Apgar's评分关系探讨

    Institute of Scientific and Technical Information of China (English)

    甘丽芳

    2006-01-01

    目的:探讨新生儿窒息后脑损伤与Apgar's评分关系.方法:选取2002~2004年住院的窒息新生儿56例,1min、5min、10min脑损伤发生率比较采用x2检验,P<0.05为有显著性差异.结果:1min、5min Apgar's评分≤3分者与评分4~7分者脑损伤发生率差异无显著性(P>0.05).而10min Apgar's评分≤7分者脑损伤发生率明显高于评分>7分者,差异有高度显著性(P<0.01),有6例1min Apgar's评分>3分,而5min却≤3分(即倒评分),结果均出现了脑损伤.结论:Apgar's评分对正确、真实反映窒息程度及预测窒息后脑损伤有一定局限性,应结合窒息和缺氧缺血持续时间长短,有无脑性惊厥和持续肌张力异常等予综合分析.

  11. Apresentação pélvica na gestação de termo em pacientes com partos vaginais prévios Breech presentation in term pregnancy in patients with previous vaginal deliveries

    Directory of Open Access Journals (Sweden)

    José Mauro Madi

    2004-12-01

    malformation, no complications in the current pregnancy, birth weight between 2,500 and 3,750 g, and no previous cesarean section. The breech group was matched to 1,327 newborns in vertex position from pregnant women with no previous cesarean section (vertex group. Maternal age, parity, gestational age, delivery way, birth weight, meconium-stained amniotic fluid, 1- and 5-min Apgar score, need of neonatal intensive care unit, and small- and big-for-gestational age newborns were analyzed. Statistical analysis was performed by the c² test and by Student's t test, with the level of significance set at p<0.05. RESULTS: when breech and vertex groups were compared, they showed significant differences regarding the following variables: birth weight (3,091±538 g vs 3,250±497 g; p<0.01, vaginal delivery (63.8 vs 95.0%; p<0.0001, cesarean section (36.2 vs 5.0%; p<0,0001, and 1-min Apgar score (p<0.0001, respectively. CONCLUSIONS: we conclude that in term fetuses in breech position from pregnant women with previous vaginal deliveries, birth weight, delivery way, and 1-min Apgar score were different compared to fetuses in vertex position from women with the same characteristics.

  12. Contributions of Selected Perinatal Variables to Seven-Year Psychological and Achievement Test Scores.

    Science.gov (United States)

    Henderson, N. B.; And Others

    Perinatal variables were used to predict 7-year outcome for 538 children, 32% Negro and 68% white. Mother's age, birthplace, education, occupation, marital status, neuropsychiatric status, family income, number supported, birth weight, one- and five-minute Apgar scores were regressed on 7-year Verbal, Performance and Full Scale IQ, Bender, Wide…

  13. Dilemma in Timing of Delivery in a Patient with an Acute Myocardial Infarction

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    Laura M. Héman

    2015-01-01

    Full Text Available Introduction. Acute myocardial infarction (AMI in a pregnant woman is rare. When occurring, AMI is a major cause of maternal and neonatal death. By presenting the following case we describe the dilemma concerning the timing of delivery. Case. A 36-year-old, multiparous women, at 35 6/7 weeks of gestation, suffered from an AMI due to an acute blockage of the left anterior descending artery (LAD. This was treated by angiographic thrombosuction and biodegradable stent placement. Within 5 hours after this procedure, a cesarean section (CS was performed because of a nonreassuring fetal condition. A healthy son with an Apgar score of 9/10 was born. The patient’s postoperative course was complicated by a big wound hematoma, a hemoglobin drop, and heart failure. Discussion. In case of AMI during pregnancy, the cardiological management has absolute priority. The obstetrical management is not outlined. In a nonreassuring fetal condition, delivery is indicated after stabilization of the mother. However, delivery after recent AMI and angiography will bring new risks of cardiologic stress and bleeding complications. The limited literature available tends to an expectant obstetrical management, but this case emphasizes the difficulty of waiting in suspected fetal distress.

  14. Vacuum-assisted vaginal delivery (VAVD)-basics for the risk manager.

    Science.gov (United States)

    Veltman, Larry

    2014-01-01

    The neonatal intensive care unit (NICU) manager calls you about a baby delivered last night now with brain trauma. She understands that it was a difficult delivery with a vacuum. There were "multiple pop-offs" and, after the baby was delivered, the NICU resuscitation team was called. The Apgar scores were 3 and 5. They are requesting risk management to lead a debriefing today. What to ask? How many pop-offs are allowed? What was the interaction between the nurses and physician? Why wasn't the resuscitation team in attendance before the delivery? Was the vacuum placed properly? How many pulls? How long was the vacuum in place? What should be documented, and was the documentation adequate? All of these are appropriate questions for an adequate analysis of an adverse outcome resulting from a vacuum-assisted vaginal delivery (VAVD). This article focuses on the risk management issues of VAVD in order to give the risk manager a better understanding of appropriate use, data-gathering tools, educational opportunities, and assistance in establishing a culture of safety for the entire perinatal team regarding the use of the vacuum device. © 2014 American Society for Healthcare Risk Management of the American Hospital Association.

  15. Comparison of different mode of delivery for women on postpartum hemorrhage and immune function%不同分娩方式对产妇产后出血及新生儿免疫功能的影响

    Institute of Scientific and Technical Information of China (English)

    夏红梅; 牟海波; 孟晓蓉; 李其香; 张彦

    2013-01-01

    目的 探讨阴道分娩与剖宫产对产后出血及新生儿免疫功能的影响.方法 选择健康初产妇120例,按照选择分娩方式的不同分为阴道分娩组和剖宫产组,每组各60例.检测两组产妇产后出血情况以及新生儿Apgar评分,脐带血免疫球蛋白(IgA、IgG和IgM)及C-反应蛋白(CRP)的变化水平.结果 剖宫分娩的产后出血率显著高于阴道分娩组(P< 0.05),而分娩方式对新生儿1 min和5 min Apgar评分结果并无显著影响(P>0.05).剖宫产组IgA、CRP水平显著高于阴道分娩(P<0.05),而IgG、IgM水平则低于阴道分娩组(P<0.05),且剖宫产男性新生儿IgA和IgM水平明显低于女性新生儿,IgG水平则高于女性新生儿,差异均有统计学意义(P<0.05).结论 阴道分娩与剖宫产对新生儿的Apgar评分无明显的影响,但剖宫产术可导致产后出血率增加并降低新生儿免疫力.%Objective To explore the vaginal delivery and cesarean section on the postpartum hemorrhage,Apgar score of newborns,and immune function by the primiparous women.Methods 120 cases of pregnant women were divided into vaginal delivery and cesarean section group,60 cases in each group.Apgar score,immunoglobulin (IgA,IgG and IgM) and C-reactive protein (CRP) level,and the levels of postpartum hemorrhage were detected in the two groups of newborns.Results The vaginal delivery mode showed significant lower rate of postpartum hemorrhage (P < 0.05).There were no significant differences on the 1 min and 5 min Apgar score results between the two groups (P =0.17; P=0.50).IgA,CRP level was significantly higher in cesarean section group than that of vaginal delivery group (P <0.05),while IgG,IgM level was lower than that of the vaginal delivery group (P < 0.05).Male newborns IgA and IgM levels were significantly lower in female newborns,but IgG was higher than the female newborns in the cesarean group (P < 0.05).Conclusion Vaginal delivery and cesarean have no

  16. A clinical study of the effectiveness of continuous epidural labour analgesia for vaginal delivery with 0.0625% bupivacaine with 0.0002% fentanyl

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    Vijay Kanna

    2015-10-01

    Results: The onset of analgesia was significantly faster in 0.0625% bupivacaine with 0.0002% fentanyl (9.7 minutes. A greater proportion of parturient achieved a maximum level of analgesia unto T8. The duration of analgesia was also significantly longer. The effectiveness of analgesia was better. There were no significant cardiovascular changes or any motor blockade. The side effects were mild sedation and in the parturient who received fentanyl. The mode of delivery and the Apgar scores of the neonates at 1 and 5 minutes were comparable. Conclusions: It was concluded that continuous lumbar epidural analgesia with 8 ml of 0.0625% bupivacaine with 2 and micro;g of fentanyl improved the quality and duration of analgesia without producing any adverse effects on the mother or on the neonate. [Int J Res Med Sci 2015; 3(10.000: 2553-2560

  17. A 'busy day' effect on perinatal complications of delivery on weekends: a retrospective cohort study.

    Science.gov (United States)

    Snowden, Jonathan M; Kozhimannil, Katy Backes; Muoto, Ifeoma; Caughey, Aaron B; McConnell, K John

    2017-01-01

    To evaluate whether busy days on a labour and delivery unit are associated with maternal and neonatal complications of childbirth in California hospitals, accounting for weekday/weekend births. This is a population-based retrospective cohort study. Linked vital statistics/patient discharge data for California births between 2009 and 2010 from the Office of Statewide Health Planning and Development. All singleton, cephalic, non-anomalous California births between 2009 and 2010 (N=724 967). The key exposure was high daily obstetric volume, defined as giving birth on a day when the number of births exceeded the hospital-specific 75th percentile of daily delivery volume. Outcomes were a range of maternal and neonatal complications. Several maternal and neonatal complications were increased on high-volume days and weekends following adjustment for maternal demographics, annual hospital birth volume and teaching hospital status. For example, compared with low-volume weekdays, the odds of Apgar <7 on low-volume weekend days and high-volume weekend days were 11% (adjusted OR (aOR) 1.11, CI 1.03 to 1.21) and 29% higher (aOR 1.29, CI 1.10 to 1.52), respectively. High volume was associated with increased odds of neonatal seizures on weekdays (aOR 1.33, CI 1.01 to 1.71) and haemorrhage on weekends (aOR 1.11, CI 1.01 to 1.22). After accounting for between-hospital variation, weekend delivery remained significantly associated with increased odds of Apgar score <7, neonatal intensive care unit admission, prolonged maternal length of stay and the odds of neonatal seizures remained increased on high-volume weekdays. Our findings suggest that weekend delivery is a consistent risk factor for a range of perinatal complications and there may be variability in how well hospitals handle surges in volume. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  18. Cesarean Births and Attachment Behaviors of Fathers.

    Science.gov (United States)

    1984-01-01

    Apgar scores are 7 or greater at both 1 and 5...status, indications for cesarean delivery, anesthesis, and infant’s gestational age, birth weight, and apgar scores . Prior to meeting the father, the...delivery and attachment score ; highest school grade completed and attachment score ; and age and child care experience of the father and attachment score

  19. Mode of delivery and antenatal steroids and their association with survival and severe intraventricular hemorrhage in very low birth weight infants.

    Science.gov (United States)

    Hübner, M E; Ramirez, R; Burgos, J; Dominguez, A; Tapia, J L

    2016-10-01

    To determine whether CS delivery and receipt of antenatal steroids (ANS) in vertex-presenting singletons with a gestational age (GA) between 24 and 30 weeks is associated with improved survival and improved severe intraventricular hemorrhage (sIVH)-free survival. Multicenter cohort, retrospective analysis of prospectively collected data. Vertex-presenting singletons newborns with GA 24 to 30 weeks, birth weight between 500 and 1500 g, without major congenital malformations, born between 2001 and 2011 at Neocosur centers were included. Four thousand three hundred and eighty-six infants fulfilled inclusion criteria: 45.8% were delivered vaginally and 54.2% by cesarean section (CS). Newborns delivered vaginally received less ANS, had lower GA, Apgar scores and a lower incidence of survival and sIVH-free survival (P<0.001). Newborns with better survival were those with ANS, independent of mode of delivery. At 24 to 25 weeks GA, increased survival and sIVH-free survival were associated with ANS and CS delivery, compared with those who received ANS and delivered vaginally. Among vertex-presenting singletons with GA 24 to 30 weeks, better survival and IVH-free survival were associated with ANS, independent of mode of delivery. In infants at 24 to 25 weeks gestation the combination of ANS/CS was associated with improvement in both outcomes.

  20. Maternal and neonatal outcomes after implementation of a hospital policy to limit low-risk planned caesarean deliveries before 39 weeks of gestation: an interrupted time-series analysis.

    Science.gov (United States)

    Hutcheon, J A; Strumpf, E C; Harper, S; Giesbrecht, E

    2015-08-01

    To evaluate the extent to which implementing a hospital policy to limit planned caesarean deliveries before 39 weeks of gestation improved neonatal health, maternal health, and healthcare costs. Retrospective cohort study. British Columbia Women's Hospital, Vancouver, Canada, in the period 2005-2012. Women with a low-risk planned repeat caesarean delivery. An interrupted time series design was used to evaluate the policy to limit planned caesarean deliveries before 39 weeks of gestation, introduced on 1 April 2008. Composite adverse neonatal health outcome (respiratory morbidity, 5-minute Apgar score of policy, the proportion of planned caesareans dropped by 20 percentage points (adjusted risk difference of 20 fewer cases per 100 deliveries; 95% CI -25.8, -14.3) to 41% (1033/2518). The policy had no detectable impact on adverse neonatal outcomes (2.2 excess cases per 100; 95% CI -0.4, 4.8), maternal complications, or healthcare costs, but increased the risk of out-of-hours delivery from 16.2 to 21.1% (adjusted risk difference 6.3 per 100; 95% CI 1.6, 10.9). We found little evidence that a hospital policy to limit planned caesareans before 39 weeks of gestation reduced adverse neonatal outcomes. Hospital administrators intending to introduce such policies should anticipate, and plan for, modest increases in out-of-hours and emergency-timing. © 2015 Royal College of Obstetricians and Gynaecologists.

  1. Comparable risk of childhood asthma after vaginal delivery and emergency caesarean section.

    Science.gov (United States)

    Brix, Nis; Stokholm, Lonny; Jonsdottir, Fjola; Kristensen, Kim; Secher, Niels Jørgen

    2017-01-01

    Caesarean section is thought to be a risk factor for childhood asthma, but this association may be caused by confounding from, for instance, familial factors. To address this problem, we used twin pairs to assess the risk of childhood asthma after emergency caesarean section. The study was a register-based nation-wide matched cohort study using twin pairs to minimise residual confounding. Included were twin pairs in which the first twin was delivered vaginally and the second by emergency caesarean section during the study period from January 1997 through December 2012. In total, 464 twin pairs (928 twins) were included. In 30 pairs, the first twin (vaginal delivery) was diagnosed with asthma, but the second twin (emergency caesarean section) was not. In 20 pairs, the second twin (emergency caesarean section) was diagnosed with asthma, but the first twin (vaginal delivery) was not. In 11 pairs, both twins developed asthma. In the unadjusted analysis, emergency caesarean section did not affect the risk of asthma (odds ratio = 0.67 (95% confidence interval: 0.38-1.17); p = 0.16). After adjusting for birth weight, gender, umbilical cord pH, Apgar score at 5 min. and neonatal respiratory morbidity, the risk of childhood asthma following emergency caesarean section remained unchanged. Emergency caesarean section was not associated with childhood asthma. none. not relevant.

  2. Safety of cesarean delivery through placental incision in patients with anterior placenta previa.

    Science.gov (United States)

    Hong, Deok-Ho; Kim, Eugene; Kyeong, Kyu-Sang; Hong, Seung Hwa; Jeong, Eun-Hwan

    2016-03-01

    To demonstrate the safety of fetal delivery through placental incision in a placenta previa pregnancy. We examined the medical records of 80 women with singleton pregnancy diagnosed with placenta previa who underwent cesarean section between May 2010 and May 2015 at the Department of Obstetrics and Gynecology, Chungbuk National University Hospital. Among the women with placenta previa, those who did not have the placenta in the uterine incision site gave birth via conventional uterine incision, while those with anterior placenta previa or had placenta attached to the uterine incision site gave birth via uterine incision plus placental incision. We compared the postoperative hemoglobin level and duration of hospital stay for the mother and newborn of the two groups. There was no difference between the placental incision group and non-incision group in terms of preoperative and postoperative hemoglobin change, the amount of blood transfusions required by the mother, newborns with 1-min or 5-min Apgar scores below 7 points or showing signs of acidosis on umbilical cord blood gas analysis result of pH below 7.20. Moreover, neonatal hemoglobin levels did not differ between the two groups. Fetal delivery through placental incision during cesarean section for placenta previa pregnancy does not negatively influence the prognosis of the mother or the newborn, and therefore, is considered a safe surgical technique.

  3. The effect of chorionicity and twin-to-twin delivery time interval on short-term outcome of the second twin.

    Science.gov (United States)

    Hjortø, Sofie; Nickelsen, Carsten; Petersen, Janne; Secher, Niels Jørgen

    2014-01-01

    To investigate the effect of chorionicity and twin-to-twin delivery time interval on short-term outcome in the second twin as well as to investigate the predictors of adverse outcome in both twins. Data included vaginally delivered twins (≥36 weeks) from Copenhagen University Hospitals (2001-2009). The association between delivery interval and adverse outcome parameters was compared for monochorionic (MC) and dichorionic (DC) twins by multiple linear regression. Predictors were studied by logistic regression. There were 554 twin pairs, of which 57 were MC and 485 DC. We found no difference in the decrease of pH (p = 0.912) and Apgar (p = 0.609) in relation to increasing time interval. Neonatal unit (NICU) admissions did not differ (p = 0.167). Apgar ≤7 (p < 0.001) and pH ≤ 7.20 (p = 0.002) increased first twin risk of NICU admission, whereas first (p = 0.001) or second (p < 0.001) twin Apgar ≤7 and second twin pH ≤7.00 (p = 0.003) increased second twin risk of NICU admission. Increasing delivery interval was associated with a significant decrease in pH and Apgar, but there was no difference between MC and DC twins. Low Apgar of the first twin increased the risk of second twin NICU admission.

  4. Premedication with midazolam prior to cesarean delivery in preeclamptic parturients: A randomized controlled trial.

    Science.gov (United States)

    Mokhtar, Ali M; Elsakka, Ahmed I; Ali, Hassan M

    2016-01-01

    Anxiety is a concern in obstetrics, especially in preeclamptic mothers. Sedation is not commonly used in parturients for fear of adverse neonatal effect. We investigated maternal and neonatal outcome of midazolam as an adjuvant to spinal anesthesia for elective cesarean delivery. A prospective randomized controlled trial, in which eighty preeclamptic parturients received either an intravenous dose of 0.035 mg/kg of midazolam or an equal volume of normal saline, 30 min before spinal anesthesia. Maternal anxiety was assessed using Amsterdam Preoperative Anxiety and Information Scale (APAIS); postoperative maternal satisfaction was assessed using Maternal Satisfaction Scale for Cesarean Section (MSSCS). Newborns were assessed using Apgar score, Neonatal Neurologic and Adaptive Capacity Score (NACS), and umbilical artery blood gases. Mothers premedicated with midazolam showed a lower level of preoperative anxiety and a higher degree of postoperative satisfaction than the control group. There were no between-group differences regarding the neonatal outcome. Preeclamptic parturients premedicated with midazolam (0.035 mg/kg) before spinal anesthesia have lower anxiety and higher postoperative satisfaction levels, with no adverse effects on the newborns.

  5. Premedication with midazolam prior to cesarean delivery in preeclamptic parturients: A randomized controlled trial

    Science.gov (United States)

    Mokhtar, Ali M.; Elsakka, Ahmed I.; Ali, Hassan M.

    2016-01-01

    Background: Anxiety is a concern in obstetrics, especially in preeclamptic mothers. Sedation is not commonly used in parturients for fear of adverse neonatal effect. We investigated maternal and neonatal outcome of midazolam as an adjuvant to spinal anesthesia for elective cesarean delivery. Methods: A prospective randomized controlled trial, in which eighty preeclamptic parturients received either an intravenous dose of 0.035 mg/kg of midazolam or an equal volume of normal saline, 30 min before spinal anesthesia. Maternal anxiety was assessed using Amsterdam Preoperative Anxiety and Information Scale (APAIS); postoperative maternal satisfaction was assessed using Maternal Satisfaction Scale for Cesarean Section (MSSCS). Newborns were assessed using Apgar score, Neonatal Neurologic and Adaptive Capacity Score (NACS), and umbilical artery blood gases. Results: Mothers premedicated with midazolam showed a lower level of preoperative anxiety and a higher degree of postoperative satisfaction than the control group. There were no between-group differences regarding the neonatal outcome. Conclusion: Preeclamptic parturients premedicated with midazolam (0.035 mg/kg) before spinal anesthesia have lower anxiety and higher postoperative satisfaction levels, with no adverse effects on the newborns. PMID:27746564

  6. Comparable risk of childhood asthma after vaginal delivery and emergency caesarean section

    DEFF Research Database (Denmark)

    Brix, Nis; Stokholm, Lonny; Jonsdottir, Fjola

    2017-01-01

    ) was not. In 11 pairs, both twins developed asthma. In the unadjusted analysis, emergency caesarean section did not affect the risk of asthma (odds ratio = 0.67 (95% confidence interval: 0.38-1.17); p = 0.16). After adjusting for birth weight, gender, umbilical cord pH, Apgar score at 5 min. and neonatal...

  7. Impending macrosomia: will induction of labour modify the risk of caesarean delivery?

    Science.gov (United States)

    Cheng, YW; Sparks, TN; Laros, RK; Nicholson, JM; Caughey, AB

    2012-01-01

    Objective To compare the annual incidence rates of caesarean delivery between induction of labour and expectant management in the setting of macrosomia. Design This is a retrospective cohort study. Setting Deliveries in the USA in 2003. Population Singleton births of macrosomic neonates to low-risk nulliparous women at 39 weeks of gestation and beyond. Methods Women who had induction of labour at 39 weeks of gestation with a neonatal birthweight of 4000 ± 125 g (3875–4125 g) were compared with women who delivered (either induced or spontaneous labour) at 40, 41 or 42 weeks (i.e. expectant management), assuming an intrauterine fetal weight gain of 200 g per additional week of gestation. Similar comparisons were made at 40 and 41 weeks of gestation. Chi-square test and multivariable logistic regression analysis were used for statistical comparison. Main outcome measures Method of delivery, 5-minute Apgar scores, neonatal injury. Results There were 132 112 women meeting the study criteria. In women whose labours were induced at 39 weeks and who delivered a neonate with a birthweight of 4000 ± 125 g, the frequency of caesarean was lower compared with women who delivered at a later gestational age (35.2% versus 40.9%; adjusted OR 1.25, 95% CI 1.17–1.33). This trend was maintained at both 40 weeks (36.1% versus 42.6%; adjusted OR 1.31, 95% CI 1.23–1.40) and 41 weeks (38.9% versus 41.8%; adjusted OR 1.16, 95% CI 1.06–1.28) of gestation. Conclusions In the setting of known birthweight, it appears that induction of labour may reduce the risk of caesarean delivery. Future research should concentrate on clinical and radiological methods to better estimate birthweight to facilitate improved clinical care. These findings deserve examination in a large, prospective, randomised trial. PMID:22251443

  8. Maternal and neonatal factors associated with mode of delivery under a universal newborn hearing screening programme in Lagos, Nigeria

    Directory of Open Access Journals (Sweden)

    Solanke Olumuyiwa A

    2009-09-01

    Full Text Available Abstract Background Emerging evidence from a recent pilot universal newborn hearing screening (UNHS programme suggests that the burden of obstetric complications associated with mode of delivery is not limited to maternal and perinatal mortality but may also include outcomes that undermine optimal early childhood development of the surviving newborns. However, the potential pathways for this association have not been reported particularly in the context of a resource-poor setting. This study therefore set out to establish the pattern of delivery and the associated neonatal outcomes under a UNHS programme. Methods A cross-sectional study in which all consenting mothers who delivered in an inner-city tertiary maternity hospital in Lagos, Nigeria from May 2005 to December 2007 were enrolled during the UNHS programme. Socio-demographic, obstetric and neonatal factors independently associated with vaginal, elective and emergency caesarean deliveries were determined using multinomial logistic regression analyses. Results Of the 4615 mothers enrolled, 2584 (56.0% deliveries were vaginal, 1590 (34.4% emergency caesarean and 441 (9.6% elective caesarean section. Maternal age, parity, social class and all obstetric factors including lack of antenatal care, maternal HIV and multiple gestations were associated with increased risk of emergency caesarean delivery compared with vaginal delivery. Only parity, lack of antenatal care and prolonged/obstructed labour were associated with increased risk of emergency compared with elective caesarean delivery. Infants delivered by vaginal method or by emergency caesarean section were more likely to be associated with the risk of sensorineural hearing loss but less likely to be associated with hyperbilirubinaemia compared with infants delivered by elective caesarean section. Emergency caesarean delivery was also associated with male gender, low five-minute Apgar scores and admission into special care baby unit compared

  9. Maternal and neonatal factors associated with mode of delivery under a universal newborn hearing screening programme in Lagos, Nigeria

    Science.gov (United States)

    Olusanya, Bolajoko O; Solanke, Olumuyiwa A

    2009-01-01

    Background Emerging evidence from a recent pilot universal newborn hearing screening (UNHS) programme suggests that the burden of obstetric complications associated with mode of delivery is not limited to maternal and perinatal mortality but may also include outcomes that undermine optimal early childhood development of the surviving newborns. However, the potential pathways for this association have not been reported particularly in the context of a resource-poor setting. This study therefore set out to establish the pattern of delivery and the associated neonatal outcomes under a UNHS programme. Methods A cross-sectional study in which all consenting mothers who delivered in an inner-city tertiary maternity hospital in Lagos, Nigeria from May 2005 to December 2007 were enrolled during the UNHS programme. Socio-demographic, obstetric and neonatal factors independently associated with vaginal, elective and emergency caesarean deliveries were determined using multinomial logistic regression analyses. Results Of the 4615 mothers enrolled, 2584 (56.0%) deliveries were vaginal, 1590 (34.4%) emergency caesarean and 441 (9.6%) elective caesarean section. Maternal age, parity, social class and all obstetric factors including lack of antenatal care, maternal HIV and multiple gestations were associated with increased risk of emergency caesarean delivery compared with vaginal delivery. Only parity, lack of antenatal care and prolonged/obstructed labour were associated with increased risk of emergency compared with elective caesarean delivery. Infants delivered by vaginal method or by emergency caesarean section were more likely to be associated with the risk of sensorineural hearing loss but less likely to be associated with hyperbilirubinaemia compared with infants delivered by elective caesarean section. Emergency caesarean delivery was also associated with male gender, low five-minute Apgar scores and admission into special care baby unit compared with vaginal or elective

  10. Apgar bajo al nacer y convulsiones neonatales. Desarrollo motor grueso en el primer año de vida

    Directory of Open Access Journals (Sweden)

    Juan Gabriel Ruiz

    2006-03-01

    Full Text Available Objetivo: Determinar si haber tenido un Apgar bajo a los cinco minutos y/o convulsiones neonatales aumenta el riesgo de trastornos del desarrollo motor grueso, que se identifican como resultado anormal de Infanib al año de edad. Diseño: Cohorte histórica. Escenario: Programa de seguimiento de recién nacidos de riesgo en un hospital de nivel 1 de complejidad, con una población de estrato socioeconómico bajo de Cali entre 1989 y 1997. Población: Se incluyeron 287 lactantes que completaron un año de seguimiento en el programa. Intervenciones: No aplica. Desenlaces principales: Frecuencia de compromiso neuromotor estimado mediante la prueba de Infanib. Resultados: Al año se evaluaron 80% de los niños que eran parte del programa. En 39 (13.6% hubo un Apgar anormal a los 5 minutos. En 36 (12.5% presentaron convulsiones neonatales, asociadas principalmente con asfixia perinatal severa e hipoglicemia. La prueba de Infanib fue anormal en 47 niños para una incidencia acumulada de 16.4% y una densidad de incidencia de 1.3 casos nuevos por 100 lactantes-año. La presencia de convulsiones se asoció con un Infanib anormal (RR crudo = 2.39 IC 95% 1.37-4.16. No hay modificación de efecto entre Apgar bajo y convulsiones. De los potenciales modificadores de efecto sólo el antecedente de meningitis bacteriana confundió el estimativo de la asociación entre convulsiones y un Infanib anormal. Conclusiones: Tanto las convulsiones neonatales como la meningitis bacteriana se asociaron independientemente con un Infanib anormal al año. Las convulsiones son un factor de riesgo importante (RR ajustado = 2.51 IC 95% 1.10-5.72 y fácil de reconocer que permite al clínico identificar pacientes con alto riesgo de compromiso neuromotor durante el primer año de vida.

  11. Apgar bajo al nacer y convulsiones neonatales. Desarrollo motor grueso en el primer año de vida.

    Directory of Open Access Journals (Sweden)

    Carlos Armando Echandía

    2009-11-01

    Full Text Available Objetivo: Determinar si haber tenido un Apgar bajo a los cinco minutos y/o convulsiones neonatales aumenta el riesgo de trastornos del desarrollo motor grueso, que se identifican como resultado anormal de Infanib al año de edad. Diseño: Cohorte histórica. Escenario: Programa de seguimiento de recién nacidos de riesgo en un hospital de nivel 1 de complejidad, con una población de estrato socioeconómico bajo de Cali entre 1989 y 1997. Población: Se incluyeron 287 lactantes que completaron un año de seguimiento en el programa. Intervenciones: No aplica. Desenlaces principales: Frecuencia de compromiso neuromotor estimado mediante la prueba de Infanib. Resultados: Al año se evaluaron 80% de los niños que eran parte del programa. En 39 (13.6% hubo un Apgar anormal a los 5 minutos. En 36 (12.5% presentaron convulsiones neonatales, asociadas principalmente con asfixia perinatal severa e hipoglicemia. La prueba de Infanib fue anormal en 47 niños para una incidencia acumulada de 16.4% y una densidad de incidencia de 1.3 casos nuevos por 100 lactantes-año. La presencia de convulsiones se asoció con un Infanib anormal (RR crudo = 2.39 IC 95% 1.37-4.16. No hay modificación de efecto entre Apgar bajo y convulsiones. De los potenciales modificadores de efecto sólo el antecedente de meningitis bacteriana confundió el estimativo de la asociación entre convulsiones y un Infanib anormal. Conclusiones: Tanto las convulsiones neonatales como la meningitis bacteriana se asociaron independientemente con un Infanib anormal al año. Las convulsiones son un factor de riesgo importante (RR ajustado = 2.51 IC 95% 1.10-5.72 y fácil de reconocer que permite al clínico identificar pacientes con alto riesgo de compromiso neuromotor durante el primer año de vida.

  12. The effect of chorionicity and twin-to-twin delivery time interval on short-term outcome of the second twin

    DEFF Research Database (Denmark)

    Hjortø, Sofie; Nickelsen, Carsten; Petersen, Janne;

    2013-01-01

    Abstract Objectives: To investigate the effect of chorionicity and twin-to-twin delivery time interval on short-term outcome in the second twin. Additionally, to investigate predictors of adverse outcome in both twins. Methods: Data included vaginally delivered twins (≥ 36 weeks) from Copenhagen...... University Hospitals (2001-09). The association between delivery interval and adverse outcome parameters were compared for monochorionic (MC) and dichorionic (DC) twins by multiple linear regression. Predictors were studied by logistic regression. Results: There were 554 twin pairs: 57 MC and 485 DC. We...... found no difference in the decrease of pH (p = 0.912) and Apgar (p = 0.609) in relation to increasing time interval. Neonatal unit (NICU) admissions did not differ (p = 0.167). Apgar ≤ 7 (p twin, whereas first (p = 0.001) or second (p twin Apgar...

  13. Evaluation of selected reasons and analysis of the course of delivery accompanied by a partner

    Directory of Open Access Journals (Sweden)

    Beata Bąk

    2014-09-01

    Full Text Available Introduction : The popularity of family deliveries has been increasing for several years, so it is reasonable to make an evaluation of the factors that influence decisions on choosing this type of delivery as well as an evaluation of the effects of such a decision. Aim of the research : The aim of the research was to define how the age of a woman in labour, her marital status, residence, her and her partner’s education, financial situation, parity, and participation in classes at a childbirth school can affect a decision on having a family delivery. The research also defined the objective indices of the birth-giving process: the method of its completion, the performance of episiotomy, application of painkillers, and the condition of the newborn. The quality of the completed labour was evaluated in the subjective opinions of young mothers. Material and methods: By means of a survey and analysis of medical documentation, 80 women giving birth in the company of their partners were compared with 80 women giving birth in the traditional way. Results : Place of residence, economic status, parity, education, and attendance of a childbirth school are strongly associated with the chosen form of childbirth. Episiotomy was performed more frequently in women who gave birth in the presence of their partners. Newborn babies received similar scores in the Apgar Scale. Painkillers were applied more often in family deliveries than in conventional ones. Conclusions : The main advantages of a family delivery include the feeling of higher self-esteem and safety, and the strengthening of ties between partners. The disadvantages included fear of worsened quality of sexual life.

  14. Prediction of labour and delivery by ascertaining the fetal head position with transabdominal ultrasound in pregnancies with prelabour rupture of membranes after 37 weeks.

    Science.gov (United States)

    Eggebø, T M; Heien, C; Okland, I; Gjessing, L K; Smedvig, E; Romundstad, P; Salvesen, K A

    2008-04-01

    To evaluate the proportion of fetal head rotation from occiput posterior (OP) to occiput anterior (OA) during labour after term prelabour rupture of membranes (PROM), and to study if OP before labour are associated with a higher risk of operative deliveries and a longer duration of labour. A transabdominal ultrasound examination was performed in 152 women with PROM after 37 weeks with a single live fetus in cephalic position. The course of labour was compared in women with the fetal head in occiput posterior position or other positions before the start of labour. Before the start of labour, 40 (26%) fetuses were in occiput posterior position (OP), but 34 (85%) of them rotated to occiput anterior (OA) during labour. Ten (6.6%) fetuses were delivered in OP, and six of them were in OP before the start of labour. There were no statistically significant associations between the head position before the start of labour and the duration from PROM to delivery, induction of labour, use of epidural analgesia, augmentation with oxytocin, operative deliveries, perineal tears, Apgar scores, pH or base excess in the umbilical artery. Transabdominal ultrasound examination can determine the fetal head position before the start of labour, but the position of the head did not predict the course of labour, probably because the fetal head may rotate during labour even after PROM.

  15. Score Correlation

    OpenAIRE

    Fabián, Z. (Zdeněk)

    2010-01-01

    In this paper, we study a distribution-dependent correlation coefficient based on the concept of scalar score. This new measure of association of continuous random variables is compared by means of simulation experiments with the Pearson, Kendall and Spearman correlation coefficients.

  16. Breech deliveries in the Cantonal Hospital Zenica in the five-yearperiod(1999-2003

    Directory of Open Access Journals (Sweden)

    H. Karahasan,

    2005-02-01

    Full Text Available In this retrospective study we analysed the influence of gestation age,parity and the way of a delivery completion on postpartum vitality of new born infants in breech deliveries of singleton fetal pregnancies and none-malformed fetuses in the five-yearperiod.Out of the total number of 13431 deliveries, 502 ofthem(3.7%were completed by breech delivery in the period from 1999 to 2003. Breech deliveries are classified according to gestation age,parity and the way of delivery completion. Each delivery is further classified in one of the three groups of postpartum vitality, according to the method of Virginia Apgar (regular Apgar, mild and heavy hypoxia. Out of 502 breech deliveries, 211 (42% were delivered vaginally, and 291 (58% in sectio Caesarean. 98 (19,5% new born babies were delivered in mild hypoxia, and 33 (6.6% in heavier hypoxia. All infants with heavier hypoxia, 24 of them (72.7%, were delivered vaginally. Preterm born infants made 78,8% of children who were born in heavy hypoxia. Analysis based on parity does not show any significant difference in postpartum vitality of new born infants. Sectio Caesarea participated in significantly better postpartum vitality of newborn childrenin particular gestational age and parity groups. It should be preferred at term breech deliveries of the primiparas, and preterm breech deliveries of 33-37 weeks of gestational age regardless of parity.

  17. A late-preterm, early-term stratified analysis of neonatal outcomes by gestational age in placenta previa: defining the optimal timing for delivery.

    Science.gov (United States)

    Balayla, Jacques; Wo, Bi Lan; Bédard, Marie-Josée

    2015-01-01

    Though no official guidelines address the issue of the optimal timing of delivery in placenta previa, common practice is to conduct delivery between 36 and 37 weeks gestation. Given the rising concerns regarding unnecessary premature deliveries, the objective of this study was to compare neonatal outcomes among pregnancies complicated by placenta previa delivered at the late-preterm period (35, 36 weeks) relative to the early-term period (37 and 38 weeks). We conducted a retrospective, population-based, cohort study using the CDC’s Linked Birth-Infant Death data files from the U.S. for the year 2004. We stratified the cohort according to gestational age and placenta previa status. Using 38 weeks gestation as reference controls, the effect of delivery in a pregnancy with placenta previa at 35, 36 and 37 weeks gestation on the risk of several neonatal outcomes was estimated using logistic regression analysis, adjusting for relevant confounders. We analyzed a total of 4 118 956 births, of which 5675 (0.1%) met inclusion criteria. Late-preterm delivery was associated with lower birthweight and increased adequacy of care. Relative to neonates born at 38 weeks, birth at 35, 36 and 37 weeks was associated with no greater odds of meconium passage, fetal distress, fetal anemia, neonatal seizures, increased ventilator needs, or infant death at 1 year. However, odds of 5-min APGAR scores placenta previa is associated with fewer complications and no greater risk than late-preterm delivery. This information may be helpful in the development of future guidelines, which are currently needed to guide the management of these pregnancies.

  18. 不同分娩方式对孕产妇分娩结局及新生儿的影响%Different Mode of Delivery on Maternal Birth Outcomes and Neonatal

    Institute of Scientific and Technical Information of China (English)

    古丽巴哈尔·肉孜

    2012-01-01

      Objective:To discusse different modes of delivery on maternal birth outcomes and newborn.Method:Randomly selected hospital spontaneous onset of labor in patients 53 were in group A,and choose the outcome of induction of labor in patients with 43 known as the Group B and A,B group of patients with birth,time of delivery,mode of delivery,neonatal apgar scores were retrospectively select hospitalstudy. Result:Group A patients with spontaneous onset of labor to delivery time of less than group B patients,caesarean section less than group B,the probability of complications after childbirth lower than group B,neonatal Apgar score higher than the B group. Conclusion:Patients with natural childbirth delivery better,low probability of caesarean section rate and post-natal complications,neonatal good physical condition.%  目的:研究不同分娩方式对孕产妇分娩结局和新生儿的影响。方法:随机选择本院自然临产患者53例为A组,选择择期引产患者43例为B组,将A、B组分娩结局、分娩时间、分娩方式、新生儿阿氏评分等临床资料进行回顾性研究。结果:A组自然临产患者分娩时间少于B组,剖腹产率低于B组,分娩后并发症发生率低于B组,新生儿阿氏评分高于B组。结论:自然分娩患者分娩产时损伤较大,但剖腹产率和产后并发症发生率低,新生儿身体状况较好。

  19. 深圳地区新生儿Apgar评分1550例临床分析%Clinecal analysis on the Apgar score of newborns in 1550 cases

    Institute of Scientific and Technical Information of China (English)

    李晴

    2000-01-01

    @@ 1953年Virginia Apgar向医学界推出了Apgar评分,此方法简单、实用,有利新生儿窒息的诊断及估计预后,很快为医学临床所广泛接受,并成为指导治疗、抢救新生儿窒息的重要依据,至今仍处于无可替代的位置.本文将分析我院98年头5个月分娩的新生儿Apgar评分的情况,并对其相关因素,进行逐步回归分析,以期对影响Apgar评分的多重因素有一个具体认识,以便指导产科的临床工作,改善新生儿出生前后的条件,降低围产儿病率和围产儿死亡率.

  20. Delivery assistance in fetal macrosomia Assistência ao parto na macrossomia fetal

    Directory of Open Access Journals (Sweden)

    Renato Augusto Moreira de Sá

    2003-12-01

    Full Text Available OBJECTIVES: to evaluate delivery assistance in fetal macrosomia. METHODS: this was a hospital-based cohort study of consecutive births at a tertiary perinatal center from January 1, 1996 to October 31, 1999. A total of 5261 pregnancies met the inclusion criteria which were singleton pregnancies with minimal birth weight of 1000 g. Fetal macrosomia was defined as birth weight of 4000 g or more. We studied the mode of delivery, the newborn condition at birth, considered low when the Apgar scored below seven in the first or fifth minute, and the presence of abnormalities that could indicate a Caesarian section (disproportion, uterine dysfunction, prolonged second period of birth and fetal distress. RESULTS: 296 (5,6% of the babies were macrosomic. Macrosomia was a risk factor for Caesarian section (RR = 1,59, p OBJETIVOS: avaliar a assistência ao parto na macrossomia fetal. MÉTODOS: Estudo do tipo coorte realizado em centro perinatal terciário no período de 1 de janeiro de 1996 a 31 de outubro de 1999. Foram selecionadas 5261 gestações de acordo com os critérios de inclusão, que foram: gestação única e peso mínimo ao nascimento de 1000 g. A macrossomia fetal foi definida como peso ao nascimento acima de 4000 g. Estudamos a via de parto, as condições ao nascimento, Apgar baixo quando inferior a sete no primeiro e quinto minutos e as anormalidades que serviram de indicação para cesariana (desproporção, distocia uterina, segundo período prolongado e sofrimento fetal. RESULTADOS: 296 (5,6% dos conceptos eram macrossômicos. Macrossomia foi fator de risco para cesariana (RR = 1,59, p <0,001 e para parto operatório vaginal (RR = 1,12 p <0,001. As condições do recém-nascido não foram piores nos fetos macrossômicos. Houve correlação positiva entre macrossomia fetal e desproporção mas não para distocia uterina, prolongamento do segundo período ou sofrimento fetal. CONCLUSÕES: Houve maior número de indicações de cesariana

  1. PROMOTE Study: Safety of Osteopathic Manipulative Treatment During the Third Trimester by Labor and Delivery Outcomes.

    Science.gov (United States)

    Hensel, Kendi L; Roane, Brandy M; Chaphekar, Anita Vikas; Smith-Barbaro, Peggy

    2016-11-01

    Few quality data exist on the safety of osteopathic manipulative treatment (OMT) during pregnancy. The Pregnancy Research on Osteopathic Manipulation Optimizing Treatment Effects (PROMOTE) study was a randomized controlled clinical trial that studied the application of an OMT protocol to manage pain and dysfunction in pregnant patients during their third trimester. To evaluate the safety of an OMT protocol applied during the third trimester of pregnancy by analyzing incidence of high-risk status and labor and delivery outcomes. In the PROMOTE study, 400 pregnant patients were randomly assigned to 1 of 3 study groups: usual care plus OMT (OMT), usual care plus placebo ultrasound treatment (PUT), or usual care only (UCO). The incidence of high-risk status of participants and outcomes of labor and delivery, including length of labor, fever in mother during labor, operative vaginal delivery, conversion to cesarean delivery, need for forceps or vacuum device, need for episiotomy, incidence of perineal laceration, meconium-stained amniotic fluid, and infants' Apgar scores, were analyzed. Data from 380 participants were studied. High-risk status was less likely to develop in participants who received OMT (95% CI, 0.16-0.91; P=.03). The OMT protocol also did not increase risk of precipitous labor, operative vaginal delivery, conversion to cesarean delivery, need for forceps or vacuum device, need for episiotomy, incidence of perineal laceration, or meconium-stained amniotic fluid when compared with participants in the other 2 groups (P>.05). Of all other maternal outcomes examined, no difference was reported among the 3 treatment groups with the exception of incidence of prolonged labor in the OMT group. Participants receiving OMT had longer durations of labor than participants in the other groups (P=.002). These results suggest that the OMT protocol given during the third trimester of pregnancy as applied in the PROMOTE study is safe with regard to labor and delivery

  2. Morbidade neonatal e maternas relacionada ao tipo de parto Neonatal and maternal morbidity related to the type of delivery

    Directory of Open Access Journals (Sweden)

    Priscila Oliveira Cardoso

    2010-03-01

    Full Text Available Foi realizada uma análise da morbidade neonatal e materna e a mortalidade neonatal de acordo com o tipo de parto, cesariana ou vaginal. Foram estudadas prospectivamente 170 parturientes sem complicações gestacionais e com nascimento a termo: Grupo 1 (n = 95, puérpera com parto por via vaginal, Grupo 2 (n = 75, puérpera submetida à cesariana. Parâmetros maternos e fetais foram avaliados. Foi observada maior incidência de partos por via vaginal nas pacientes que estudaram até o ensino fundamental incompleto (p = 0,0045. Houve prevalência maior de partos prévios por via vaginal no Grupo 1 e de cesáreas no Grupo 2 (p An evaluation of infant morbimortality and mother morbidity was undertaken according to the type of delivery. A prospective study was undertaken on 170 puerperal patients divided into two groups: Group 1 (n = 95, natural or vaginal delivery, Group 2 (n = 75, submitted to caesarean delivery. Complications in mothers were classified in small, moderate and severe. The infant parameters were: period of pregnancy, weight on birth, Apgar score, necessity of intensive care and neurological disorders. Mothers who had not completed elementary school (p=0.0045 had more vaginal delivery. Previous vaginal deliveries were more common in Group 1 than caesarean section in Group 2 (p = < 0.001 (OR = 104.00; 21.11 < OR < 610.99. In Group 1, vaginal delivery was preferred by 78 (82,1% of mothers comparing to 28 (37.3% from Group 2, who preferred caesarean section (p = 0.0002 (OR = 4; 1.77 < OR < 9.17. Post-operative was more intense and frequent after caesarean section (8 cases than patients of Group 1 (2 cases (p = 0.018 (OR = 0.18; 0.03 < OR < 0.96. Obstetric trauma was found in 14 deliveries of Group 1 and 7 of Group 2 (p = 0.28. Infant hospitalization was greater in Group 2 (3.43 +/- 0.70 days in comparison with Group 1 (2.71 +/- 0.67 days (p < 0.0001. The infant morbidity was greater after vaginal deliveries, but maternal morbidity was

  3. The impact of introducing universal umbilical cord blood gas analysis and lactate measurement at delivery.

    Science.gov (United States)

    White, Christopher R H; Doherty, Dorota A; Newnham, John P; Pennell, Craig E

    2014-02-01

    There is growing support for umbilical cord blood gas analysis (UCBGA) to be conducted at delivery. A recent study in a tertiary level obstetric unit found that universal UCBGA was associated with improved perinatal outcomes, but there is less evidence of benefit in lower-risk environments. In such settings, lactate analysis may be a suitable alternative. This study evaluated the introduction of universal UCBGA into a secondary obstetric unit and universal umbilical cord lactate analysis program into primary and secondary units. After education, universal UCBGA or lactate analysis was introduced into one primary and two secondary level obstetric units. Univariate and adjusted analysis assessed changes in UCBGA values and Apgar scores over the study period. There were no significant changes in mean blood gas and lactate values at any centre following introduction of universal UCBGA or lactate analysis. However, there was at the primary level obstetric unit a significant reduction in the proportion of neonates with moderate to severe elevations in umbilical artery lactate values. There was a non-significant reduction in arterial pH values less than 7.10 at the secondary metropolitan centre. The data presented in this study suggest that the benefits of introducing UCBGA into a tertiary obstetric centre may be reproduced in a primary obstetric centre within 12 months of implementation. Larger studies are required in secondary units to assess infrequent adverse obstetric and neonatal outcomes. © 2013 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

  4. 自由体位分娩加分娩减痛法在初产顺产妇中的综合应用效果观察%Effect of comprehensive application of free position delivery and delivery analgesia method in primiparous and eutocia puerperants

    Institute of Scientific and Technical Information of China (English)

    王灿辉; 鞠丽红

    2013-01-01

    目的 探讨自由体位分娩加分娩减痛法在初产顺产妇中的综合应用效果.方法 选取2011年12月至2012年12月本院的180例初产顺产妇为研究对象,将其随机分为A组(自由体位分娩组)60例、B组(分娩减痛法组)60例和C组(自由体位分娩加分娩减痛法组)60例,将三组患者的三个产程、疼痛评分、出血量、转剖宫产率、产后不良情况发生率及新生儿Apgar评分进行比较.结果 C组的三个产程及总产程均短于A组及B组,疼痛评分优于A组及B组,出血量小于A组及B组,转剖宫产率及产后不良情况发生率均低于A组及B组,新生儿Apgar评分也优于A组及B组,其差异均有统计学意义(P均<0.05),而A组与B组之间的差异均无统计学意义(P均>0.05).结论 自由体位分娩加分娩减痛法在初产顺产妇中的综合应用效果相对较好,对于产妇及新生儿的影响均更为积极.%Objective To study the effect of comprehensive application of free position delivery and delivery analgesia method in primiparous and eutocia puerperants.Methods One hundred and eighty primiparous and eutocia puerperants in our hospital from December 2011 to December 2012 were selected as research subjects.The patients were randomly divided into group A (free position delivery group,60 cases),group B (delivery analgesia method group,60 cases),and group C (free position delivery and delivery analgesia method group,60 cases).Then the three stages of labor,pain score,blood loss,rate of cesarean section,rate of postpartum adverse situation,and neonatal Apgar score of the three groups were compared.Results The three stages of labor in group C were shorter than those of group A and group B; the pain score of group C was better than those of group A and group B; blood loss was less;rates of cesarean section and postpartum adverse situation were lower; neonatal Apgar score was better,all with statistically significant difference (P<0.05).The items of

  5. Effect of combined interventions on promoting natural delivery%联合干预措施对促进自然分娩作用的研究

    Institute of Scientific and Technical Information of China (English)

    田红霞; 陈丽丽; 王嵩川

    2014-01-01

    Objective To provide psychological and physiological knowledge for pregnant women by combined interventions with Doula accompany delivery, so as to establish confidence, shorten birth process, reduce cesarean section rate and promote and support natural childbirth.Methods Pregnant women admitted in Luoyang City Women and Children Health Care Center from January to March in 2012 were divided into two groups according to stochastic selective model.Control group (n=350) accepted conventional service model, while observation group (n=328) was given combined interventions including Doula accompany delivery, music and patient controlled epidural analgesia.The mode of delivery, blood loss 24h after delivery and neonatal Apgar score were observed.Results In the observation group, there were 264 cases of vaginal delivery (80.5%) and 64 cases of cesarean section (19.5%), while in the control group there were 194 cases of vaginal delivery (55.4%) and 156 cases of cesarean section (44.6%).The difference between two groups was statistically significant (χ2 =48.51,P0.05). No significant difference was found in neonatal Apgar score between two groups (χ2 =0.99, P>0.05).Conclusion Normal delivery rate is high with Doula accompany delivery.The combined intervention measures can promote natural delivery and improve service quality.%目的:通过导乐陪产联合干预措施为产妇提供心理和生理上的专业知识,使其树立自信,以利于缩短产程,降低剖宫产率,促进和支持自然分娩。方法按随机选择模式将2012年1至3月在洛阳市妇女儿童医疗保健中心住院分娩的产妇分为2组,对照组350例沿用常规产时服务模式,观察组328例实施导乐陪产、播放潜脑音乐、自控硬膜外镇痛等联合干预措施,观察2组的分娩方式、产后24小时出血及新生儿Apgar评分情况。结果观察组阴道分娩264例(80.5%),剖宫产64例(19.5%);对照组阴道分娩194例(55

  6. FACTORES QUE INFLUYEN EN EL APGAR BAJO AL NACER, EN EL HOSPITAL AMÉRICA ARIAS DE LA HABANA, CUBA, 2000

    OpenAIRE

    Laffita B.,Alfredo

    2005-01-01

    Objetivo: Identificar los factores perinatales y maternos que influyen en el Apgar bajo al nacer. Material y método: Análisis retrospectivo y descriptivo de algunos antecedentes clínicos en 87 neonatos con Apgar < 7 puntos al minuto y 5º minuto de vida. Resultados: Las patologías asociadas fueron: hipertensión arterial crónica 20%, asma bronquial 15% e infección urinaria 15%; 55% de las pacientes no presentaban patologías. De los recién nacidos: el 16,1% eran de pretérmino y 14,9% de postérmi...

  7. 无保护会阴接生法与会阴侧切术在分娩中的效果比较%Effect comparison of unprotected perineal delivery and lateral episiotomy in delivery

    Institute of Scientific and Technical Information of China (English)

    张建芬; 金蕾

    2015-01-01

    Objective To compare the clinical effect of unprotected perineal delivery and lateral episiotomy delivery. Methods 101 puerpera in our hospital from January 2014 to December 2014 were selected as research objects.All puerpera were given perineal delivery,and were divided into the lateral episiotomy group (39 puerpera) and the unpro-tected group (62 puerpera).The lateral episiotomy group was given perineal episiotomy and conventional perineal protec-tion delivery by supporting anus,the unprotected group was given unprotected perineal delivery.Time of the second stage of labor,Apgar scores,intrapartum hemorrhage,degree of pain and swelling of perineal wound,recovery of perineal wound in two groups was compared. Results There was no significant difference in time of the second stage of labor, Apgar score,intrapartum hemorrhage between two groups (P>0.05).Degree of pain and swelling of perineal wound in the first day in the unprotected group was lower than that in the lateral episiotomy group,with significant difference (P<0.05).The perineal wound healing in the unprotected group was better than that in the lateral episiotomy group,with significant difference(P<0.05). Conclusion Unprotected perineal delivery does not increase the time of the second stage of labor,has no adverse effects on neonatal outcome,which can alleviate the degree of pain and swelling of perineal wound,and has fast recovery time,it is worthy of clinical promotion and application.%目的:比较无保护会阴接生法与会阴侧切接生法的临床效果。方法选取2014年1~12月本院收治的101例产妇作为研究对象,所有产妇均为阴道分娩。将其随机分为侧切组(39例)和无保护组(62例)。侧切组采用会阴侧切传统托肛会阴保护接生法,无保护组采用无保护会阴接生法。比较两组的第二产程时间、Apgar评分、产时出血量、会阴伤口疼痛肿胀程度、会阴伤口愈合情况。结果两组的第二产程时间、Apgar

  8. A cohort study of maternal and neonatal morbidity in relation to use of sequential instruments at operative vaginal delivery.

    LENUS (Irish Health Repository)

    Murphy, Deirdre J

    2012-02-01

    OBJECTIVE: To evaluate the risk factors and maternal and neonatal morbidity associated with sequential use of instruments (vacuum and forceps) at operative vaginal delivery. STUDY DESIGN: A cohort study of 1360 nulliparous women delivered by a single instrument (vacuum or forceps) or by both instruments, within two university teaching hospitals in Scotland and England. Outcomes were compared for use of sequential instruments versus use of any single instrument. A sub-group analysis compared sequential instruments versus forceps alone. Outcomes of interest included anal sphincter tears, postpartum haemorrhage, urinary retention, urinary incontinence, prolonged hospital admission, neonatal trauma, low Apgar scores, abnormal cord bloods and admission to the neonatal intensive care unit (NICU). RESULTS: Use of sequential instruments at operative vaginal delivery was associated with fetal malpositions, Odds Ratio (OR) 1.8 (95% Confidence Interval (CI) 1.3-2.6), and large neonatal head circumference (>37 cm) (OR 5.0, 95% CI 2.6-9.7) but not with maternal obesity or grade of operator. Sequential use of instruments was associated with greater maternal and neonatal morbidity than single instrument use (anal sphincter tear 17.4% versus 8.4%, adjusted OR 2.1, 95% CI 1.2-3.3; umbilical artery pH <7.10, 13.8% versus 5.0%, adjusted OR 3.3, 95% CI 1.7-6.2). Sequential instrument use had greater morbidity than single instrument use with forceps alone (anal sphincter tear OR 1.8, 95% CI 1.1-2.9; umbilical artery pH <7.10 OR 3.0, 95% CI 1.7-5.5). CONCLUSIONS: The use of sequential instruments significantly increases maternal and neonatal morbidity. Obstetricians need training in the appropriate selection and use of instruments with the aim of completing delivery safely with one instrument.

  9. Via de Parto e Resultados Perinatais em Gestantes Diabéticas Route of Delivery and Perinatal Outcomes of Diabetic Pregnant Women

    Directory of Open Access Journals (Sweden)

    Belmiro Gonçalves Pereira

    1999-10-01

    Full Text Available Objetivo: apresentar os resultados perinatais obtidos a partir da aplicação de um protocolo de assistência às gestantes diabéticas no Centro de Atenção Integral à Saúde da Mulher (CAISM da UNICAMP. Métodos: foram estudadas 90 gestantes diabéticas que iniciaram controle pré-natal na instituição e foram submetidas a este protocolo. Foram comparadas com dois grupos controles de 180 gestantes cada: um constituído por gestantes pareadas por idade e número de gestações (controle A e outro por gestantes aleatoriamente selecionadas (controle B. Nos três grupos foram avaliadas as seguintes variáveis: tipo de parto, indicações de cesárea, idade gestacional, índice de Apgar ao primeiro e quinto minuto de vida, peso e adequação de peso para idade gestacional, morbidade e mortalidade perinatal. Para a análise estatística utilizaram-se médias, desvio-padrão, os testes t de Student e do chi². Resultados: entre as gestantes diabéticas ocorreu maior incidência de cesáreas, recém-nascidos prematuros e grandes para a idade gestacional (GIG, assim como uma maior freqüência de patologias neonatais (hipoglicemia, hipocalcemia, hiperbilirrubinemia, desconforto respiratório e depressão neonatal. A incidência de Apgar Purpose: to present the perinatal outcomes resulting from the use of a protocol for assistance to diabetic pregnant women used at the Center for Integral Assistance to Women's Health (CAISM, of the University of Campinas. Methods: ninety diabetic pregnant women, who were assisted at the institution with this protocol, were compared with two control grups: the first consisted of 180 pregnant women with equal number of gestations and same age (control A and the second consisted of 180 randomly selected pregnant women (control B. The study variables were route of delivery, indication for cesarean section, gestational age, Apgar score at first and fifth minute, weight, adequacy of weight for gestational age and perinatal

  10. Laryngeal Mask Airway for Cesarean Delivery: A 5-Year Retrospective Cohort Study

    Science.gov (United States)

    Geng, Zhi-Yu; Wang, Dong-Xin

    2017-01-01

    Background: The laryngeal mask airway (LMA) is the most commonly used rescue airway in obstetric anesthesia. The aim of this retrospective cohort study was to evaluate the application of the LMA in parturients undergoing cesarean delivery (CD) for 5 years in our hospital. As a secondary objective, we investigated the incidence of airway-related complication in obstetric general anesthesia (GA). Methods: We collected electronic data for all obstetric patients who received GA for CD between January 2010 and December 2014 in Peking University First Hospital. Based on the different types of airway device, patients were divided into endotracheal intubation (ET) group and LMA group. The incidences of regurgitation and aspiration, as well as maternal and neonatal postoperative outcomes were compared between groups. Results: During the 5-year study, GA was performed in 192 cases, which accounted for 2.0% of all CDs. The main indications for GA were contraindication to neuraxial anesthesia or a failed block. Among these, ET tube was used in 124 cases (68.9%) and LMA in 56 cases (31.1%). The percentage of critical patients above the American Society of Anesthesiologists' Grade II was 24/124 in ET group and 4/56 in LMA group (P = 0.036). The emergent delivery rate was 63.7% for ET group and 37.5% for LMA group (P = 0.001). None of the patients had regurgitation or aspiration. There were no significant differences in terms of neonatal Apgar scores, maternal and neonatal postoperative outcomes between the two groups. Conclusions: Our results suggested that GA was mainly used for contraindication to neuraxial anesthesia or a failed block, and emergent CDs accounted for most cases. The second-generation LMA could be used for obstetric anesthesia, but correct position to achieve a good seal is the key to prevent reflux and aspiration. Whether they could replace the tracheal tube in routine practice needs further large prospective studies. PMID:28218212

  11. Colloid cohydration and variable rate phenylephrine infusion effectively prevents postspinal hypotension in elective Cesarean deliveries

    Directory of Open Access Journals (Sweden)

    Indu Sen

    2013-01-01

    Full Text Available Background: Prevention of post-spinal hypotension in obstetric patients can be accomplished using intravenous fluid expansion and prophylactic use of sympathomimetic drugs. The affect of combination of colloids and phenylephrine infusion on maternal hemodynamics has not been widely studied and there is no consensus about the dosage required and time of starting its administration. Materials and Methods: This prospective, randomized, double-blind study enrolled 90 healthy term parturients undergoing elective Cesarean delivery under lumbar subarachnoid block (0.5% hyperbaric bupivacaine 10 mg with fentanyl 25 μg. Patients in Group A received prophylactic intravenous phenylephrine infusion (60 μg/minute along with hydroxyl-ethyl-starch cohydration (6% HES 130/0.42;15 ml/kg immediately after subarachnoid block. In Group B, patients received 6% HES cohydration and intermittent intravenous 50 μg boluses of phenylephrine. The efficacy of these in maintaining maternal SBP at 90-110% of baseline and neonatal well-being was evaluated. Results: In Group B, 75.5% of patients required rescue phenylephrine boluses to maintain SBP while maternal hemodynamics were well maintained in Group A and rescue drug was not needed. Reactive hypertension occurred in one patient (2.2% and bradycardia in two patients (4.4% in Group A. Six patients complained of nausea in Group B (13.3% compared to one in Group A. All the newborns had normal Apgar scores and Umbilical arterial pH > 7.2. Conclusion: A combination of colloid cohydration and prophylactic phenylephrine infusion initiated at 60 μg/minute maintained maternal hemodynamics and neonatal well-being during Cesarean deliveries requiring minimum interventions by the anesthesiologist.

  12. The effects of anemia in pregnancy on the mode of delivery and newborn

    Directory of Open Access Journals (Sweden)

    Necmi Arslan

    2014-03-01

    Full Text Available Objective: The aim of this study is to evaluate the effects of anemia in pregnancy on the mode of delivery and new-born. Methods: Between June and October 2009, 307 pregnant women were evaluated in terms of hemoglobin (Hb and hematocrit (Hct values, and delivery mode retrospectively. And also, the first and fifth minute Apgar scores, birth weight, and the values of Hb, Hct, and bilirubin, which obtained from the cord blood of neonates, were analyzed. Pregnant women were divided into two groups and classified as: hemoglobin value under 11.1 g / dl as anemic and the others as non-anemic group. In addition, the anemic group were divided into three group in terms of hemoglobin value, as follows: Group 1: 10.1 -11 mg/dl, group 2: 9.1 - 10 mg/dl, and group 3: <9 mg/dl. Results: In the study, 146 pregnants were anemic, while the 161 were non-anemic. The rate of low birth weight neonates was significantly higher in anemic pregnant women (p=0.029. The values of Hb (p=0.026 and Htc (p=0.006 were found to be lower in the anemic pregnant’ neonates. The incidence of low birth weight was significant increased when the maternal Hb value was smaller than 10g/dl (62.5% sensitivity, 74.7% specificity. Conclusion: It is observed that the low birth weight and the low values of Hb and Hct were more common in anemic pregnant neonates. Therefore, anemia should be screened and treated during the pregnancy due to the potential negative consequences.

  13. Comparision of mother-infant prognosis between analgesia and no analgesia delivery in birth process%产程中镇痛与无镇痛分娩的效果比较

    Institute of Scientific and Technical Information of China (English)

    王文革; 窦林彬; 高慧; 谢燕

    2013-01-01

    Objective To analuse the impace of analgesia delivery on mother - infant prognosis. Methods Take 200 puerperae of analgesic delivery during November 2010 to November 2011 as group A, and 200 puerperae of non analgesic delivery during November 2010 to November 2011 as group B. Compare the labor pain,contraaction situation,the progress of labor,mode of delivery and the newborn situation between these two groups. Results The labor pain of group A decreased obviously,and the contractions strength is decreased, and the first stage of labor of group A is shorter than group B obviously, and have no effect on Mother' s vital signs and neonatal apgar score. Conclusions Analgesic drug delivery can relief the labor pain, shorten stages of labor, decrease the rate of cesarean.%目的 分析、比较镇痛与无镇痛分娩对母婴的影响.方法 选择本院住院镇痛分娩200例产妇进行分析,同期分娩的非镇痛200例产妇作为对照.对两组产妇的疼痛程度、宫缩情况、产程进展、分娩方式、新生儿情况进行对比分析.结果 镇痛组产妇产痛VAS明显降低,宫缩强度降低,但第一产程明显短于对照组;镇痛分娩不影响产妇的生命体征及新生儿Apger评分.结论 药物镇痛分娩能明显缓解产痛,缩短产程,降低剖宫产率.

  14. Maternal and perinatal outcomes of delivery after a previous Cesarean section in Enugu, Southeast Nigeria: a prospective observational study.

    Science.gov (United States)

    Ugwu, George O; Iyoke, Chukwuemeka A; Onah, Hyacinth E; Egwuatu, Vincent E; Ezugwu, Frank O

    2014-01-01

    Obstetricians in developing countries appear generally reluctant to conduct vaginal delivery in women with a previous Cesarean because of lack of adequate facilities for optimal fetomaternal monitoring. To describe delivery outcomes among women with one previous Cesarean section at a tertiary hospital in Southeast Nigeria. This was a prospective observational study to determine maternal and perinatal outcomes of attempted vaginal birth after Cesarean sections (VBAC) following one previous Cesarean section. Analysis was done with SPSS statistical software version 17.0 for Windows using descriptive and inferential statistics at 95% level of confidence. Two thousand six hundred and ten women delivered in the center during the study period, of whom 395 had one previous Cesarean section. A total of 370 women with one previous Cesarean section had nonrecurrent indications, of whom 355 consenting pregnant women with one previous Cesarean section were studied. A majority of the women (320/355, 90.1%) preferred to have vaginal delivery despite the one previous Cesarean section. However, only approximately 54% (190/355) were found suitable for trial of VBAC, out of whom 50% (95/190 had successful VBAC. Ninety-five women (50.0%) had failed attempt at VBAC and were delivered by emergency Cesarean section while 35 women (9.8%) had emergency Cesarean section for other obstetric indications (apart from failed VBAC). There was no case of uterine rupture or neonatal and maternal deaths recorded in any group. Apgar scores of less than 7 in the first minute were significantly more frequent amongst women who had vaginal delivery when compared to those who had elective repeat Cesarean section (P=0.03). Most women who had one previous Cesarean delivery chose to undergo trial of VBAC, although only about half were considered suitable for VBAC. The maternal and fetal outcomes of trial of VBAC in selected women with one previous Cesarean delivery for non-recurrent indications were good

  15. 犯罪青少年家庭教养方式及家庭关怀度分析%Study on parental rearing styles and family APGAR in adolescent criminals

    Institute of Scientific and Technical Information of China (English)

    景璐石; 辜慧; 徐科; 冯军; 蒋宪君; 徐涛; 孟婧; 廖远霞

    2011-01-01

    Objective To analyze the differences of parental rearing styles and family APCAR between young criminals, and influencing factors of the parental rearing styles of young criminals. Methods Eighty criminals were randomly selected from a penitentiary of Chengdu as observation group, and 80 students were enrolled randomly from school as control group. The observation group matched the control group on the age, gender and region. They were all tested by Egma Minnen av Bardndosna Uppforstran( EMBU) , Family APGAK index and a questionnaire about the family made by the investigate themselves. Results The scores of emotional warmth and understanding in the paternal rearing styles were lower in the observation group than the control group( P <0.01). The scores of punishment and strictness, Excessive interference, Partialism, Refusal and denial in the paternal rearing styles were higher in the observation group than the control group( P <0.05 ,P <0.01) . The scores of family APGAR were lower in the observation group than the control group( P <0.01). The parental rearing styles had correction to the number of brothers and sisters, education level of parents, whether or not parents alive, whether or not parents divorced, residence and family APGAR. Conclusion The young criminals' family have serious family questions: lacking of emotional warmth and understanding and tendentiousness of extremeness. The defect is related to the disadvantage of family factors.%目的 分析犯罪青少年父母教养方式和家庭关怀度的特点,为从家庭因素层面预防青少年犯罪的发生提供依据.方法 以成都市某少管所80名学员作为观察组,抽取成都市 80名在校学生作为对照组,与观察组在性别、年龄、地区上相匹配.采用父母教养方式评价量表、家庭关怀度指数和自编的一般情况问卷进行问卷调查.结果 观察组母亲教养方式中情感温暖、理解得分低于对照组(P<0.01),父亲教养方式中惩罚

  16. Delivery presentations

    Science.gov (United States)

    ... passage will take place depends on how your baby is positioned during delivery. The best position for the baby to be ... possible, but labor will generally take longer. After delivery, the baby's face or brow will be swollen and may ...

  17. Correlation between the different fetal heart monitoring patterns and neonatal NABA score, Apgar score%不同胎心监护图型与新生儿NABA评分、Apgar评分的相关性研究

    Institute of Scientific and Technical Information of China (English)

    何娅娟; 张小欣; 张秀华

    2013-01-01

    目的 探讨不同胎心监护图型与新生儿NABA评分、Apgar评分的相关性.方法 选取2010年8月至2013年3月于本院进行胎心监护的351例孕妇为研究对象,将其中异常胎心监护图形发生率进行统计,并将不同新生儿NABA评分、Apgar评分者的异常胎心监护图形发生率进行统计及比较.结果 不同时间段的新生儿NABA评分异常者异常胎心监护图形发生率高于NABA评分正常者,Apgar评分重度窒息者异常胎心监护图形发生率高于轻度窒息及正常者,Apgar评分轻度窒息者发生率高于正常者,NABA评分、Apgar评分与胎心监护图型异常率有密切的相关性,其差异均具有统计学意义(P<0.05).结论 新生儿NABA评分、Apgar评分异常者的异常胎心监护图形发生率明显较高,胎心监护图形与新生儿NABA评分、Apgar评分密切相关.

  18. [Anaesthesia in abdominal delivery in pregnant patients with hypertension].

    Science.gov (United States)

    Tolmachev, G N; Volodin, A V; Marichik, N V; Nemirovskiĭ, V B; Pivovarova, G M; Shepetovskaia, N L; Gur'ianov, V A

    2010-01-01

    A differentiated administration of calcium antagonists in preoperative preparation of pregnant patients with hypertension enabled the conversion of circulatory system state to "normal pregnancy range": a conversion of hypokinetic (including the HES solution infusion) and hyperkinetic types of haemodynamics to eukinetic one, with the decrease of total peripheral resistance and myocardium need for oxygen, autonomous nervous system state to physiological sympathicotonia. Evidence shows that continued intra-operative treatment including tranexamic acid enables to maintain those results during the surgery. In postoperational period, the clinical manifestations of SIRS in patients who has received the mentioned therapy were marked less then in control group, and the newborns have a higher Apgar score.

  19. Percepción del funcionamiento familiar: Análisis psicométrico de la Escala APGAR-familiar en adolescentes de Lima

    Directory of Open Access Journals (Sweden)

    Humberto A. Castilla

    2014-06-01

    Full Text Available El artículo describe el análisis psicométrico de la Escala APGAR de Smilkstein (1978, integrada por 5 ítems de tipo likert con cinco alternativas, la cual evalúa la percepción del funcionamiento familiar (Gómez & Ponce, 2010. La escala se administró a 256 estudiantes varones de 11 a 18 años de edad de un colegio nacional de Lima. El análisis de correlación ítem-test encontró asociaciones altamente significativas (p<.001 para cada uno de los reactivos, indicando que los reactivos evalúan indicadores de un mismo constructo. La Escala APGAR para valorar la percepción del funcionamiento familiar presenta moderada consistencia interna (α de Cronbach=.788. La validez de constructo se estableció mediante análisis factorial obteniendo, por medio análisis de componentes principales y la rotación ortogonal (Varimax, un único factor.

  20. Does Time of Delivery Influence the Risk of Neonatal Morbidity?

    Science.gov (United States)

    Brookfield, Kathleen F; O'Malley, Katharine; El-Sayed, Yasser Y; Blumenfeld, Yair J; Butwick, Alexander J

    2016-04-01

    To examine whether time of delivery influences the risk of neonatal morbidity among women with singleton pregnancies. Secondary analysis of data from the Maternal Fetal Medicine Units Network Factor V Leiden Mutation study. We categorized time of delivery as day (07:00-16:59), evening (17:00-23:59), and overnight (midnight-06:59). Severe neonatal morbidity was defined by at least one of the following: respiratory distress syndrome, transient tachypnea of the newborn, sepsis, seizures, neonatal intensive care admission, or a 5-minute APGAR ≤3. We calculated frequencies of severe neonatal morbidity by time of delivery. Multivariate analysis was performed to determine whether time of delivery was independently associated with severe neonatal morbidity. Among 4,087 women, 1,917 (46.9%) delivered during the day, 1,140 (27.9%) delivered in the evening, and 1,030 (25.2%) delivered overnight. We observed no significant differences in the rates of neonatal morbidity between delivery time periods (day: 12.3%; evening: 12.8%; overnight: 12.6%; p = 0.9). No significant association was observed between time of delivery and neonatal morbidity after adjustment for maternal, obstetric, and peripartum factors. Our findings suggest that time of delivery is not associated with severe neonatal morbidity. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  1. Scar uterine pregnancy by mode of 268 cases of delivery%瘢痕子宫再次妊娠268例分娩方式分析

    Institute of Scientific and Technical Information of China (English)

    范春梅

    2011-01-01

    Objective To study the scar uterine pregnancies dilivery method, understand again the feasibility of vaginal commissioning.Methods 268 example scar uterine again pregnancy were retrospectively analyzed. Results 268 cases, 207 cases of cesarean section in pregnant women, 61 cases of vaginal trial production, trial production successfully in 37 cases, the success rate of 60.66%. Caesarean section compared with vaginal delivery, Apgar score were not significant ( P > 0.05 ), but the number of cases of maternal blood loss and bleeding were significantly increased, the difference was significant ( P < 0.05 ). Conclusion Scar uterine cesarean delivery is not absolute indications, as long as cases,selecting the appropriate closely monitoring can be transvaginal trial - produce delivery.%目的 探讨瘢痕子宫再次妊娠分娩方式,了解阴道试产的可行性.方法 对268例瘢痕子宫再次妊娠病例进行回顾性分析.结果 268例孕妇中有207例剖宫产,61例阴道试产,试产成功37例,成功率60.66%.剖宫产组与阴道分娩组比较,新生儿Apgar评分差异无显著性(P>0.05),但产妇术中出血例数和出血量均明显上升,差异具有显著性(P<0.05).结论 瘢痕子宫并非剖宫产绝对指征,只要病例选择适当,在严密监护下可经阴道试产分娩.

  2. The effect of a multidisciplinary obstetric emergency team training program, the In Time course, on diagnosis to delivery interval following umbilical cord prolapse - A retrospective cohort study.

    Science.gov (United States)

    Copson, Sean; Calvert, Katrina; Raman, Puvaneswary; Nathan, Elizabeth; Epee, Mathias

    2017-06-01

    Cord prolapse is an uncommon obstetric emergency, with potentially fatal consequences for the baby if prompt action is not taken. Simulation training provides a means by which uncommon emergencies can be practised, with the aim of improving teamwork and clinical outcomes. This study aimed to determine if the introduction of a simulation-based training course was associated with an improvement in the management of cord prolapse, in particular the diagnosis to delivery interval. We also aimed to investigate if an improvement in perinatal outcomes could be demonstrated. A retrospective cohort study was performed. All cases of cord prolapse in the designated time period were identified and reviewed and a comparison of outcome measures pre- and post-training was undertaken. Thirty-one cases were identified in the pre-training period, and compared to 64 cases post-training. Documentation improved significantly post-training. There were non-significant improvements in use of spinal anaesthetic, and in the length of stay in the special care neonatal unit. There was a significant increase in the number of babies with Apgar scores less than seven at 5 min. There were no differences in the diagnosis to delivery interval, or in perinatal mortality rates. Obstetric emergency training was associated with improved teamwork, as evidenced by the improved documentation post-training in this study, but not with improved diagnosis to delivery interval. Long-term follow-up studies are required to ascertain whether training has an impact on longer-term paediatric outcomes, such as cerebral palsy rates. © 2016 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

  3. Effects of Lamaze breathing less pain childbirth on delivery pain and pregnancy outcomes%拉玛泽呼吸减痛分娩法对产妇分娩疼痛及妊娠结局的影响

    Institute of Scientific and Technical Information of China (English)

    周香看

    2014-01-01

    Objective To investigate the effects of Lamaze breathing less pain childbirth on delivery pain and pregnancy outcomes.Methods From August 2012 to July 2013,400 delivery women were randomly divided into observation group and control group,with 200 cases in each group.The patients in observation group received prenatal learning of Lamaze childbirth,and the patients in control group received routine antenatal sexual health education.The labor pain,labor progress,delivery mode,Apgar score,postpartum hemorrhage,postpartum lactation,bloody lochia duration were compared.Results Compared with those before treatment,the SAS,SDS scores in observation group after intervention significantly decreased (P < 0.05),while there was no significant difference in SAS,SDS scores in control group before and after intervention (P > 0.05).There were significant differences in labor pain level,neonatal Apgar rating scale between the two groups (P < 0.05).The rate of cesarean section,postpartum hemorrhage was significantly lower than that of the control group,the first stage of labor,second stage of labor,total production process and bloody lochia duration was significantly lower than that of the control group,and postpartum lactation increased compared with the control group,the differences were significant(P < 0.05).Conclusions Prenatal Lamaze breathing less pain childbirth can effectively relieve the anxiety and delivery pain of delivery women,shorten the delivery time and reduce the rate of cesarean section.%目的 探讨拉玛泽呼吸减痛分娩法对产妇分娩疼痛及妊娠结局的影响.方法 选择2012年8月至2013年7月在本院产检并住院分娩的初产妇400例为研究对象,随机将产妇分为观察组及对照组,每组200例.观察组产前接受拉玛泽分娩法学习,对照组产前接受常规性健康教育.对比分析两组分娩疼痛程度、产程进展、分娩方式、Apgar评分、产后出血、产后泌乳量、

  4. Antiretroviral agents and acid-base balance at delivery of the neonate

    Directory of Open Access Journals (Sweden)

    P. El-Beitune

    2007-07-01

    Full Text Available Limited evidence is available regarding antiretroviral (ARV safety for uninfected infants exposed to these drugs in utero. Our objective was to determine if ARV administered to pregnant women is associated with decreasing umbilical arterial pH and base excess in uninfected infants. A prospective study was conducted on 57 neonates divided into three groups: ZDV group, born to mothers taking zidovudine (N = 20, triple therapy (TT group, born to mothers taking zidovudine + lamivudine + nelfinavir (N = 25, and control group (N = 12, born to uninfected mothers. Umbilical cord blood was used to determine umbilical artery gases. A test was performed to calculate the sample by comparing means by the unpaired one-tailed t-test, with a = 0.05 and ß = 20%, indicating the need for a sample of 18 newborn infants for the study groups to detect differences higher than 20%. The control and ARV groups were similar in gestational age, birth weight, and Apgar scores. Values of pH, pCO2, bicarbonate, and base excess in cord arterial blood obtained at delivery from the newborns exposed to TT were 7.23, 43.2 mmHg, 19.5 mEq/L, and -8.5 nmol/L, respectively, with no significant difference compared to the control and ZDV groups. We conclude that intrauterine exposure to ARV is not associated with a pathological decrease in umbilical arterial pH or base excess. While our data are reassuring, follow-up is still limited and needs to be continued into adulthood because of the possible potential for adverse effects of triple antiretroviral agents.

  5. 无保护会阴接生法与会阴侧切接生法临床效果比较%Comparison of the Effects of Unprotected Perineum Delivery Technique and Episiotomy Delivery Technique on the Clinic

    Institute of Scientific and Technical Information of China (English)

    李咏冰

    2014-01-01

    目的:比较传统的会阴侧切接生方法与无保护会阴接生法对分娩结局、会阴伤口的影响。方法传统的会阴侧切组81例产妇用右手托肛会阴保护接生方法,无保护会阴接生组184例产妇不用手扶持会阴的新接生方法。对比两组第二产程时间、新生儿情况、产后出血、会阴伤口疼痛肿胀程度、会阴伤口愈合情况。结果两组孕妇年龄、孕周、新生儿体重比较差异无统计学意义(P >0.05);两组产妇在第二产程时间、Apgar 评分、产后出血量的比较差异无统计学意义(P >0.05);两组产妇会阴疼痛肿胀程度比较差异有统计学意义(P <0.05);无保护会阴组产妇伤口愈合分期明显高于会阴侧切组,差异有统计学意义(P <0.05)。结论改良后的接生方法可降低会阴伤口疼痛肿胀程度,提高会阴伤口愈合分期,不增加第二产程时间及新生儿窒息。该方法操作简单、安全、有效,有益于保护孕产妇安全,减少会阴体损伤,值得临床推广使用。%Objective To compare the effect of unprotected perineum delivery technique and episiotomy delivery tech-nique on outcomes of delivery and the perineal wound. Methods A prospective follow-up study of 265 women with spontaneous vaginal delivery in thehospital from January to November 2013. These women were randomized into the unprotected perineum deliv-ery group(184)and the control group(81),that is routine episiotomy delivery technique group. The time of second stage of labor, newborns conditions,the blood loss,perineal pain and woundhealing stage in the two groups were compared. Results No signifi-cant difference among the pariae’s age,newborn weight,the second stage time,the scores of APCAR and the postpartum blood loss was found between groups. Women who delivered with unprotected perineum delivery techniquehad significantly lower perineal pain scores compared to women whohad an episiotomy technique

  6. Forceps Delivery

    Science.gov (United States)

    ... in place to control the advance of your baby's head. Forceps deliveries aren't always successful. If your health care ... com. Accessed June 12, 2015. You and your baby: Prenatal care, labor and delivery, and postpartum care. Washington, D.C.: The American ...

  7. Test Scoring [book review].

    Science.gov (United States)

    Meijer, Rob R.

    2003-01-01

    This book discusses how to obtain test scores and, in particular, how to obtain test scores from tests that consist of a combination of multiple choice and open-ended questions. The strength of the book is that scoring solutions are presented for a diversity of real world scoring problems. (SLD)

  8. Study on clinical application of Lamaza delivery method combined with spinal-epidural anesthesia analgesia for labor analgesia%拉玛泽分娩法联合腰硬联合阻滞分娩镇痛的临床应用研究

    Institute of Scientific and Technical Information of China (English)

    宁丰; 韦凤莲; 周霓

    2012-01-01

    Objective: To explore the clinical effect of Lamaza delivery method combined with spinal - epidural anesthesia analgesia for labor analgesia. Methods: A total of 400 primiparous women were selected and divided into group A ( Lamaza delivery method combined with spinal - epidural anesthesia analgesia) , group B ( Lamaza delivery method) , group C ( spinal - epidural anesthesia analgesia) , and group D ( Doula labor, control group) , 100 primiparous women in each group; the degrees of pain during delivery, stages of labor, delivery modes, indications of cesarean section, doses of oxytocin, amount of postpartum hemorrhage, neonatal Apgar scores in the four groups were observed. Results; Compared with the other three groups, the degree of pain during delivery in group A relieved significantly, the stages of labor shortened, the rate of spontaneous delivery increased, the rate of cesarean section decreased, the dose of oxytocin increased, there were statistically significant difference in the above - mentioned indexes (P 0. 05 ) . Conclusion: Lamaza delivery method combined with spinal -epidural anesthesia analgesia used for labor analgesia can effectively relieve labor pain, shorten stages of labor, increase the rate of spontaneous delivery, and reduce the rate of cesarean section, which doesnt affect the amount of postpartum hemorrhage and neonatal Apgar score, but it can increase the dose of oxytocin.%目的:探讨拉玛泽分娩法联合腰硬联合阻滞分娩镇痛在分娩中应用的临床效果.方法:选择400例初产妇,分为拉玛泽联合腰硬联合阻滞分娩镇痛组(A组)、拉玛泽组(B组)、腰硬联合阻滞分娩镇痛组(C组)和导乐陪伴组(对照组D组),每组100人,观察产妇产时疼痛程度、产程时间、分娩方式、剖宫产指征、缩宫素使用、产后出血、新生儿Apgar评分等.结果:A组产妇与其他3组比较,产时疼痛程度明显减轻,产程时间缩短,自然分娩率上升,剖宫产率下降,缩宫素

  9. ED50 and ED95 of Intrathecal Bupivacaine Coadministered with Sufentanil for Cesarean Delivery Under Combined Spinal-epidural in Severely Preeclamptic Patients

    Institute of Scientific and Technical Information of China (English)

    Fei Xiao; Wen-Ping Xu; Xiao-Min Zhang; Yin-Fa Zhang; Li-Zhong Wang; Xin-Zhong Chen

    2015-01-01

    ' Apgar score and the blood gas analysis of umbilical artery serum (P > 0.05).Conclusion:Our study showed that the ED50 and ED95 of intrathecal bupivacaine for severely preeclamptic patients undergoing elective cesarean delivery were 5.67 mg and 8.82 mg,respectively.In addition,decreasing the dose of intrathecal bupivacaine could reduce the incidence of maternal hypotension.

  10. 雷米芬太尼用于静脉自控分娩镇痛的模式和剂量%Mode and dosage of patient-controlled intravenous labor analgesia with remifentanil during natural delivery

    Institute of Scientific and Technical Information of China (English)

    沈明坤; 朱爱兵; 许建娟

    2011-01-01

    目的 探讨结合导乐分娩产妇的雷米芬太尼自控静脉分娩镇痛模式和剂量.方法 60例自然分娩初产妇随机均分成三组:A组用雷米芬太尼单次剂量0.25 μg/kg,锁定时间3min行静脉自控镇痛(PCIA);B组加用背景剂量0.025μg·kg-1·min-1;C组常规产科镇痛.比较三组产妇的镇静、镇痛效果、分娩过程和新生儿Apgar评分.结果 B组产妇的镇静、镇痛效果最好.B组VAS评分明显低于A、C组[(3.4±0.9)分vs.(6.4±1.0)分、(8.2±1.5)分.B组I度呼吸抑制发生率与A组相仿(12.7%vs.10.2%)(P>0.05).三组产妇的宫缩、胎心监测结果、新生儿Apgar评分、产程时间、出血量、催产素使用率、器械助产率和剖宫产率等指标均无明显差异.结论 在导乐分娩的同时,用雷米芬太尼0.025μg·kg-1 ·min-1背景输注复合PCA雷米芬太尼0.25μg/kg是较理想的PCIA分娩镇痛模式.%Objective To discuss the mode and dosage of patient-controlled intravenous labor analgesia with remifentanil during natural delivery. Methods Sixty natural childbirth primiparas were randomly divided into 3 groups with 20 cases each. At the same time of doula delivery, PCIA in group A was performed with a single dose of remifentanil 0. 25μg/kg and lockout period of 3 min. The patients in group B were given additional infusion of remifentanil 0.025 μg · kg-1 · min-1. The patients in group C were treated in a conventional way of analgesia. The indexes of sedation and analgesia,labor course and Apgar score of neonatus were compared. Results The effects of sedation and analgesia of group B were the best among three groups. Visual analogue score(VAS) was (3. 4±0. 9) points in group B, which was significantly lower than (6. 4±1. 0) points of group A or (8. 2±1. 5) points of groupC(P0. 05). There were no significant differences in the indexes of uterine contraction, fetal heart rate, Apgar score of neonates.the time of each delivery paragraph,blood loss

  11. Effect of Empathy Care on Psychological State and Delivery Outcomes on Primipara%同感心护理对初产妇心理状况及分娩结局的影响

    Institute of Scientific and Technical Information of China (English)

    郑惠容; 成金焕; 张金云; 邓海燕; 林洁容; 罗思媚

    2016-01-01

    目的:探讨同感心护理对初产妇的心理健康状况及分娩结局的影响。方法:将150例初产妇随机分为观察组75例和对照组75例。对观察组实施同感心护理,对照组实行传统护理。采用90项症状清单(SCL -90)评估心理健康状况。比较2组的心理健康状况和分娩结局(包括分娩方式、总产程时间、产后2 h 出血量及新生儿1min Ap-gar 评分)。结果:①观察组抑郁、焦虑因子分低于对照组(t =-2.127、-2.116,P <0.05);②观察组阴道分娩率高于对照组(χ2=72.516,P <0.05);观察组的总产程时间短于对照组(t =-2.454,P <0.05)。结论:同感心护理有利于减轻分娩初产妇的负性情绪,在一定程度上改善分娩结局。%Objective To explore the effect of empathy care on psychological state and delivery outcomes on primipa-ra. Method 150 primiparas were randomly divided into two groups:observation group 75 casesand control group 75 cases. the observation group received empathy care,and the control group received the routine nursing care. All subjects were evaluated by Symptom Checklist 90(SCL - 90)and delivery outcomes(including delivery route,total delivery time,postpartum hemorrhage and Apgar score). Results ①The scores of depressive,and anxiety factors in the observation group were lawer than that in the control group( t = - 2. 127、- 2. 116,P < 0. 05);②The rate of natural childbearing in the observation group was higher than that in the control group(χ2 = 72. 516,P < 0. 05);The total delivery time was shorter in the observation group than that in the control group(t = - 2. 454,P < 0. 05). Conclusion Empathy care may help release the negative emotions on primipara,to some extent,and improve delivery outcomes.

  12. Diagnóstico pré-natal e parto transpelviano na osteogênese imperfeita: relato de caso Prenatal diagnosis and vaginal delivery in osteogenesis imperfecta: a case report

    Directory of Open Access Journals (Sweden)

    Alex Sandro Rolland de Souza

    2006-04-01

    had 6 and 8 in Apgar scores. The neonate was clearly abnormal, presenting irregular cranial shape, with poor ossification on X-ray, blue sclera, fractures and limb deformities. Postnatal evaluation was satisfactory and the neonate was discharged in good conditions. Prenatal diagnosis is important for an adequate pregnancy follow-up. Postnatal outcome was not related to vaginal delivery, as there were no recent fractures in the newborn.

  13. Subgroup Balancing Propensity Score

    OpenAIRE

    DONG, JING; Zhang, Junni L; Li, Fan

    2017-01-01

    We investigate the estimation of subgroup treatment effects with observational data. Existing propensity score matching and weighting methods are mostly developed for estimating overall treatment effect. Although the true propensity score should balance covariates for the subgroup populations, the estimated propensity score may not balance covariates for the subgroup samples. We propose the subgroup balancing propensity score (SBPS) method, which selects, for each subgroup, to use either the ...

  14. Analysis Clinical Value of Different Delivery Methods on Maternal and Fetal%不同的分娩方式对母体和胎儿的临床价值分析

    Institute of Scientific and Technical Information of China (English)

    刘玉宏

    2016-01-01

    Objective To study the effects of different delivery methods on maternal and fetal.Methods 90 parturient women were divided into natural delivery group and the cesarean section group,Natural delivery group, the implementation of vaginal natural childbirth,cesarean section maternal implementation of cesarean section,record the situation of postpartum maternal and newborn.Results Maternal blood pressure, maternal postpartum hemorrhage, neonatal Apgar scores were better than the cesarean section, the two groups of fetal distress no difference. Conclusion Natural childbirth way higher value of application of the maternal and fetal childbirth, if it occurred during childbirth cesarean section surgery is needed.%目的:研究不同分娩方式对母体和胎儿的影响。方法将90例临产产妇分为自然分娩组和剖宫产组,自然分娩组产妇实施经阴道自然分娩的方式,剖宫产组产妇实施剖宫产的方式,记录产后产妇的情况和新生儿的情况。结果自然分娩组的产妇血压、产妇产后出血、新生儿的Apgar评分优于剖宫产组,两组的胎儿窘迫差别不大。结论自然分娩的分娩方式对母体和胎儿的应用价值更高,若发生难产则需进行剖宫产手术。

  15. Impact of Mode of Delivery on Female Postpartum Sexual Functioning: Spontaneous Vaginal Delivery and Operative Vaginal Delivery vs. Cesarean Section.

    Science.gov (United States)

    Barbara, Giussy; Pifarotti, Paola; Facchin, Federica; Cortinovis, Ivan; Dridi, Dhohua; Ronchetti, Camilla; Calzolari, Luca; Vercellini, Paolo

    2016-03-01

    Several studies have explored the association between modes of delivery and postpartum female sexual functioning, although with inconsistent findings. To investigate the impact of mode of delivery on female postpartum sexual functioning by comparing spontaneous vaginal delivery, operative vaginal delivery, and cesarean section. One hundred thirty-two primiparous women who had a spontaneous vaginal delivery, 45 who had an operative vaginal delivery, and 92 who underwent a cesarean section were included in the study (N = 269). Postpartum sexual functioning was evaluated 6 months after childbirth using the Female Sexual Function Index. Time to resumption of sexual intercourse, postpartum depression, and current breastfeeding also were assessed 6 months after delivery. Female Sexual Function Index total and domain scores and time to resumption of sexual intercourse at 6 months after childbirth. Women who underwent an operative vaginal delivery had poorer scores on arousal, lubrication, orgasm, and global sexual functioning compared with the cesarean section group and lower orgasm scores compared with the spontaneous vaginal delivery group (P < .05). The mode of delivery did not significantly affect time to resumption of sexual intercourse. Women who were currently breastfeeding had lower lubrication, more pain at intercourse, and longer time to resumption of sexual activity. Operative vaginal delivery might be associated with poorer sexual functioning, but no conclusions can be drawn from this study regarding the impact of pelvic floor trauma (perineal laceration or episiotomy) on sexual functioning because of the high rate of episiotomies. Overall, obstetric algorithms currently in use should be refined to decrease further the risk of operative vaginal delivery. Copyright © 2016. Published by Elsevier Inc.

  16. Chronic myeloid leukemia with pregnancy: Successful management of pregnancy and delivery with hydroxyurea and imatinib continued till delivery

    Directory of Open Access Journals (Sweden)

    Usha Yadav

    2013-01-01

    Full Text Available The concomitant occurrence of pregnancy and chronic myeloid leukemia is uncommon. We describe the successful management of a 30-year-old G3 P0, A2 woman who was diagnosed to have chronic myelogenous leukemia (CML in the third trimester of her pregnancy with intra-uterine growth retardation and oligohydroamnios. She was started on hydroxyurea and imatinib, and was continued till delivery and beyond. The use of imatinib did not have any adverse effects on the fetus, except for low birth weight and low APGAR at birth, but the later progress of the child was normal. We conclude that imatinib and hydroxyurea can be continued even at the third trimester in a pregnant lady with CML, if necessary.

  17. Chronic myeloid leukemia with pregnancy: Successful management of pregnancy and delivery with hydroxyurea and imatinib continued till delivery.

    Science.gov (United States)

    Yadav, Usha; Solanki, Sohan Lal; Yadav, Rupesh

    2013-01-01

    The concomitant occurrence of pregnancy and chronic myeloid leukemia is uncommon. We describe the successful management of a 30-year-old G3 P0, A2 woman who was diagnosed to have chronic myelogenous leukemia (CML) in the third trimester of her pregnancy with intra-uterine growth retardation and oligohydroamnios. She was started on hydroxyurea and imatinib, and was continued till delivery and beyond. The use of imatinib did not have any adverse effects on the fetus, except for low birth weight and low APGAR at birth, but the later progress of the child was normal. We conclude that imatinib and hydroxyurea can be continued even at the third trimester in a pregnant lady with CML, if necessary.

  18. SCORE - A DESCRIPTION.

    Science.gov (United States)

    SLACK, CHARLES W.

    REINFORCEMENT AND ROLE-REVERSAL TECHNIQUES ARE USED IN THE SCORE PROJECT, A LOW-COST PROGRAM OF DELINQUENCY PREVENTION FOR HARD-CORE TEENAGE STREET CORNER BOYS. COMMITTED TO THE BELIEF THAT THE BOYS HAVE THE POTENTIAL FOR ETHICAL BEHAVIOR, THE SCORE WORKER FOLLOWS B.F. SKINNER'S THEORY OF OPERANT CONDITIONING AND REINFORCES THE DELINQUENT'S GOOD…

  19. 探讨正常分娩会阴标准评分表的设计及在无保护会阴接生中的应用%Study on Design of Normal Labor Perineal Standard Scoring Table in the Unprotected Perineum Delivery

    Institute of Scientific and Technical Information of China (English)

    谭志华; 熊永芳

    2016-01-01

    statistical significance by comparison (P<0.05), the higher the perineal standard score, the fewer the perineal laceration rate and the milder the laceration degree. Conclusion Perineal standard scoring sys-tem in guiding the unprotected perineum delivery can reduce the teral episiotomy rate and reduce the perineal laceration degree of primiparas, which is worth application and promotion.

  20. The Bandim tuberculosis score

    DEFF Research Database (Denmark)

    Rudolf, Frauke; Joaquim, Luis Carlos; Vieira, Cesaltina

    2013-01-01

    Background: This study was carried out in Guinea-Bissau ’ s capital Bissau among inpatients and outpatients attending for tuberculosis (TB) treatment within the study area of the Bandim Health Project, a Health and Demographic Surveillance Site. Our aim was to assess the variability between 2...... physicians in performing the Bandim tuberculosis score (TBscore), a clinical severity score for pulmonary TB (PTB), and to compare it to the Karnofsky performance score (KPS). Method : From December 2008 to July 2009 we assessed the TBscore and the KPS of 100 PTB patients at inclusion in the TB cohort and...

  1. Reporting Valid and Reliable Overall Scores and Domain Scores

    Science.gov (United States)

    Yao, Lihua

    2010-01-01

    In educational assessment, overall scores obtained by simply averaging a number of domain scores are sometimes reported. However, simply averaging the domain scores ignores the fact that different domains have different score points, that scores from those domains are related, and that at different score points the relationship between overall…

  2. Volleyball Scoring Systems.

    Science.gov (United States)

    Calhoun, William; Dargahi-Noubary, G. R.; Shi, Yixun

    2002-01-01

    The widespread interest in sports in our culture provides an excellent opportunity to catch students' attention in mathematics and statistics classes. One mathematically interesting aspect of volleyball, which can be used to motivate students, is the scoring system. (MM)

  3. Volleyball Scoring Systems.

    Science.gov (United States)

    Calhoun, William; Dargahi-Noubary, G. R.; Shi, Yixun

    2002-01-01

    The widespread interest in sports in our culture provides an excellent opportunity to catch students' attention in mathematics and statistics classes. One mathematically interesting aspect of volleyball, which can be used to motivate students, is the scoring system. (MM)

  4. 介入技术在完全性前置胎盘和胎盘植入中的临床应用价值%Clinical Value of Interventional Radiologic Technique Combined with Cesarean Delivery in Placenta Previa and Placenta Accrete Patients

    Institute of Scientific and Technical Information of China (English)

    谢娅; 张颖; 彭铮

    2014-01-01

    Objective:To investigate the clinical value of interventional radiologic technique combined with cesarean delivery. Method:40 consecutive patients in our hospital with complete placenta previa or suspected placenta accrete were prospectively assessed from June 2011 to December 2013. 20 cases were treated by traditional cesarean delivery methods, termination of pregnancy as the control group. 20 patients were treated by obstetric joint intervention carried out new DSA in the operating room for abdominal aortic balloon placed+cesarean delivery+the iliac artery and uterine artery embolization, as the DSA group,the different outcomes of the two groups were compared. Result:There were no statistical significance in the neonatal Apgar scores of the two groups(P>0.05);intraoperative and postpartum blood loss,blood transfusion amount in the DSA group were significantly lower than the control group,the differences had statistical significance(P0.05);DSA组术中及产后失血量、输血量均明显低于对照组,差异均有统计学意义(P<0.05);DSA组子宫切除率显著低于对照组,母乳喂养率显著高于对照组,差异均有统计学意义(P<0.05)。结论:剖宫产术中腹主动脉放置球囊联合术后髂内动脉子宫动脉栓塞技术能够显著降低产时产后出血量、输血量、子宫切除率,并提高母乳喂养率。

  5. Birth guidance in early pregnancy by a volunteer team: its impact on delivery outcome%成立志愿小组实施孕早期指导对分娩结局的影响

    Institute of Scientific and Technical Information of China (English)

    何秀影; 李青; 李秀荣; 石毅; 姚荣芬

    2011-01-01

    Objective To reduce Cesarean section rate, and to improve outcome of childbirth. Methods Totally, 385 pregnant women with gestational age less than 12 weeks were randomized into two groups. The contraol group (n=195) received routine prenatal checkups and education, while participants in the observation group additionally receiced one-to-one telephone instruction provided by a volunteer team formed by physicians and nurses. Results The cesarean section rates, the rates of forceps delivery, macrosomia and neonates with low Apgar scores in the observation group were significantly lower than those in the control group (P<0. 05, P<0. 01). Conclusion The delivery outcome can be improved by establishing a volunteer team providing instructions during early pregnancy.%目的 降低剖宫产率和改善分娩结局.方法 成立由医生和护士组成的志愿小组,将孕周<12周的385例孕妇按自愿方式分成观察组(190例)和对照组(195例),对照组实行常规孕检和孕期教育;观察组在此基础上实施志愿小组成员一对一电话指导.结果 观察组剖宫产率、产钳使用率、巨大儿及低评分新生儿显著低于和少于对照组(P<0.05,P<0.01).结论 成立志愿小组实施孕早期指导,可显著改善分娩结局.

  6. Influência do tipo de parto sobre a concentração de imunoglobulinas A, G e M no colostro materno Influence of type of delivery on A, G and M immunoglobulin concentration in maternal colostrum

    Directory of Open Access Journals (Sweden)

    Gabriel A. J. Striker

    2004-04-01

    puerperium- associated diseases. The following aspects were also considered as inclusion criteria for the newborn: weight > 2,500 g, Apgar score > 7 in the first minute and exclusive breastfeeding until discharge from the nursery. The women were divided into three groups: A - vaginal delivery, B - caesarean section with labor and C - elective caesarean section. Colostrum was collected manually between 48 and 72h after delivery. Immunoglobulins were dosed using the ELISA technique. RESULTS: There were no differences between the three groups in terms of time of colostrum collection. The shorter the time of colostrum collection, the greater the concentration of immunoglobulin A. Primiparous women had higher concentrations of IgA and IgM in maternal colostrum than did multiparous women. The group submitted to caesarean section with labor had higher concentrations of IgA in maternal colostrum than did the normal delivery group. IgM and IgG concentrations in colostrum were not influenced by type of delivery. CONCLUSION: The occurrence of labor together with surgical stress induce higher IgA concentrations in the colostrum of women submitted to caesarean section with labor.

  7. 瘢痕子宫足月妊娠孕妇阴道分娩的临床分析%Clinical Analysis of Vaginal Delivery in Scarred Uterus Pregnant Women With Full-term Pregnancy

    Institute of Scientific and Technical Information of China (English)

    王冉

    2016-01-01

    目的:探讨瘢痕子宫再次妊娠行阴道分娩的临床效果及安全性。方法选择我院200例瘢痕子宫孕妇为研究对象,根据分娩方式的不同将剖宫产术后阴道分娩(VBAC)娩出胎儿者作为阴道分娩组,另瘢痕子宫女性再次妊娠剖宫产术分娩(RCS)的孕妇作为剖宫产组,每组各100例。观察两组产妇分娩出血量、分娩成功率、住院时间、术后并发症情况,并对新生儿进行Apgar评分。结果阴道分娩组分娩出血量低于剖宫产组,但是分娩时间长于剖宫产组,差异均有统计学意义(P<0.05);分娩后,阴道分娩组住院时间少于剖宫产组,伤口感染、产后出血发生率低于剖宫产组,差异均有统计学意义(P<0.05);两组新生儿Apgar评分与新生儿窒息率比较,差异均无统计学意义(P>0.05)。结论对于具备阴道分娩条件的瘢痕子宫孕妇,应优先考虑阴道分娩途径分娩,阴道试产过程中严密监护。经阴道分娩是安全可行的。%Objective To explore the clinical effect and safety of vaginal delivery in scarred uterus pregnant women with ful-term pregnancy.Methods 200 cases of pregnant women with scar uterus in our hospital were colected as study objects,according to the different ways of delivery,100 cases of uterine scar again pregnancy vaginal birth after cesarean(VBAC)were selected as the vaginal delivery group,and another 100 cases of uterine scar again pregnancy repeat cesarean section(RCS)were selected as the cesarean section group.The vaginal bleeding,delivery success rate,hospitalization time, postoperative complications of two groups were observed,and the newborns were scored by Apgar scoreing.Results The amount of bleeding of the vaginal delivery group was significantly lower than that in the cesarean section group,but the delivery time was significantly longer than that of the cesarean section group,the differences were statisticaly

  8. Premature delivery

    Directory of Open Access Journals (Sweden)

    Bernardita Donoso Bernales

    2012-09-01

    Full Text Available Preterm delivery is the single most important cause of perinatal morbidity and mortality. In Chile, preterm births have increased in the past decade, although neonatal morbidity and mortality attributable to it shows a downward trend, thanks to improvements in neonatal care of premature babies, rather than the success of obstetric preventive and therapeutic strategies. This article describes clinical entities, disease processes and conditions that constitute predisposing factors of preterm birth, as well as an outline for the prevention and clinical management of women at risk of preterm birth.

  9. Resolution of isolated large fetal pericardial effusion after delivery

    Directory of Open Access Journals (Sweden)

    Amar M Taksande

    2016-01-01

    Full Text Available Pericardial effusion (PE is detectable during routine obstetric ultrasonography. PE is the result of the same mechanism that produces fetal hydrops. Structural cardiac malformations and fetal cardiac arrhythmias are the most common cause of nonimmune hydrops. A male infant weighing 2300 g was born by through elective cesarean section. Isolated large PE was detected in a fetus at 34 weeks of gestation. The women delivered a male neonate at 37 weeks period of gestation through elective cesarean section. Baby cried immediately after birth with APGAR score 7, 9, 10 at 1, 5, and 10 min, respectively. Though the mother condition was stable. The baby was shifted to special care neonatal unit in view of for respiratory distress and severe grunt. Neonatal echocardiography showed trivial tricuspid regurgitation with no PE. Most fetal PEs resolve and fetuses with isolated PEs have a good prognosis.

  10. The natural delivery outcome of primipara without interventions%无医疗干预初产妇自然分娩的妊娠结局分析

    Institute of Scientific and Technical Information of China (English)

    孙梅玲; 贺梦雅; 马玉燕

    2016-01-01

    目的::探讨无医疗干预初产妇自然分娩的妊娠结局。方法:将2013年1月至2014年12月在山东大学齐鲁医院住院分娩的3000例初产妇根据有无产程干预分为观察组和对照组,观察组1500例孕妇自然分娩,第一产程自由活动、饮食、休息,第二产程自主用力、自由体位分娩、无会阴保护、自然娩肩,第三产程延迟断脐、胎盘自然娩出;对照组1500例孕妇给予不同程度的医疗干预。比较两组孕妇的最终分娩方式及母儿结局。结果:观察组的自然分娩率、会阴完整率、新生儿评分高于对照组,而会阴切开率、会阴二度裂伤率、剖宫产率、产后出血量、羊水污染率明显低于对照组,差异有统计学意义(P0.05)。结论:对于低危初产妇,减少医疗干预,促进自然分娩,可获得较好的母儿结局。%Objective:To explore the natural delivery outcome of primipara without medical interventions. Methods:3000 primipara who had delivery in Qilu Hospital of Shandong University from Jan. 2013 to Dec. 2014 were divided into two groups according to the delivery approach:observing group,1500 cases without medical intervention, who had free activities, food,rest in the first labor stage and independent labor force,free position without perineal pro-tection delivery,waiting for shouders natural delivery in the second stage and delayed umbilical cord clamping after pulsation loss,natural delivery of placenta in the third stage;other 1500 ca-ses with different medical interventions were taken as control group. Mode of delivery and preg-nancy outcomes were compared between the two groups. Results:The natural delivery rate,in-tact perineum rate and apgar score at the 1 st min after birth were higher in the observing group than that in the control group. The episiotomy rate,perineal second degree laceration rate,cesar-ean section rate,postpartum bleeding,amniotic fluid pollution rate in the

  11. The relation between Apgar scores and the change of cardiomyonases in preterm infants%早产儿Apgar评分与心肌酶谱变化关系的分析

    Institute of Scientific and Technical Information of China (English)

    吉玲; 程秀永

    2004-01-01

    目的: 探讨早产儿的Apgar评分与心肌酶谱变化关系.方法: 将早产儿按照Apgar评分分为正常组、轻度窒息组和重度窒息组.比较三组患儿在生后24~48小时内心肌酶谱的变化情况.结果: Apgar评分正常组与轻度窒息组的心肌酶谱的变化之间无明显差异,但正常组与重度窒息组、重度窒息组与轻度窒息组的心肌酶谱的变化之间有明显统计学意义(P<0.05).结论: 早产儿Apgar评分与心肌酶谱变化密切相关,且Apgar评分越低,心肌酶谱变化越明显.

  12. Control study of one minute Apgar score in premature and mature infants%早产儿和足月儿1分钟Apgar评分对比观察

    Institute of Scientific and Technical Information of China (English)

    杨兴华; 何亚娟

    2007-01-01

    目的 对比观察早产儿和足月儿1分钟Apgar评分的差异.方法 分析173例早产儿1分钟Apgar的评分结果,并与同期随机抽出的189例足月新生儿进行比较.结果 早产儿组一分钟Apgar评分(8.15±2.36)明显低于足月儿组(9.32±1.23).结论 在早产儿治疗及预后评估中应考虑早产儿1分钟Apgar评分低于正常儿的诸多因素与不良影响,有助于临床对早产儿治疗与护理水平的提高.

  13. Instant MuseScore

    CERN Document Server

    Shinn, Maxwell

    2013-01-01

    Get to grips with a new technology, understand what it is and what it can do for you, and then get to work with the most important features and tasks. Instant MuseScore is written in an easy-to follow format, packed with illustrations that will help you get started with this music composition software.This book is for musicians who would like to learn how to notate music digitally with MuseScore. Readers should already have some knowledge about musical terminology; however, no prior experience with music notation software is necessary.

  14. ANALYSIS OF THE RELATIVITY BETWEEN APGAR GRADE AND NBNA DETERMINATION%Apgar评分与NBNA测定的相关性分析

    Institute of Scientific and Technical Information of China (English)

    陈肇迁; 余伟萍

    2009-01-01

    目的 通过对Apgar评分正常及Apgar评分异常的新生儿进行新生儿神经行为测定(NB-NA),早期发现中枢神经系统的功能异常,早期干预,并比较两种测试方法的相关性.方法 采用新生儿行为神经测定对2007年3月~2008年5月769名在我院分娩新生儿(早产儿纠正胎龄为40周后)进行检测.结果 769名新生儿中Apgar异常30人,其中重度窒息7人,轻度窒息23人.NBNA评分7天≤35分为24例,14天复查评分≤35分14例,其中Apgar评分异常3例,均为重度窒息患儿.结论 Apgar评分在新生儿窒息的诊断及估计预后中有重要意义,重度窒息患儿NBNA评分明显比轻度窒息患儿低,出现中枢神经系统的功能异常的概率也明显较高;但相当大部分NBNA评分异常的新生儿出生时Apgar评分正常,表明Apgar评分与NBNA评分之间无明显相关性,NBNA不仅可以发现新生儿由于窒息脑损伤引起的神经行为异常,还可以及早发现先天缺陷,敏感性和特异性高因此建议对所有新生儿无论Apgar评分正常与否均常规进行NBNA测定,以早期发现中枢神经系统的功能异常.

  15. Tensorial Orientation Scores

    NARCIS (Netherlands)

    van de Gronde, Jasper J.; Azzopardi, George; Petkov, Nicolai

    2015-01-01

    Orientation scores are representations of images built using filters that only select on orientation (and not on the magnitude of the frequency). Importantly, they allow (easy) reconstruction, making them ideal for use in a filtering pipeline. Traditionally a specific set of orientations has to be c

  16. Developing Scoring Algorithms

    Science.gov (United States)

    We developed scoring procedures to convert screener responses to estimates of individual dietary intake for fruits and vegetables, dairy, added sugars, whole grains, fiber, and calcium using the What We Eat in America 24-hour dietary recall data from the 2003-2006 NHANES.

  17. The lod score method.

    Science.gov (United States)

    Rice, J P; Saccone, N L; Corbett, J

    2001-01-01

    The lod score method originated in a seminal article by Newton Morton in 1955. The method is broadly concerned with issues of power and the posterior probability of linkage, ensuring that a reported linkage has a high probability of being a true linkage. In addition, the method is sequential, so that pedigrees or lod curves may be combined from published reports to pool data for analysis. This approach has been remarkably successful for 50 years in identifying disease genes for Mendelian disorders. After discussing these issues, we consider the situation for complex disorders, where the maximum lod score (MLS) statistic shares some of the advantages of the traditional lod score approach but is limited by unknown power and the lack of sharing of the primary data needed to optimally combine analytic results. We may still learn from the lod score method as we explore new methods in molecular biology and genetic analysis to utilize the complete human DNA sequence and the cataloging of all human genes.

  18. Nursing activities score

    NARCIS (Netherlands)

    Miranda, DR; Nap, R; de Rijk, A; Schaufeli, W; Lapichino, G

    Objectives. The instruments used for measuring nursing workload in the intensive care unit (e.g., Therapeutic Intervention Scoring System-28) are based on therapeutic interventions related to severity of illness. Many nursing activities are not necessarily related to severity of illness, and

  19. Automated Essay Scoring

    Directory of Open Access Journals (Sweden)

    Semire DIKLI

    2006-01-01

    Full Text Available Automated Essay Scoring Semire DIKLI Florida State University Tallahassee, FL, USA ABSTRACT The impacts of computers on writing have been widely studied for three decades. Even basic computers functions, i.e. word processing, have been of great assistance to writers in modifying their essays. The research on Automated Essay Scoring (AES has revealed that computers have the capacity to function as a more effective cognitive tool (Attali, 2004. AES is defined as the computer technology that evaluates and scores the written prose (Shermis & Barrera, 2002; Shermis & Burstein, 2003; Shermis, Raymat, & Barrera, 2003. Revision and feedback are essential aspects of the writing process. Students need to receive feedback in order to increase their writing quality. However, responding to student papers can be a burden for teachers. Particularly if they have large number of students and if they assign frequent writing assignments, providing individual feedback to student essays might be quite time consuming. AES systems can be very useful because they can provide the student with a score as well as feedback within seconds (Page, 2003. Four types of AES systems, which are widely used by testing companies, universities, and public schools: Project Essay Grader (PEG, Intelligent Essay Assessor (IEA, E-rater, and IntelliMetric. AES is a developing technology. Many AES systems are used to overcome time, cost, and generalizability issues in writing assessment. The accuracy and reliability of these systems have been proven to be high. The search for excellence in machine scoring of essays is continuing and numerous studies are being conducted to improve the effectiveness of the AES systems.

  20. Fetal Biophysical Profile Scoring

    Directory of Open Access Journals (Sweden)

    H.R. HaghighatKhah

    2009-01-01

    Full Text Available   "nFetal biophysical profile scoring is a sonographic-based method of fetal assessment first described by Manning and Platt in 1980. "nThe biophysical profile score was developed as a method to integrate real-time observations of the fetus and his/her intrauterine environment in order to more comprehensively assess the fetal condition. These findings must be evaluated in the context of maternal/fetal history (i.e., chronic hypertension, post-dates, intrauterine growth restriction, etc, fetal structural integrity (presence or absence of congenital anomalies, and the functionality of fetal support structures (placental and umbilical cord. For example, acute asphyxia due to placental abruption may result in an absence of the acute variables of the biophysical profile score (fetal breathing movements, fetal movement, fetal tone, and fetal heart rate reactivity with a normal amniotic fluid volume. With post maturity the asphyxial event may be intermittent and chronic resulting in a decrease in amniotic fluid volume, but with the acute variables remaining normal. "nWhile the 5 components of the biophysical profile score have remained unchanged since 1980 (Manning, 1980, the definitions of a normal and abnormal parameter have evolved with increasing experience. "nIn 1984 the definition of oligohydramnios was increased from < 1cm pocket of fluid to < 2.0 x 1.0 cm pocket. Oligohydramnios is now defined as a pocket of amniotic fluid < 2.0 x 2.0 cm (Manning, 1995a "nIf the four ultrasound variables are normal, the accuracy of the biophysical profile score was not found to be significantly improved by adding the non-stress test. As a result, in 1987 the profile score was modified to incorporate the non-stress test only when one of the ultrasound variables was abnormal (Manning 1987. Table 1 outlines the current definitions for quantifying a variable as present or absent. "nEach of the 5 components of the biophysical profile score does not have equal

  1. Planned early delivery versus expectant management of the term suspected compromised baby for improving outcomes.

    Science.gov (United States)

    Bond, Diana M; Gordon, Adrienne; Hyett, Jon; de Vries, Bradley; Carberry, Angela E; Morris, Jonathan

    2015-11-24

    trial, 459 women, evidence graded moderate), major neonatal morbidity (risk ratio (RR) 0.15, 95% confidence interval (CI) 0.01 to 2.81, one trial, 459 women, evidence graded low), or neurodevelopmental disability/impairment at two years of age (RR 2.04, 95% CI 0.62 to 6.69,one trial, 459 women, evidence graded low). There was no difference in the risk of necrotising enterocolitis (one trial, 333 infants) or meconium aspiration (one trial, 459 infants), There was also no difference in the reported primary maternal outcomes: maternal mortality (RR 3.07, 95% CI 0.13 to 74.87, one trial, 459 women, evidence graded low), and significant maternal morbidity (RR 0.92, 95% CI 0.38 to 2.22, one trial, 459 women, evidence graded low).The gestational age at birth was on average 10 days earlier in women randomised to early delivery (mean difference (MD) -9.50, 95% CI -10.82 to -8.18, one trial, 459 women) and women in the early delivery group were significantly less likely to have a baby beyond 40 weeks' gestation (RR 0.10, 95% CI 0.01 to 0.67, one trial, 33 women). Significantly more infants in the planned early delivery group were admitted to intermediate care nursery (RR 1.28, 95% CI 1.02 to 1.61, two trials, 491 infants). There was no difference in the risk of respiratory distress syndrome, (one trial, 333 infants), Apgar score less than seven at five minutes (three trials, 546 infants), resuscitation required (one trial, 459 infants), mechanical ventilation (one trial, 337 infants), admission to neonatal intensive care unit (NICU) (RR 0.88, 95% CI 0.35 to 2.23, three trials, 545 infants, evidence graded very low), length of stay in NICU/SCN (one trial, 459 infants), and sepsis (two trials, 366 infants).Babies in the expectant management group were more likely to be babies with birthweight delivery one trial, 124 women). There was an expected increase in induction in the early delivery group (RR 2.05, 95% CI 1.78 to 2.37, one trial, 459 women).No data were reported for the pre

  2. Credit scoring for individuals

    Directory of Open Access Journals (Sweden)

    Maria DIMITRIU

    2010-12-01

    Full Text Available Lending money to different borrowers is profitable, but risky. The profits come from the interest rate and the fees earned on the loans. Banks do not want to make loans to borrowers who cannot repay them. Even if the banks do not intend to make bad loans, over time, some of them can become bad. For instance, as a result of the recent financial crisis, the capability of many borrowers to repay their loans were affected, many of them being on default. That’s why is important for the bank to monitor the loans. The purpose of this paper is to focus on credit scoring main issues. As a consequence of this, we presented in this paper the scoring model of an important Romanian Bank. Based on this credit scoring model and taking into account the last lending requirements of the National Bank of Romania, we developed an assessment tool, in Excel, for retail loans which is presented in the case study.

  3. Earthquake forecast enrichment scores

    Directory of Open Access Journals (Sweden)

    Christine Smyth

    2012-03-01

    Full Text Available The Collaboratory for the Study of Earthquake Predictability (CSEP is a global project aimed at testing earthquake forecast models in a fair environment. Various metrics are currently used to evaluate the submitted forecasts. However, the CSEP still lacks easily understandable metrics with which to rank the universal performance of the forecast models. In this research, we modify a well-known and respected metric from another statistical field, bioinformatics, to make it suitable for evaluating earthquake forecasts, such as those submitted to the CSEP initiative. The metric, originally called a gene-set enrichment score, is based on a Kolmogorov-Smirnov statistic. Our modified metric assesses if, over a certain time period, the forecast values at locations where earthquakes have occurred are significantly increased compared to the values for all locations where earthquakes did not occur. Permutation testing allows for a significance value to be placed upon the score. Unlike the metrics currently employed by the CSEP, the score places no assumption on the distribution of earthquake occurrence nor requires an arbitrary reference forecast. In this research, we apply the modified metric to simulated data and real forecast data to show it is a powerful and robust technique, capable of ranking competing earthquake forecasts.

  4. An analysis on the effects of different time of stopping pumping on stages of labour and delivery outcomes during self-controlled combined spinal-epidural labour analgesia%自控腰硬联合分娩镇痛不同的停泵时机对产程和分娩结局的影响

    Institute of Scientific and Technical Information of China (English)

    熊桂生; 潘丽莉; 王玉珏

    2014-01-01

    cervix was wide open for group B, and restarted immediately after delivery; group C kept receiving labour analgesia all the way through the first, second and third stages. All three groups terminated analgesia at the third stage. The analgesia was terminated after perineorrhaphy and tubes for epidural analgesia were removed. Basic conditions of parturients, VAS scores, durations of the first, second and third stages, amount of bleeding in two hours after delivery, use of oxytocin, rate of caesarean section, rate of delivery by pliers, quality of amniotic fluid, satisfaction rate of parturients and Apgar scores were observed and compared. Results No differences of amount of bleeding in two hours after delivery, Apgar scores, and durations of the third stages were detected between the three groups;ratios of labour pain for parturients in group A and B were higher than those in group C, and the number of parturients who encountered pain during perineorrhaphy or felt uncomfortable was higher than that in group C. The satisfaction rate in group C was higher than that in group A and B, and the differences were statistically significant. No statistically significant differences of indices between group A and B were seen. Conclusion Different time of stopping pumping does not prolong the second stage, does not affect Apgar scores or exacerbate postpartum haemorrhage. Application rate of oxytocin increases in the group which receives continued analgesia (P<0.05), and the difference is statistically significant. Continued analgesia may promote the trend of caesarean section, yet improves parturients’satisfaction rate.

  5. Effect of the whole course nursing intervention on mental state and the only maternal influence of delivery quality%全程护理干预对独生女产妇心理状态及分娩质量的影响

    Institute of Scientific and Technical Information of China (English)

    任秀琼; 杨康春; 马妮; 邓金凤; 陈利

    2013-01-01

    Objective:To investigate the leffect of prenatal, delivery, postpartum nursing intervention to the only female maternal mental state and quality of delivery. Methods;80 cases of maternal admission only daughter in accordance with single and double date were divided into experimental group and control group with 40 cases in each group, while the control group adopted conventional obstrical service model, experiment group took prenatal information support and musing intervention of cognition, accompanied by pain and nursing intervention of postpartum rehabilitation refers to guard, psychological intervention, compared two groups at the time of admission and discharge of maternal anxiety and depression level, mode of delivery, the total duration of labor, postpar-tum hemorrhage and neonatal Apgar 2 h score. Results;The two groups of maternal anxiety and depression severity, mode of delivery, the total duration of labor, postpartum hemorrhage and neonatal Apgar score compared to the situation in the difference was statistically significant (P<0.05). Conclusion:The only daughter of maternal prenatal, intrapartum, postpartum nursing intervention, can significantly relieve maternal anxiety and depressive symptoms; short-en the stages of labor, postpartum hemorrhage, improve the obstetric quality, reduce the rateof cesarean section.%目的:探讨产前、产时、产后全程护理干预对独生女产妇心理状态及分娩质量的影响.方法:将80例独生女产妇按照入院单双日期分为试验组和对照组各40例,对照组采取传统的产科服务模式,试验组采取产前信息支持与认知护理干预、产时全程陪伴及疼痛护理干预、产后康复指导护理干预等,比较两组产妇入院时与出院时的焦虑及抑郁程度、分娩方式、总产程时间、产后2h出血量及新生儿Apgar评分等.结果:两组产妇焦虑及抑郁程度、分娩方式、总产程时间、产后出血量及新生儿Apgar评分等情况比

  6. The International Bleeding Risk Score

    DEFF Research Database (Denmark)

    Laursen, Stig Borbjerg; Laine, L.; Dalton, H.

    2017-01-01

    The International Bleeding Risk Score: A New Risk Score that can Accurately Predict Mortality in Patients with Upper GI-Bleeding.......The International Bleeding Risk Score: A New Risk Score that can Accurately Predict Mortality in Patients with Upper GI-Bleeding....

  7. Association of Higher Maternal Serum Fluoride with Adverse Fetal Outcomes

    Directory of Open Access Journals (Sweden)

    Gurumurthy M Sastry

    2011-04-01

    Full Text Available Background: Despite prevalence of fluorosis in India, previous studies did not emphasize on the effect of maternal fluorosis on fetal outcomes. Objectives: To study the associations of higher maternal serum Fluoride (F with low birth weight and poor APGAR count. Methods: One hundred and eight apparently healthy pregnant women aged 17-36 years were included in the study. Samples collected were maternal and cord blood, placenta and drinking and ground water. The samples were processed and analyzed for Fluoride. Fetal gestational age was measured on ultrasound scan and the birth weight of the baby on a digital scale. Fifth minute APGAR score was measured. Results: A significant negative correlation was found for maternal serum F vs Birth weight, Gestational Age and APGAR score. Significant negative correlations were also found for cord serum F vs Birth Weight, Gestational Age and APGAR score. Fairly negative correlations were also found for birth weight, APGAR score and Gestational age compared to Fluoride concentrations in maternal surface of placenta, fetal surface of placenta and marginal side of the placenta. However, significant positive correlations were observed when Gestational age was compared with Birth weight and APGAR score. When the maternal serum F was greater than 1 ppm, there was 10.58 times higher risk for low birth weight, 8.65 times higher risk for preterm delivery and 3.8 times higher risk for low APGAR score. When the cord serum F was greater than 0.22ppm, there was 2.76 times higher risk for low birth weight, 4.6 times higher risk for preterm delivery and 2.5 times higher risk for low APGAR score. Conclusion: With increased serum F in the mother, there is an inclination towards pre term delivery, low birth weight and poor APGAR count.

  8. VAGINAL DELIVERY OF GIANT FETUS – SHOULDER DYSTOCIA

    Directory of Open Access Journals (Sweden)

    Jasmina Popović

    2009-04-01

    Full Text Available Shoulder dystocia (SD is defined as unpredictable and urgent obstetric complication that happens when the pelvis of a mother is spread sufficiently to deliver fetal head, but insufficiently to deliver fetal shoulders. It is associated with high percentage of maternal and fetal morbidity. Fetal lethality from hypoxia ranges from 2-16%.We observed the case of vaginal delivery in a multiparous woman in the 39th gestational week. Head delivery was performed by using vacuum extraction. Because of the shoulder dystocia, we applied McRoberts’ maneuver with Resnik’s suprapubic pressure and performed one more episiotomy. Since these maneuvers did not give the expected result, we did the aspiration of the upper respiratory paths of the fetus, after which we performed Hibbard’s cord with simultaneous Kristeler’s maneuver. It led to releasing the shoulders and fetal delivery. On delivery, male fetus was 6000 g/60 cm, estimated with Apgar 1. The urgent reanimation was undertaken. After few hours, the baby was transferred to Pediatric Surgical Clinic for further treatment of present pneumotorax and humerus fracture. After many days, the baby being in normal state, was referred to physical rehabilitation treatment. Today, the baby is without sequelae.SD is one of the most difficult, hardly predictable perilous obstetric complications with high percentage of maternal morbidity and fetal morbidity and mortality. It requires caution, training and skills of obstetric-neonatal team. Liberalization of the use of Caesarian section in managing SD decreases the appearance of injuries in both mother and child. However, regardless of very rapid development of perinatology and the use of modern diagnostic-therapeutic protocols, some questions from classical, practical obstetrics remain unanswered.

  9. Comparison of mortality risk: a score for very low birthweight infants

    Science.gov (United States)

    Maier, R; Rey, M; Metze, B; Obladen;, M; TARNOW-MORDI, W.

    1997-01-01

    AIM—To develop and evaluate a score which quantifies mortality risk in very low birthweight (VLBW) infants (birthweight below 1500 g) at admission to the neonatal intensive care unit.
METHODS—Five hundred and seventy two VLBW infants admitted from 1978 to 1987 were randomly assigned to a cohort (n = 396) for score development and a cohort (n = 176) for score validation. Two hundred and ninety four VLBW infants admitted from 1988 to 1991 were used to compare risk adjusted mortality between the two eras.
RESULTS—Using multiple regression analysis, birthweight, Apgar score at 5 minutes, base excess at admission, severity of respiratory distress syndrome, and artificial ventilation were predictive of death in the development cohort. According to regression coefficients, a score ranging from 3 to 40 was developed. At a cutoff of 21, it predicted death in the validation cohort with a sensitivity of 0.85, a specificity of 0.73, and a correct classification rate of 0.76. The area under the receiver operating characteristic curve was 0.86. There was no significant difference in risk severity and in risk adjusted mortality between the eras 1978-87 and 1988-91.
CONCLUSION—The present score is robust, easily obtainable at admission, and permits early randomisation based on mortality risk.

 Keywords: mortality risk; scoring system; very low birthweight PMID:9175942

  10. Fingerprinting of music scores

    Science.gov (United States)

    Irons, Jonathan; Schmucker, Martin

    2004-06-01

    Publishers of sheet music are generally reluctant in distributing their content via the Internet. Although online sheet music distribution's advantages are numerous the potential risk of Intellectual Property Rights (IPR) infringement, e.g. illegal online distributions, disables any innovation propensity. While active protection techniques only deter external risk factors, additional technology is necessary to adequately treat further risk factors. For several media types including music scores watermarking technology has been developed, which ebeds information in data by suitable data modifications. Furthermore, fingerprinting or perceptual hasing methods have been developed and are being applied especially for audio. These methods allow the identification of content without prior modifications. In this article we motivate the development of watermarking and fingerprinting technologies for sheet music. Outgoing from potential limitations of watermarking methods we explain why fingerprinting methods are important for sheet music and address potential applications. Finally we introduce a condept for fingerprinting of sheet music.

  11. Transdermal drug delivery

    OpenAIRE

    Prausnitz, Mark R.; Langer, Robert

    2008-01-01

    Transdermal drug delivery has made an important contribution to medical practice, but has yet to fully achieve its potential as an alternative to oral delivery and hypodermic injections. First-generation transdermal delivery systems have continued their steady increase in clinical use for delivery of small, lipophilic, low-dose drugs. Second-generation delivery systems using chemical enhancers, non-cavitational ultrasound and iontophoresis have also resulted in clinical products; the ability ...

  12. Temporal contrast of salt delivery in mouth increases salt perception

    NARCIS (Netherlands)

    Busch, J.L.H.C.; Tournier, C.; Knoop, J.E.; Kooyman, G.; Smit, G.

    2009-01-01

    The impact of salt delivery in mouth on salt perception was investigated. It was hypothesized that fast concentration changes in the delivery to the receptor can reduce sensory adaptation, leading to an increased taste perception. Saltiness ratings were scored by a panel over time during various

  13. [Scoring--criteria for operability].

    Science.gov (United States)

    Oestern, H J

    1997-01-01

    For therapeutic recommendations three different kinds of scores are essential: 1. The severity scores for trauma; 2. Severity scores for mangled extremities; 3. Intensive care scores. The severity of polytrauma patients is measurable by the AIS, ISS, RTS, PTS and TRISS which is a combination of RTS, ISS, age, and mechanism of injury. For mangled extremities there are also different scores available: MESI (Mangled Extremity Syndrome Index) and MESS (Mangled Extremity Severity Score). The aim of these scores is to assist in the indication with regard to amputate or to save the extremity. These scoring indices can be used to evaluate the severity of a systemic inflammatory reaction syndrome with respect to multiple organ failure. All scores are dynamic values which are variable with improvement of therapy.

  14. Ultrasound-mediated gastrointestinal drug delivery.

    Science.gov (United States)

    Schoellhammer, Carl M; Schroeder, Avi; Maa, Ruby; Lauwers, Gregory Yves; Swiston, Albert; Zervas, Michael; Barman, Ross; DiCiccio, Angela M; Brugge, William R; Anderson, Daniel G; Blankschtein, Daniel; Langer, Robert; Traverso, Giovanni

    2015-10-21

    There is a significant clinical need for rapid and efficient delivery of drugs directly to the site of diseased tissues for the treatment of gastrointestinal (GI) pathologies, in particular, Crohn's and ulcerative colitis. However, complex therapeutic molecules cannot easily be delivered through the GI tract because of physiologic and structural barriers. We report the use of ultrasound as a modality for enhanced drug delivery to the GI tract, with an emphasis on rectal delivery. Ultrasound increased the absorption of model therapeutics inulin, hydrocortisone, and mesalamine two- to tenfold in ex vivo tissue, depending on location in the GI tract. In pigs, ultrasound induced transient cavitation with negligible heating, leading to an order of magnitude enhancement in the delivery of mesalamine, as well as successful systemic delivery of a macromolecule, insulin, with the expected hypoglycemic response. In a rodent model of chemically induced acute colitis, the addition of ultrasound to a daily mesalamine enema (compared to enema alone) resulted in superior clinical and histological scores of disease activity. In both animal models, ultrasound treatment was well tolerated and resulted in minimal tissue disruption, and in mice, there was no significant effect on histology, fecal score, or tissue inflammatory cytokine levels. The use of ultrasound to enhance GI drug delivery is safe in animals and could augment the efficacy of GI therapies and broaden the scope of agents that could be delivered locally and systemically through the GI tract for chronic conditions such as inflammatory bowel disease.

  15. Credit Scoring Modeling

    Directory of Open Access Journals (Sweden)

    Siana Halim

    2014-01-01

    Full Text Available It is generally easier to predict defaults accurately if a large data set (including defaults is available for estimating the prediction model. This puts not only small banks, which tend to have smaller data sets, at disadvantage. It can also pose a problem for large banks that began to collect their own historical data only recently, or banks that recently introduced a new rating system. We used a Bayesian methodology that enables banks with small data sets to improve their default probability. Another advantage of the Bayesian method is that it provides a natural way for dealing with structural differences between a bank’s internal data and additional, external data. In practice, the true scoring function may differ across the data sets, the small internal data set may contain information that is missing in the larger external data set, or the variables in the two data sets are not exactly the same but related. Bayesian method can handle such kind of problem.

  16. Developmental Sentence Scoring for Japanese

    Science.gov (United States)

    Miyata, Susanne; MacWhinney, Brian; Otomo, Kiyoshi; Sirai, Hidetosi; Oshima-Takane, Yuriko; Hirakawa, Makiko; Shirai, Yasuhiro; Sugiura, Masatoshi; Itoh, Keiko

    2013-01-01

    This article reports on the development and use of the Developmental Sentence Scoring for Japanese (DSSJ), a new morpho-syntactical measure for Japanese constructed after the model of Lee's English Developmental Sentence Scoring model. Using this measure, the authors calculated DSSJ scores for 84 children divided into six age groups between 2;8…

  17. Do Test Scores Buy Happiness?

    Science.gov (United States)

    McCluskey, Neal

    2017-01-01

    Since at least the enactment of No Child Left Behind in 2002, standardized test scores have served as the primary measures of public school effectiveness. Yet, such scores fail to measure the ultimate goal of education: maximizing happiness. This exploratory analysis assesses nation level associations between test scores and happiness, controlling…

  18. Line Lengths and Starch Scores.

    Science.gov (United States)

    Moriarty, Sandra E.

    1986-01-01

    Investigates readability of different line lengths in advertising body copy, hypothesizing a normal curve with lower scores for shorter and longer lines, and scores above the mean for lines in the middle of the distribution. Finds support for lower scores for short lines and some evidence of two optimum line lengths rather than one. (SKC)

  19. 瘢痕子宫阴道分娩可行性与安全性临床分析%Clinical analysis of feasibility and safety of scarred uterus vaginal delivery

    Institute of Scientific and Technical Information of China (English)

    杜佩英; 吴静璇

    2015-01-01

    ObjectiveTo investigate the feasibility and safety of scarred uterus vaginal delivery, in order to provide further clinical guide.MethodsThere were 98 scarred uterus re-pregnant puerpera choosing vaginal delivery as observation group, and another 98 puerpera without scarred uterus as control group. Vaginal delivery situation, complications of puerpera and newborn of the two groups were compared and analyzed.ResultsThere were no statistically significant differences of vaginal trial production success rate, labor time, and hospital stay between the two groups (P>0.05). Compared with the control group, the observation group had no statistically significant differences of postpartum hemorrhage volume, impending of rupture of uterus, and neonatal Apgar score (P>0.05).ConclusionVaginal trial production under corresponding conditions has high safety and feasibility for scarred uterus re-pregnancy. This method can effectively reduce cesarean section rate, and it is worthy of clinical reference.%目的:探讨瘢痕子宫阴道分娩的可行性与安全性,进一步指导临床。方法98例瘢痕子宫再次妊娠选择阴道分娩产妇作为观察组,同期随机选取98例非瘢痕子宫选择阴道分娩的产妇作为对照组,对比分析两组产妇阴道分娩情况及产妇、新生儿并发症情况。结果观察组阴道试产成功率、产程时间、住院时间与对照组相比,差异无统计学意义(P>0.05),观察组产后出血量、先兆子宫破裂及新生儿Apgar评分与对照组相比,差异无统计学意义(P>0.05)。结论瘢痕子宫再次妊娠在符合试产条件下行阴道试产具有较高的安全性与可行性,可以有效降低剖宫产率,值得临床借鉴。

  20. Goal-directed Fluid Therapy May Improve Hemodynamic Stability of Parturient with Hypertensive Disorders of Pregnancy Under Combined Spinal Epidural Anesthesia for Cesarean Delivery and the Well-being of Newborns

    Directory of Open Access Journals (Sweden)

    Wei Xiao

    2015-01-01

    Full Text Available Background: Hypotension induced by combined spinal epidural anesthesia in parturient with hypertensive disorders of pregnancy (HDP can easily compromise blood supply to vital organs including uteroplacental perfusion and result in fetal distress. The aim of this study was to investigate whether the goal-directed fluid therapy (GDFT with LiDCO rapid system can improve well-being of both HDP parturient and their babies. Methods: Fifty-two stable HDP parturient scheduled for elective cesarean delivery were recruited. After loading with 10 ml/kg lactated Ringer′s solution (LR, parturient were randomized to the GDFT and control group. In the GDFT group, individualized fluid therapy was guided by increase in stroke volume (ΔSV provided via LiDCO rapid system. The control group received the routine fluid therapy. The primary endpoints included maternal hypotension and the doses of vasopressors administered prior to fetal delivery. The secondary endpoints included umbilical blood gas abnormalities and neonatal adverse events. Results: The severity of HDP was similar between two groups. The total LR infusion (P < 0.01 and urine output (P < 0.05 were higher in the GDFT group than in the control group. Following twice fluid challenge tests, the systolic blood pressure, mean blood pressure, cardiac output and SV in the GDFT group were significantly higher, and the heart rate was lower than in the control group. The incidence of maternal hypotension and doses of phenylephrine used prior to fetal delivery were significantly higher in the control group than in the GDFT group (P < 0.01. There were no differences in the Apgar scores between two groups. In the control group, the mean values of pH in umbilical artery/vein were remarkably decreased (P < 0.05, and the incidences of neonatal hypercapnia and hypoxemia were statistically increased (P < 0.05 than in the GDFT group. Conclusions: Dynamic responsiveness guided fluid therapy with the LiDCO rapid system

  1. 经阴道分娩初产妇行会阴侧切术85例分析%Analysis of 85 cases of primiparas with vaginal delivery treated with lateral episiotomy

    Institute of Scientific and Technical Information of China (English)

    蒋玉

    2016-01-01

    Objective:To analyze the effect of lateral episiotomy on the delivery outcome of primiparas with vaginal delivery. Methods:170 cases of primiparas with vaginal delivery were divided into two groups randomly.The observation group was given lateral episiotomy,and the control group was given traditional protection of perineum.The second stage of labor time,perineal laceration,postpartum 2 h hemorrhage volume and neonatal asphyxia incidence of two groups were compared.Results:The second stage of labor time in the observation group was shorter than that of the control group;the postpartum 2 h hemorrhage volume was less than that of the control group(P<0.05).The incidence of perineal laceration in observation group was lower than that in control group,and the neonatal asphyxia Apgar score was better than that of the control group(P<0.05).Conclusion:Lateral episiotomy could reduce the occurrence of perineal laceration and neonatal asphyxia,shorten the process of labor,reduce the amount of postpartum hemorrhage,which protect the pelvic muscles.%目的:分析会阴侧切术对经阴道分娩初产妇分娩结局的影响。方法:收治阴道分娩初产妇170例,随机分为两组。观察组行会阴侧切术,对照组行传统的单纯会阴保护,比较两组第二产程时间、会阴裂伤、产后2 h出血量及新生儿窒息发生情况。结果:观察组第二产程短于对照组,产后2 h出血量少于对照组(P<0.05)。观察组会阴裂伤发生率低于对照组,且新生儿窒息Apgar评分优于对照组(P<0.05)。结论:会阴侧切术可减少会阴裂伤和新生儿窒息的发生,缩短产程,减少产后出血量,保护盆底肌肉。

  2. Goal-directed Fluid Therapy May Improve Hemodynamic Stability of Parturient with Hypertensive Disorders of Pregnancy Under Combined Spinal Epidural Anesthesia for Cesarean Delivery and the Well-being of Newborns

    Institute of Scientific and Technical Information of China (English)

    Wei Xiao; Qing-Fang Duan; Wen-Ya Fu; Xin-Zuo Chi; Feng-Ying Wang; Da-Qing Ma; Tian-Long Wang

    2015-01-01

    Background:Hypotension induced by combined spinal epidural anesthesia in parturient with hypertensive disorders of pregnancy (HDP) can easily compromise blood supply to vital organs including uteroplacental perfusion and result in fetal distress.The aim of this study was to investigate whether the goal-directed fluid therapy (GDFT) with LiDCOrapid system can improve well-being of both HDP parturient and their babies.Methods:Fifty-two stable HDP parturient scheduled for elective cesarean delivery were recruited.After loading with 10 ml/kg lactated Ringer's solution (LR),parturient were randomized to the GDFT and control group.In the GDFT group,individualized fluid therapy was guided by increase in stroke volume (ASV) provided via LiDCOrapid system.The control group received the routine fluid therapy.The primary endpoints included maternal hypotension and the doses ofvasopressors administered prior to fetal delivery.The secondary endpoints included umbilical blood gas abnormalities and neonatal adverse events.Results:The severity of HDP was similar between two groups.The total LR infusion (P < 0.01) and urine output (P < 0.05) were higher in the GDFT group than in the control group.Following twice fluid challenge tests,the systolic blood pressure,mean blood pressure,cardiac output and SV in the GDFT group were significantly higher,and the heart rate was lower than in the control group.The incidence of maternal hypotension and doses of phenylephrine used prior to fetal delivery were significantly higher in the control group than in the GDFT group (P < 0.01).There were no differences in the Apgar scores between two groups.In the control group,the mean values of pH in umbilical artery/vein were remarkably decreased (P < 0.05),and the incidences of neonatal hypercapnia and hypoxemia were statistically increased (P < 0.05) than in the GDFT group.Conclusions:Dynamic responsiveness guided fluid therapy with the LiDCOrapid system may provide potential benefits to

  3. ANALYSIS OF MATERNAL AND FETAL OUTCOME IN SPINAL VERSUS EPIDURAL ANESTHESIA FOR CESAREAN DELIVERY IN SEVERE PRE-ECLAMPSIA

    Directory of Open Access Journals (Sweden)

    Jyothi

    2015-12-01

    Full Text Available AIM Our primary aim is to analyze of maternal and fetal outcome in spinal versus epidural anesthesia for cesarean delivery in severe pre-eclampsia. MATERIALS AND METHODS Sixty parturients (60 with severe pre-eclampsia posted for cesarean section were randomized into two groups of thirty (30 each for either spinal anesthesia that is group S or epidural anesthesia that is group E. Spinal group (group S, n=30 received 10mg (2ml of 0.5% of hyperbaric bupivacaine solution intrathecally in left lateral decubitus or sitting position at L3-4 lumbar space with 25G quincke-babcock spinal needle. Patients received 6l/min of oxygen through Hudson’s face mask throughout the surgery. In Epidural group (group E, n=30, after thorough aseptic precautions, an 18G Tuohy’s epidural needle inserted at the L3-4 lumbar space with the patient in lateral decubitus or sitting position. Three ml of 1.5% lidocaine with was given as a test dose. After ruling out any intrathecal injection of the drug, initially 8ml of 0.5% isobaric bupivacaine given and the vitals monitored. Then 3ml top-ups of the same bupivacaine solution is given in a graded manner slowly, simultaneously checking the height of block. A blockade upto T4 to T6 is required. Vitals are carefully monitored and oxygen is provided 6l/min throughout the procedure and surgery. Blood pressure (systolic, mean, diastolic, pulse rate, oxygen saturation are recorded immediately after giving anesthesia, every minute for first 10mins, then every 3mins for the rest of the surgery. Then vitals are also noted post-operatively for the first 24hrs. Apgar score after 1 and 5 minutes, of the newborn baby is also recorded. Other parameters noted were incidence and duration of hypotension or hypertension both intra-operatively and post-operatively, any usage of vasopressors (ephedrine and its dose, convulsions, renal failure, pulmonary edema, requirement for ICU stay and the number of days in the mother, and the incidence of

  4. 罗哌卡因复合芬太尼硬膜外注入用于无痛分娩的临床观察%The clinical observation for application of ropivacaine combined with fentanyl used for pain free delivery via epidural infusion

    Institute of Scientific and Technical Information of China (English)

    康志雄

    2014-01-01

    determined time 20 minutes via extradural catheterization while the control group was treated routinely. Then, we observed and recorded the analgesic effectiveness, the degree of nerve block, period of labor stage, delivery mode, women and newborn infants, etc. Results: after administration of solution infused via epidural space of the analgesic group, 97.04% primipara were free from pain with VAS scores (0.26±0.027). 6.2% primipara has a slight motor nerve block. All the primipara could move their lower extremities freely. The active period of the analgesic group was shorter than the control group and the period of the second labor stage obviously longer than that of the control group. The utility of Oxytocin in the analgesic group was higher than that in the control group. There was no difference in the results such as period of the third labor stage, the apgar scores, the rate of cesarean section, the rate of assistant delivery between the two groups. Conclusion: it is confirmed that the effectiveness of the application of Ropivacaine conbined with Fentanyl used for PECA through infusion via epidural catheterization. It has slight motor nerve block and can prompt the active stage but may prolong the second labor stage and increases the use of Oxytocin. It has no influence on the rate of cesarean section, the rate of assistant delivery as well as newborn infant’s apgar scores.

  5. Effects of epidural analgesia on maternal and infant by vaginal delivery%硬膜外分娩镇痛对经阴道分娩母婴影响的临床研究

    Institute of Scientific and Technical Information of China (English)

    杨絮; 杨泳; 吕国义

    2015-01-01

    right time as feotus was delivered. Apgar scores at 1,5 and 10 minutes after neonatus was delivered were recorded for analysis. The stages of labor,weather the cases with oxytocin used during the stage,postpartum hemorrhage,visual analogue score( VAS) and Bromage score as orifice of the uterus expansed to 6 to 7 cm,lactation starting time and Neonatal Behavioral Neurological As-sessment after 72 hours neonatus delivered were recorded. Results There were no significant differences in the general condi-tions of pregnant women between the two groups. Either the first or second stage of labor was prolonged in EA group than that of NA group(P0. 05). There was no significant difference in initial time of lactation between the two group(34. 1 ± 1. 4 vs 37. 6 ± 1. 3,P>0. 05). There was significant difference in Apgar score of neonates between EA and NA group at 1,5 minutes after delivery(7. 241 ± 0. 077vs 7. 282 ± 0. 058,P<0. 05). Blood gas analysis in UVS:there were no significant differences in other parameters besides pH,which value in EA group was a little lower than that of NA group. Conclusion The epidural analgesia can provide a satisfactory labor-pain relief during delivery sta-ges without affecting on post-labor lactation,increasing bleeding after a delivery or blocking motor nerve,there is no adverse in-fluence on virginal delivery women. There were no actually significant side-effects on newborns found during labor pain relief with epidural analgesia. It is deserved to spread clinically.

  6. Assisted Vaginal Delivery

    Science.gov (United States)

    ... be needed. What are the risks for my baby if I have assisted vaginal delivery? Although the overall rate of injury to the baby as a result of assisted vaginal delivery is low, there still is a risk of ...

  7. eDelivery

    Data.gov (United States)

    US Agency for International Development — eDelivery provides the electronic packaging and delivery of closed and complete OPM investigation files to government agencies, including USAID, in a secure manner....

  8. Plomo en la sangre del cordón umbilical y su impacto sobre el peso, longitud, hemoglobina y APGAR en zonas con diferente grado de contaminación

    Directory of Open Access Journals (Sweden)

    J. Castro Bedriñana

    2012-01-01

    Full Text Available En el presente estudio se ha evaluado la concentración de plomo en la sangre del cordón umbilical de 64 neonatos nacidos de mujeres gestantes que viven en las ciudades de Huancayo (zona urbana-comercial y La Oroya (zona metalúrgica del Centro del Perú y su impacto sobre el nivel de hemoglobina, longitud, peso y APGAR al nacimiento. El estudio transversal se realizó en los Hospitales II de EsSalud de La Oroya y Hospital Regional de Huancayo entre noviembre del 2003 a abril del 2004, cuando la fundición de la Oroya estaba en normal funcionamiento. La cuantificación del plomo se realizó por espectrometría de absorción atómica con horno de grafito en el Instituto Peruano de Energía Nuclear. El muestreo biológico respondio a los protocolos de Iyengar y Rapp. Los neonatos de Huancayo y la Oroya tuvieron concentraciones promedio de plomo de 18,03ug/dLy 22,96 ug/dL(p=0,016, siendo estos valores 1,8 y 2,3 veces más altos que el nivel crítico sugerido por la CDC y la WHO (10ug/dL. Los niveles de hemoglobina para los neonatos de Huancayo y La Oroya fueron 18,3 y 16,9g/dL (p=0,000. Solo se registraron cuadros de anemia en los neonatos de la Oroya (9,38%. Al análisis de regresión, fue evidente la asociación inversa entre el contenido de plomo en la sangre del cordón umbilical y el contenido de hemoglobina, peso, logitud y puntaje APGAR al nacimiento.

  9. Association of maternal and neonatal plasma interleukin-6 levels in relation to model of delivery

    Directory of Open Access Journals (Sweden)

    Mahmoud Imani

    2011-07-01

    Full Text Available Background: Cytokines play an important role during labor of full – or pretern delivery. In umbilical cord blood, Interleukin-6 (IL-6 was thought to be a marker of defense to stress, surgery and infection. The aim of this study was to investigate the cytokine IL-6 concentrations in the mother and neonate depends on the mode of the delivery.Materials and Method: This study was done on mothers and neonates in 80 single term deliveries (vaginal and cesarean in Mahdieh Hospital in Tehran. Age of mothers was 21-39 years old, parity was 1 and 2. There wasn't history of underlying disease and drug usage in mothers and neonate was AGA and apgar was more than 8. There wasn't clinical evidence of infection in neonate and mothers. IL-6 was evaluated by enzyme-immunoassays in maternal serum and neonatal umbilical cord. Data were analyzed with SPSS and were applied fishers exact test for compare means.Results: There were 37 vaginal deliveries and 43cesarean section. The mean (±standard error of maternal IL-6 concentration in vaginal delivery (0.18±0.02 was significantly (P=0.000 higher than cesarean section (0.1±0.02 and neonatal IL-6 concentration in vaginal delivery (0.17±0.03 was significantly (P=0.000 higher than cesarean section (0.07±0.01.Conclusion: Results show that vaginal delivery cause to increase IL-6 compared to cesarean section in mother and neonate

  10. Assisted delivery with forceps

    Science.gov (United States)

    ... technique your doctor may use to deliver the baby is called vacuum assisted delivery . When is a Forceps Delivery Needed? Even after ... Problems with urinating or moving your bowels after delivery For the baby, the risks are: Bumps, bruises or marks on ...

  11. 全麻对剖宫产胎儿影响的临床研究%Clinical study of the influence of general anesthesia on cesarean delivery fetus

    Institute of Scientific and Technical Information of China (English)

    李莉; 苏利

    2014-01-01

    Objective To compare the influence of general anesthesia and combined spinal-epidural anesthesia on neonatal Apgar score. Methods A total of 65 cases of single pregnancy to full term undergone cesarean section were taken as study subjects. There were 32 cases in the general anesthesia group received general anesthesia due to intraspinal anesthesia taboo, and the other 33 cases in the combined spinal-epidural anesthesia group received combined spinal-epidural anesthesia. The fetal childbirth time, birth weight, and apgar score at 1 min and 5 min were recorded. Results Apgar score at 1 min of general anesthesia group and combined spinal-epidural anesthesia group were (9.5±0.8) points and (9.8±0.6) points respectively, and there was no significant difference between the two groups (P>0.05). Apgar scores at 5 min were all 10 points in the two groups. Conclusion General anesthesia and combined spinal-epidural anesthesia have no obviously variant influences on fetus.%目的:比较剖宫产施行全身麻醉(全麻)和腰硬联合麻醉对新生儿Apgar评分的影响。方法选择足月单胎妊娠行择期剖宫产的产妇65例,椎管内麻醉禁忌而需使用全麻的剖宫产为全麻组32例,其余33例行腰硬联合麻醉作为腰硬联合麻醉组。记录胎儿娩出时间,新生儿体重和1、5 min的Apgar评分。结果全麻组和腰硬联合麻醉组新生儿1 min的Apgar评分分别为(9.5±0.8)分、(9.8±0.6)分,两组差异无统计学意义(P>0.05)。5 min Apgar评分均为10分。结论全麻和硬联合麻醉对胎儿的影响没有明显差异。

  12. Obstructed Defecation Syndrome After Delivery Trauma

    Directory of Open Access Journals (Sweden)

    Mehrvarz

    2015-11-01

    Full Text Available Background Obstructed defecation syndrome (ODS occurs in about 7% of adults; it seems that the etiology of pelvic floor disorders is multifactorial. Pregnancy and childbirth damage to the pelvic nerve and muscles are proposed causes for this condition. The precise role of vaginal delivery (VD is not clearly defined, although in recent studies association of pelvic floor disorder with Operative vaginal delivery and episiotomy has been proposed. Objectives In this prospective study, we assessed the outcome of stapled transanal rectal resection (STARR in females with one of the two modes of delivery (VD or caesarean section (C/S. Patients and Methods We used Longo’s ODS score for the assessment of the severity of pelvic floor malfunction. Stapled Trans Anal Rectal Resection (STARR procedure was performed using two circular staplers. Follow-up was done 12 months after the discharge. To assess the role of episiotomy in patient with VD, we divided them into two subgroups; females who had VD with episiotomy (Vd + epi and females who had VD alone. Data were analyzed using SPSS version 20 software. P values less than 0.05 were considered statistically significant. Results In 30 consecutive females undergoing STARR for the treatment of ODS, who enrolled in this prospective study, 19 (63.3% had Vaginal Delivery VD and 11 (36.7% had Cesarean Section (C/S. The ODS score before the surgery was higher in females who had C/S, although there was no significant difference between VD and C/S groups in terms of the percentage of the ODS score improvement after the STARR surgery. Conclusions Higher ODS score in females who had C/S showed that C/S could not protect the pelvic organ from pregnancy and delivery trauma. It seems that episiotomy has a protective effect during VD; it can reduce the severity of trauma in pelvic organs during childbearing.

  13. Comparison of remifentanil and fentanyl regarding hemodynamic changes due to endotracheal intubation in preeclamptic parturient candidate for cesarean delivery.

    Science.gov (United States)

    Pournajafian, Alireza; Rokhtabnak, Faranak; Kholdbarin, Alireza; Ghodrati, Mohammadreza; Ghavam, Siamak

    2012-01-01

    Intravenous opioids are administered to prevent and control hemodynamic changes due to endotracheal intubation. Except for special cases such as preeclampsia, these drugs are not recommended for parturants candidate for cesarean section because of the respiratory depression caused in the newborn. According to rapid metabolism of remifentanil, the current study aimed to compare hemodynamic changes in preeclamptic parturants who received remifentanil and fentanyl for cesarean section under general anesthesia. This single blind randomized clinical trial was performed on preeclamptic pregnant women candidate for cesarean section under general anesthesia. They were divided into two groups. In the first group 0.05 μg/kg/min remifentanil was infused for 3 minutes before induction of anesthesia and in the second group 1ml (50 μg) fentanyl was injected before induction. Heart rate (HR), systolic blood pressure (SBP) and diastolic blood pressure (DBP) before and after intubation and also Apgar index were measured and compared between the two groups. All hemodynamic variables increased after intubation in the fentanyl group (pSBP = 0.146, pDBP = 0.019, pHR intubation in the remifentanil group was observed. No significant difference was found between Apgar indexes of the two groups (P = 0.771). It can be postulated that remifentanil can be used in partituents candidate for cesarean delivery under general anesthesia to prevent severe increase in blood pressure and heart rate during tracheal intubation without adverse effects on newborn.

  14. [Propensity score matching in SPSS].

    Science.gov (United States)

    Huang, Fuqiang; DU, Chunlin; Sun, Menghui; Ning, Bing; Luo, Ying; An, Shengli

    2015-11-01

    To realize propensity score matching in PS Matching module of SPSS and interpret the analysis results. The R software and plug-in that could link with the corresponding versions of SPSS and propensity score matching package were installed. A PS matching module was added in the SPSS interface, and its use was demonstrated with test data. Score estimation and nearest neighbor matching was achieved with the PS matching module, and the results of qualitative and quantitative statistical description and evaluation were presented in the form of a graph matching. Propensity score matching can be accomplished conveniently using SPSS software.

  15. Confidence scores for prediction models

    DEFF Research Database (Denmark)

    Gerds, Thomas Alexander; van de Wiel, MA

    2011-01-01

    modelling strategy is applied to different training sets. For each modelling strategy we estimate a confidence score based on the same repeated bootstraps. A new decomposition of the expected Brier score is obtained, as well as the estimates of population average confidence scores. The latter can be used...... to distinguish rival prediction models with similar prediction performances. Furthermore, on the subject level a confidence score may provide useful supplementary information for new patients who want to base a medical decision on predicted risk. The ideas are illustrated and discussed using data from cancer...

  16. 剖宫产术后再次妊娠分娩方式的临床探讨%Discussion on Clinical Pregnancy Delivery Modes after Cesarean Section

    Institute of Scientific and Technical Information of China (English)

    彭敏; 陈燕桢

    2012-01-01

    目的 探讨剖宫产术后再次妊娠分娩方式的选择.方法 对2005年1月至2010年12月在我院住院的150例剖宫产术后再次妊娠分娩者的临床资料进行回顾性分析,并将其中104例剖宫产术后再次妊娠剖宫产(RCS组)及46例剖宫产术后再次妊娠阴道分娩(VBAC组),与同期104例首次剖宫产(PCS组)及46例非瘢痕子宫阴道分娩(VBNC组)比较.分析各组分娩结局、新生儿Apgar评分以及住院时间等差异.结果 150例剖宫产术后再次妊娠者,再次剖宫产者104例(69.3%),阴道分娩者46例(30.7%).VBAC组与RCS组比较,两组在产时出血量、新生儿Apgar评分以及住院时间方面均有统计学意义(P<0.05).VBAC组与VBNC组相比较,两者在产程时间、产时出血量、新生儿Apgar评分、新生儿窒息数及住院时间方面均无统计学意义(P>0.05).RCS组与PCS组相比较,在手术时间、产时出血量、术后腹腔粘连及住院时间方面均有统计学意义(P<0.05),新生儿Apgar评分无统计学意义(P>0.05).结论 剖宫产术后再次妊娠分娩并非是剖宫产的绝对指征,符合试产条件者在严密监护下阴道试产是安全可行的,且能改善分娩结局.%Objective To discuss the selection of secondary deliver}' mode after cesarean section. Methods A total of 150 cases of second pregnancy after cesarean delivery admitted in our hospital during Jan. 2005 to Dec. 2010 were reviewed, of which 104 cases underwent repeat cesarean section( KCS group ),46 had vaginal birth after cesarean section( VBAC group ). 104 corresponding cases that underwent first cesarean section( PCS )and 46 that had non-scarred uterus with vaginal delivery( VBNC Muring the same period were also selected for comparison of delivery outcomes. Results Of the 150 cases, 104( 69. 3% )had HCS,46 ( 30.7% )had VBAC, and significant differences in blood loss volume, Apgar score, and hospital stay length were observed between the two groups( P 0

  17. Colloidal drug delivery systems in vaccine delivery.

    Science.gov (United States)

    Beg, Sarwar; Samad, Abdus; Nazish, Iram; Sultana, Ruksar; Rahman, Mahfoozur; Ahmad, Md Zaki; Akbar, Md

    2013-01-01

    Vaccines play a vital role in the field of community medicine to combat against several diseases of human existence. Vaccines primarily trigger the acquired immune system to develop long-lasting immunity against pathogens. Conventional approaches for vaccine delivery lacks potential to target a particular antigen to develop acquired immunity by specific antibodies. Recent advancements in vaccine delivery showed that inclusion of adjuvants in vaccine formulations or delivery of them in a carrier helps in achieving desired targeting ability, reducing the immunogenicity and significant augmentation in the immune response. Colloidal carriers (liposomes, niosomes, microspheres, proteosomes, virosomes and virus like particles (VLPs), antigen cochleates, dendrimers and carbon nanotubes) have been widely explored for vaccine delivery. Further, surface engineering of these carriers with ligands, functional moieties and monoclonal antibodies tend to enhance the immune recognition potential of vaccines by differentiation of antigen specific memory T-cells. The current review, therefore, provides an updated account on the recent advancements in various colloidal delivery systems in vaccine delivery, outlining the mechanism of immune response initiated by them along with potential applications and marketed instances in an explicit manner.

  18. Modelling sequentially scored item responses

    NARCIS (Netherlands)

    Akkermans, W.

    2000-01-01

    The sequential model can be used to describe the variable resulting from a sequential scoring process. In this paper two more item response models are investigated with respect to their suitability for sequential scoring: the partial credit model and the graded response model. The investigation is c

  19. Classification of current scoring functions.

    Science.gov (United States)

    Liu, Jie; Wang, Renxiao

    2015-03-23

    Scoring functions are a class of computational methods widely applied in structure-based drug design for evaluating protein-ligand interactions. Dozens of scoring functions have been published since the early 1990s. In literature, scoring functions are typically classified as force-field-based, empirical, and knowledge-based. This classification scheme has been quoted for more than a decade and is still repeatedly quoted by some recent publications. Unfortunately, it does not reflect the recent progress in this field. Besides, the naming convention used for describing different types of scoring functions has been somewhat jumbled in literature, which could be confusing for newcomers to this field. Here, we express our viewpoint on an up-to-date classification scheme and appropriate naming convention for current scoring functions. We propose that they can be classified into physics-based methods, empirical scoring functions, knowledge-based potentials, and descriptor-based scoring functions. We also outline the major difference and connections between different categories of scoring functions.

  20. The Machine Scoring of Writing

    Science.gov (United States)

    McCurry, Doug

    2010-01-01

    This article provides an introduction to the kind of computer software that is used to score student writing in some high stakes testing programs, and that is being promoted as a teaching and learning tool to schools. It sketches the state of play with machines for the scoring of writing, and describes how these machines work and what they do.…

  1. Skyrocketing Scores: An Urban Legend

    Science.gov (United States)

    Krashen, Stephen

    2005-01-01

    A new urban legend claims, "As a result of the state dropping bilingual education, test scores in California skyrocketed." Krashen disputes this theory, pointing out that other factors offer more logical explanations of California's recent improvements in SAT-9 scores. He discusses research on the effects of California's Proposition 227,…

  2. Quadratic prediction of factor scores

    NARCIS (Netherlands)

    Wansbeek, T

    1999-01-01

    Factor scores are naturally predicted by means of their conditional expectation given the indicators y. Under normality this expectation is linear in y but in general it is an unknown function of y. II is discussed that under nonnormality factor scores can be more precisely predicted by a quadratic

  3. Trends in Classroom Observation Scores

    Science.gov (United States)

    Casabianca, Jodi M.; Lockwood, J. R.; McCaffrey, Daniel F.

    2015-01-01

    Observations and ratings of classroom teaching and interactions collected over time are susceptible to trends in both the quality of instruction and rater behavior. These trends have potential implications for inferences about teaching and for study design. We use scores on the Classroom Assessment Scoring System-Secondary (CLASS-S) protocol from…

  4. D-score: a search engine independent MD-score.

    Science.gov (United States)

    Vaudel, Marc; Breiter, Daniela; Beck, Florian; Rahnenführer, Jörg; Martens, Lennart; Zahedi, René P

    2013-03-01

    While peptides carrying PTMs are routinely identified in gel-free MS, the localization of the PTMs onto the peptide sequences remains challenging. Search engine scores of secondary peptide matches have been used in different approaches in order to infer the quality of site inference, by penalizing the localization whenever the search engine similarly scored two candidate peptides with different site assignments. In the present work, we show how the estimation of posterior error probabilities for peptide candidates allows the estimation of a PTM score called the D-score, for multiple search engine studies. We demonstrate the applicability of this score to three popular search engines: Mascot, OMSSA, and X!Tandem, and evaluate its performance using an already published high resolution data set of synthetic phosphopeptides. For those peptides with phosphorylation site inference uncertainty, the number of spectrum matches with correctly localized phosphorylation increased by up to 25.7% when compared to using Mascot alone, although the actual increase depended on the fragmentation method used. Since this method relies only on search engine scores, it can be readily applied to the scoring of the localization of virtually any modification at no additional experimental or in silico cost.

  5. [Optimization of anesthetic service during abdominal delivery of pregnant women with gestosis].

    Science.gov (United States)

    Tiukov, V L; Pyregov, A V; Shepetovskaia, N L; Pivovarova, G M; Gur'ianov, V A

    2007-01-01

    Differential preoperative preparation of pregnant women with gestosis, by using calcium antagonists is an effective preventive measure against a circulatory hyperdynamic response to transportation to the operating suite. In pregnant women who had all hemodynamic types at baseline, the eukinetic type achieved during the preparation is retained. The patients with gestosis who did not receive calcium antagonists were found to have a circulatory hyperdynamic response with increased myocardial oxygen uptake (during surgery in particular). The use of calcium antagonists, ketonal, tranexamic acid, and hydroxyethyl starch-130/04 solution in the anesthetic appliance promoted the preservation of eukinetic hemodynamics in all those operated on, without increasing myocardial oxygen demands. The better reaction of the circulatory system and myocardial oxygen demands to surgical injury (the second mediatory wave of the systemic inflammatory response syndrome) correlated with higher neonatal Apgar scores in this category of puerperas with gestosis.

  6. Induction of labor in grand multiparous women with previous cesarean delivery: how safe is this?

    Science.gov (United States)

    Chibber, Rachana; Al-Harmi, Jehad; Foda, Mohamed; Mohammed K, Zeinab; Al-Saleh, Eyad; Mohammed, Asiya Tasneem

    2015-02-01

    To compare the outcome of induced and spontaneous labor in grand multiparous women with one previous lower segment cesarean section (CS), so that the safety of labor induction could be assessed. In 102 women (study group), labor was induced and the outcome was compared with 280 women (control group) who went into spontaneous labor. All 382 women were grand multiparous and had one previous CS. There were no significant difference in oxytocin augmentation, CS, scar dehiscence, fetal birth weight or apgar scores between groups. There was one neonatal death, two still births, one early neonatal death and one congenital malformation in the study group and this was not significant. There was no significant difference in vaginal birth in the study (80.9%) and the control group (83.8%). In this moderate-sized study, induction of labor may be a safe option in grand multiparous women, if there is no absolute induction for repeating CS.

  7. Cross sectional study of mode of delivery and maternal and perinatal outcomes in mainland China

    Science.gov (United States)

    Vitonis, Allison; Zou, Liying; Ruan, Yan; Wang, Xin; Zhang, Weiyuan

    2017-01-01

    Background Cesarean delivery (CD) rates have risen globally with nearly 50% of the non-indicated CDs worldwide in China and Brazil. In China’s One Child Policy era (1979–2015) most deliveries were women having their only child. Family size is a major determinant of the safety of medically non-indicated CD or CD on maternal request. The goal of this study is to document CD rates, indications, and analyze the relative safety of non-indicated CD compared to SVD and intrapartum CD. Methods Univariate and multivariate logistic regression analyses of the association between mode of delivery and short-term maternal and perinatal outcomes were performed on a cross-section of all deliveries at 39 hospitals in 14 provinces of China in 2011, presented as adjusted odds ratio (aOR), 99% confidence intervals (CI). Findings Among 108,847 deliveries, 59,415 were CD (54.6%) with 20.8% of deliveries or 38.2% of all cesareans were non-indicated CD. Compared to SVD, antepartum non-indicated CD was associated with a decreased likelihood of post-partum hemorrhage (PPH) (aOR = 0.80, CI = 0.69–0.92) and was not associated with maternal death or combined severe outcomes (maternal death, transfusion, or hysterectomy). Intrapartum indicated CD was associated with an increased risk of PPH (aOR = 1.68, CI = 1.50–1.89) compared to SVD. Compared to SVD, antepartum non-indicated CD was associated with lower likelihood of neonatal death (aOR = 0.14, CI = 0.06–0.34), neonatal ICU admission (aOR = 0.50, CI = 0.36–0.69), 5-minute ApgarSVD. Now that all Chinese women can have a second child the safety profile may change. PMID:28182668

  8. Project delivery system (PDS)

    CERN Document Server

    2001-01-01

    As business environments become increasingly competitive, companies seek more comprehensive solutions to the delivery of their projects. "Project Delivery System: Fourth Edition" describes the process-driven project delivery systems which incorporates the best practices from Total Quality and is aligned with the Project Management Institute and ISO Quality Standards is the means by which projects are consistently and efficiently planned, executed and completed to the satisfaction of clients and customers.

  9. Cesarean Delivery in Adolescents.

    Science.gov (United States)

    Katz Eriksen, Jennifer L; Melamed, Alexander; Clapp, Mark A; Little, Sarah E; Zera, Chloe

    2016-10-01

    To examine the effect of maternal age on indication for primary cesarean delivery in low-risk nulliparous women. Retrospective cohort study. Urban academic tertiary care center. Nulliparous women younger than 35 years of age delivering vertex-presenting singletons at term. Participants underwent spontaneous, operative or cesarean delivery. Mode of delivery, indication, and timing of cesarean delivery. Adolescents were half as likely to undergo cesarean delivery overall (odds ratio [OR], 0.48; 95% confidence interval [CI], 0.43-0.54), and more than one-third less likely to undergo cesarean delivery in labor (OR, 0.59; 95% CI, 0.53-0.66). Adjustment for potential confounders did not alter the strength of these associations. Adolescents were half as likely to undergo cesarean delivery for failure to progress (OR, 0.49; 95% CI, 0.43-0.54). There was no difference in the odds of cesarean delivery for nonreassuring fetal status (OR, 0.91; 95% CI, 0.77-1.06), or genital herpes (OR, 1.44; 95% CI, 0.57-3.68). Induction, macrosomia, oxytocin augmentation, and any labor complication were all associated with increased risk of cesarean delivery. There was no difference in the duration of second stage for adolescents who delivered by cesarean delivery compared with adults (240.0 vs 237.7 minutes; P = .84), but adolescents who delivered vaginally had a second stage that was one-third shorter than adults (62.5 vs 100.3 minutes; P cesarean delivery overall, and 40% less likely to undergo a primary cesarean delivery in labor, even after adjustment for multiple maternal, neonatal, and labor characteristics. This difference is not explained by differences in the duration of the second stage of labor. Copyright © 2016 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

  10. Buccal drug delivery.

    Science.gov (United States)

    Smart, John D

    2005-05-01

    Buccal formulations have been developed to allow prolonged localised therapy and enhanced systemic delivery. The buccal mucosa, however, while avoiding first-pass effects, is a formidable barrier to drug absorption, especially for biopharmaceutical products (proteins and oligonucleotides) arising from the recent advances in genomics and proteomics. The buccal route is typically used for extended drug delivery, so formulations that can be attached to the buccal mucosa are favoured. The bioadhesive polymers used in buccal drug delivery to retain a formulation are typically hydrophilic macro-molecules containing numerous hydrogen bonding groups. Newer second-generation bioadhesives have been developed and these include modified or new polymers that allow enhanced adhesion and/or drug delivery, in addition to site-specific ligands such as lectins. Over the last 20 years a wide range of formulations has been developed for buccal drug delivery (tablet, patch, liquids and semisolids) but comparatively few have found their way onto the market. Currently, this route is restricted to the delivery of a limited number of small lipophilic molecules that readily cross the buccal mucosa. However, this route could become a significant means for the delivery of a range of active agents in the coming years, if the barriers to buccal drug delivery are overcome. In particular, patient acceptability and the successful systemic delivery of large molecules (proteins, oligonucleotides and polysaccharides) via this route remains both a significant opportunity and challenge, and new/improved technologies may be required to address these.

  11. Obstetrical disseminated intravascular coagulation score.

    Science.gov (United States)

    Kobayashi, Takao

    2014-06-01

    Obstetrical disseminated intravascular coagulation (DIC) is usually a very acute, serious complication of pregnancy. The obstetrical DIC score helps with making a prompt diagnosis and starting treatment early. This DIC score, in which higher scores are given for clinical parameters rather than for laboratory parameters, has three components: (i) the underlying diseases; (ii) the clinical symptoms; and (iii) the laboratory findings (coagulation tests). It is justifiably appropriate to initiate therapy for DIC when the obstetrical DIC score reaches 8 points or more before obtaining the results of coagulation tests. Improvement of blood coagulation tests and clinical symptoms are essential to the efficacy evaluation for treatment after a diagnosis of obstetrical DIC. Therefore, the efficacy evaluation criteria for obstetrical DIC are also defined to enable follow-up of the clinical efficacy of DIC therapy.

  12. From Rasch scores to regression

    DEFF Research Database (Denmark)

    Christensen, Karl Bang

    2006-01-01

    Rasch models provide a framework for measurement and modelling latent variables. Having measured a latent variable in a population a comparison of groups will often be of interest. For this purpose the use of observed raw scores will often be inadequate because these lack interval scale propertie....... This paper compares two approaches to group comparison: linear regression models using estimated person locations as outcome variables and latent regression models based on the distribution of the score....

  13. Commercial Building Energy Asset Score

    Energy Technology Data Exchange (ETDEWEB)

    2017-05-26

    This software (Asset Scoring Tool) is designed to help building owners and managers to gain insight into the as-built efficiency of their buildings. It is a web tool where users can enter their building information and obtain an asset score report. The asset score report consists of modeled building energy use (by end use and by fuel type), building systems (envelope, lighting, heating, cooling, service hot water) evaluations, and recommended energy efficiency measures. The intended users are building owners and operators who have limited knowledge of building energy efficiency. The scoring tool collects minimum building data (~20 data entries) from users and build a full-scale energy model using the inference functionalities from Facility Energy Decision System (FEDS). The scoring tool runs real-time building energy simulation using EnergyPlus and performs life-cycle cost analysis using FEDS. An API is also under development to allow the third-party applications to exchange data with the web service of the scoring tool.

  14. Prediction of preterm delivery

    NARCIS (Netherlands)

    Wilms, F.F.

    2014-01-01

    Preterm delivery is in quantity and in severity an important issue in the obstetric care in the Western world. There is considerable knowledge on maternal and obstetric risk factors of preterm delivery. Of the women presenting with preterm labor, the majority is pregnant with a male fetus and in

  15. Prediction of preterm delivery

    NARCIS (Netherlands)

    Wilms, F.F.

    2014-01-01

    Preterm delivery is in quantity and in severity an important issue in the obstetric care in the Western world. There is considerable knowledge on maternal and obstetric risk factors of preterm delivery. Of the women presenting with preterm labor, the majority is pregnant with a male fetus and in Cau

  16. Delivery by Cesarean Section

    Science.gov (United States)

    ... often when: The mother has had a previous baby by Cesarean delivery The obstetrician feels that the baby’s health might ... lost time. Don’t be surprised if your baby is still affected by the anesthesia for six to twelve hours after delivery and appears a little sleepy. If you’re ...

  17. Vacuum-assisted delivery

    Science.gov (United States)

    ... a handle on the cup to move the baby through the birth canal. When is Vacuum-assisted Delivery Needed? Even after your cervix is fully dilated ( ... delivers the baby's head, you will push the baby the rest of the way out. After delivery, you can hold your baby on your tummy ...

  18. Quality of Life after Cesarean and Vaginal Delivery

    Directory of Open Access Journals (Sweden)

    Seyed Abbas Mousavi

    2013-07-01

    Full Text Available Objective: Cesarean rates in recent decades have been increasing and a number of studies have shown that cesarean increases maternal morbidities. The aim of this study is to compare the quality of life after cesarean and vaginal delivery.Methods: This prospective study was carried out on 356 pregnant women visiting urban health centers in Shahroud City, Northeast Iran, in 2011. The subjects completed the quality of life questionnaire in the third trimester of pregnancy and at 8 weeks postpartum.Results: In primiparas, the mean global QOL scores for the cesarean and vaginal delivery groups were 67.65 ± 12.7 and 72.12 ± 11.8, respectively. Also, the scores for the physical, psychological and social domains of QOL as well as the global score of QOL were higher in the vaginal delivery group than the cesarean group (p<0.05. In the case of primiparas, multiple regression analysis revealed that after adjusting for education, desirability of pregnancy and the General Health Questionnaire score, the delivery type remained as a predictor of the scores for the physical (R2=1.7%; B=-3.826; p=0.031; CI [-7.301, -.350] and social (R2=2.5%; B=-5.708; p=0.017; CI [-10.392, -1.023] domains of QOL and the global QOL score (R2=2.6%; B=-4.065; p=0.006; CI [-6.964, -1.164]. While multiparas, there was no relationship between QOL and type of delivery.Conclusion: In this sample of low-risk women, cesarean negatively affected the QOL of primiparas. More studies with larger sample sizes should be conducted to examine the effects of cesarean on QOL in both primiparas and multiparas within a shorter period after delivery.

  19. Application effects of nursing midwifery of modified low forceps delivery combined with unprotected perineum for primipara%改良式低位产钳术联合无保护会阴助产护理在初产妇中的应用效果

    Institute of Scientific and Technical Information of China (English)

    吴雅丽; 黄定根; 张海清; 黄月红

    2015-01-01

    Objective To discuss the application effects of nursing midwifery of modified low forceps delivery combined with unprotected perineum for primipara. Methods 214 primipara with single birth in our hospital from October 2012 to June 2014 were selected.They were assigned to two groups based on a random number table,107 patients in each group.Control group was given nursing midwifery of modified low forceps delivery,and observation group was given nursing midwifery of modified low forceps delivery combined with unprotected perineum.Nursing effects between two groups of primipara were compared. Results The second stage of labor,amount of bleeding during delivery,amount of bleeding after delivery and hospitalization time in observation group was significantly shorter or lower than that in con-trol group respectively.Apgar scores was significantly higher than that in control group,and the incidences of complica-tions(perineum abrasion,degreeⅠ laceration,degreeII laceration,urinary retention and infections) was significantly low-er than that in control group respectively,with statistical difference(P<0.05). Conclusion Nursing midwifery of modified low forceps delivery combined with unprotected perineum is able to improve the delivery quality,significantly shorter delivery time and recovery time,and has few injuries and less complications,which is worthy of clinical promotion and application.%目的:探讨改良式低位产钳术联合无保护会阴助产护理在初产妇中的应用效果。方法选取本院2012年10月~2014年6月单胎初产妇214例,采用随机数字表法分为两组,每组107例。对照组采用改良式低位产钳术助产护理,观察组采用改良式低位产钳术联合无保护会阴助产护理,比较两组产妇的护理效果。结果观察组产妇第二产程、住院时间均明显短于对照组,产时出血量、产后出血量均明显少于对照组,新生儿Apgar评分明显高于对照组,并发症(会阴黏

  20. The relation of breech presentation at term to cerebral palsy

    DEFF Research Database (Denmark)

    Krebs, L; Topp, M; Langhoff-Roos, J

    1999-01-01

    OBJECTIVE: To examine the relation between breech delivery and cerebral palsy, considering the influence of intrauterine growth, low Apgar score at birth, and mode of delivery. DESIGN: Register-based, case-control study. POPULATION: A cohort of infants with cerebral palsy born between 1979 and 1986...... in East Denmark, identified by linkage of the cerebral palsy register with the national birth register. Discharge letters from births of breech infants with cerebral palsy were reviewed. MAIN OUTCOME MEASURES: Presentation, mode of delivery, gestational age, birthweight, Apgar score, type of cerebral...... palsy, severity of handicap. RESULTS: Breech presentation at term was associated with a borderline significantly higher risk of cerebral palsy than vertex presentation (OR 1.56; 95% CI 0.9-2.4). Breech presentation infants more often had a lower Apgar score (

  1. Neonatal status: an objective scoring method for identifying infants at risk for poor outcome.

    Science.gov (United States)

    Salamy, A; Davis, S; Eldredge, L; Wakeley, A; Tooley, W H

    1988-01-01

    The likelihood of sustaining neurological, sensory or cognitive deficits is considerably greater for very low birthweight (VLBW) infants who require intensive care in early postnatal life than those without major neonatal illness. Identifying which, if any, medical events are responsible for an adverse outcome is most difficult in the face of multiple concurrent complications. In this research, a principal components analysis was performed in order to arrive at a set of orthogonal variables which succinctly described clinical involvement in the nursery. With this procedure, a single hypothetical factor depicting neonatal status (NS) was computed. Principal component scores were then generated for NS and assigned to 252 VLBW (less than 1500 g) infants. These subjects were followed prospectively from birth to 4 years of age. Standardized measures of neurological, sensory and intellectual function were regularly administered. Neonatal status was shown to be significantly correlated with the various test results and predictive of long-term development. When subjects were divided into quartiles with respect to NS, a specific subgroup was identified as "at high risk" for poor outcome. Those subjects falling into the lower quartile incurred more neurological abnormalities persisting beyond the first year. They also suffered a higher incidence of intracranial hemorrhage and sensori-neural hearing loss. In addition, the lower 25%, as a group, scored well below all others on traditional tests of mental ability. These differences were sustained throughout infancy and early childhood and could not be attributed to a number of demographic variables including sex, gestational age, birthweight, Apgar scores or parental educational level.

  2. Airway changes in pregnant women before and after delivery.

    Science.gov (United States)

    Aydas, A D; Basaranoglu, G; Ozdemir, H; Dooply, S L S; Muhammedoglu, N; Kucuk, S; Saidoglu, L

    2015-06-01

    High incidence of difficult or failed intubation in obstetric patients is still a major problem to challenge anaesthesiologists. Although the probability of difficult intubation is impossible to predict preoperatively, some simple, practical bedside tests may help. This study used five simple tests in an attempt to better evaluate airway changes in pregnant women before and after delivery. Pregnant women from the ASA I-II group who were planning to undergo a normal vaginal delivery were evaluated as to the possibility of experiencing difficult intubation. Mallampati scores, thyromental distance, sternomental distance, mouth opening, and the degree of neck extension were recorded just before delivery and 24 h after delivery. Significant differences were seen in the pre- and post-delivery measurements (p changed in one-third (n 21, 36.6%) of the patients. Significant differences between the two measurements of thyromental and sternomental distances, mouth opening, and the degree of neck extension confirm difficult airway management in pregnant women.

  3. Skin scoring in systemic sclerosis

    DEFF Research Database (Denmark)

    Zachariae, Hugh; Bjerring, Peter; Halkier-Sørensen, Lars

    1994-01-01

    Forty-one patients with systemic sclerosis were investigated with a new and simple skin score method measuring the degree of thickening and pliability in seven regions together with area involvement in each region. The highest values were, as expected, found in diffuse cutaneous systemic sclerosis...... (type III SS) and the lowest in limited cutaneous systemic sclerosis (type I SS) with no lesions extending above wrists and ancles. A positive correlation was found to the aminoterminal propeptide of type III procollagen, a serological marker for synthesis of type III collagen. The skin score...

  4. Skin scoring in systemic sclerosis

    DEFF Research Database (Denmark)

    Zachariae, Hugh; Bjerring, Peter; Halkier-Sørensen, Lars

    1994-01-01

    Forty-one patients with systemic sclerosis were investigated with a new and simple skin score method measuring the degree of thickening and pliability in seven regions together with area involvement in each region. The highest values were, as expected, found in diffuse cutaneous systemic sclerosis...... (type III SS) and the lowest in limited cutaneous systemic sclerosis (type I SS) with no lesions extending above wrists and ancles. A positive correlation was found to the aminoterminal propeptide of type III procollagen, a serological marker for synthesis of type III collagen. The skin score...

  5. Global Delivery Models

    DEFF Research Database (Denmark)

    Manning, Stephan; Larsen, Marcus M.; Bharati, Pratyush

    2013-01-01

    This article examines antecedents and performance implications of global delivery models (GDMs) in global business services. GDMs require geographically distributed operations to exploit both proximity to clients and time-zone spread for efficient service delivery. We propose and empirically show...... that service providers who differentiate based on speed of service delivery are likely to set up GDM structures, and that these structures positively affect deal renewal rates if speed is important for clients in selecting vendors. Findings imply that, as co-location becomes less necessary for providing...... digitalized services, time zones increasingly affect....

  6. Global Delivery Models

    DEFF Research Database (Denmark)

    Manning, Stephan; Møller Larsen, Marcus; Bharati, Pratyush

    We investigate antecedents and contingencies of location configurations supporting global delivery models (GDMs) in global outsourcing. GDMs are a new form of IT-enabled client-specific investment promoting services provision integration with clients by exploiting client proximity and time......-zone spread allowing for 24/7 service delivery and access to resources. Based on comprehensive data we show that providers are likely to establish GDM configurations when clients value access to globally distributed talent pools and speed of service delivery, and in particular when services are highly...

  7. Global Delivery Models

    DEFF Research Database (Denmark)

    Manning, Stephan; Møller Larsen, Marcus; Bharati, Pratyush

    We investigate antecedents and contingencies of location configurations supporting global delivery models (GDMs) in global outsourcing. GDMs are a new form of IT-enabled client-specific investment promoting services provision integration with clients by exploiting client proximity and time......-zone spread allowing for 24/7 service delivery and access to resources. Based on comprehensive data we show that providers are likely to establish GDM configurations when clients value access to globally distributed talent pools and speed of service delivery, and in particular when services are highly...... commoditized. Findings imply that coordination across time zones increasingly affects international operations in business-to-business and born-global industries....

  8. Focus on Delivery

    DEFF Research Database (Denmark)

    Hasman, Kirsten; Barfoed, Anne

    2016-01-01

    (2). It is, however, not clarified which of the multifaceted aspects of preventing perineal injury that might explain the decrease (3). Aims: We hypothesized that the use of structured reflection on a clinical practice by midwives and midwifery students would increase both parts’ knowledge on how...... attended a delivery. The tool was developed based on five categories: communication, pace, ergonomic positions, perineal support in the chosen birth position and delivery of the shoulders, and five predefined questions guided an overall reflection upon practice. After a delivery a project midwife, who had...

  9. Impact of the mode of delivery on female sexual function after childbirth.

    Science.gov (United States)

    Eid, M A; Sayed, A; Abdel-Rehim, R; Mostafa, T

    2015-01-01

    This cohort study aimed to assess the effect of the mode of delivery on female sexual function (FSF) after childbirth. Out of 256 primiparous women, 200 subjects that completed the study were divided into two groups; women that delivered vaginally and women that had elective cesarean section (CS). They were subjected to a translated version of female sexual function index (FSFI) questionnaire evaluating desire, lubrication, orgasm, satisfaction, pain both antenatally and 12 weeks postpartum. The mean FSFI total score of the two investigated groups demonstrated nonsignificant difference 12 weeks after delivery compared with these scores antenatally. Women that delivered vaginally demonstrated significant decreases in the scores of desire, arousal and lubrication domains 12 weeks after delivery compared with these scores antenatally where other scores demonstrated nonsignificant differences. Women that delivered by CS demonstrated a significant difference in desire domain 12 weeks after delivery compared with these scores antenatally where other scores demonstrated nonsignificant differences. It is concluded that the mode of delivery has nonsignificant effect on the FSF 12 weeks after childbirth. Specifically, vaginal delivery is associated with significant decrease in the desire, arousal and lubrication domains where elective CS is associated with significant decrease in the desire domain.

  10. Developing Scoring Algorithms (Earlier Methods)

    Science.gov (United States)

    We developed scoring procedures to convert screener responses to estimates of individual dietary intake for fruits and vegetables, dairy, added sugars, whole grains, fiber, and calcium using the What We Eat in America 24-hour dietary recall data from the 2003-2006 NHANES.

  11. Outcome of Teenage Pregnancy at a Tertiary Hospital in Abakaliki ...

    African Journals Online (AJOL)

    Statistical analysis was performed using 2008 Epi‑info statistical software version 3.5.1 ... American Pediatric Gross Assessment Records score. ... higher risk of anemia in pregnancy, HIV in pregnancy, malaria in pregnancy, cesarean deliveries and poor fetal outcome. Health .... In the 5th min APGAR score fetal death was.

  12. Transdermal delivery of proteins.

    Science.gov (United States)

    Kalluri, Haripriya; Banga, Ajay K

    2011-03-01

    Transdermal delivery of peptides and proteins avoids the disadvantages associated with the invasive parenteral route of administration and other alternative routes such as the pulmonary and nasal routes. Since proteins have a large size and are hydrophilic in nature, they cannot permeate passively across the skin due to the stratum corneum which allows the transport of only small lipophilic drug molecules. Enhancement techniques such as chemical enhancers, iontophoresis, microneedles, electroporation, sonophoresis, thermal ablation, laser ablation, radiofrequency ablation and noninvasive jet injectors aid in the delivery of proteins by overcoming the skin barrier in different ways. In this review, these enhancement techniques that can enable the transdermal delivery of proteins are discussed, including a discussion of mechanisms, sterility requirements, and commercial development of products. Combination of enhancement techniques may result in a synergistic effect allowing increased protein delivery and these are also discussed.

  13. MUCOSAL DRUG DELIVERY SYSTEM

    OpenAIRE

    Madan Jyotsana; Banode Sagar; Dangi Mahesh

    2010-01-01

    The process of mucoadhesion involving a polymeric drug delivery system is a complex one that includes processes such as wetting, adsorption and interpenetration of polymer chains. The success and degree of mucoadhesion bonding is influenced by various polymer-based properties such as the degree of cross-linking, chain length and the presence of various functional groupings. The attractiveness of mucosal-targeted controlled drug delivery of active pharmaceutical ingredients, has led formulatio...

  14. Re-Scoring the Game’s Score

    DEFF Research Database (Denmark)

    Gasselseder, Hans-Peter

    2014-01-01

    This study explores immersive presence as well as emotional valence and arousal in the context of dynamic and non-dynamic music scores in the 3rd person action-adventure video game genre while also considering relevant personality traits of the player. 60 subjects answered self-report questionnai......This study explores immersive presence as well as emotional valence and arousal in the context of dynamic and non-dynamic music scores in the 3rd person action-adventure video game genre while also considering relevant personality traits of the player. 60 subjects answered self...... that a compatible integration of global and local goals in the ludonarrative contributes to a motivational-emotional reinforcement that can be gained through musical feedback. Shedding light on the implications of music dramaturgy within a semantic ecology paradigm, the perception of varying relational attributes...

  15. Estimating Decision Indices Based on Composite Scores

    Science.gov (United States)

    Knupp, Tawnya Lee

    2009-01-01

    The purpose of this study was to develop an IRT model that would enable the estimation of decision indices based on composite scores. The composite scores, defined as a combination of unidimensional test scores, were either a total raw score or an average scale score. Additionally, estimation methods for the normal and compound multinomial models…

  16. Some medico-socio-demographic factors and intra-uterine growth retardation.

    Science.gov (United States)

    Chhabra, S; Bhandari, V

    1996-04-01

    In the present prospective pilot study an attempt has been made to find out the correlation between some maternopaternal factors (demographic, socio-economic and medical) that suggest a high risk for intra-uterine growth retardation. The mean height and booking weight of women in study group were significantly less than the height and weight of women in control group (p instrumental vaginal delivery, emergency caesarean section for foetal distress, incidence of intrapartum foetal distress, and number of babies with low Apgar scores at 1 and 5 minutes were significantly more in the study group (p < .05 and p < 0.001 respectively for operative delivery and Apgar scores).

  17. Cesarean Delivery, Overweight throughout Childhood, and Blood Pressure in Adolescence.

    Science.gov (United States)

    Pluymen, Linda P M; Smit, Henriëtte A; Wijga, Alet H; Gehring, Ulrike; De Jongste, Johan C; Van Rossem, Lenie

    2016-12-01

    To investigate whether children delivered by cesarean had a higher risk of being overweight from early until late childhood and whether they had a higher blood pressure in adolescence compared with children delivered vaginally. We used data from a Dutch birth cohort study with prenatal inclusion in 1996 and 1997. Mode of delivery (cesarean or vaginal delivery) was ascertained at 3 months after birth by questionnaire. During clinical examinations, height and weight (at age 4, 8, 12, and 16 years) and blood pressure (at age 12 and 16 years) were measured. We used mixed model analysis to estimate associations of cesarean delivery with overweight and blood pressure z scores in 2641 children who participated in at least 1 of the 4 examinations. Children born by cesarean delivery (n = 236, 8.9%) had a 1.52 (95% CI 1.18, 1.96) higher odds of being overweight throughout childhood than children delivered vaginally. Children born by cesarean delivery had no higher systolic blood pressure z-score (0.11 SD, 95% CI -0.04, 0.26), nor a different diastolic blood pressure z-score (-0.00 SD, 95% CI -0.10, 0.09) in adolescence than children delivered vaginally. Compared with children delivered vaginally, children delivered by cesarean had a 52% higher risk of being overweight throughout childhood, but this was not accompanied by a higher blood pressure in adolescence. Copyright © 2016 Elsevier Inc. All rights reserved.

  18. Interpreting force concept inventory scores: Normalized gain and SAT scores

    Directory of Open Access Journals (Sweden)

    Vincent P. Coletta

    2007-05-01

    Full Text Available Preinstruction SAT scores and normalized gains (G on the force concept inventory (FCI were examined for individual students in interactive engagement (IE courses in introductory mechanics at one high school (N=335 and one university (N=292, and strong, positive correlations were found for both populations (r=0.57 and r=0.46, respectively. These correlations are likely due to the importance of cognitive skills and abstract reasoning in learning physics. The larger correlation coefficient for the high school population may be a result of the much shorter time interval between taking the SAT and studying mechanics, because the SAT may provide a more current measure of abilities when high school students begin the study of mechanics than it does for college students, who begin mechanics years after the test is taken. In prior research a strong correlation between FCI G and scores on Lawson’s Classroom Test of Scientific Reasoning for students from the same two schools was observed. Our results suggest that, when interpreting class average normalized FCI gains and comparing different classes, it is important to take into account the variation of students’ cognitive skills, as measured either by the SAT or by Lawson’s test. While Lawson’s test is not commonly given to students in most introductory mechanics courses, SAT scores provide a readily available alternative means of taking account of students’ reasoning abilities. Knowing the students’ cognitive level before instruction also allows one to alter instruction or to use an intervention designed to improve students’ cognitive level.

  19. Interpreting force concept inventory scores: Normalized gain and SAT scores

    Directory of Open Access Journals (Sweden)

    Jeffrey J. Steinert

    2007-05-01

    Full Text Available Preinstruction SAT scores and normalized gains (G on the force concept inventory (FCI were examined for individual students in interactive engagement (IE courses in introductory mechanics at one high school (N=335 and one university (N=292 , and strong, positive correlations were found for both populations ( r=0.57 and r=0.46 , respectively. These correlations are likely due to the importance of cognitive skills and abstract reasoning in learning physics. The larger correlation coefficient for the high school population may be a result of the much shorter time interval between taking the SAT and studying mechanics, because the SAT may provide a more current measure of abilities when high school students begin the study of mechanics than it does for college students, who begin mechanics years after the test is taken. In prior research a strong correlation between FCI G and scores on Lawson’s Classroom Test of Scientific Reasoning for students from the same two schools was observed. Our results suggest that, when interpreting class average normalized FCI gains and comparing different classes, it is important to take into account the variation of students’ cognitive skills, as measured either by the SAT or by Lawson’s test. While Lawson’s test is not commonly given to students in most introductory mechanics courses, SAT scores provide a readily available alternative means of taking account of students’ reasoning abilities. Knowing the students’ cognitive level before instruction also allows one to alter instruction or to use an intervention designed to improve students’ cognitive level.

  20. Bias Adjusted Precipitation Threat Scores

    Directory of Open Access Journals (Sweden)

    F. Mesinger

    2008-04-01

    Full Text Available Among the wide variety of performance measures available for the assessment of skill of deterministic precipitation forecasts, the equitable threat score (ETS might well be the one used most frequently. It is typically used in conjunction with the bias score. However, apart from its mathematical definition the meaning of the ETS is not clear. It has been pointed out (Mason, 1989; Hamill, 1999 that forecasts with a larger bias tend to have a higher ETS. Even so, the present author has not seen this having been accounted for in any of numerous papers that in recent years have used the ETS along with bias "as a measure of forecast accuracy".

    A method to adjust the threat score (TS or the ETS so as to arrive at their values that correspond to unit bias in order to show the model's or forecaster's accuracy in extit{placing} precipitation has been proposed earlier by the present author (Mesinger and Brill, the so-called dH/dF method. A serious deficiency however has since been noted with the dH/dF method in that the hypothetical function that it arrives at to interpolate or extrapolate the observed value of hits to unit bias can have values of hits greater than forecast when the forecast area tends to zero. Another method is proposed here based on the assumption that the increase in hits per unit increase in false alarms is proportional to the yet unhit area. This new method removes the deficiency of the dH/dF method. Examples of its performance for 12 months of forecasts by three NCEP operational models are given.

  1. Global Delivery Models

    DEFF Research Database (Denmark)

    Manning, Stephan; Møller Larsen, Marcus; Bharati, Pratyush M.

    2015-01-01

    Global delivery models (GDMs) are transforming the global IT and business process outsourcing industry. GDMs are a new form of client-specific investment promoting service integration with clients by combining client proximity with time-zone spread for 24/7 service operations. We investigate...... antecedents and contingencies of setting up GDM structures. Based on comprehensive data we show that providers are likely to establish GDM location configurations when clients value access to globally distributed talent and speed of service delivery, in particular when services are highly commoditized...

  2. Ethical issues in cesarean delivery.

    Science.gov (United States)

    Chervenak, Frank A; McCullough, Laurence B

    2017-08-01

    Cesarean delivery is the most common and important surgical intervention in obstetric practice. Ethics provides essential guidance to obstetricians for offering, recommending, recommending against, and performing cesarean delivery. This chapter provides an ethical framework based on the professional responsibility model of obstetric ethics. This framework is then used to address two especially ethically challenging clinical topics in cesarean delivery: patient-choice cesarean delivery and trial of labor after cesarean delivery. This chapter emphasizes a preventive ethics approach, designed to prevent ethical conflict in clinical practice. To achieve this goal, a preventive ethics approach uses the informed consent process to offer cesarean delivery as a medically reasonable alternative to vaginal delivery, to recommend cesarean delivery, and to recommend against cesarean delivery. The limited role of shared decision making is also described. The professional responsibility model of obstetric ethics guides this multi-faceted preventive ethics approach. Copyright © 2017. Published by Elsevier Ltd.

  3. The HEART score for chest pain patients

    NARCIS (Netherlands)

    Backus, B.E.

    2012-01-01

    The HEART score was developed to improve risk stratification in chest pain patients in the emergency department (ED). This thesis describes series of validation studies of the HEART score and sub studies for individual elements of the score. The predictive value of the HEART score for the occurrence

  4. Scoring and Standard Setting with Standardized Patients.

    Science.gov (United States)

    Norcini, John J.; And Others

    1993-01-01

    The continuous method of scoring a performance test composed of standardized patients was compared with a derivative method that assigned each of the 131 examinees (medical residents) a dichotomous score, and use of Angoff's method with these scoring methods was studied. Both methods produce reasonable means and distributions of scores. (SLD)

  5. Trainee Occupational Therapists Scoring the Barthel ADL.

    Science.gov (United States)

    Martin, Elizabeth; Nugent, Chris; Bond, Raymond; Martin, Suzanne

    2015-09-01

    Within medical applications there are two main types of information design; paper-based and digital information [1]. As technology is constantly changing, information within healthcare management and delivery is continually being transitioned from traditional paper documents to digital and online resources. Activity of Daily Living (ADL) charts are still predominantly paper based and are therefore prone to "human error" [2]. In light of this, an investigation has taken place into the design for reducing the amount of human error, between a paper based ADL, specifically the Barthel Index, and the same ADL created digitally. The digital ADL was developed as an online platform as this offers the best method of data capture for a large group of participants all together [3]. The aim of the study was to evaluate the usability of the Barthel Index ADL in paper format and then reproduce the same ADL digitally. This paper presents the findings of a study involving 26 participants who were familiar with ADL charts, and used three scenarios requiring them to complete both a paper ADL and a digital ADL. An evaluation was undertaken to ascertain if there were any 'human errors' in completing the paper ADL and also to find similarities/differences through using the digital ADL. The results from the study indicated that 22/26 participants agreed that the digital ADL was better, if not the same as a paper based ADL. Further results indicated that participants rate highly the added benefit of the digital ADL being easy to use and also that calculation of assessment scores were performed automatically. Statistically the digital BI offered a 100 % correction rate in the total calculation, in comparison to the paper based BI where it is more common for users to make mathematical calculation errors. Therefore in order to minimise handwriting and calculation errors, the digital BI proved superior than the traditional paper based method.

  6. Score lists in multipartite hypertournaments

    CERN Document Server

    Pirzada, Shariefuddin; Iványi, Antal

    2010-01-01

    Given non-negative integers $n_{i}$ and $\\alpha_{i}$ with $0 \\leq \\alpha_{i} \\leq n_i$ $(i=1,2,...,k)$, an $[\\alpha_{1},\\alpha_{2},...,\\alpha_{k}]$-$k$-partite hypertournament on $\\sum_{1}^{k}n_{i}$ vertices is a $(k+1)$-tuple $(U_{1},U_{2},...,U_{k},E)$, where $U_{i}$ are $k$ vertex sets with $|U_{i}|=n_{i}$, and $E$ is a set of $\\sum_{1}^{k}\\alpha_{i}$-tuples of vertices, called arcs, with exactly $\\alpha_{i}$ vertices from $U_{i}$, such that any $\\sum_{1}^{k}\\alpha_{i}$ subset $\\cup_{1}^{k}U_{i}^{\\prime}$ of $\\cup_{1}^{k}U_{i}$, $E$ contains exactly one of the $(\\sum_{1}^{k} \\alpha_{i})!$ $\\sum_{1}^{k}\\alpha_{i}$-tuples whose entries belong to $\\cup_{1}^{k}U_{i}^{\\prime}$. We obtain necessary and sufficient conditions for $k$ lists of non-negative integers in non-decreasing order to be the losing score lists and to be the score lists of some $k$-partite hypertournament.

  7. Disclosure Risk from Factor Scores

    Directory of Open Access Journals (Sweden)

    Drechsler Jörg

    2014-03-01

    Full Text Available Remote access can be a powerful tool for providing data access for external researchers. Since the microdata never leave the secure environment of the data-providing agency, alterations of the microdata can be kept to a minimum. Nevertheless, remote access is not free from risk. Many statistical analyses that do not seem to provide disclosive information at first sight can be used by sophisticated intruders to reveal sensitive information. For this reason the list of allowed queries is usually restricted in a remote setting. However, it is not always easy to identify problematic queries. We therefore strongly support the argument that has been made by other authors: that all queries should be monitored carefully and that any microlevel information should always be withheld. As an illustrative example, we use factor score analysis, for which the output of interest - the factor loading of the variables - seems to be unproblematic. However, as we show in the article, the individual factor scores that are usually returned as part of the output can be used to reveal sensitive information. Our empirical evaluations based on a German establishment survey emphasize that this risk is far from a purely theoretical problem.

  8. Vaginal delivery simulation in the Obstetrics and Gynaecology clerkship.

    Science.gov (United States)

    Nitsche, Joshua; Morris, Dana; Shumard, Kristina; Akoma, Ugochi

    2016-10-01

    Although simulation is now used in other areas of obstetrics and gynaecology, its utility in the training of an uncomplicated vaginal delivery is surprisingly under-explored. Here we describe our experience integrating simulation into the third-year Obstetrics and Gynaecology (OB/GYN) clerkship. In 2013/14, at the start of each 4-week OB/GYN clerkship, each third-year student participated in a 90-minute vaginal delivery simulation session using the Noelle(®) simulator. Upon completion of the clerkship, they were surveyed using a five-point Likert scale questionnaire (1, inferior; 5, superior) to assess self-perceived training adequacy, clinical preparedness and number of deliveries performed during the clerkship. Students who completed the clerkship in 2012/13, before the introduction of the simulation, were also surveyed to serve as a comparison group. Survey scores and number of deliveries performed were compared between the two cohorts of students. The 2013/14 cohort (n = 98) who received simulation training gave their training in vaginal deliveries an average rating of 4.1, versus 2.7 for the 2012/13 cohort that did not receive the simulation (n = 80; p < 0.001). Self-perceived preparedness to perform a vaginal delivery was 4.0 in the 2013/14 cohort, versus 3.0 in the 2012/13 cohort (p < 0.001). There was no difference in the number of deliveries performed between the cohorts. Students that received simulation rated their training adequacy and readiness to perform a vaginal delivery higher than students that did not receive training. Simulation did not increase participation in real-life deliveries. The utility of simulation in the training of an uncomplicated vaginal delivery is under-explored. © 2015 John Wiley & Sons Ltd.

  9. [Complications of cesarean deliveries].

    Science.gov (United States)

    Valgeirsdottir, Heiddis; Hardardottir, Hildur; Bjarnadottir, Ragnheidur I

    2010-01-01

    The objective of the study was to determine the rate of complications which accompany cesarean sections at Landspitali University Hospital (LSH). All deliveries by cesarean section from July 1st 2001 to December 31st 2002 were examined in a retrospective manner. Information was collected from maternity records regarding the operation and its complications if they occurred, during or following the operation. During this period 761 women delivered by cesarean section at LSH. The overall complication rate was 35,5%. The most common complications were; blood loss > or =1000 ml (16.5%), post operative fever (12.2%), extension from the uterine incision (7.2%) and need for blood transfusion (4.3%). Blood transfusion was most common in women undergoing cesarean section after attempted instrumental vaginal delivery (20%). Fever and extension from the uterine incision were most common in women undergoing cesarean section after full cervical dilation without attempt of instrumental delivery (19,4%). These complications were least likely to occur if the patient underwent an elective cesarean section. Complications following cesarean section are common, especially if labor is advanced. Each indication for an operative delivery should be carefully weighed and the patient informed accordingly.

  10. A Medical Delivery Device

    DEFF Research Database (Denmark)

    2010-01-01

    The present invention relates to a medical delivery device comprising at least two membrane electrode assembly units each of which comprises three layers: an upper and a lower electrode and a selective ionic conductive membrane provided there-between. At least one of the three layers are shared...

  11. Recovering from Delivery

    Science.gov (United States)

    ... suicidal thoughts, or any thoughts of harming your baby While recovering from delivery can be a lot to handle, things will get easier. Before you know it, you will be able to fully focus on enjoying your new baby. Reviewed by: Larissa Hirsch, MD Date reviewed: June ...

  12. A Medical Delivery Device

    DEFF Research Database (Denmark)

    2010-01-01

    The present invention relates to a medical delivery device comprising at least two membrane electrode assembly units each of which comprises three layers: an upper and a lower electrode and a selective ionic conductive membrane provided there-between. At least one of the three layers are shared...

  13. 利多卡因联合阿托品治疗分娩时宫颈水肿102例研究%Lidocaine and Atropine in the Treatment of 102 Cases of Delivery of Cervical Edema

    Institute of Scientific and Technical Information of China (English)

    何健华; 李玉香

    2014-01-01

    目的:探讨利多卡因联合阿托品治疗分娩时宫颈水肿的效果。方法将2010年5月至2013年4月在我院进行阴道试产时发生宫颈水肿的初产妇102例纳入实验组,采用利多卡因联合阿托品宫颈多点注射。以同期采用传统静脉注射地西泮治疗者100例作为对照组。对比两组在宫口全开时间、转剖宫产率、新生儿Apgar评分等方面的差异性。结果与对照组对比,我们发现实验组宫口全开时间较短,转剖宫产率较低,组间差异经统计学分析后认为有意义(P<0.05)。对比两组新生儿Apgar评分发现,组间差异统计学分析后认为无意义(P>0.05)。结论采用利多卡因联合阿托品治疗分娩时宫颈水肿具有满意的疗效,有助于缩短产程时间,增加阴道试产成功率,今后可将其作为阴道试产时宫颈水肿治疗的有效方案进行推广应用。%Objective Investigate lidocaine and atropine in the treatment of intrapartum cervix edema effect. Methods Choose 102 cases as experimental group, using lidocaine and atropine cervical multi point injection. Choose 100 cases as control group, injection of diazepam. Compared two groups in the palace mouth open time, turn the cesarean section rate, neonatal Apgar score etc. Results Compared with control group, experimental group palace mouth open for a short time, turn the cesarean section rate is low, differences had significant(P0.05). Conclusion Lidocaine and atropine in the treatment of intrapartum cervix edema has satisfactory curative effect, help to shorten labor time, increase the success rate of vaginal delivery, can be applied effectively for treatment of vaginal cervical edema in the future.

  14. Self-nanoemulsifying drug delivery systems for oral insulin delivery

    DEFF Research Database (Denmark)

    Li, Ping; Tan, Angel; Prestidge, Clive A

    2014-01-01

    This study aims at evaluating the combination of self-nanoemulsifying drug delivery systems (SNEDDS) and enteric-coated capsules as a potential delivery strategy for oral delivery of insulin. The SNEDDS preconcentrates, loaded with insulin-phospholipid complex at different levels (0, 2.5 and 10% w...

  15. Nanotopography applications in drug delivery

    Science.gov (United States)

    Walsh, Laura A; Allen, Jessica L; Desai, Tejal A

    2016-01-01

    Refinement of micro- and nanofabrication in the semiconductor field has led to innovations in biomedical technologies. Nanotopography, in particular, shows great potential in facilitating drug delivery. The flexibility of fabrication techniques has created a diverse array of topographies that have been developed for drug delivery applications. Nanowires and nanostraws deliver drug cytosolically for in vitro and ex vivo applications. In vivo drug delivery is limited by the barrier function of the epithelium. Nanowires on microspheres increase adhesion and residence time for oral drug delivery, while also increasing permeability of the epithelium. Low aspect ratio nanocolumns increase paracellular permeability, and in conjunction with microneedles increase transdermal drug delivery of biologics in vivo. In summary, nanotopography is a versatile tool for drug delivery. It can deliver directly to cells or be used for in vivo delivery across epithelial barriers. This editorial highlights the application of nanotopography in the field of drug delivery. PMID:26512871

  16. A Prognostic Scoring Tool for Cesarean Organ/Space Surgical Site Infections: Derivation and Internal Validation.

    Science.gov (United States)

    Assawapalanggool, Srisuda; Kasatpibal, Nongyao; Sirichotiyakul, Supatra; Arora, Rajin; Suntornlimsiri, Watcharin

    Organ/space surgical site infections (SSIs) are serious complications after cesarean delivery. However, no scoring tool to predict these complications has yet been developed. This study sought to develop and validate a prognostic scoring tool for cesarean organ/space SSIs. Data for case and non-case of cesarean organ/space SSI between January 1, 2007 and December 31, 2012 from a tertiary care hospital in Thailand were analyzed. Stepwise multivariable logistic regression was used to select the best predictor combination and their coefficients were transformed to a risk scoring tool. The likelihood ratio of positive for each risk category and the area under receiver operating characteristic (AUROC) curves were analyzed on total scores. Internal validation using bootstrap re-sampling was tested for reproducibility. The predictors of 243 organ/space SSIs from 4,988 eligible cesarean delivery cases comprised the presence of foul-smelling amniotic fluid (four points), vaginal examination five or more times before incision (two points), wound class III or greater (two points), being referred from local setting (two points), hemoglobin less than 11 g/dL (one point), and ethnic minorities (one point). The likelihood ratio of cesarean organ/space SSIs with 95% confidence interval among low (total score of 0-1 point), medium (total score of 2-5 points), and high risk (total score of ≥6 points) categories were 0.11 (0.07-0.19), 1.03 (0.89-1.18), and 13.25 (10.87-16.14), respectively. Both AUROCs of the derivation and validation data were comparable (87.57% versus 86.08%; p = 0.418). This scoring tool showed a high predictive ability regarding cesarean organ/space SSIs on the derivation data and reproducibility was demonstrated on internal validation. It could assist practitioners prioritize patient care and management depending on risk category and decrease SSI rates in cesarean deliveries.

  17. Optimizing drugs for local delivery.

    Science.gov (United States)

    Collingwood, S; Lock, R; Searcey, M

    2009-12-01

    An international panel of speakers together with approximately 70 delegates were brought together by The Society for Medicines Research's symposium on Optimising Drugs for Local Delivery, held on June 11, 2009 at the Novartis Institutes for Biomedical Research, Horsham, UK. The focus of the conference was on the delivery of drugs direct to the site of action and the consequences of this delivery route on delivery technologies, formulation science and molecular design.

  18. Microprocessor controlled transdermal drug delivery.

    Science.gov (United States)

    Subramony, J Anand; Sharma, Ashutosh; Phipps, J B

    2006-07-06

    Transdermal drug delivery via iontophoresis is reviewed with special focus on the delivery of lidocaine for local anesthesia and fentanyl for patient controlled acute therapy such as postoperative pain. The role of the microprocessor controller in achieving dosimetry, alternating/reverse polarity, pre-programmed, and sensor-based delivery is highlighted. Unique features such as the use of tactile signaling, telemetry control, and pulsatile waveforms in iontophoretic drug delivery are described briefly.

  19. MEMS: Enabled Drug Delivery Systems.

    Science.gov (United States)

    Cobo, Angelica; Sheybani, Roya; Meng, Ellis

    2015-05-01

    Drug delivery systems play a crucial role in the treatment and management of medical conditions. Microelectromechanical systems (MEMS) technologies have allowed the development of advanced miniaturized devices for medical and biological applications. This Review presents the use of MEMS technologies to produce drug delivery devices detailing the delivery mechanisms, device formats employed, and various biomedical applications. The integration of dosing control systems, examples of commercially available microtechnology-enabled drug delivery devices, remaining challenges, and future outlook are also discussed.

  20. What Is a Cesarean Delivery?

    Science.gov (United States)

    ... are common complications? What is a high-risk pregnancy? What is labor? What is a cesarean delivery? Other FAQs NICHD Research Information Clinical Trials Resources and Publications What is a cesarean delivery? Skip sharing on social media links Share this: Page Content A cesarean delivery ...

  1. Antenatal Maternity Leave and Childbirth Using the First Baby Study: A Propensity Score Analysis.

    Science.gov (United States)

    Goodman, Julia M; Guendelman, Sylvia; Kjerulff, Kristen H

    Most employed American women work during pregnancy and continue working through the month they deliver. Yet, few studies estimate the relationship between maternity leave taken during pregnancy and maternal health. We evaluate the association of antenatal leave (ANL) uptake with obstetric outcomes, assessing the potential role of protective and adverse selection pathways on this relationship. We sample 1,740 employed women who delivered at term from the First Baby Study, a prospective cohort of nulliparous women in Pennsylvania. We use propensity scores to estimate the relationship between ANL and negative delivery outcomes (labor induction, long labor duration, unplanned cesarean delivery, and self-reported negative birth experience). We estimated propensity scores using a range of employment, health, and sociodemographic variables. One-half of the sampled women worked until the day before or day of delivery. Women who stopped working at least 2 days before delivery experienced 16% more negative delivery outcomes, on average, than women who worked until delivery, driven largely by a 25% higher predicted probability of unplanned cesarean section deliveries. These robust findings hold up to a range of sensitivity analyses and demonstrate selective mechanisms operating in ANL uptake. Our findings suggest that, even after controlling for an extensive set of observable employment, health, and sociodemographic characteristics, women who take ANL continue to differ in unobserved characteristics that lead to negative delivery outcomes. Like most U.S. states, Pennsylvania does not grant paid maternity leave. In a context of limited maternity leave availability, only relatively unhealthy women take ANL. Copyright © 2016 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

  2. Mucoadhesive drug delivery systems

    Directory of Open Access Journals (Sweden)

    Rahamatullah Shaikh

    2011-01-01

    Full Text Available Mucoadhesion is commonly defined as the adhesion between two materials, at least one of which is a mucosal surface. Over the past few decades, mucosal drug delivery has received a great deal of attention. Mucoadhesive dosage forms may be designed to enable prolonged retention at the site of application, providing a controlled rate of drug release for improved therapeutic outcome. Application of dosage forms to mucosal surfaces may be of benefit to drug molecules not amenable to the oral route, such as those that undergo acid degradation or extensive first-pass metabolism. The mucoadhesive ability of a dosage form is dependent upon a variety of factors, including the nature of the mucosal tissue and the physicochemical properties of the polymeric formulation. This review article aims to provide an overview of the various aspects of mucoadhesion, mucoadhesive materials, factors affecting mucoadhesion, evaluating methods, and finally various mucoadhesive drug delivery systems (buccal, nasal, ocular, gastro, vaginal, and rectal.

  3. Social video content delivery

    CERN Document Server

    Wang, Zhi; Zhu, Wenwu

    2016-01-01

    This brief presents new architecture and strategies for distribution of social video content. A primary framework for socially-aware video delivery and a thorough overview of the possible approaches is provided. The book identifies the unique characteristics of socially-aware video access and social content propagation, revealing the design and integration of individual modules that are aimed at enhancing user experience in the social network context. The change in video content generation, propagation, and consumption for online social networks, has significantly challenged the traditional video delivery paradigm. Given the massive amount of user-generated content shared in online social networks, users are now engaged as active participants in the social ecosystem rather than as passive receivers of media content. This revolution is being driven further by the deep penetration of 3G/4G wireless networks and smart mobile devices that are seamlessly integrated with online social networking and media-sharing s...

  4. Pyomyositis after vaginal delivery.

    LENUS (Irish Health Repository)

    Gaughan, Eve

    2011-01-01

    Pyomyositis is a purulent infection of skeletal muscle that arises from haematogenous spread, usually with abscess formation. It can develop after a transient bacteraemia of any cause. This type of infection has never been reported before in the literature after vaginal delivery. A 34-year-old woman had progressive severe pain in the left buttock and thigh and weakness in the left lower limb day 1 post spontaneous vaginal delivery. MRI showed severe oedema of the left gluteus, iliacus, piriformis and adductor muscles of the left thigh and a small fluid collection at the left hip joint. She was diagnosed with pyomyositis. She had fever of 37.9°C immediately postpartum and her risk factors for bacteraemia were a mild IV cannula-associated cellulitis and labour itself. She required prolonged treatment with antibiotics before significant clinical improvement was noted.

  5. Delivery strategies for antiparasitics.

    Science.gov (United States)

    Kayser, Oliver; Kiderlen, Albrecht F

    2003-02-01

    Optimisation of drug carrier systems and drug delivery strategies that take into account the peculiarities of individual infectious agents and diseases are key elements of modern drug development. In the following, different aspects of a rational design for antiparasitic drug formulation will be reviewed, covering delivery systems such as nano- and microparticles, liposomes, emulsions and microemulsions, cochleates and bioadhesive macromolecules. Functional properties for each carrier system will be discussed as well as their therapeutic efficacy for parasitic diseases, including leishmaniasis, human African trypanosomiasis, human cryptosporidiosis, malaria and schistosomiasis. Critical issues for the application of drug carrier systems will be discussed, focusing on biopharmaceutical and pathophysiological parameters such as routes of application, improvement of body distribution and targeting intracellularly persisting pathogens.

  6. Transcutaneous antigen delivery system

    Directory of Open Access Journals (Sweden)

    Mi-Young Lee

    2013-01-01

    Full Text Available Transcutaneous immunization refers to the topical applicationof antigens onto the epidermis. Transcutaneous immunizationtargeting the Langerhans cells of the skin has received muchattention due to its safe, needle-free, and noninvasive antigendelivery. The skin has important immunological functions withunique roles for antigen-presenting cells such as epidermalLangerhans cells and dermal dendritic cells. In recent years,novel vaccine delivery strategies have continually beendeveloped; however, transcutaneous immunization has not yetbeen fully exploited due to the penetration barrier representedby the stratum corneum, which inhibits the transport ofantigens and adjuvants. Herein we review recent achievementsin transcutaneous immunization, focusing on the variousstrategies for the enhancement of antigen delivery andvaccination efficacy. [BMB Reports 2013; 46(1: 17-24

  7. Transdermal Delivery of Proteins

    OpenAIRE

    Kalluri, Haripriya; Banga, Ajay K.

    2011-01-01

    Transdermal delivery of peptides and proteins avoids the disadvantages associated with the invasive parenteral route of administration and other alternative routes such as the pulmonary and nasal routes. Since proteins have a large size and are hydrophilic in nature, they cannot permeate passively across the skin due to the stratum corneum which allows the transport of only small lipophilic drug molecules. Enhancement techniques such as chemical enhancers, iontophoresis, microneedles, electro...

  8. Clinical research of Baseline fetal heart rate variability decreased or dis-appeared for delivery and pregnancy outcomes%胎心率基线变异减弱或消失与产妇分娩方式及新生儿结局的临床研究

    Institute of Scientific and Technical Information of China (English)

    朱彩红

    2014-01-01

    disappeared were selected as observation group, and at the same time 40 patients of electronic fetal monitoring showed fetal tips normal baseline heart rate variability were randomly selected as control group. The maternal umbilical cord and placen-ta abnormalities, NST type, cesarean section, stillbirth, severe asphyxia, the ratio of full-term age small gestational,and the relationship of two different types NST and neonatal Apgar score were compared. Results The puerperae appeared sail-shaped placenta, placental abruption, placenta racket-shaped, slender cord around the neck, spiral cord around the neck, umbilical cord first exposed, the ratios of combing II degrees amniotic of the observation group were higher than those of the control group, the differences were statistically significant (P< 0.05). The ratios of suspicious type NST, non-reactive NST of the observation group were higher than those of the control group, the differences were sta-tistically significant (P<0.05). The cesarean section rate (34 cases, 85.0%) of the observation group was higher than that of the control group (9 cases, 22.5%), and the ratios of newborn asphyxia (3 cases, 7.5%), death (2 cases 5.0%), full-term age small gestational (2 cases, 5.0%) of the observation group were lower than those of the control group (no case, 0.0%;no case, 0.0%;no case, 0.0%), the differences were statistically significant (P<0.05). The ratios of suspi-cious type NST and Apgar score ≥7 points of the observation group were lower than those of the control group (55.56% v s 100.00%), and the ratios of Apgar score < 7 points of the observation group were higher than those of the control group (44.44% vs 0.00%), the differences were statistically significant (P<0.05). Conclusion The fetal heart rate variability decreased or disappeared tips by the baseline fetal heart rate monitoring can indicate occurrence of fetal distress and hypoxia,so take active processing at the same time combine with NST, such as timely

  9. Cardiovascular risk scores for coronary atherosclerosis.

    Science.gov (United States)

    Yalcin, Murat; Kardesoglu, Ejder; Aparci, Mustafa; Isilak, Zafer; Uz, Omer; Yiginer, Omer; Ozmen, Namik; Cingozbay, Bekir Yilmaz; Uzun, Mehmet; Cebeci, Bekir Sitki

    2012-10-01

    The objective of this study was to compare frequently used cardiovascular risk scores in predicting the presence of coronary artery disease (CAD) and 3-vessel disease. In 350 consecutive patients (218 men and 132 women) who underwent coronary angiography, the cardiovascular risk level was determined using the Framingham Risk Score (FRS), the Modified Framingham Risk Score (MFRS), the Prospective Cardiovascular Münster (PROCAM) score, and the Systematic Coronary Risk Evaluation (SCORE). The area under the curve for receiver operating characteristic curves showed that FRS had more predictive value than the other scores for CAD (area under curve, 0.76, P MFRS, PROCAM, and SCORE) may predict the presence and severity of coronary atherosclerosis.The FRS had better predictive value than the other scores.

  10. An ultrasound score for knee osteoarthritis

    DEFF Research Database (Denmark)

    Riecke, B F; Christensen, R.; Torp-Pedersen, S

    2014-01-01

    OBJECTIVE: To develop standardized musculoskeletal ultrasound (MUS) procedures and scoring for detecting knee osteoarthritis (OA) and test the MUS score's ability to discern various degrees of knee OA, in comparison with plain radiography and the 'Knee injury and Osteoarthritis Outcome Score' (KO...

  11. Breaking of scored tablets : a review

    NARCIS (Netherlands)

    van Santen, E; Barends, D M; Frijlink, H W

    2002-01-01

    The literature was reviewed regarding advantages, problems and performance indicators of score lines. Scored tablets provide dose flexibility, ease of swallowing and may reduce the costs of medication. However, many patients are confronted with scored tablets that are broken unequally and with diffi

  12. Developing Score Reports for Cognitive Diagnostic Assessments

    Science.gov (United States)

    Roberts, Mary Roduta; Gierl, Mark J.

    2010-01-01

    This paper presents a framework to provide a structured approach for developing score reports for cognitive diagnostic assessments ("CDAs"). Guidelines for reporting and presenting diagnostic scores are based on a review of current educational test score reporting practices and literature from the area of information design. A sample diagnostic…

  13. Credit Scores, Race, and Residential Sorting

    Science.gov (United States)

    Nelson, Ashlyn Aiko

    2010-01-01

    Credit scores have a profound impact on home purchasing power and mortgage pricing, yet little is known about how credit scores influence households' residential location decisions. This study estimates the effects of credit scores on residential sorting behavior using a novel mortgage industry data set combining household demographic, credit, and…

  14. Credit Scores, Race, and Residential Sorting

    Science.gov (United States)

    Nelson, Ashlyn Aiko

    2010-01-01

    Credit scores have a profound impact on home purchasing power and mortgage pricing, yet little is known about how credit scores influence households' residential location decisions. This study estimates the effects of credit scores on residential sorting behavior using a novel mortgage industry data set combining household demographic, credit, and…

  15. Semiparametric score sevel susion: Gaussian sopula approach

    NARCIS (Netherlands)

    Susyanyo, N.; Klaassen, C.A.J.; Veldhuis, R.N.J.; Spreeuwers, L.J.

    2015-01-01

    Score level fusion is an appealing method for combining multi-algorithms, multi- representations, and multi-modality biometrics due to its simplicity. Often, scores are assumed to be independent, but even for dependent scores, accord- ing to the Neyman-Pearson lemma, the likelihood ratio is the opti

  16. An objective fluctuation score for Parkinson's disease.

    Directory of Open Access Journals (Sweden)

    Malcolm K Horne

    Full Text Available Establishing the presence and severity of fluctuations is important in managing Parkinson's Disease yet there is no reliable, objective means of doing this. In this study we have evaluated a Fluctuation Score derived from variations in dyskinesia and bradykinesia scores produced by an accelerometry based system.The Fluctuation Score was produced by summing the interquartile range of bradykinesia scores and dyskinesia scores produced every 2 minutes between 0900-1800 for at least 6 days by the accelerometry based system and expressing it as an algorithm.This Score could distinguish between fluctuating and non-fluctuating patients with high sensitivity and selectivity and was significant lower following activation of deep brain stimulators. The scores following deep brain stimulation lay in a band just above the score separating fluctuators from non-fluctuators, suggesting a range representing adequate motor control. When compared with control subjects the score of newly diagnosed patients show a loss of fluctuation with onset of PD. The score was calculated in subjects whose duration of disease was known and this showed that newly diagnosed patients soon develop higher scores which either fall under or within the range representing adequate motor control or instead go on to develop more severe fluctuations.The Fluctuation Score described here promises to be a useful tool for identifying patients whose fluctuations are progressing and may require therapeutic changes. It also shows promise as a useful research tool. Further studies are required to more accurately identify therapeutic targets and ranges.

  17. The Comparison of Perinatal Outcomes in Early Delivery Versus Postdate Labor

    Directory of Open Access Journals (Sweden)

    Maryam Khooshideh

    2017-02-01

    Full Text Available Background Prenatal mortality and morbidity increase after 40 weeks of gestation. The current study aimed at comparing maternal and neonatal outcomes between term and postterm pregnancies. Methods The current prospective cohort study was performed on 1180 singleton, cephalic fetus, and uncomplicated pregnancy cases admitted for labor. Pregnant mothers were divided into 3 groups. Group 1 included 750 cases in 38 to 40 weeks, group 2 included 250 cases in 40 to 41 weeks, and group 3 included 180 cases in over 41 weeks of gestation. Prenatal outcomes were recorded as: fetal distress, meconium passage, meconium aspiration, fetal weight ≥ 4 kg, Apgar score in 1 and 5 minutes, neonatal intensive care unit (NICU admission, maternal infection, postpartum hemorrhage, and the rate of cesarean section. Results There were significant differences in the rate of fetal distress (P < 0.001, meconium passage (P = 0.001, meconium aspiration syndrome (P < 0.001, Apgar score ≤ 3 at 1 (P = 0.025 and 5 minutes (P < 0.001, admission to NICU (P < 0.001, rate of cesarean section (P < 0.001, and maternal infection (P = 0.001 among the groups. The frequency of fetal distress was lower in group1 compared with group 2 (1.6% versus 4.4%; P = 0.011. Also fetal distress was significantly lower in group 1 than group 3 (1.6% versus 10.9%; P < 0.001. The meconium passage and meconium aspiration syndrome were statistically lower in group 1 compared with group 2 (1.6% versus 8%; P < 0.001 for meconium passage, and 0.9% versus 5.6%; P < 0.001 for meconium aspiration syndrome. Also meconium passage and meconium aspiration syndrome were significantly lower in group 1 compared with group 3 (1.6% versus 13.9%; P < 0.001 for meconium passage, and 0.9% versus 10%; P < 0.001 for meconium aspiration syndrome. The cesarean section was more frequent in group 2 compared with group 1 (24.8% versus 13.6%; P < 0.001 and in group 3 compared with group 1 (33.3% versus 13.6%, P < 0.001. There

  18. [Adding parity to the Bishop score for term labor induction: a retrospective study].

    Science.gov (United States)

    Journet, D; Gaucherand, P; Doret, M

    2012-06-01

    To evaluate the interest to add parity to the Bishop score before induction of labor by intravenous oxytocin. This retrospective cohort study compared cesarean section rate for induction failure by intravenous oxytocin in nulliparous and multiparous with modified Bishop score from 7 to 9. The modified Bishop score is calculated by adding 2 points to the Bishop score if the patient had a previous vaginal delivery and 0 point in nulliparous. Over 2 years, 468 patients were included (201 nulliparous and 267 multiparous). Cesarean section rate for induction failure was higher for nulliparous with a modified Bishop score equal to 7 or varying between 7 and 9. These results confirm that parity is an important predicting factor of successful labor induction. In multiparous, cesarean section rates for induction failure were not significantly different with Bishop score or modified Bishop score equal to 7. Adding 2 points for multiparity at the Bishop score did not increase cesarean for failure of labor induction with intravenous oxytocin with a modified Bishop score from 7 to 9. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

  19. Severity scoring systems in the modern intensive care unit.

    Science.gov (United States)

    Clermont, G; Angus, D C

    1998-05-01

    In recent years, several factors have led to increasing focus on the meaning of appropriateness of care and clinical performance in the intensive care unit (ICU). The emergence of new and expensive treatment modalities, a deeper reflection on what constitutes a desirable outcome, increasing financial pressure from cost containment efforts, and new attitudes regarding end-of-life decisions are reshaping the delivery of intensive care worldwide. This quest for a measure of ICU performance has led to the development of severity adjustment systems that will allow standardised comparisons of outcome and resource use across ICUs. These systems, for many years used only in the research setting, have evolved to become sophisticated, computer-based decision-support tools, in some instances commercially developed, and capable of predicting a diverse set of outcomes. Their application has broadened to include ICU performance assessment, individual patient decision-making, and pre- and post-hoc risk stratification in randomised trials. In this paper, we review the popular scoring systems currently in use; design issues in the development and evaluation of new scoring systems; current applications of scoring systems; and future directions.

  20. Development of a difficulty score for spinal anaesthesia.

    Science.gov (United States)

    Atallah, M M; Demian, A D; Shorrab, A A

    2004-03-01

    Multiple attempts at spinal puncture may be hazardous. Accurate preoperative prediction of difficulty adds to the delivery of high quality care. This clinical trial was designed to: (i). determine the predictive performance of difficulty variables; (ii). compare senior and junior anaesthetists; (iii). develop a score to predict difficulty during the performance of spinal anaesthesia. A total of 300 patients subjected to urological procedures and scheduled for spinal anaesthesia were independently assessed and stratified according to the categories of the difficulty predictors of spinal anaesthesia into one of nine grades (0-8) and randomized according to the experience of the anaesthetist into two groups (group A, staff with more than 15 yrs' experience; group B, resident with more than 6 months but less than 1 yr in training). The number of attempts and levels, and success rate of the technique were the outcome variables. Data were analysed by multivariate analysis and receiver operating characteristic (ROC) curves. The bony landmarks of the back and the radiological characteristics of the lumbar vertebrae were two independent predictors of difficulty. Multivariate analysis indicated differences between junior and senior staff but ROC curves indicated no difference. Grade 4 was the difficulty score at or above which difficulty was expected whether or not radiological characteristics of the vertebrae were included. Spinal bony landmarks and radiological characteristics of the lumbar vertebrae are independent predictors of difficulty during spinal anaesthesia. There is no difference between senior and junior anaesthetists. Grade 4 is the difficulty score at or above which difficulty is expected.

  1. Observation on effect of improved midwifery vaginal delivery to reduce episiotomy rate%改良助产方式对降低阴道分娩会阴侧切率的效果观察

    Institute of Scientific and Technical Information of China (English)

    叶兆兰; 张轶兰; 彭继蓉

    2016-01-01

    目的:探讨改良助产方式对于降低阴道分娩产妇会阴侧切率的效果。方法按照随机数字表的分组方法将成都市妇女儿童中心医院2014年1月至12月间3400例产妇分为观察组和对照组,各1700例。对照组产妇接受传统助产方式助产,观察组产妇接受改良助产方式助产。比较两组产妇会阴侧切率及裂伤程度、产后出血量、疼痛程度、新生儿出生Apgar评分及住院时间。结果观察组分娩时会阴情况显著优于对照组,会阴完整率、侧切率均显著低于对照组(χ2值分别为23.100、11.442,均P<0.01),而会阴Ⅰ度裂伤发生率显著高于对照组(χ2=17.553,均P<0.01),两组会阴Ⅱ度裂伤发生率比较无显著性差异(χ2=0.901,P>0.05)。观察组产后出血量、VAS评分及住院时间均显著优于对照组(t值分别为52.128、23.272、39.637,均P<0.05),而新生儿出生Apgar评分比较无显著性差异( t=0.000,P>0.05)。结论改良助产方式可较好的保护会阴,降低会阴侧切率,具有较高的临床应用价值,值得临床推广应用。%Objective To explore the effect of improved midwifery vaginal delivery on reducing episiotomy rate.Methods According to random number table method, 3 400 puerperas admitted in Chengdu Center of Women and Children Hospital during January to December in 2014 were divided into observation group and control group, and 1 700 cases were recruited in each group.The control group received traditional way of midwifery, while the observation group received improved midwifery vaginal delivery.The maternal episiotomy rate and laceration, postpartum bleeding volume, pain degree, neonatal Apgar score and hospitalization time were compared between two groups. Results The perineum of cases in the observation group was significantly better than that in the control group, and the perineum complete rate and

  2. Conditional Reliability Coefficients for Test Scores.

    Science.gov (United States)

    Nicewander, W Alan

    2017-04-06

    The most widely used, general index of measurement precision for psychological and educational test scores is the reliability coefficient-a ratio of true variance for a test score to the true-plus-error variance of the score. In item response theory (IRT) models for test scores, the information function is the central, conditional index of measurement precision. In this inquiry, conditional reliability coefficients for a variety of score types are derived as simple transformations of information functions. It is shown, for example, that the conditional reliability coefficient for an ordinary, number-correct score, X, is equal to, ρ(X,X'|θ)=I(X,θ)/[I(X,θ)+1] Where: θ is a latent variable measured by an observed test score, X; p(X, X'|θ) is the conditional reliability of X at a fixed value of θ; and I(X, θ) is the score information function. This is a surprisingly simple relationship between the 2, basic indices of measurement precision from IRT and classical test theory (CTT). This relationship holds for item scores as well as test scores based on sums of item scores-and it holds for dichotomous as well as polytomous items, or a mix of both item types. Also, conditional reliabilities are derived for computerized adaptive test scores, and for θ-estimates used as alternatives to number correct scores. These conditional reliabilities are all related to information in a manner similar-or-identical to the 1 given above for the number-correct (NC) score. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  3. Effects of maternal smoking on neonatal morbidity

    NARCIS (Netherlands)

    Jong-Pley, EA de; Wouters, EJ; Jong, PA de; Voorhorst, FJ; Stolte, SB; Kurver,

    1994-01-01

    In this paper a prospective study of the association between maternal smoking and neonatal morbidity variables is presented. Caucasian nulliparous women (n = 115)were studied throughout pregnancy, childbirth and puerperal period. Birthweight(-centiles), Apgar scores, mode of delivery, umbilical arte

  4. Developmental and Social Influences from Birth on School Readiness in a Metropolitan Cohort.

    Science.gov (United States)

    Jordan, Thomas E.

    This paper reports on a longitudinal study of significant influences on the cognitive readiness of a group of children, aged 60 to 66 months. All measures were obtained by prospective study, which began with Apgar scores calculated in the delivery room. Subsequent measures were gathered by individual case studies in homes, with children and…

  5. Severe Human Parechovirus Infections in Infants and the Role of Older Siblings

    DEFF Research Database (Denmark)

    Nielsen, Nete Munk; Midgley, Sofie Elisabeth; Nielsen, Alex Christian Yde

    2016-01-01

    other than type 3 (non-HPeV-3), were detected among 132 children. Neither birth weight, mode of delivery, Apgar score, nor gestational age was associated with the risk of HPeV infections. Compared with firstborn children, secondborn children were at a 9-fold increased risk (incidence rate ratio = 8...

  6. Admission Hypothermia in Very Preterm Infants and Neonatal Mortality and Morbidity

    DEFF Research Database (Denmark)

    Wilson, Emilija; Maier, Rolf F; Norman, Mikael

    2016-01-01

    and in-hospital mortality and neonatal morbidity were analyzed by the use of mixed effects generalized linear models. The final model adjusted for pregnancy complications, singleton or multiple pregnancy, antenatal corticosteroids, mode of delivery, gestational age, infant size and sex, and Apgar score...

  7. Top of the basilar artery embolic stroke and neonatal myoclonus

    NARCIS (Netherlands)

    Govaert, Paul; Dudink, Jeroen; Visser, Gerhard; Breukhoven, Petra; Vanhatalo, Sampsa; Lequin, Maarten

    2009-01-01

    Cerebellar stroke has been virtually unreported in the living newborn infant. A term newborn male weighing 3380g at birth suffered myoclonic seizures within 24 hours of birth by spontaneous vaginal delivery. Apgar scores were 3 and 4 at 1 and 5 minutes. Myoclonus persisted for 9 days, responding poo

  8. Cesarean section for the second twin

    DEFF Research Database (Denmark)

    Engelbrechtsen, Line; Nielsen, Elise Hoffmann; Perin, Trine

    2013-01-01

    deliveries. Data were extracted from medical records, a fetal medicine software program (Astraia), and the National Birth Registry. Short-term poor neonatal outcome was measured as a 5-minute Apgar score ≤ 7, umbilical cord pH ≤ 7.10, and admission to neonatal intensive care unit for more than 3 days...

  9. Does internal podalic version of the non-vertex second twin still have a place in obstetrics?

    DEFF Research Database (Denmark)

    Jonsdottir, Fjola; Stokholm, Lonny Merete; Secher, Niels Jørgen

    2015-01-01

    of delivery mode, 5-min Apgar score, asphyxia, umbilical cord pH, admission to neonatal intensive care unit, treatment by mechanical ventilation, and experience level of obstetricians performing internal podalic version. RESULTS: 457 births were available for analysis: 39 cases of internal podalic version...

  10. Multifunctional Nanoparticles for Drug Delivery Applications Imaging, Targeting, and Delivery

    CERN Document Server

    Prud'homme, Robert

    2012-01-01

    This book clearly demonstrates the progression of nanoparticle therapeutics from basic research to applications. Unlike other books covering nanoparticles used in medical applications, Multifunctional Nanoparticles for Drug Delivery Applications presents the medical challenges that can be reduced or even overcome by recent advances in nanoscale drug delivery. Each chapter highlights recent progress in the design and engineering of select multifunctional nanoparticles with topics covering targeting, imaging, delivery, diagnostics, and therapy.

  11. Application of Kiwi OmniCup system in assisted vaginal delivery%Kiwi Omni 胎头吸引器在阴道助产分娩中的应用

    Institute of Scientific and Technical Information of China (English)

    王青青; 白小艺; 侯红瑛

    2016-01-01

    目的:评估 Kiwi Omni 胎头吸引器在阴道助产分娩中的安全性及有效性。方法收集规律产检且通过阴道助产分娩的45例孕妇作为研究对象,其中使用 Kiwi Omni 胎头吸引器的16例为观察组,使用产钳的29例为对照组。对比观察组与对照组的产妇阴道裂伤率、会阴侧切率、新生儿出生后阿普加评分、新生儿脐动脉血气分析及新生儿头皮下血肿、颅内出血等情况,评估不同阴道助产分娩方式的安全性。结果观察组产妇中阴道裂伤1例(6%)、会阴侧切6例(32%),对照组产妇中出现阴道裂伤10例(34%)、会阴侧切23例(88%),观察组产妇的阴道裂伤率及会阴侧切率均低于对照组(P 均<0.05)。观察组新生儿中出现头皮下血肿4例(25%),对照组新生儿中仅1例(3%)出现头皮下血肿,2组比较差异有统计学意义(P <0.05)。2组新生儿的阿普加评分、脐动脉血气分析、转科率及住院时间比较差异均无统计学意义(P 均>0.05)。结论Kiwi Omni 胎头吸引器在阴道助产分娩中可以降低产妇软产道损伤,不增加新生儿窒息率及新生儿转科率。%Objective To evaluate the safety and efficacy of the Kiwi OmniCup system in assisted vaginal delivery.Methods Forty five pregnant women who received prenatal examination and underwent vagi-nal delivery were recruited in this study.Sixteen subjects utilizing the Kiwi OmniCup system were assigned into the observation group and 29 using obstetrics forceps were allocated into the control group.Vaginal laceration rate,lateral episiotomy rate,the Apgar score after birth,neonate umbilical cord artery blood gas analysis,neo-nate subscalp hematoma and neonate intracranial hemotoma were statistically compared between the observation and control groups.The safety of different modes of vaginal delivery was evaluated.Results In the observa-tion group,1 case (6%)had vaginal

  12. Metrology for drug delivery.

    Science.gov (United States)

    Lucas, Peter; Klein, Stephan

    2015-08-01

    In various recently published studies, it is argued that there are underestimated risks with infusion technology, i.e., adverse incidents believed to be caused by inadequate administration of the drugs. This is particularly the case for applications involving very low-flow rates, i.e., metrological infrastructure for low-flow rates. Technical challenges such as these were the reason a European research project "Metrology for Drug Delivery" was started in 2011. In this special issue of Biomedical Engineering, the results of that project are discussed.

  13. Predicting adverse obstetric outcome after early pregnancy events and complications: a review

    DEFF Research Database (Denmark)

    van Oppenraaij, R H F; Jauniaux, E; Christiansen, O B

    2009-01-01

    score after detection of an intrauterine haematoma, the risk of VPTD and intrauterine growth restriction after a crown-rump length discrepancy, the risk of VPTD, LBW and VLBW after a vanishing twin phenomenon and the risk of PTD, LBW and low 5-min Apgar score in a pregnancy complicated by severe...... pregnancy with an OR > 2.0 after complications in the index pregnancy are the risk of LBW and very low birthweight (VLBW) after a threatened miscarriage, the risk of pregnancy-induced hypertension, pre-eclampsia, placental abruption, preterm delivery (PTD), small for gestational age and low 5-min Apgar...

  14. Forecasting the value of credit scoring

    Science.gov (United States)

    Saad, Shakila; Ahmad, Noryati; Jaffar, Maheran Mohd

    2017-08-01

    Nowadays, credit scoring system plays an important role in banking sector. This process is important in assessing the creditworthiness of customers requesting credit from banks or other financial institutions. Usually, the credit scoring is used when customers send the application for credit facilities. Based on the score from credit scoring, bank will be able to segregate the "good" clients from "bad" clients. However, in most cases the score is useful at that specific time only and cannot be used to forecast the credit worthiness of the same applicant after that. Hence, bank will not know if "good" clients will always be good all the time or "bad" clients may become "good" clients after certain time. To fill up the gap, this study proposes an equation to forecast the credit scoring of the potential borrowers at a certain time by using the historical score related to the assumption. The Mean Absolute Percentage Error (MAPE) is used to measure the accuracy of the forecast scoring. Result shows the forecast scoring is highly accurate as compared to actual credit scoring.

  15. CONTROLLED DRUG DELIVERY THROUGH MICROENCAPSULATION

    Directory of Open Access Journals (Sweden)

    NIKHIL K. SACHAN

    2006-01-01

    Full Text Available An appropriately designed controlled release drug delivery system can be a major advance towards solving problems concerning to the targeting of drug to a specific organ or tissue and controlling the rate of drug delivery to the target site. The development of oral controlled release systems has been a challenge to formulation scientist due to their inability to restrain and localize the system at targeted areas of gastrointestinal tract. Microparticulate drug delivery systems are an interesting and promising option when developing an oral controlled release system. The objective of this paper is to take a closer look at microparticles as drug delivery devices for increasing efficiency of drug delivery, improving the release profile and drug targeting. In order to appreciate the application possibilities of microcapsules in drug delivery, some fundamental aspects are briefly reviewed.

  16. The Mystery of the Z-Score.

    Science.gov (United States)

    Curtis, Alexander E; Smith, Tanya A; Ziganshin, Bulat A; Elefteriades, John A

    2016-08-01

    Reliable methods for measuring the thoracic aorta are critical for determining treatment strategies in aneurysmal disease. Z-scores are a pragmatic alternative to raw diameter sizes commonly used in adult medicine. They are particularly valuable in the pediatric population, who undergo rapid changes in physical development. The advantage of the Z-score is its inclusion of body surface area (BSA) in determining whether an aorta is within normal size limits. Therefore, Z-scores allow us to determine whether true pathology exists, which can be challenging in growing children. In addition, Z-scores allow for thoughtful interpretation of aortic size in different genders, ethnicities, and geographical regions. Despite the advantages of using Z-scores, there are limitations. These include intra- and inter-observer bias, measurement error, and variations between alternative Z-score nomograms and BSA equations. Furthermore, it is unclear how Z-scores change in the normal population over time, which is essential when interpreting serial values. Guidelines for measuring aortic parameters have been developed by the American Society of Echocardiography Pediatric and Congenital Heart Disease Council, which may reduce measurement bias when calculating Z-scores for the aortic root. In addition, web-based Z-score calculators have been developed to aid in efficient Z-score calculations. Despite these advances, clinicians must be mindful of the limitations of Z-scores, especially when used to demonstrate beneficial treatment effect. This review looks to unravel the mystery of the Z-score, with a focus on the thoracic aorta. Here, we will discuss how Z-scores are calculated and the limitations of their use.

  17. Magnetic targeted drug delivery

    Directory of Open Access Journals (Sweden)

    Timothy Wiedmann

    2009-10-01

    Full Text Available Lung cancer is the most common cause of death from cancer in both men and women. Treatment by intravenous or oral administration of chemotherapy agents results in serious and often treatment-limiting side effects. Delivery of drugs directly to the lung by inhalation of an aerosol holds the promise of achieving a higher concentration in the lung with lower blood levels. To further enhance the selective lung deposition, it may be possible to target deposition by using external magnetic fields to direct the delivery of drug coupled to magnetic particles. Moreover, alternating magnetic fields can be used to induce particle heating, which in turn controls the drug release rate with the appropriate thermal sensitive material.With this goal, superparamagetic nanoparticles (SPNP were prepared and characterized, and enhanced magnetic deposition was demonstrated in vitro and in vivo. SPNPs were also incorporated into a lipid-based/SPNP aerosol formulation, and drug release was shown to be controlled by thermal activation. Because of the inherent imaging potential of SPNPs, this use of nanotechnology offers the possibility of coupling the diagnosis of lung cancer to drug release, which perhaps will ultimately provide the “magic bullet” that Paul Ehrlich originally sought.

  18. The relationship between second-year medical students' OSCE scores and USMLE Step 1 scores.

    Science.gov (United States)

    Simon, Steven R; Volkan, Kevin; Hamann, Claus; Duffey, Carol; Fletcher, Suzanne W

    2002-09-01

    The relationship between objective structured clinical examinations (OSCEs) and standardized tests is not well known. We linked second-year medical students' physical diagnosis OSCE scores from 1998, 1999 and 2000 (n = 355) with demographic information, Medical College Admission Test (MCAT) scores, and United States Medical Licensing Examination (USMLE) Step 1 scores. The correlation coefficient for the total OSCE score with USMLE Step 1 score was 0.41 (p USMLE Step 1 score. OSCE station scores accounted for approximately 22% of the variability in USMLE Step 1 scores. A second-year OSCE in physical diagnosis is correlated with scores on the USMLE Step 1 exam, with skills that foreshadow the clinical clerkships most predictive of USMLE scores. This correlation suggests predictive validity of this OSCE and supports the use of OSCEs early in medical school.

  19. Document delivery services contrasting views

    CERN Document Server

    1999-01-01

    Design and maintain document delivery services that are ideal for academic patrons! In Document Delivery Services: Contrasting Views, you'll visit four university library systems to discover the considerations and challenges each library faced in bringing document delivery to its clientele. This book examines the questions about document delivery that are most pressing in the profession of library science. Despite their own unique experiences, you'll find common practices among all four?including planning, implementation of service, and evaluation of either user satisfaction and/or vendor per

  20. Cesarean section for the second twin

    DEFF Research Database (Denmark)

    Engelbrechtsen, Line; Nielsen, Elise Hoffmann; Perin, Trine

    2013-01-01

    deliveries. Data were extracted from medical records, a fetal medicine software program (Astraia), and the National Birth Registry. Short-term poor neonatal outcome was measured as a 5-minute Apgar score ≤ 7, umbilical cord pH ≤ 7.10, and admission to neonatal intensive care unit for more than 3 days....... RESULTS: Vertex-nonvertex fetal presentations were more prevalent in combined deliveries than vaginal deliveries (OR 4.4, 2.5-7.8). Nonvertex second twins born by combined delivery had a higher risk of Apgar score ≤ 7 and umbilical cord pH ≤ 7.10 compared with vaginal delivery, unadjusted OR 6.2 (2...

  1. Role of computed tomography in estimation of severity and prognosis in neonatal hypoxic encephalopathy

    Energy Technology Data Exchange (ETDEWEB)

    Hirabayashi, S. (Showa Univ., Tokyo (Japan). School of Medicine)

    1981-12-01

    CT (computed tomography) scans in 53 infants whose 1 minute Apgar scores had been 5 or less were reviewed. Comparing the CT findings between the patients of low and high Apgar scores which are checked both at 1 and 5 minutes after delivery, it was confirmed that the 5 minute Apgar score, particularly, is a good predictor of future neurological sequelae of the infants in perinatal hypoxia. Intracranial hemorrhage on the early scans and cerebral atrophy on the follow-up scans were the majority of abnormalities. Between infants with and without neurological sequelae, periventricular hypodensity that may be responsible for future periventricular leucomalacia was quantitatively compared. Differences in absorption density between the two groups were, unexpectedly, not obvious. Usefulness of CT, on the other hand, in detection of intracranial hemorrhage should be emphasized.

  2. Random Walk Picture of Basketball Scoring

    CERN Document Server

    Gabel, Alan

    2011-01-01

    We present evidence, based on play-by-play data from all 6087 games from the 2006/07--2009/10 seasons of the National Basketball Association (NBA), that basketball scoring is well described by a weakly-biased continuous-time random walk. The time between successive scoring events follows an exponential distribution, with little memory between different scoring intervals. Using this random-walk picture that is augmented by features idiosyncratic to basketball, we account for a wide variety of statistical properties of scoring, such as the distribution of the score difference between opponents and the fraction of game time that one team is in the lead. By further including the heterogeneity of team strengths, we build a computational model that accounts for essentially all statistical features of game scoring data and season win/loss records of each team.

  3. Scoring functions for AutoDock.

    Science.gov (United States)

    Hill, Anthony D; Reilly, Peter J

    2015-01-01

    Automated docking allows rapid screening of protein-ligand interactions. A scoring function composed of a force field and linear weights can be used to compute a binding energy from a docked atom configuration. For different force fields or types of molecules, it may be necessary to train a custom scoring function. This chapter describes the data and methods one must consider in developing a custom scoring function for use with AutoDock.

  4. Pneumonia severity scores in resource poor settings

    Directory of Open Access Journals (Sweden)

    Jamie Rylance

    2014-06-01

    Full Text Available Clinical prognostic scores are increasingly used to streamline care in well-resourced settings. The potential benefits of identifying patients at risk of clinical deterioration and poor outcome, delivering appropriate higher level clinical care, and increasing efficiency are clear. In this focused review, we examine the use and applicability of severity scores applied to patients with community acquired pneumonia in resource poor settings. We challenge clinical researchers working in such systems to consider the generalisability of existing severity scores in their populations, and where performance of scores is suboptimal, to promote efforts to develop and validate new tools for the benefit of patients and healthcare systems.

  5. Security Risk Scoring Incorporating Computers' Environment

    Directory of Open Access Journals (Sweden)

    Eli Weintraub

    2016-04-01

    Full Text Available A framework of a Continuous Monitoring System (CMS is presented, having new improved capabilities. The system uses the actual real-time configuration of the system and environment characterized by a Configuration Management Data Base (CMDB which includes detailed information of organizational database contents, security and privacy specifications. The Common Vulnerability Scoring Systems' (CVSS algorithm produces risk scores incorporating information from the CMDB. By using the real updated environmental characteristics the system enables achieving accurate scores compared to existing practices. Framework presentation includes systems' design and an illustration of scoring computations.

  6. Coronary artery calcium score: current status

    Science.gov (United States)

    Neves, Priscilla Ornellas; Andrade, Joalbo; Monção, Henry

    2017-01-01

    The coronary artery calcium score plays an Important role In cardiovascular risk stratification, showing a significant association with the medium- or long-term occurrence of major cardiovascular events. Here, we discuss the following: protocols for the acquisition and quantification of the coronary artery calcium score by multidetector computed tomography; the role of the coronary artery calcium score in coronary risk stratification and its comparison with other clinical scores; its indications, interpretation, and prognosis in asymptomatic patients; and its use in patients who are symptomatic or have diabetes. PMID:28670030

  7. [The cardiovascular surgeon and the Syntax score].

    Science.gov (United States)

    Gómez-Sánchez, Mario; Soulé-Egea, Mauricio; Herrera-Alarcón, Valentín; Barragán-García, Rodolfo

    2015-01-01

    The Syntax score has been established as a tool to determine the complexity of coronary artery disease and as a guide for decision-making among coronary artery bypass surgery and percutaneous coronary intervention. The purpose of this review is to systematically examine what the Syntax score is, and how the surgeon should integrate the information in the selection and treatment of patients. We reviewed the results of the SYNTAX Trial, the clinical practice guidelines, as well as the benefits and limitations of the score. Finally we discuss the future directions of the Syntax score.

  8. 导乐分娩配合GT-4A导乐分娩镇痛仪在阴道分娩中的临床应用%Clinical application of Daole childbirth combined with the GT-4A Daole childbirth for vaginal delivery

    Institute of Scientific and Technical Information of China (English)

    任晓娅; 刘艳云; 田亚菊; 张芳; 牟岩涛; 韩娜; 贾艳君

    2015-01-01

    neonatal Apgar score and reduced postpartum complications. The differences were all statistically significant (P<0.05). The intervention effect of the Daole group was significantly better than that of the epidural group, and the difference was statistically significant (P<0.05). Conclusion Daole childbirth combined with the GT-4A Daole childbirth for vaginal delivery can effectively reduce the labor pain, im-prove the quality of epidural, reduce epidural postoperative complications and improve the quality of delivery, which is worthy of further clinical application.

  9. [Induced labor for gravidae with low Bishop's scores (with report of 242 cases)].

    Science.gov (United States)

    Shan, J

    1990-07-01

    In planned/selective delivery, gravidae with Bishop's score 5 or below 5 are deal with lower position water sac, the aim of which is to induce regular uterine contraction and complete physiological latent period of cervical dilation. From Oct 1986 to Dec 1988, 242 cases of primiparae by this method and the latent period in physiological limit. This is a great breakthrough in induced labour for gravidae with low Bishop's scores. We found that this method is simple, effective, safe, and economic. It not only alleviates pain of the gravidae, but also helps to prevent the rise of caesarean section rate.

  10. Rhythmomimetic drug delivery

    CERN Document Server

    Calderer, M Carme; Siegel, Ronald A; Yao, Lingxing

    2015-01-01

    We present modeling, analysis and numerical simulation of a prototype glucose driven drug delivery device based on chemomechanical interactions and volume phase transitions in polyelectrolyte gels. The device consists of two fluid compartments, an external cell (I) mimicking the physiological environment, and a closed chamber (II), separated by a hydrogel membrane. Cell I, which is held at constant pH and ionic strength, provides a constant supply of glucose to cell II, and also serves as clearance station for reaction products. Cell II contains the drug to be delivered to the body, an enzyme that catalyzes conversion of glucose into hydrogen ions, and a piece of marble to remove excess hydrogen ions that would otherwise overwhelm the system. When the membrane is swollen, glucose flux into Cell II is high, leading to rapid production of hydrogen ions. However, the hydrogen ions are not immediately released to Cell I but react, instead, with the negatively charged carboxyl groups of the membrane, which collaps...

  11. Drug delivery goes supercritical

    Directory of Open Access Journals (Sweden)

    Patrick J. Ginty

    2005-08-01

    Full Text Available In the field of drug delivery, the ability to control the size, morphology, and release of drug particles is fundamental to good targeting, but is often hampered by harsh processing conditions or inadequate methods; likewise for the processing of polymeric controlled-release systems. However, the use of supercritical fluids such as supercritical CO2 (scCO2 has provided a ‘clean’ and effective alternative to traditional methods of drug and polymer processing. In particular, scCO2 has a number of unique properties that make it possible to process both bioactive molecules and amorphous polymers without using toxic organic solvents or elevated temperatures. Here, we review the positive impact that supercritical fluids have had on the micronization, encapsulation, and impregnation of molecules of interest to both the pharmaceutical and biotechnology industries.

  12. Widening clinical applications of the SYNTAX Score.

    Science.gov (United States)

    Farooq, Vasim; Head, Stuart J; Kappetein, Arie Pieter; Serruys, Patrick W

    2014-02-01

    The SYNTAX Score (http://www.syntaxscore.com) has established itself as an anatomical based tool for objectively determining the complexity of coronary artery disease and guiding decision-making between coronary artery bypass graft (CABG) surgery and percutaneous coronary intervention (PCI). Since the landmark SYNTAX (Synergy between PCI with Taxus and Cardiac Surgery) Trial comparing CABG with PCI in patients with complex coronary artery disease (unprotected left main or de novo three vessel disease), numerous validation studies have confirmed the clinical validity of the SYNTAX Score for identifying higher-risk subjects and aiding decision-making between CABG and PCI in a broad range of patient types. The SYNTAX Score is now advocated in both the European and US revascularisation guidelines for decision-making between CABG and PCI as part of a SYNTAX-pioneered heart team approach. Since establishment of the SYNTAX Score, widening clinical applications of this clinical tool have emerged. The purpose of this review is to systematically examine the widening applications of tools based on the SYNTAX Score: (1) by improving the diagnostic accuracy of the SYNTAX Score by adding a functional assessment of lesions; (2) through amalgamation of the anatomical SYNTAX Score with clinical variables to enhance decision-making between CABG and PCI, culminating in the development and validation of the SYNTAX Score II, in which objective and tailored decisions can be made for the individual patient; (3) through assessment of completeness of revascularisation using the residual and post-CABG SYNTAX Scores for PCI and CABG patients, respectively. Finally, the future direction of the SYNTAX Score is covered through discussion of the ongoing development of a non-invasive, functional SYNTAX Score and review of current and planned clinical trials.

  13. Nursing Care Hour Standards Study. Part 2 thru Part 4

    Science.gov (United States)

    1981-09-01

    mother and fetus, provide assistance to physician and patient during the delivery room process. Establish the airway, determine apgar score , obtain...Rater Two . 10 7. Descriptive Data of Patient Care Indicator Scores for Rater One vs Rater Two by Sex ..... ... .. ........................ 10 8...Rater Two for Category of Care ....... 12 10. Critical Care Patient Classification Instrument Total Patient Care Indicator Score (PCIS) by Category of

  14. Effect of Single Shot Intrathecal Sufentanil on Delivery Time and Analgesia in Nuliparae

    Directory of Open Access Journals (Sweden)

    E. Khoshraftar

    2008-04-01

    Full Text Available Introduction & Objective : The objective of this study was to determine the evaluation of intrathecal sufentanil for labor analgesia with respect to duration of labor stages and relief of pain during labor.Materials & Methods : In a clinical trial 60 subjects with ASA class I were selected and randomly divided in two equal groups. 30 subjects had received sufentanil 10 gr in 1 ml of saline during active phase of first stage of labor. The other group as controls, did not receive anything for analgesia. Parturient visual analog scale (VAS , HR, RR, BP, sensory and motor block, FHR and complications such as nausea, vomiting, pruritus and duration of stage I been monitored recorded and compared among those two groups.Results : Comparison of results in two groups have showed that sufentanil does not prolong the duration of labor in stage 1 and 2. We observed lack of hypotension and respiratory depression in sufentanil group FHR changes that had been associated with adverse neonatal out come had not occurred. The apgar scores in two groups were identical. There was itching in majority of parturient who had received sufentanil (83.3%. The pruritus were defined as mild and moderate. Conclusion : Intrathecal sufentanil provide a good analgesia in stage I labor and does not prolong the duration of labor with minimum adverse effects on parturient and fetus.

  15. Hydrogen Delivery Technical Team Roadmap

    Energy Technology Data Exchange (ETDEWEB)

    None

    2013-06-01

    The mission of the Hydrogen Delivery Technical Team (HDTT) is to enable the development of hydrogen delivery technologies, which will allow for fuel cell competitiveness with gasoline and hybrid technologies by achieving an as-produced, delivered, and dispensed hydrogen cost of $2-$4 per gallon of gasoline equivalent of hydrogen.

  16. Decationized polyplexes for gene delivery

    NARCIS (Netherlands)

    Novo, L.; Mastrobattista, E.; Nostrum, van C.F.; Lammers, T.G.G.M.; Hennink, W.E.

    2015-01-01

    Gene therapy has received much attention in the field of drug delivery. Synthetic, nonviral gene delivery systems have gained increasing attention as vectors for gene therapy mainly due to a favorable immunogenicity profile and ease of manufacturing as compared to viral vectors. The great majority o

  17. Chemical Abstracts' Document Delivery Service.

    Science.gov (United States)

    Rollins, Stephen

    1984-01-01

    The Document Delivery Service offered by Chemical Abstracts is described in terms of the DIALORDER option on the Dialog information retrieval system, mail requests, and requests transmitted through OCLC's Interlibrary Loan system. Transmission costs, success rates, delivery rates, and other considerations in utilizing the service are included.…

  18. Birth delivery trauma and malocclusion.

    Science.gov (United States)

    Cattaneo, Ruggero; Monaco, Annalisa; Streni, Oriana; Serafino, Vittorio; Giannoni, Mario

    2005-01-01

    The aim of the investigation was to determine the dynamic of birth delivery and relate to dental occlusion among a group of adult subjects. The group studied was made up of 106 subjects (57 females and 49 males) referred for dental diagnosis and treatment. The average age was 26 with a range 22 to 30 years. In data collection and analysis the following were used as measures: dental occlusion (Angle Class I, II div 1, II div 2 and III) and type of delivery (normal, short, long, caesarean and other). Results showed that among 106 subjects 72 (68%) had malocclusion versus 34 (32%) with normal occlusion; 24 subjects (22.6%) have been normal delivery versus 82 (77.4%) with non-normal delivery. Class I is present in 34 subjects (32%), class II division 1 in 26 (24%), class II division 2 in 22. (20%), class III in 16 (14%), and 8 subjects (6%) fall in the section "other". Among 24 subjects with normal delivery 100% presented class I occlusion. However, among 82 subjects with non-normal delivery 10 subjects had a class I (12.2%) and the 72 (87.8%) had in the other classes, are distributed in the various subgroups of non-normal labor/delivery. None of the subjects with a malocclusion have a normal labor/delivery. Better understanding of the connections among osteopathic theory, craniosacral treatment and the outcomes upon dental occlusion, more rigorous evaluations are warranted.

  19. On k-hypertournament losing scores

    CERN Document Server

    Pirzada, Shariefuddin

    2010-01-01

    We give a new and short proof of a theorem on k-hypertournament losing scores due to Zhou et al. [G. Zhou, T. Yao, K. Zhang, On score sequences of k-tournaments, European J. Comb., 21, 8 (2000) 993-1000.

  20. ON HOW CULTURAL KNOWLEDGE AFFECTS TOEFL SCORES

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    This paper presents a study of the effect of cultur-al background on TOEFL scores.It proceeds from therelation between culture and language,then illus-trates with actual questions from various sections ofTOEFL tests how American cultural background exertsa remarkable influence on TOEFL scores,and con-cludes with revelations with regard to English teachingin this country.

  1. Causal Moderation Analysis Using Propensity Score Methods

    Science.gov (United States)

    Dong, Nianbo

    2012-01-01

    This paper is based on previous studies in applying propensity score methods to study multiple treatment variables to examine the causal moderator effect. The propensity score methods will be demonstrated in a case study to examine the causal moderator effect, where the moderators are categorical and continuous variables. Moderation analysis is an…

  2. Comparability of IQ scores over time

    NARCIS (Netherlands)

    Must, O.; te Nijenhuis, J.; Must, A.; van Vianen, A.E.M.

    2009-01-01

    This study investigates the comparability of IQ scores. Three cohorts (1933/36, 1997/98, 2006) of Estonian students (N = 2173) are compared using the Estonian National Intelligence Test. After 72 years the secular rise of the IQ test scores is.79 SD. The mean .16 SD increase in the last 8 years

  3. Bayesian Model Averaging for Propensity Score Analysis

    Science.gov (United States)

    Kaplan, David; Chen, Jianshen

    2013-01-01

    The purpose of this study is to explore Bayesian model averaging in the propensity score context. Previous research on Bayesian propensity score analysis does not take into account model uncertainty. In this regard, an internally consistent Bayesian framework for model building and estimation must also account for model uncertainty. The…

  4. Diagnosis. Severity scoring system for paediatric FMF.

    Science.gov (United States)

    Livneh, Avi

    2012-04-17

    Severity scoring systems for adult familial Mediterranean fever (FMF) are established and used as important clinical and analytical tools in disease management and research. A recent paper highlights the need for a paediatric FMF severity measure. How should such a score be built and what challenges might be faced?

  5. Clinical scoring scales in thyroidology: A compendium

    Directory of Open Access Journals (Sweden)

    Sanjay Kalra

    2011-01-01

    Full Text Available This compendium brings together traditional as well as contemporary scoring and grading systems used for the screening and diagnosis of various thyroid diseases, dysfunctions, and complications. The article discusses scores used to help diagnose hypo-and hyperthyroidism, to grade and manage goiter and ophthalmopathy, and to assess the risk of thyroid malignancy.

  6. Starreveld scoring method in diagnosing childhood constipation

    NARCIS (Netherlands)

    Kokke, F.T.; Sittig, J.S.; de Bruijn, A.; Wiersma, T.; van Rijn, R.R.; Limpen, J.L.; Houwen, R.H.; Fischer, K.; Benninga, M.A.

    2010-01-01

    Four scoring methods exist to assess severity of fecal loading on plain abdominal radiographs in constipated patients (Barr-, Starreveld-, Blethyn- and Leech). So far, the Starreveld score was used only in adult patients. To determine accuracy and intra- and inter-observer agreement of the Starrevel

  7. What do educational test scores really measure?

    DEFF Research Database (Denmark)

    McIntosh, James; D. Munk, Martin

    measure of pure cognitive ability. We find that variables which are not closely associated with traditional notions of intelligence explain a significant proportion of the variation in test scores. This adds to the complexity of interpreting test scores and suggests that school culture, attitudes...

  8. Propensity score weighting with multilevel data.

    Science.gov (United States)

    Li, Fan; Zaslavsky, Alan M; Landrum, Mary Beth

    2013-08-30

    Propensity score methods are being increasingly used as a less parametric alternative to traditional regression to balance observed differences across groups in both descriptive and causal comparisons. Data collected in many disciplines often have analytically relevant multilevel or clustered structure. The propensity score, however, was developed and has been used primarily with unstructured data. We present and compare several propensity-score-weighted estimators for clustered data, including marginal, cluster-weighted, and doubly robust estimators. Using both analytical derivations and Monte Carlo simulations, we illustrate bias arising when the usual assumptions of propensity score analysis do not hold for multilevel data. We show that exploiting the multilevel structure, either parametrically or nonparametrically, in at least one stage of the propensity score analysis can greatly reduce these biases. We applied these methods to a study of racial disparities in breast cancer screening among beneficiaries of Medicare health plans.

  9. A Bayesian Approach to Learning Scoring Systems.

    Science.gov (United States)

    Ertekin, Şeyda; Rudin, Cynthia

    2015-12-01

    We present a Bayesian method for building scoring systems, which are linear models with coefficients that have very few significant digits. Usually the construction of scoring systems involve manual effort-humans invent the full scoring system without using data, or they choose how logistic regression coefficients should be scaled and rounded to produce a scoring system. These kinds of heuristics lead to suboptimal solutions. Our approach is different in that humans need only specify the prior over what the coefficients should look like, and the scoring system is learned from data. For this approach, we provide a Metropolis-Hastings sampler that tends to pull the coefficient values toward their "natural scale." Empirically, the proposed method achieves a high degree of interpretability of the models while maintaining competitive generalization performances.

  10. 新生儿血气分析:ⅢApgar评分与血pH、BE关系的初步研究%Blood gas analysis in neonates: Ⅲ. A Preliminary observation of the relationship between apgar score and blood pH, BE

    Institute of Scientific and Technical Information of China (English)

    冯星; 何馥贞; 何军; 王琼; 梅秀兰

    1992-01-01

    Apgar评分作为新生儿窒息的临床判断标准应用已久,但近年来有关Apgar评分与脐血pH、BE的研究几乎一致认为两者并不相关,且后者更为客观.本研究通过22例不同Apgar评分的脐血pH、BE分析认为两者之间并无一致关系,而宫内窘迫儿的脐血pH、BE与正常儿差别有高度显著意义(P<0.01),有关脐血pH、BH与生后短时间内足跟动脉化血的pH、BE值有显著的正相关关系(P<0.05),但足跟动脉化血pH、BE在窒息研究中的作用还有待进一步探讨.

  11. Neonates recovering from neonates 1 minute Apgar scores 0-1 : perinatal factors and neurological outcome%影响1min Apgar评分0~1分新生儿的围产期因素及复苏后结局分析

    Institute of Scientific and Technical Information of China (English)

    余彦亮; 张谦慎; 杨传忠; 朱小瑜

    2015-01-01

    目的 探讨影响1 min Apgar评分0~1分新生儿复苏结局的围产期因素、复苏过程及5 min Apgar评分对神经系统预后的影响.方法 回顾性分析2010-2013年4年间在本院分娩的1 min Apgar评分0~1分的重度窒息患儿围产期因素和复苏后的临床资料.结果 研究期间共有38例1 min Apgar评分0~1分患儿,1例放弃抢救,6例死亡,31例复苏成功患儿(81.6%)转入NICU进一步治疗,其中2例住院48 h内放弃治疗.1 min Apgar评分0~1分的围产期因素主要有胎盘早剥(9例)、早产(7例),先天畸形(4例)、羊水Ⅲ度污染(4例)、脐带异常(4例)和分娩困难(4例)等.31例成功复苏的0~1分重度窒息患儿中,5 min Apgar评分≤5分者(15例)脐动脉血气pH <7.0、早期有神经系统症状、头颅磁共振改变的比例均高于5 min评分>5分者(16例),差异有统计学意义(P<0.05),两组脑瘫发生率差异无统计学意义(P =0.072).结论 积极有效的复苏可使绝大多数1 min Apgar评分0~1分新生儿抢救成功,5 min Apgar评分≤5分患儿是重点关注人群.

  12. 妊娠期肝内胆汁淤积症总胆汁酸、雌三醇与新生儿Apgar评分的关系%Relationship between total bile acid and estriol of patients with intrahepatic cholestasis of pregnancy and neonatal Apgar score

    Institute of Scientific and Technical Information of China (English)

    蔡林燕

    2016-01-01

    目的 研究妊娠期肝内胆汁淤积症(ICP)总胆汁酸、雌三醇与新生儿APgar评分的关系.方法 收集2013年6月-2014年12月于该院就诊的ICP患者80例,所有患者均行肝功能生化指标及激素水平检测,对其新生儿均进行出生1 min时的APgar评价,应用单因素方差分析比较正常新生儿、中度窒息新生儿及重度窒息新生儿其母亲的血清胆汁酸和雌三醇情况的差异,采用多重线性回归分析患者血清胆汁酸和雌三醇与其产儿的新生儿Apgar评分的相关性.结果 不同级别Apgar评分的新生儿相对应母亲的血清胆汁酸和雌三醇差异较大,P<0.01,差异具有统计学意义;建立回归方程发现CIP患者血清胆汁酸和雌三醇的回归系数t检验的P值均<0.05,具有统计学意义,总胆汁酸、雌三醇的标准回归系数分别-12.047、-2.473,说明其与新生儿的Apgar评分具有负相关性,且对于新生儿的Apgar评分中总胆汁酸对其影响更大.结论 ICP患者血清胆汁酸和雌三醇与其新生儿的Apgar评分呈现负相关性,ICP患者进行血清胆汁酸和雌三醇的检测对新生儿窒息有一定的预警作用.

  13. The clinical application of combined analysis of neonatal umbilical artery blood pH and 1 min Apgar score%新生儿脐动脉血pH值联合1 min Apgar评分检测的应用

    Institute of Scientific and Technical Information of China (English)

    刘晓静

    2015-01-01

    目的 探讨新生儿脐动脉血pH值联合1 min Apgar检测的应用价值.方法 选取分娩新生儿206例为研究对象,其中临床诊断胎儿窘迫92例,无胎儿窘迫114例.胎儿娩出后立即行脐动脉血气分析和1 min Apgar评分,依据是否胎儿窘迫和1 min Apgar评分分组,并追踪新生儿结局.结果 (1)胎儿窘迫组中脐动脉血pH值<7.20者70例(76.1%),无胎儿窘迫组中为56例(49.1%),差异有统计学意义(P<0.01).(2)新生儿1 min Apgar评分>7分者中脐动脉血pH值<7.20者46例(40.4%),而Apgar评分≤7分者中为73例(79.3%),差异有统计学意义(P<0.01).(3)脐动脉血气及Apgar评分对新生儿缺血缺氧性脑病(HIE)的预测:HIE发生26例.Apgar评分≤7分对HIE诊断敏感度为88.5%,特异性为61.7%;pH值<7.20对HIE诊断的敏感度76.9%,特异性45.0%.联合检测对HIE诊断的敏感性为90.5%,特异性为55.0%.结论 血气分析是Apgar评分的补充,二者结合能增加对HIE诊断的特异性.

  14. A comparison between modified Alvarado score and RIPASA score in the diagnosis of acute appendicitis.

    Science.gov (United States)

    Singla, Anand; Singla, Satpaul; Singh, Mohinder; Singla, Deeksha

    2016-12-01

    Acute appendicitis is a common but elusive surgical condition and remains a diagnostic dilemma. It has many clinical mimickers and diagnosis is primarily made on clinical grounds, leading to the evolution of clinical scoring systems for pin pointing the right diagnosis. The modified Alvarado and RIPASA scoring systems are two important scoring systems, for diagnosis of acute appendicitis. We prospectively compared the two scoring systems for diagnosing acute appendicitis in 50 patients presenting with right iliac fossa pain. The RIPASA score correctly classified 88 % of patients with histologically confirmed acute appendicitis compared with 48.0 % with modified Alvarado score, indicating that RIPASA score is more superior to Modified Alvarado score in our clinical settings.

  15. THE EFFICIENCY OF TENNIS DOUBLES SCORING SYSTEMS

    Directory of Open Access Journals (Sweden)

    Geoff Pollard

    2010-09-01

    Full Text Available In this paper a family of scoring systems for tennis doubles for testing the hypothesis that pair A is better than pair B versus the alternative hypothesis that pair B is better than A, is established. This family or benchmark of scoring systems can be used as a benchmark against which the efficiency of any doubles scoring system can be assessed. Thus, the formula for the efficiency of any doubles scoring system is derived. As in tennis singles, one scoring system based on the play-the-loser structure is shown to be more efficient than the benchmark systems. An expression for the relative efficiency of two doubles scoring systems is derived. Thus, the relative efficiency of the various scoring systems presently used in doubles can be assessed. The methods of this paper can be extended to a match between two teams of 2, 4, 8, …doubles pairs, so that it is possible to establish a measure for the relative efficiency of the various systems used for tennis contests between teams of players.

  16. Using grey literature to prepare pharmacy students for an evolving healthcare delivery system.

    Science.gov (United States)

    Happe, Laura E; Walker, Desiree'

    2013-05-13

    To assess the impact of using "grey literature" (information internally produced in print or electronic format by agencies such as hospitals, government, businesses, etc) rather than a textbook in a course on healthcare delivery systems on students' perception of the relevance of healthcare delivery system topics and their ability to identify credible sources of this information. A reading from the grey literature was identified and assigned to the students for each topic in the course. Pre- and post-course survey instruments were used for the assessment. Students reported healthcare delivery systems topics to be moderately relevant to the profession of pharmacy on both the pre- and post-course survey instruments. Students' knowledge of current and credible sources of information on healthcare delivery system topics significantly improved based on self-reports and scores on objective assessments (phealthcare delivery systems can be used to ensure that information in the pharmacy school curriculum is the most current and credible information available.

  17. Do MCAT scores predict USMLE scores? An analysis on 5 years of medical student data

    Directory of Open Access Journals (Sweden)

    Jacqueline L. Gauer

    2016-09-01

    Full Text Available Introduction: The purpose of this study was to determine the associations and predictive values of Medical College Admission Test (MCAT component and composite scores prior to 2015 with U.S. Medical Licensure Exam (USMLE Step 1 and Step 2 Clinical Knowledge (CK scores, with a focus on whether students scoring low on the MCAT were particularly likely to continue to score low on the USMLE exams. Method: Multiple linear regression, correlation, and chi-square analyses were performed to determine the relationship between MCAT component and composite scores and USMLE Step 1 and Step 2 CK scores from five graduating classes (2011–2015 at the University of Minnesota Medical School (N=1,065. Results: The multiple linear regression analyses were both significant (p<0.001. The three MCAT component scores together explained 17.7% of the variance in Step 1 scores (p<0.001 and 12.0% of the variance in Step 2 CK scores (p<0.001. In the chi-square analyses, significant, albeit weak associations were observed between almost all MCAT component scores and USMLE scores (Cramer's V ranged from 0.05 to 0.24. Discussion: Each of the MCAT component scores was significantly associated with USMLE Step 1 and Step 2 CK scores, although the effect size was small. Being in the top or bottom scoring range of the MCAT exam was predictive of being in the top or bottom scoring range of the USMLE exams, although the strengths of the associations were weak to moderate. These results indicate that MCAT scores are predictive of student performance on the USMLE exams, but, given the small effect sizes, should be considered as part of the holistic view of the student.

  18. Do MCAT scores predict USMLE scores? An analysis on 5 years of medical student data

    OpenAIRE

    Gauer, Jacqueline L.; Wolff, Josephine M.; Jackson, J. Brooks

    2016-01-01

    Introduction: The purpose of this study was to determine the associations and predictive values of Medical College Admission Test (MCAT) component and composite scores prior to 2015 with U.S. Medical Licensure Exam (USMLE) Step 1 and Step 2 Clinical Knowledge (CK) scores, with a focus on whether students scoring low on the MCAT were particularly likely to continue to score low on the USMLE exams.Method: Multiple linear regression, correlation, and chi-square analyses were performed to determi...

  19. Cyclodextrins for drug delivery.

    Science.gov (United States)

    Laza-Knoerr, A L; Gref, R; Couvreur, P

    2010-11-01

    Cyclodextrins (CDs) are macrocyclic oligosaccharides composed of α(1,4)-linked glucopyranose subunits. These molecules possess a cage-like supramolecular structure, comparable with the structures of crown ethers, cryptands, spherands, cyclophanes, or calixarenes. However, it took 50 years to establish the molecular structure of CDs. Owing to their capability to form inclusion complexes with a variety of guest molecules, CDs are considered as the most important supramolecular host family among all supramolecular structures mentioned above. They can form complexes with various types of molecules including inorganic, organic, or organometallic that can be radical, cationic, anionic, or neutral molecules. This phenomenon bears the name "molecular recognition," while the selectivity in the formation of complexes with enantiomeric species as guests is called "chiral recognition." In addition, the properties of the molecules forming the complexes with CDs can be modified significantly. As such, a large number of scientists have attempted to elaborate and evaluate various CD derivatives that are able to complex a variety of drugs, enhancing by this way their in vivo solubility and activity. Moreover, a large number of publications describe CD uses in other fields such as foods, textile, cosmetics, or agriculture. This review reports on the recent developments of CDs in drug delivery using various routes of administration.

  20. Induction of labour by balloon catheter with extra-amniotic saline infusion (BCEAS): a randomised comparison with PGE2 vaginal pessaries

    DEFF Research Database (Denmark)

    Lyndrup, J; Nickelsen, Carsten Nahne Amtoft; Weber, Tom

    1994-01-01

    section followed BCEAS than PGE2 (29% and 10%, respectively; P Apgar scores and umbilical artery pH and SBE). The women, delivering vaginally, commented......: The efficiency of inducing vaginal delivery and the level of 'disadvantages following induction of labour' (DisFIL scorings). RESULTS: Overall, BCEAS was less efficient inducing vaginal delivery than vaginal PGE2 (P ...) primiparous women group, and particularly in the subgroup of these having very low pelvic scores (Lange score, scorings were not significantly different. However, higher rates of caesarean...

  1. Kernel score statistic for dependent data.

    Science.gov (United States)

    Malzahn, Dörthe; Friedrichs, Stefanie; Rosenberger, Albert; Bickeböller, Heike

    2014-01-01

    The kernel score statistic is a global covariance component test over a set of genetic markers. It provides a flexible modeling framework and does not collapse marker information. We generalize the kernel score statistic to allow for familial dependencies and to adjust for random confounder effects. With this extension, we adjust our analysis of real and simulated baseline systolic blood pressure for polygenic familial background. We find that the kernel score test gains appreciably in power through the use of sequencing compared to tag-single-nucleotide polymorphisms for very rare single nucleotide polymorphisms with <1% minor allele frequency.

  2. Facilitating the Interpretation of English Language Proficiency Scores: Combining Scale Anchoring and Test Score Mapping Methodologies

    Science.gov (United States)

    Powers, Donald; Schedl, Mary; Papageorgiou, Spiros

    2017-01-01

    The aim of this study was to develop, for the benefit of both test takers and test score users, enhanced "TOEFL ITP"® test score reports that go beyond the simple numerical scores that are currently reported. To do so, we applied traditional scale anchoring (proficiency scaling) to item difficulty data in order to develop performance…

  3. Cesarean delivery times and adhesion severity associated with prior placement of a sodium hyaluronate-carboxycellulose barrier.

    Science.gov (United States)

    Gaspar-Oishi, Maria; Aeby, Tod

    2014-10-01

    To evaluate the association between the prior use of a sodium hyaluronate-carboxycellulose adhesion barrier and the incision-to-delivery time and adhesion scores at first repeat cesarean delivery. In this cohort study, intraoperative data were prospectively collected at the time of the study participants' first repeat cesarean delivery. Subsequent retrospective chart review of each patient's primary cesarean operative note was then performed to determine whether hyaluronate-carboxycellulose barrier film had been used. The primary outcome was incision-to-delivery time. Secondary outcomes were adhesion grade and blood loss. A total of 97 patients were analyzed; 71 did not have hyaluronate-carboxycellulose barrier film used during their primary cesarean and 26 did. Mean ± standard deviation incision-to-delivery time was 9.5 ± 4.3 minutes in the no hyaluronate-carboxycellulose barrier film group and 10.6 ± 5.8 minutes in the hyaluronate-carboxycellulose barrier film group (P=.8). Average blood loss was 564 ± 255 mL and 563 ± 246 mL, respectively (P=.4). There was no difference between the mean fascia adhesion scores (1.45 compared with 1.31 Z -1.06, P=.29) and mean intraperitoneal adhesion scores (1.11 compared with 0.92 Z -1.09, P=.27). Our sample size yielded a power of 91% to detect a 5-minute difference in delivery times and 99% for a 1-point difference in adhesion scores. Our study showed no difference in the delivery time, blood loss, or adhesion scores at first repeat cesarean delivery between women who had hyaluronate-carboxycellulose barrier film placed at the time of their primary cesarean delivery and those who did not. : II.

  4. Delivery technologies for genome editing.

    Science.gov (United States)

    Yin, Hao; Kauffman, Kevin J; Anderson, Daniel G

    2017-03-24

    With the recent development of CRISPR technology, it is becoming increasingly easy to engineer the genome. Genome-editing systems based on CRISPR, as well as transcription activator-like effector nucleases (TALENs) and zinc-finger nucleases (ZFNs), are becoming valuable tools for biomedical research, drug discovery and development, and even gene therapy. However, for each of these systems to effectively enter cells of interest and perform their function, efficient and safe delivery technologies are needed. This Review discusses the principles of biomacromolecule delivery and gene editing, examines recent advances and challenges in non-viral and viral delivery methods, and highlights the status of related clinical trials.

  5. COMPARATIVE STUDY OF 6% HYDROXYETHYL STARCH (450/0 . 7 AND RINGER’S LACTATE AS PRELOADING FLUID FOR PREVENTION OF HYPOTENSION DURING SPINAL ANESTHESIA IN ELECTIVE CESAREAN DELIVERY

    Directory of Open Access Journals (Sweden)

    Javid

    2015-09-01

    % and that in group B 23 . 3% . The mean time period of onset of hypotension in group A was 6 . 3±2 . 09 (range 4 - 10 min and that in group B was 12 . 9±2 . 27 ( R ange 10 - 16 min . The lowest systolic pressure noted in group A was 109 . 8mmHg and in group was 113 . 9mmHg . None of the patients in group A and group B had bradycardia . The mean amount of Ephedrine required in group A and group B was 13 and 9 . 4 mg respectively . The average amount of i . v fluid used intra - operatively in group A was 1200±152 . 56 ( R ange 1000 - 1500 ml and in group B was 1191 . 70±130 . 70 ( R ange 1000 - 1450 ml . The average intraoperative blood loss in group A was 837 . 50±65 . 90 ( R ange 750 - 1000 ml and in group B was 819 . 20±64 . 56 ( R ange 750 - 950 ml . 4 patients in group A and 3 patients in group B developed vomiting . The neonatal Apgar scores were good and similar in both groups . CONCLUSION : It is concluded that:Among prel oading agents, colloids are superior to crystalloids in reducing the onset and incidence of spinal - induced hypotension . Hydroxyethyl starch 6% is an ideal preloading agent . High molecular weight HEAS (e . g . 450/0 . 7 seems to be better option than Ringer’s anaesthesia in parturients scheduled for elective cesarean section . It is suggested to use 500 ml of high molecular weight 6% HEAS 450/0 . 7 as an effective prophylactic measure to reduce the incidence of spinal - induced hypotension in parturients planned for elective cesarean section . Also no allergic reaction with 6% HEAS 450/0 . 7 were observed in our study

  6. GMAT Scores of Undergraduate Economics Majors

    Science.gov (United States)

    Nelson, Paul A.; Monson, Terry D.

    2008-01-01

    The average score of economics majors on the Graduate Management Admission Test (GMAT) exceeds those of nearly all humanities and arts, social sciences, and business undergraduate majors but not those of most science, engineering, and mathematics majors. (Contains 1 table.)

  7. GMAT Scores of Undergraduate Economics Majors

    Science.gov (United States)

    Nelson, Paul A.; Monson, Terry D.

    2008-01-01

    The average score of economics majors on the Graduate Management Admission Test (GMAT) exceeds those of nearly all humanities and arts, social sciences, and business undergraduate majors but not those of most science, engineering, and mathematics majors. (Contains 1 table.)

  8. Multifactor Screener in OPEN: Scoring Procedures & Results

    Science.gov (United States)

    Scoring procedures were developed to convert a respondent's screener responses to estimates of individual dietary intake for percentage energy from fat, grams of fiber, and servings of fruits and vegetables.

  9. Film scoring today - Theory, practice and analysis

    OpenAIRE

    Flach, Paula Sophie

    2012-01-01

    This thesis considers film scoring by taking a closer look at the theoretical discourse throughout the last decades, examining current production practice of film music and showcasing a musical analysis of the film Inception (2010).

  10. Knee Injury and Osteoarthritis Outcome Score (KOOS)

    DEFF Research Database (Denmark)

    Collins, N J; Prinsen, C A C; Christensen, R

    2016-01-01

    OBJECTIVE: To conduct a systematic review and meta-analysis to synthesize evidence regarding measurement properties of the Knee injury and Osteoarthritis Outcome Score (KOOS). DESIGN: A comprehensive literature search identified 37 eligible papers evaluating KOOS measurement properties in partici...

  11. Cardiovascular risk score in Rheumatoid Arthritis

    Science.gov (United States)

    Wagan, Abrar Ahmed; Mahmud, Tafazzul E Haque; Rasheed, Aflak; Zafar, Zafar Ali; Rehman, Ata ur; Ali, Amjad

    2016-01-01

    Objective: To determine the 10-year Cardiovascular risk score with QRISK-2 and Framingham risk calculators in Rheumatoid Arthritis and Non Rheumatoid Arthritis subjects and asses the usefulness of QRISK-2 and Framingham calculators in both groups. Methods: During the study 106 RA and 106 Non RA patients age and sex matched participants were enrolled from outpatient department. Demographic data and questions regarding other study parameters were noted. After 14 hours of fasting 5 ml of venous blood was drawn for Cholesterol and HDL levels, laboratory tests were performed on COBAS c III (ROCHE). QRISK-2 and Framingham risk calculators were used to get individual 10-year CVD risk score. Results: In this study the mean age of RA group was (45.1±9.5) for Non RA group (43.7±8.2), with female gender as common. The mean predicted 10-year score with QRISK-2 calculator in RA group (14.2±17.1%) and Non RA group was (13.2±19.0%) with (p-value 0.122). The 10-year score with Framingham risk score in RA group was (12.9±10.4%) and Non RA group was (8.9±8.7%) with (p-value 0.001). In RA group QRISK-2 (24.5%) and FRS (31.1%) cases with predicted score were in higher risk category. The maximum agreement scores between both calculators was observed in both groups (Kappa = 0.618 RA Group; Kappa = 0.671 Non RA Group). Conclusion: QRISK-2 calculator is more appropriate as it takes RA, ethnicity, CKD, and Atrial fibrillation as factors in risk assessment score. PMID:27375684

  12. Use score card to boost quality.

    Science.gov (United States)

    2002-10-01

    Keeping a score card can identify problem areas and track improvements. When specific goals are reached, staff are given rewards such as thank-you letters, tokens, or pizza parties. Staff are kept informed about the results of the score card through bulletin board postings, staff meetings, and the hospital Intranet. Data are collected with manual entry by nursing staff, chart review by performance improvement, and a computerized program.

  13. Pharmacophore-based similarity scoring for DOCK.

    Science.gov (United States)

    Jiang, Lingling; Rizzo, Robert C

    2015-01-22

    Pharmacophore modeling incorporates geometric and chemical features of known inhibitors and/or targeted binding sites to rationally identify and design new drug leads. In this study, we have encoded a three-dimensional pharmacophore matching similarity (FMS) scoring function into the structure-based design program DOCK. Validation and characterization of the method are presented through pose reproduction, crossdocking, and enrichment studies. When used alone, FMS scoring dramatically improves pose reproduction success to 93.5% (∼20% increase) and reduces sampling failures to 3.7% (∼6% drop) compared to the standard energy score (SGE) across 1043 protein-ligand complexes. The combined FMS+SGE function further improves success to 98.3%. Crossdocking experiments using FMS and FMS+SGE scoring, for six diverse protein families, similarly showed improvements in success, provided proper pharmacophore references are employed. For enrichment, incorporating pharmacophores during sampling and scoring, in most cases, also yield improved outcomes when docking and rank-ordering libraries of known actives and decoys to 15 systems. Retrospective analyses of virtual screenings to three clinical drug targets (EGFR, IGF-1R, and HIVgp41) using X-ray structures of known inhibitors as pharmacophore references are also reported, including a customized FMS scoring protocol to bias on selected regions in the reference. Overall, the results and fundamental insights gained from this study should benefit the docking community in general, particularly researchers using the new FMS method to guide computational drug discovery with DOCK.

  14. Introducing the SKIN score: a validated scoring system to assess severity of mastectomy skin flap necrosis.

    Science.gov (United States)

    Lemaine, Valerie; Hoskin, Tanya L; Farley, David R; Grant, Clive S; Boughey, Judy C; Torstenson, Tiffany A; Jacobson, Steven R; Jakub, James W; Degnim, Amy C

    2015-09-01

    With increasing use of immediate breast reconstruction (IBR), mastectomy skin flap necrosis (MSFN) is a clinical problem that deserves further study. We propose a validated scoring system to discriminate MSFN severity and standardize its assessment. Women who underwent skin-sparing (SSM) or nipple-sparing mastectomy (NSM) and IBR from November 2009 to October 2010 were studied retrospectively. A workgroup of breast and plastic surgeons scored postoperative photographs using the skin ischemia necrosis (SKIN) score to assess depth and surface area of MSFN. We evaluated correlation of the SKIN score with reoperation for MSFN and its reproducibility in an external sample of surgeons. We identified 106 subjects (175 operated breasts: 103 SSM, 72 NSM) who had ≥1 postoperative photograph within 60 days. SKIN scores correlated strongly with need for reoperation for MSFN, with an AUC of 0.96 for SSM and 0.89 for NSM. External scores agreed well with the gold standard scores for the breast mound photographs with weighted kappa values of 0.82 (depth), 0.56 (surface area), and 0.79 (composite score). The agreement was similar for the nipple-areolar complex photographs: 0.75 (depth), 0.63 (surface area), and 0.79 (composite score). A simple scoring system to assess the severity of MSFN is proposed, incorporating both depth and surface area of MSFN. The SKIN score correlates strongly with the need for reoperation to manage MSFN and is reproducible among breast and plastic surgeons.

  15. GalaxyDock BP2 score: a hybrid scoring function for accurate protein-ligand docking

    Science.gov (United States)

    Baek, Minkyung; Shin, Woong-Hee; Chung, Hwan Won; Seok, Chaok

    2017-07-01

    Protein-ligand docking is a useful tool for providing atomic-level understanding of protein functions in nature and design principles for artificial ligands or proteins with desired properties. The ability to identify the true binding pose of a ligand to a target protein among numerous possible candidate poses is an essential requirement for successful protein-ligand docking. Many previously developed docking scoring functions were trained to reproduce experimental binding affinities and were also used for scoring binding poses. However, in this study, we developed a new docking scoring function, called GalaxyDock BP2 Score, by directly training the scoring power of binding poses. This function is a hybrid of physics-based, empirical, and knowledge-based score terms that are balanced to strengthen the advantages of each component. The performance of the new scoring function exhibits significant improvement over existing scoring functions in decoy pose discrimination tests. In addition, when the score is used with the GalaxyDock2 protein-ligand docking program, it outperformed other state-of-the-art docking programs in docking tests on the Astex diverse set, the Cross2009 benchmark set, and the Astex non-native set. GalaxyDock BP2 Score and GalaxyDock2 with this score are freely available at http://galaxy.seoklab.org/softwares/galaxydock.html.

  16. Continuous Delivery and Quality Monitoring

    CERN Document Server

    CERN. Geneva

    2016-01-01

    After introducing Continuous Delivery, I will switch the topic and try to answer the question how much should we invest in quality and how to do it efficiently. My observations reveal that software quality is often considered as the slo...

  17. Bioresponsive matrices in drug delivery

    Directory of Open Access Journals (Sweden)

    Ye George JC

    2010-11-01

    Full Text Available Abstract For years, the field of drug delivery has focused on (1 controlling the release of a therapeutic and (2 targeting the therapeutic to a specific cell type. These research endeavors have concentrated mainly on the development of new degradable polymers and molecule-labeled drug delivery vehicles. Recent interest in biomaterials that respond to their environment have opened new methods to trigger the release of drugs and localize the therapeutic within a particular site. These novel biomaterials, usually termed "smart" or "intelligent", are able to deliver a therapeutic agent based on either environmental cues or a remote stimulus. Stimuli-responsive materials could potentially elicit a therapeutically effective dose without adverse side effects. Polymers responding to different stimuli, such as pH, light, temperature, ultrasound, magnetism, or biomolecules have been investigated as potential drug delivery vehicles. This review describes the most recent advances in "smart" drug delivery systems that respond to one or multiple stimuli.

  18. The delivery of therapeutic oligonucleotides.

    Science.gov (United States)

    Juliano, Rudolph L

    2016-08-19

    The oligonucleotide therapeutics field has seen remarkable progress over the last few years with the approval of the first antisense drug and with promising developments in late stage clinical trials using siRNA or splice switching oligonucleotides. However, effective delivery of oligonucleotides to their intracellular sites of action remains a major issue. This review will describe the biological basis of oligonucleotide delivery including the nature of various tissue barriers and the mechanisms of cellular uptake and intracellular trafficking of oligonucleotides. It will then examine a variety of current approaches for enhancing the delivery of oligonucleotides. This includes molecular scale targeted ligand-oligonucleotide conjugates, lipid- and polymer-based nanoparticles, antibody conjugates and small molecules that improve oligonucleotide delivery. The merits and liabilities of these approaches will be discussed in the context of the underlying basic biology. © The Author 2016. Published by Oxford University Press on behalf of Nucleic Acids Research.

  19. Extracellular vesicles for drug delivery

    NARCIS (Netherlands)

    Vader, Pieter; Mol, Emma A; Pasterkamp, Gerard; Schiffelers, Raymond M

    Extracellular vesicles (EVs) are cell-derived membrane vesicles, and represent an endogenous mechanism for intercellular communication. Since the discovery that EVs are capable of functionally transferring biological information, the potential use of EVs as drug delivery vehicles has gained

  20. Oral delivery of anticancer drugs

    DEFF Research Database (Denmark)

    Thanki, Kaushik; Gangwal, Rahul P; Sangamwar, Abhay T

    2013-01-01

    The present report focuses on the various aspects of oral delivery of anticancer drugs. The significance of oral delivery in cancer therapeutics has been highlighted which principally includes improvement in quality of life of patients and reduced health care costs. Subsequently, the challenges...... incurred in the oral delivery of anticancer agents have been especially emphasized. Sincere efforts have been made to compile the various physicochemical properties of anticancer drugs from either literature or predicted in silico via GastroPlus™. The later section of the paper reviews various emerging...... trends to tackle the challenges associated with oral delivery of anticancer drugs. These invariably include efflux transporter based-, functional excipient- and nanocarrier based-approaches. The role of drug nanocrystals and various others such as polymer based- and lipid based...

  1. Organoclays for drug delivery Systems

    OpenAIRE

    Canovas Creus, Alba

    2008-01-01

    Modified clays can be used as carriers of drugs due to their suitable properties and structure in order to achieve improvements in drug delivery. The study of this thesis starts with an introduction to mineral clays and its classification, properties and characterization, then deepens into modified clays (properties, comparison with mineral clays, applications and procedure of modification). Another chapter is focused in drug delivery: definition, its difficulties nowadays and the different w...

  2. Electroporation-mediated gene delivery.

    Science.gov (United States)

    Young, Jennifer L; Dean, David A

    2015-01-01

    Electroporation has been used extensively to transfer DNA to bacteria, yeast, and mammalian cells in culture for the past 30 years. Over this time, numerous advances have been made, from using fields to facilitate cell fusion, delivery of chemotherapeutic drugs to cells and tissues, and most importantly, gene and drug delivery in living tissues from rodents to man. Electroporation uses electrical fields to transiently destabilize the membrane allowing the entry of normally impermeable macromolecules into the cytoplasm. Surprisingly, at the appropriate field strengths, the application of these fields to tissues results in little, if any, damage or trauma. Indeed, electroporation has even been used successfully in human trials for gene delivery for the treatment of tumors and for vaccine development. Electroporation can lead to between 100 and 1000-fold increases in gene delivery and expression and can also increase both the distribution of cells taking up and expressing the DNA as well as the absolute amount of gene product per cell (likely due to increased delivery of plasmids into each cell). Effective electroporation depends on electric field parameters, electrode design, the tissues and cells being targeted, and the plasmids that are being transferred themselves. Most importantly, there is no single combination of these variables that leads to greatest efficacy in every situation; optimization is required in every new setting. Electroporation-mediated in vivo gene delivery has proven highly effective in vaccine production, transgene expression, enzyme replacement, and control of a variety of cancers. Almost any tissue can be targeted with electroporation, including muscle, skin, heart, liver, lung, and vasculature. This chapter will provide an overview of the theory of electroporation for the delivery of DNA both in individual cells and in tissues and its application for in vivo gene delivery in a number of animal models.

  3. Insulin-like growth factor-binding protein-1 (IGFBP-1 in cervical secretions in women with symptoms of preterm delivery

    Directory of Open Access Journals (Sweden)

    Amra Habibović

    2008-08-01

    Full Text Available The aim of this prospective study was to investigate a value ofinsulin-like growth factor-binding protein-1 (IGFBP-1 in cervicalsecretion in women with symptoms of preterm delivery and correlatethis test to the Bishop Score in prediction of a preterm delivery.The study group included 30 pregnant women with singletonpregnancy between 24 – 34 gestational weeks who were hospitalizedbecause of a threatening preterm delivery with intact fetalmembranes. A positive Actim Partus test (concentration higherthan 10 µg/l and Bishop Score higher than 4 signify a risk of thepreterm delivery. The Bishop Score is a better predictor of the pretermdelivery in patients with symptoms of the preterm delivery.

  4. Analysis on the effects of different delivery modes on physical and psychological health of mothers and infants%分娩方式的不同对母婴身心健康的影响分析

    Institute of Scientific and Technical Information of China (English)

    吕迎春

    2012-01-01

    Objective: To explore the effects of different delivery modes on the amount of postpartum hemorrhage of parturient women, the time of breast feeding and physical fitness of perinatal infants, provide a basis for choosing a delivery mode which has minimal injury to physical and psychological health of mothers and infants. Methods: One hundred and twenty primiparous women who underwent ce-sarean section in the hospital from 2011 were selected as control group, one hundred and twenty primiparous women who adopted vaginal delivery in the hospital during the same period were selected as observation group, the effects of two kinds of delivery modes on the amount of postpartum hemorrhage of parturient women, the time of breast feeding and physical fitness of perinatal infants were analyzed statistically. Results; The amounts of postpartum hemorrhage of parturient women in observation group and control group were ( 112. 5 ± 45.8) ml and (233.2 ±67. 8) ml, respectively, there was significant difference between the two groups (t = 3.437, P<0.05); the starting lime of breast feeding in control group was (49. 89 ±6. 87) hours, which was significantly later than that in observation group [ (36. 52 ± 5. 75) hours] , there was significant difference between the two groups (t =3.587, P <0. 05) ; the incidence of postpartum complications in observation group was significantly lower than that in control group ( P < 0. 05 ) , the bilirubin index and Apgar score of neonates in observation group were significantly lower than those in control group (P <0. 01) . Conclusion; The injury of cesarean section to maternal and infantile health is far greater than the injury of vaginal delivery, the medical staff should choose delivery modes cautiously and advise parturient women to select a delivery mode which has minimal injury to maternal and infantile health, and the mode should be conducive to maternal and infantile health.%目的:探讨不同分娩方式对产妇产后出血量、母

  5. Pelvimetry for fetal cephalic presentations at or near term for deciding on mode of delivery.

    Science.gov (United States)

    Pattinson, Robert C; Cuthbert, Anna; Vannevel, Valerie

    2017-03-30

    . Downgrading was due to risk of bias relating to lack of allocation concealment and blinding, and imprecision of effect estimates.Women undergoing X-ray pelvimetry were more likely to have a caesarean section (risk ratio (RR) 1.34, 95% confidence interval (CI) 1.19 to 1.52; 1159 women; 5 studies; low-quality evidence). There were no clear differences between groups for perinatal outcomes: perinatal mortality (RR 0.53, 95% CI 0.19 to 1.45; 1159 infants; 5 studies; very low-quality evidence), perinatal asphyxia (RR 0.66, 95% CI 0.39 to 1.10; 305 infants; 1 study), and admission to special care baby unit (RR 0.20, 95% CI 0.01 to 4.13; 288 infants; 1 study; very low-quality evidence). Other outcomes assessed were wound sepsis (RR 0.83, 95% CI 0.26 to 2.67; 288 women; 1 study; very low-quality evidence), blood transfusion (RR 1.00, 95% CI 0.39 to 2.59; 288 women; 1 study; very low-quality evidence), and scar dehiscence (RR 0.59, 95% CI 0.14 to 2.46; 390 women; 2 studies; very low-quality evidence). Again, no clear differences were found for these outcomes between the women who received X-ray pelvimetry and those who did not. Apgar score less than seven at five minutes was not reported in any study. X-ray pelvimetry versus no pelvimetry or clinical pelvimetry is the only comparison included in this review due to the lack of trials identified that used other types or pelvimetry (other radiological examination or clinical pelvimetry versus no pelvimetry). There is not enough evidence to support the use of X-ray pelvimetry for deciding on mode of delivery in women whose fetuses have a cephalic presentation. Women who undergo an X-ray pelvimetry may be more likely to have a caesarean section.Further research should be directed towards defining whether there are specific clinical situations in which pelvimetry can be shown to be of value. Newer methods of pelvimetry (CT, MRI) should be subjected to randomised trials to assess their value. Further trials of X-ray pelvimetry in cephalic

  6. Heart valve surgery: EuroSCORE vs. EuroSCORE II vs. Society of Thoracic Surgeons score

    Directory of Open Access Journals (Sweden)

    Muhammad Sharoz Rabbani

    2014-12-01

    Full Text Available Background This is a validation study comparing the European System for Cardiac Operative Risk Evaluation (EuroSCORE II with the previous additive (AES and logistic EuroSCORE (LES and the Society of Thoracic Surgeons’ (STS risk prediction algorithm, for patients undergoing valve replacement with or without bypass in Pakistan. Patients and Methods Clinical data of 576 patients undergoing valve replacement surgery between 2006 and 2013 were retrospectively collected and individual expected risks of death were calculated by all four risk prediction algorithms. Performance of these risk algorithms was evaluated in terms of discrimination and calibration. Results There were 28 deaths (4.8% among 576 patients, which was lower than the predicted mortality of 5.16%, 6.96% and 4.94% by AES, LES and EuroSCORE II but was higher than 2.13% predicted by STS scoring system. For single and double valve replacement procedures, EuroSCORE II was the best predictor of mortality with highest Hosmer and Lemmeshow test (H-L p value (0.346 to 0.689 and area under the receiver operating characteristic (ROC curve (0.637 to 0.898. For valve plus concomitant coronary artery bypass grafting (CABG patients actual mortality was 1.88%. STS calculator came out to be the best predictor of mortality for this subgroup with H-L p value (0.480 to 0.884 and ROC (0.657 to 0.775. Conclusions For Pakistani population EuroSCORE II is an accurate predictor for individual operative risk in patients undergoing isolated valve surgery, whereas STS performs better in the valve plus CABG group.

  7. "Bronchial Artery Delivery of Viral Vectors for Gene delivery in Cystic Fibrosis; Superior to Airway Delivery?"

    Directory of Open Access Journals (Sweden)

    Coutelle Charles C

    2002-04-01

    Full Text Available Abstract Background Attempts at gene therapy for the pulmonary manifestations of Cystic Fibrosis have relied mainly on airway delivery. However the efficiency of gene transfer and expression in the airway epithelia has not reached therapeutic levels. Access to epithelial cells is not homogenous for a number of reasons and the submucosal glands cannot be reached via the airways. Presentation We propose to inject gene delivery vectors directly into bronchial arteries combined with pre-delivery of vascular endothelial growth factor to increase vascular endothelial permeability and post-delivery flow reduction by balloon occlusion. Thus it may be possible to reach mucous secreting cells of the bronchial luminal epithelium and the submucosal glands in an increased and homogenous fashion. Testing This combination of techniques to the best of our knowledge has not previously been investigated, and may enable us to overcome some of the current limitations to gene therapy for Cystic Fibrosis.

  8. Neonatal outcomes and operative vaginal delivery versus cesarean delivery.

    LENUS (Irish Health Repository)

    Contag, Stephen A

    2010-06-01

    We compared outcomes for neonates with forceps-assisted, vacuum-assisted, or cesarean delivery in the second stage of labor. This is a secondary analysis of a randomized trial in laboring, low-risk, nulliparous women at >or=36 weeks\\' gestation. Neonatal outcomes after use of forceps, vacuum, and cesarean were compared among women in the second stage of labor at station +1 or below (thirds scale) for failure of descent or nonreassuring fetal status. Nine hundred ninety women were included in this analysis: 549 (55%) with an indication for delivery of failure of descent and 441 (45%) for a nonreassuring fetal status. Umbilical cord gases were available for 87% of neonates. We found no differences in the base excess (P = 0.35 and 0.78 for failure of descent and nonreassuring fetal status) or frequencies of pH below 7.0 (P = 0.73 and 0.34 for failure of descent and nonreassuring fetal status) among the three delivery methods. Birth outcomes and umbilical cord blood gas values were similar for those neonates with a forceps-assisted, vacuum-assisted, or cesarean delivery in the second stage of labor. The occurrence of significant fetal acidemia was not different among the three delivery methods regardless of the indication.

  9. RISK FACTOR DIAGNOSTIC SCORE IN DIABETIC FOOT

    Directory of Open Access Journals (Sweden)

    Mohamed Shameem P. M

    2016-09-01

    Full Text Available INTRODUCTION Diabetic foot ulcers vary in their clinical presentation and nature of severity and therefore create a challenging problem to the treating surgeon regarding the prediction of the clinical course and the end result of the treatment. Clinical studies have shown that there are certain risk factors for the progression of foot ulcers in diabetics and it may therefore be possible to predict the course of an ulcer foot at presentation itself, thus instituting proper therapy without delay. Spoken otherwise clinical scoring may tell that this particular ulcer is having highest chance of amputation, then one may be able to take an early decision for the same and avoid the septic complications, inconvenience to the patient, long hospital stay and cost of treatments. AIM OF THE STUDY Aim of the study is to evaluate the above-mentioned scoring system in predicting the course the diabetic foot ulcers. MATERIALS AND METHODS 50 patients with Diabetic Foot attending the OPD of Department of Surgery of Government Hospital attached to Calicut Medical College are included in the present study. After thorough history taking and clinical examination, six risk factors like Age, pedal vessels, renal function, neuropathy, radiological findings and ulcers were observed in the patients by giving certain scoring points to each of them. The total number of points scored by the patients at the time of admission or OPD treatment was correlated with the final outcome in these patients, whether leading to amputation or conservative management. All the data was analysed using standard statistical methods. OBSERVATIONS AND RESULTS There were 12 females and 38 males with a female to male ratio 1:3.1. All were aged above 30 years. Twenty-four (48% of them were between 30-60 years and twenty six (52% were above 60 years. 10 patients were treated conservatively with risk score range: 10 to 35. Six had single toe loss with risk score: 25 to 35. Six had multiple toe loss

  10. A scoring framework for predicting protein structures

    Science.gov (United States)

    Zou, Xiaoqin

    2013-03-01

    We have developed a statistical mechanics-based iterative method to extract statistical atomic interaction potentials from known, non-redundant protein structures. Our method circumvents the long-standing reference state problem in deriving traditional knowledge-based scoring functions, by using rapid iterations through a physical, global convergence function. The rapid convergence of this physics-based method, unlike other parameter optimization methods, warrants the feasibility of deriving distance-dependent, all-atom statistical potentials to keep the scoring accuracy. The derived potentials, referred to as ITScore/Pro, have been validated using three diverse benchmarks: the high-resolution decoy set, the AMBER benchmark decoy set, and the CASP8 decoy set. Significant improvement in performance has been achieved. Finally, comparisons between the potentials of our model and potentials of a knowledge-based scoring function with a randomized reference state have revealed the reason for the better performance of our scoring function, which could provide useful insight into the development of other physical scoring functions. The potentials developed in the present study are generally applicable for structural selection in protein structure prediction.

  11. SCORE SETS IN ORIENTED 3-PARTITE GRAPHS

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Let D(U, V, W) be an oriented 3-partite graph with |U|=p, |V|=q and |W|= r. For any vertex x in D(U, V, W), let d+x and d-x be the outdegree and indegree of x respectively. Define aui (or simply ai) = q + r + d+ui - d-ui, bvj(or simply bj) = p + r + d+vj - d-vj and Cwk (or simply ck) = p + q + d+wk - d-wk as the scores of ui in U, vj in V and wk in Wrespectively. The set A of distinct scores of the vertices of D(U, V, W) is called its score set. In this paper, we prove that if a1 is a non-negative integer, ai(2≤i≤n - 1) are even positive integers and an is any positive integer, then for n≥3, there exists an oriented 3-partite graph with the score set A = {a1,2∑i=1 ai,…,n∑i=1 ai}, except when A = {0,2,3}. Some more results for score sets in oriented 3-partite graphs are obtained.

  12. Disease severity scoring systems in dermatology

    Directory of Open Access Journals (Sweden)

    Cemal Bilaç

    2016-06-01

    Full Text Available Scoring systems have been developed to interpret the disease severity objectively by evaluating the parameters of the disease. Body surface area, visual analogue scale, and physician global assessment are the most frequently used scoring systems for evaluating the clinical severity of the dermatological diseases. Apart from these scoring systems, many specific scoring systems for many dermatological diseases, including acne (acne vulgaris, acne scars, alopecia (androgenetic alopecia, tractional alopecia, bullous diseases (autoimmune bullous diseases, toxic epidermal necrolysis, dermatitis (atopic dermatitis, contact dermatitis, dyshidrotic eczema, hidradenitis suppurativa, hirsutismus, connective tissue diseases (dermatomyositis, skin involvement of systemic lupus erythematosus (LE, discoid LE, scleroderma, lichen planoplaris, mastocytosis, melanocytic lesions, melasma, onychomycosis, oral lichen planus, pityriasis rosea, psoriasis (psoriasis vulgaris, psoriatic arthritis, nail psoriasis, sarcoidosis, urticaria, and vitiligo, have also been developed. Disease severity scoring methods are ever more extensively used in the field of dermatology for clinical practice to form an opinion about the prognosis by determining the disease severity; to decide on the most suitable treatment modality for the patient; to evaluate the efficacy of the applied medication; and to compare the efficiency of different treatment methods in clinical studies.

  13. Gambling scores for earthquake predictions and forecasts

    Science.gov (United States)

    Zhuang, Jiancang

    2010-04-01

    This paper presents a new method, namely the gambling score, for scoring the performance earthquake forecasts or predictions. Unlike most other scoring procedures that require a regular scheme of forecast and treat each earthquake equally, regardless their magnitude, this new scoring method compensates the risk that the forecaster has taken. Starting with a certain number of reputation points, once a forecaster makes a prediction or forecast, he is assumed to have betted some points of his reputation. The reference model, which plays the role of the house, determines how many reputation points the forecaster can gain if he succeeds, according to a fair rule, and also takes away the reputation points betted by the forecaster if he loses. This method is also extended to the continuous case of point process models, where the reputation points betted by the forecaster become a continuous mass on the space-time-magnitude range of interest. We also calculate the upper bound of the gambling score when the true model is a renewal process, the stress release model or the ETAS model and when the reference model is the Poisson model.

  14. [Overview of regulatory aspects guiding tablet scoring].

    Science.gov (United States)

    Teixeira, Maíra Teles; Sá-Barreto, Lívia Cristina Lira; Silva, Dayde Lane Mendonça; Cunha-Filho, Marcílio Sergio Soares

    2016-06-01

    Tablet scoring is a controversial but common practice used to adjust doses, facilitate drug intake, or lower the cost of drug treatment, especially in children and the elderly. The risks of tablet scoring are mainly related to inaccuracies in the resulting dose and stability problems. The aim of this article is to provide an overview of worldwide guidelines regarding tablet scoring. We found that regulatory health agencies in Mercosur countries as well as other South American countries do not have published standards addressing tablet splitting. Among the surveyed health agencies, the Food and Drug Administration (FDA) in the United States is the only one to present standards, ranging from splitting instructions to regulation of the manufacturing process. The concept of functional scoring implemented by the FDA has introduced some level of guarantee as to the ability of tablets to be split. In conclusion, technical and scientific bases are still insufficient to guide health rules on this subject, making the decision on scoring, in certain situations, random and highly risky to public health. The need for more detailed regulation is vital to ensure the safety of tablet medications.

  15. Immediate versus deferred delivery of the preterm baby with suspected fetal compromise for improving outcomes.

    Science.gov (United States)

    Stock, Sarah J; Bricker, Leanne; Norman, Jane E; West, Helen M

    2016-07-12

    were no differences between the immediate delivery and deferred delivery groups in any other infant mortality outcome (stillbirth, neonatal mortality, postneonatal mortality > 28 days to discharge), individual neonatal morbidity or markers of neonatal morbidity (cord pH less than 7.00, Apgar less than seven at five minutes, convulsions, interventricular haemorrhage or germinal matrix haemorrhage, necrotising enterocolitis and periventricular leucomalacia or ventriculomegaly).Some important outcomes were not reported, in particular infant admission to neonatal intensive care or special care facility, and respiratory distress syndrome. We were not able to calculate composite rates of serious neonatal morbidity, even though individual morbidities were reported, due to the risk of double counting infants with more than one morbidity.More children in the immediate delivery group had cerebral palsy at or after two years of age (RR 5.88, 95% CI 1.33 to 26.02, one trial, 507 children). There were, however, no differences in neurodevelopment impairment at or after two years (RR 1.72, 95% CI 0.86 to 3.41, one trial, 507 children), death at or after two years of age (RR 1.04, 95% CI 0.66 to 1.63, one trial, 573 children), or death or disability in childhood (six to 13 years of age) (RR 0.82, 95% CI 0.48 to 1.40, one trial, 302 children). More women in the immediate delivery group had caesarean delivery than in the deferred delivery group (RR 1.15, 95% CI 1.07 to 1.24, one trial, 547 women, high-quality evidence). Data were not available on any other maternal outcomes.There were several methodological weaknesses in the included study, and the level of evidence for the primary outcomes was graded high for caesarean section and moderate for extended perinatal mortality and death or disability at or after two years. The evidence was downgraded because the CIs for these outcomes were wide, and were consistent with both appreciable benefit and harm. Bias may have been introduced by

  16. Effect of role play education on primiparous women's fear of natural delivery and their decision on the mode of delivery

    Science.gov (United States)

    Navaee, Maryam; Abedian, Zahra

    2015-01-01

    Background: The number of women who select cesarean section due to fear of childbirth has increased. Role play education seems to be a helpful method to remove or reduce the fear of childbirth. Therefore, this study aimed to investigate the effect of role play education on primiparous women's fear of natural delivery and their decision on the mode of delivery. Materials and Methods: In this blind clinical trial, 67 primiparous women with natural pregnancy at 34–36 weeks of gestational age and with no indication of cesarean section were selected from the health care centers in Mashhad. They were randomly assigned to two groups who underwent pre-test and post-test with the help of delivery attitude questionnaire to investigate their fear of childbirth and a researcher-made pregnant women's decision investigation questionnaire. Education through role play was conducted in the form of three scenarios during seven stages. The findings were analyzed by Fisher's exact test and independent t-test through SPSS. Results: The two groups were significantly different concerning the fear of childbirth after the intervention (P = 0.007), and the fear score showed a higher reduction in the role play group compared to the lecture group. There was a significant difference between the two groups concerning the reduction of elective cesarean section and the decision on the mode of delivery at the time of admission in the labor room (P = 0.000). About 75% in the lecture group and 100% in the role play group selected natural delivery. Conclusions: In the present study, the effect of role play was more in making a decision on natural delivery, reducing the fear of childbirth, and reducing the rate of elective cesarean section. It is suggested to use role play method to educate pregnant women to reduce the rate of cesarean sections. PMID:25709689

  17. Anal endosonographic findings in women after vaginal delivery

    Energy Technology Data Exchange (ETDEWEB)

    Kolodziejczak, Malgorzata [Department of Proctology, Hospital at Solec, Warsaw (Poland); Sudol-Szopinska, Iwona, E-mail: iwsud@ciop.pl [Department of Proctology, Hospital at Solec, Warsaw (Poland); Department of Diagnostic Imaging, Second Faculty of Warsaw Medical University, Warsaw (Poland); Stefanski, Robert [Department of Proctology, Hospital at Solec, Warsaw (Poland); Department of Diagnostic Imaging, Second Faculty of Warsaw Medical University, Warsaw (Poland); Panorska, Anna K. [Department of Mathematics and Statistics, University of Nevada, Reno (United States); Gardyszewska, Agnieszka [Second Clinic of Obstetrics and Gynecology, Warsaw (Poland); Krasnodebski, Ireneusz [Department of General and Gastroenterological Surgery and Nutrition, Medical University, Warsaw (Poland)

    2011-04-15

    Objective: To estimate a frequency of obstetric anal sphincters defects in women after vaginal delivery. Methods: The study included 102 women, aged from 16 to 40 years (mean age 28.6 years). 28 women had perineal lacerations of 3rd and 4th degree. 22 women had instrumental delivery. Anal endosonography was performed on all participants using BK Medical scanner Pro focus with a 3D endoprobe during the first week after delivery. Starck's classification was used to score sphincters defects. Results: The endosonographic images were abnormal in 8 out of 102 women (7.8%). Follow-up examinations after 6 weeks confirmed defects in 6 out of 102 women (5.8%). Five women had external anal sphincter torn, and 1 woman had both sphincters, internal and external, defected. Discordance between endosonographic diagnosis of defect and clinical assessment of sphincters continuity was demonstrated in 6 (5.9%) out of 8 initially found, including 2 (1.9%) false endosonographic results and 4 (3.9%) false clinical diagnosis (occult sphincter defects). The endosonography sensitivity and accuracy in sphincter defect diagnostic amounted to 100% and 98%, respectively. Conclusions: (1) Anal sphincters' tears in symptomatic women are not as frequent as it was believed. (2) The defect diagnosis in the first week after delivery should be verified by a follow-up endosonography in 6 weeks, after regression of the edema and hematoma.

  18. The CUSUM chart method as a tool for continuous monitoring of clinical outcomes using routinely collected data

    Directory of Open Access Journals (Sweden)

    Sibanda Nokuthaba

    2007-11-01

    Full Text Available Abstract Background The lack of robust systems for monitoring quality in healthcare has been highlighted. Statistical process control (SPC methods, utilizing the increasingly available routinely collected electronic patient records, could be used in creating surveillance systems that could lead to rapid detection of periods of deteriorating standards. We aimed to develop and test a CUmulative SUM (CUSUM based surveillance system that could be used in continuous monitoring of clinical outcomes, using routinely collected data. The low Apgar score (5 minute Apgar score Method A surveillance system based on the Observed minus Expected (O-E as well as the 2-sided Log-Likelihood CUSUM charts was developed. The Log-Likelihood chart was designed to detect a 50% rise (deterioration and halving (improvement in the odds of low Apgar scores. Baseline rates were calculated from data for 2001 to 2004, and were used to monitor deliveries for 2005. Deliveries for nulliparous and multiparous women were monitored separately. All analyses were retrospective. Results The CUSUM system detected periods of increased rates of low Apgar scores for each of the nulliparous and multiparous cohorts. The overall rate for 2005 was eventually found to be 0.67%, which was higher than the baseline reference rate of 0.44% from 2001 to 2004. Conclusion CUSUM methods can be used in continuous monitoring of clinical outcomes using routinely collected data. Used prospectively, they could lead to the prompt detection of periods of suboptimal standards.

  19. Prognostic Value of TIMI Score versus GRACE Score in ST-segment Elevation Myocardial Infarction

    Directory of Open Access Journals (Sweden)

    Luis C. L. Correia

    2014-08-01

    Full Text Available Background: The TIMI Score for ST-segment elevation myocardial infarction (STEMI was created and validated specifically for this clinical scenario, while the GRACE score is generic to any type of acute coronary syndrome. Objective: Between TIMI and GRACE scores, identify the one of better prognostic performance in patients with STEMI. Methods: We included 152 individuals consecutively admitted for STEMI. The TIMI and GRACE scores were tested for their discriminatory ability (C-statistics and calibration (Hosmer-Lemeshow in relation to hospital death. Results: The TIMI score showed equal distribution of patients in the ranges of low, intermediate and high risk (39 %, 27 % and 34 %, respectively, as opposed to the GRACE Score that showed predominant distribution at low risk (80 %, 13 % and 7%, respectively. Case-fatality was 11%. The C-statistics of the TIMI score was 0.87 (95%CI = 0.76 to 0.98, similar to GRACE (0.87, 95%CI = 0.75 to 0.99 - p = 0.71. The TIMI score showed satisfactory calibration represented by χ2 = 1.4 (p = 0.92, well above the calibration of the GRACE score, which showed χ2 = 14 (p = 0.08. This calibration is reflected in the expected incidence ranges for low, intermediate and high risk, according to the TIMI score (0 %, 4.9 % and 25 %, respectively, differently to GRACE (2.4%, 25% and 73%, which featured middle range incidence inappropriately. Conclusion: Although the scores show similar discriminatory capacity for hospital death, the TIMI score had better calibration than GRACE. These findings need to be validated populations of different risk profiles.

  20. Delivery Time Reliability Model of Logistics Network

    OpenAIRE

    Liusan Wu; Qingmei Tan; Yuehui Zhang

    2013-01-01

    Natural disasters like earthquake and flood will surely destroy the existing traffic network, usually accompanied by delivery delay or even network collapse. A logistics-network-related delivery time reliability model defined by a shortest-time entropy is proposed as a means to estimate the actual delivery time reliability. The less the entropy is, the stronger the delivery time reliability remains, and vice versa. The shortest delivery time is computed separately based on two different assum...

  1. Predictors of vaginal delivery in medically indicated early preterm induction of labor.

    Science.gov (United States)

    Sievert, Rachel A; Kuper, Spencer G; Jauk, Victoria C; Parrish, Melissa; Biggio, Joseph R; Harper, Lorie M

    2017-09-01

    When delivery is indicated prior to 34 weeks, many providers perform a cesarean delivery rather than induce labor based on perceptions of a high failure rate. Given the morbidity of cesarean delivery, an accurate estimate of the success rate and factors associated with success in preterm induction of labor is important in management decisions. We sought to develop a prediction model for successful induction of labor in preterm patients using factors known at the time the decision is made to deliver. A retrospective cohort study of all live singletons undergoing an indicated induction of labor between 23 and 34 0/7 weeks from 2011 through 2015. Pregnancies with major fetal anomalies or no intrapartum fetal monitoring were excluded. Successful induction of labor was defined as vaginal delivery. The cohort was randomly split into a training cohort to develop a prediction model for vaginal delivery and a validation cohort to test the model. Factors significantly associated with vaginal delivery were identified using univariate analyses, and candidate factors were used in the multivariate logistic regression model. Only factors known at the start of the induction of labor were used in the model. Receiver-operating characteristic curves were created to estimate the predictive value of the model. Sensitivity and specificity of the model were assessed. Of 331 patients who underwent induction of labor, 208 (62.8%) delivered vaginally and 123 (37.1%) by cesarean delivery. Of the factors significantly associated with cesarean delivery, the final model included gestational age, simplified Bishop score, suspected intrauterine growth retardation, chronic hypertension, and body mass index. In the training cohort, the model correctly classified 72.3% of subjects with a sensitivity (cesarean delivery predicted/cesarean delivery performed) of 56.7% and a specificity (vaginal delivery predicted/vaginal delivery performed) of 84.1%. When applied to the validation cohort, 73.9% of

  2. Evaluation of the "medication fall risk score".

    Science.gov (United States)

    Yazdani, Cyrus; Hall, Scott

    2017-01-01

    Results of a study evaluating the predictive validity of a fall screening tool in hospitalized patients are reported. Administrative claims data from two hospitals were analyzed to determine the discriminatory ability of the "medication fall risk score" (RxFS), a medication review fall-risk screening tool that is designed for use in conjunction with nurse-administered tools such as the Morse Fall Scale (MFS). Through analysis of data on administered medications and documented falls in a population of adults who underwent fall-risk screening at hospital admission over a 15-month period (n = 33,058), the predictive value of admission MFS scores, alone or in combination with retrospectively calculated RxFS-based risk scores, was assessed. Receiver operating characteristic (ROC) curve analysis and net reclassification improvement (NRI) analysis were used to evaluate improvements in risk prediction with the addition of RxFS data to the prediction model. The area under the ROC curve for the predictive model for falls compromising both MFS and RxFS scores was computed as 0.8014, which was greater than the area under the ROC curve associated with use of the MFS alone (0.7823, p = 0.0030). Screening based on MFS scores alone had 81.25% sensitivity and 61.37% specificity. Combined use of RxFS and MFS scores resulted in 82.42% sensitivity and 66.65% specificity (NRI = 0.0587, p = 0.0003). Reclassification of fall risk based on coadministration of the MFS and the RxFS tools resulted in a modest improvement in specificity without compromising sensitivity. Copyright © 2017 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

  3. NCACO-score: An effective main-chain dependent scoring function for structure modeling

    Directory of Open Access Journals (Sweden)

    Dong Xiaoxi

    2011-05-01

    Full Text Available Abstract Background Development of effective scoring functions is a critical component to the success of protein structure modeling. Previously, many efforts have been dedicated to the development of scoring functions. Despite these efforts, development of an effective scoring function that can achieve both good accuracy and fast speed still presents a grand challenge. Results Based on a coarse-grained representation of a protein structure by using only four main-chain atoms: N, Cα, C and O, we develop a knowledge-based scoring function, called NCACO-score, that integrates different structural information to rapidly model protein structure from sequence. In testing on the Decoys'R'Us sets, we found that NCACO-score can effectively recognize native conformers from their decoys. Furthermore, we demonstrate that NCACO-score can effectively guide fragment assembly for protein structure prediction, which has achieved a good performance in building the structure models for hard targets from CASP8 in terms of both accuracy and speed. Conclusions Although NCACO-score is developed based on a coarse-grained model, it is able to discriminate native conformers from decoy conformers with high accuracy. NCACO is a very effective scoring function for structure modeling.

  4. What Do Test Scores Really Mean? A Latent Class Analysis of Danish Test Score Performance

    DEFF Research Database (Denmark)

    Munk, Martin D.; McIntosh, James

    2014-01-01

    Latent class Poisson count models are used to analyze a sample of Danish test score results from a cohort of individuals born in 1954-55, tested in 1968, and followed until 2011. The procedure takes account of unobservable effects as well as excessive zeros in the data. We show that the test scores...... of intelligence explain a significant proportion of the variation in test scores. This adds to the complexity of interpreting test scores and suggests that school culture and possible incentive problems make it more di¢ cult to understand what the tests measure....

  5. Vinardo: A Scoring Function Based on Autodock Vina Improves Scoring, Docking, and Virtual Screening.

    Directory of Open Access Journals (Sweden)

    Rodrigo Quiroga

    Full Text Available Autodock Vina is a very popular, and highly cited, open source docking program. Here we present a scoring function which we call Vinardo (Vina RaDii Optimized. Vinardo is based on Vina, and was trained through a novel approach, on state of the art datasets. We show that the traditional approach to train empirical scoring functions, using linear regression to optimize the correlation of predicted and experimental binding affinities, does not result in a function with optimal docking capabilities. On the other hand, a combination of scoring, minimization, and re-docking on carefully curated training datasets allowed us to develop a simplified scoring function with optimum docking performance. This article provides an overview of the development of the Vinardo scoring function, highlights its differences with Vina, and compares the performance of the two scoring functions in scoring, docking and virtual screening applications. Vinardo outperforms Vina in all tests performed, for all datasets analyzed. The Vinardo scoring function is available as an option within Smina, a fork of Vina, which is freely available under the GNU Public License v2.0 from http://smina.sf.net. Precompiled binaries, source code, documentation and a tutorial for using Smina to run the Vinardo scoring function are available at the same address.

  6. Vinardo: A Scoring Function Based on Autodock Vina Improves Scoring, Docking, and Virtual Screening.

    Science.gov (United States)

    Quiroga, Rodrigo; Villarreal, Marcos A

    2016-01-01

    Autodock Vina is a very popular, and highly cited, open source docking program. Here we present a scoring function which we call Vinardo (Vina RaDii Optimized). Vinardo is based on Vina, and was trained through a novel approach, on state of the art datasets. We show that the traditional approach to train empirical scoring functions, using linear regression to optimize the correlation of predicted and experimental binding affinities, does not result in a function with optimal docking capabilities. On the other hand, a combination of scoring, minimization, and re-docking on carefully curated training datasets allowed us to develop a simplified scoring function with optimum docking performance. This article provides an overview of the development of the Vinardo scoring function, highlights its differences with Vina, and compares the performance of the two scoring functions in scoring, docking and virtual screening applications. Vinardo outperforms Vina in all tests performed, for all datasets analyzed. The Vinardo scoring function is available as an option within Smina, a fork of Vina, which is freely available under the GNU Public License v2.0 from http://smina.sf.net. Precompiled binaries, source code, documentation and a tutorial for using Smina to run the Vinardo scoring function are available at the same address.

  7. Algorithm improvement program nuclide identification algorithm scoring criteria and scoring application.

    Energy Technology Data Exchange (ETDEWEB)

    Enghauser, Michael [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2016-02-01

    The goal of the Domestic Nuclear Detection Office (DNDO) Algorithm Improvement Program (AIP) is to facilitate gamma-radiation detector nuclide identification algorithm development, improvement, and validation. Accordingly, scoring criteria have been developed to objectively assess the performance of nuclide identification algorithms. In addition, a Microsoft Excel spreadsheet application for automated nuclide identification scoring has been developed. This report provides an overview of the equations, nuclide weighting factors, nuclide equivalencies, and configuration weighting factors used by the application for scoring nuclide identification algorithm performance. Furthermore, this report presents a general overview of the nuclide identification algorithm scoring application including illustrative examples.

  8. Track score processing of multiple dissimilar sensors

    OpenAIRE

    Patsikas, Dimitrios

    2007-01-01

    In this thesis, a data fusion problem when a number of different types of sensors are deployed in the vicinity of a ballistic missile launch is studied. An objective of this thesis is to calculate a scoring function for each sensor track, and the track file with the best (optimum) track score can then be used for guiding an interceptor to the threat within the boost phase. Seven active ground-based radars, two space-based passive infrared sensors and two active light detection and rangin...

  9. Assigning Numerical Scores to Linguistic Expressions

    Directory of Open Access Journals (Sweden)

    María Jesús Campión

    2017-07-01

    Full Text Available In this paper, we study different methods of scoring linguistic expressions defined on a finite set, in the search for a linear order that ranks all those possible expressions. Among them, particular attention is paid to the canonical extension, and its representability through distances in a graph plus some suitable penalization of imprecision. The relationship between this setting and the classical problems of numerical representability of orderings, as well as extension of orderings from a set to a superset is also explored. Finally, aggregation procedures of qualitative rankings and scorings are also analyzed.

  10. A lumbar disc surgery predictive score card.

    Science.gov (United States)

    Finneson, B E

    1978-06-01

    A lumbar disc surgery predictive score card or questionnaire has been developed to assess potential candidates for excision of a herniated lumbar disc who have not previously undergone lumbar spine surgery. It is not designed to encompass patients who are being considered for other types of lumbar spine surgery, such as decompressive laminectomy or fusion. In an effort to make the "score card" usable by almost all physicians who are involved in lumbar disc surgery, only studies which have broad acceptance and are generally employed are included. Studies which have less widespread use such as electromyogram, discogram, venogram, special psychologic studies (MMPI, pain drawings) have been purposely excluded.

  11. Sharp compared with blunt fascial incision at cesarean delivery

    DEFF Research Database (Denmark)

    Aabakke, Anna J M; Hare, Kristine J; Krebs, Lone

    2014-01-01

    OBJECTIVE: To compare patient preference for either sharp incision with scissors or blunt manual cleavage of the fascia at cesarean delivery in a randomized controlled trial in which each woman was her own control. STUDY DESIGN: Women undergoing primary cesarean delivery (n=34) were randomized...... to side distribution of sharp or blunt incision of the fascia (sharp right and blunt left or blunt right and sharp left) and followed three months postoperatively. The primary outcome was patient preference for the right or left side of the scar 3 months postoperatively and modeled by polytomous logistic...... difference was found in patient preference with regard to sharp or blunt incision of the fascia, nor was there a significant difference in postoperative pain scores. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov: www.clinicaltrials.org;NCT01297725....

  12. Buccal and sublingual vaccine delivery.

    Science.gov (United States)

    Kraan, Heleen; Vrieling, Hilde; Czerkinsky, Cecil; Jiskoot, Wim; Kersten, Gideon; Amorij, Jean-Pierre

    2014-09-28

    Because of their large surface area and immunological competence, mucosal tissues are attractive administration and target sites for vaccination. An important characteristic of mucosal vaccination is its ability to elicit local immune responses, which act against infection at the site of pathogen entry. However, mucosal surfaces are endowed with potent and sophisticated tolerance mechanisms to prevent the immune system from overreacting to the many environmental antigens. Hence, mucosal vaccination may suppress the immune system instead of induce a protective immune response. Therefore, mucosal adjuvants and/or special antigen delivery systems as well as appropriate dosage forms are required in order to develop potent mucosal vaccines. Whereas oral, nasal and pulmonary vaccine delivery strategies have been described extensively, the sublingual and buccal routes have received considerably less attention. In this review, the characteristics of and approaches for sublingual and buccal vaccine delivery are described and compared with other mucosal vaccine delivery sites. We discuss recent progress and highlight promising developments in the search for vaccine formulations, including adjuvants and suitable dosage forms, which are likely critical for designing a successful sublingual or buccal vaccine. Finally, we outline the challenges, hurdles to overcome and formulation issues relevant for sublingual or buccal vaccine delivery.

  13. Cesarean delivery on maternal request and childhood intelligence: a cohort study

    Institute of Scientific and Technical Information of China (English)

    LI Hong-tian; YE Rong-wei; PEI Li-jun; REN Ai-guo; ZHENG Xiao-ying; LIU Jian-meng

    2011-01-01

    Background Cesarean section births have been steadily increasing over the past decade and have become an epidemic in China.Cesarean delivery on maternal request is a major contributor to this upward trend,and there has been of much concern about its impact on maternal and child health.Most of mothers believe that cesarean delivery on maternal request can improve the child's intelligence,but direct evidence is sparse.In this cohort study,we aimed to directly assess the impact of cesarean delivery on maternal request on childhood intelligence.Methods Intelligence quotient (IQ) of 4144 preschool children from 21 cities/counties of Zhejiang and Jiangsu province whose mothers were registered in a population-based perinatal surveillance program during 1993-1996 was assessed with Chinese Wechsler Young Children Scale of Intelligence (C-WYCSI) in 2000.The outcomes were full-scale IQ,verbal IQ,and performance IQ of C-WYCSI.Mode of delivery and covariates were obtained from the surveillance program.We estimated unadjusted and adjusted effects of cesarean delivery on maternal request and assisted vaginal delivery on IQ scores compared with spontaneous vaginal delivery using regression analysis.Results The mean full-scale,verbal,and performance IQ for all children was 99.3±16.1,93.6±17.7,and 105.3±14.3.In crude analysis,cesarean delivery on maternal request versus spontaneous vaginal delivery was associated with an increase of 3.9 (95% confidence interval,0.6 to 7.2) points in full-scale IQ,4.8 (1.2 to 8.4) points in verbal IQ,and 2.4(-0.6 to 5.3) points in performance IQ.After adjusting for maternal education,occupation,and IQ,the advantage was reduced to 1.6 (-1.3 to 4.5),2.3 (-0.8 to 5.5),and 0.6 (-2.0 to 3.3) points for full-scale,verbal,and performance IQ,respectively.Assisted vaginal delivery versus spontaneous vaginal delivery was not associated with IQ scores in any analysis.Conclusion Neither cesarean delivery on maternal request nor assisted vaginal delivery

  14. Nanosuspension Technology for Drug Delivery

    Directory of Open Access Journals (Sweden)

    Jiraporn CHINGUNPITUK

    2007-06-01

    Full Text Available The poor water solubility of drugs is major problem for drug formulation. To date, nanoscale systems for drug delivery have gained much interest as a way to improve the solubility problems. The reduction of drug particles into the sub-micron range leads to a significant increase in the dissolution rate and therefore enhances bioavailability. Nanosuspensions are promising candidates that can be used for enhancing the dissolution of poorly water soluble drugs. Nanosuspensions contain submicron colloidal dispersion of pharmaceutical active ingredient particles in a liquid phase stabilized by surfactants. Production of drugs as nanosuspensions has been developed for drug delivery systems as an oral formulation and non-oral administration. This review describes the methods of pharmaceutical nanosuspension production, formulations and pharmaceutical applications in drug delivery as well as the marketed products.

  15. Albumin-based drug delivery

    DEFF Research Database (Denmark)

    Larsen, Maja Thim; Kuhlmann, Matthias; Hvam, Michael Lykke

    2016-01-01

    The effectiveness of a drug is dependent on accumulation at the site of action at therapeutic levels, however, challenges such as rapid renal clearance, degradation or non-specific accumulation requires drug delivery enabling technologies. Albumin is a natural transport protein with multiple ligand...... binding sites, cellular receptor engagement, and a long circulatory half-life due to interaction with the recycling neonatal Fc receptor. Exploitation of these properties promotes albumin as an attractive candidate for half-life extension and targeted intracellular delivery of drugs attached by covalent...... conjugation, genetic fusions, association or ligand-mediated association. This review will give an overview of albumin-based products with focus on the natural biological properties and molecular interactions that can be harnessed for the design of a next-generation drug delivery platform....

  16. Local Observed-Score Kernel Equating

    Science.gov (United States)

    Wiberg, Marie; van der Linden, Wim J.; von Davier, Alina A.

    2014-01-01

    Three local observed-score kernel equating methods that integrate methods from the local equating and kernel equating frameworks are proposed. The new methods were compared with their earlier counterparts with respect to such measures as bias--as defined by Lord's criterion of equity--and percent relative error. The local kernel item response…

  17. Progress scored in forest pest studies

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    @@ Teaming up with co-workers from State Forestry Administration (SFA), researchers of the CAS Institute of Zoology (IOZ)have scored encouraging progress in their studies of pheromones-based technology against the red turpentine beetle (Dendroctonus valens LeConte).

  18. Stability of WISC-IV process scores.

    Science.gov (United States)

    Ryan, Joseph J; Umfleet, Laura Glass; Kane, Alexa

    2013-01-01

    Forty-three students were administered on two occasions approximately 11 months apart the complete Wechsler Intelligence Scale for Children-Fourth Edition, including the seven process components of Block Design No Time Bonus, Digit Span Forward (DSF), Digit Span Backward (DSB), Cancellation Random (CAR), Cancellation Structured (CAS), Longest Digit Span Forward (LDSF), and Longest Digit Span Backward (LDSB). Mean ages at first and second testing were 7.77 years (SD = 1.91) and 8.74 years (SD = 1.93), respectively. Mean Full-Scale IQ at initial testing was 111.63 (SD = 10.71). Process score stability coefficients ranged from .75 on DSF to .32 on CAS. Discrepancy score stabilities ranged from .45 on DSF minus DSB to .05 on CAS minus CAR. Approximately 21% of participants increased their LDSF on retest, and 16.3% showed a gain on LDSB. Caution must be exercised when interpreting process scores, and interpretation of discrepancy scores should probably be avoided.

  19. What do educational test scores really measure?

    DEFF Research Database (Denmark)

    McIntosh, James; D. Munk, Martin

    Latent class Poisson count models are used to analyze a sample of Danish test score results from a cohort of individuals born in 1954-55 and tested in 1968. The procedure takes account of unobservable effects as well as excessive zeros in the data. The bulk of unobservable effects are uncorrelate...

  20. The FAt Spondyloarthritis Spine Score (FASSS)

    DEFF Research Database (Denmark)

    Pedersen, Susanne Juhl; Zhao, Zheng; Lambert, Robert Gw

    2013-01-01

    Studies have shown that fat lesions follow resolution of inflammation in the spine of patients with axial spondyloarthritis (SpA). Fat lesions at vertebral corners have also been shown to predict development of new syndesmophytes. Therefore, scoring of fat lesions in the spine may constitute both...

  1. Critical Thinking: More than Test Scores

    Science.gov (United States)

    Smith, Vernon G.; Szymanski, Antonia

    2013-01-01

    This article is for practicing or aspiring school administrators. The demand for excellence in public education has lead to an emphasis on standardized test scores. This article explores the development of a professional enhancement program designed to prepare teachers to teach higher order thinking skills. Higher order thinking is the primary…

  2. Writing Plan Quality: Relevance to Writing Scores

    Science.gov (United States)

    Chai, Constance

    2006-01-01

    If writing matters, how can we improve it? This study investigated the nature of writing plan quality and its relationship to the ensuing writing scores. Data were drawn from the 1998 Provincial Learning Assessment Programme (PLAP) in Writing, which was administered to pupils in Grades 4, 7, and 10 across British Columbia, Canada. Common features…

  3. Multidimensional CAT Item Selection Methods for Domain Scores and Composite Scores: Theory and Applications

    Science.gov (United States)

    Yao, Lihua

    2012-01-01

    Multidimensional computer adaptive testing (MCAT) can provide higher precision and reliability or reduce test length when compared with unidimensional CAT or with the paper-and-pencil test. This study compared five item selection procedures in the MCAT framework for both domain scores and overall scores through simulation by varying the structure…

  4. Relationship between Students' Scores on Research Methods and Statistics, and Undergraduate Project Scores

    Science.gov (United States)

    Ossai, Peter Agbadobi Uloku

    2016-01-01

    This study examined the relationship between students' scores on Research Methods and statistics, and undergraduate project at the final year. The purpose was to find out whether students matched knowledge of research with project-writing skill. The study adopted an expost facto correlational design. Scores on Research Methods and Statistics for…

  5. Analysis of WAIS-IV Index Score Scatter Using Significant Deviation from the Mean Index Score

    Science.gov (United States)

    Gregoire, Jacques; Coalson, Diane L.; Zhu, Jianjun

    2011-01-01

    The Wechsler Adult Intelligence Scale-Fourth Edition (WAIS-IV) does not include verbal IQ and performance IQ scores, as provided in previous editions of the scale; rather, this edition provides comparisons among four index scores, allowing analysis of an individual's WAIS-IV performance in more discrete domains of cognitive ability. To supplement…

  6. Multidimensional CAT Item Selection Methods for Domain Scores and Composite Scores: Theory and Applications

    Science.gov (United States)

    Yao, Lihua

    2012-01-01

    Multidimensional computer adaptive testing (MCAT) can provide higher precision and reliability or reduce test length when compared with unidimensional CAT or with the paper-and-pencil test. This study compared five item selection procedures in the MCAT framework for both domain scores and overall scores through simulation by varying the structure…

  7. Multidimensional Linking for Domain Scores and Overall Scores for Nonequivalent Groups

    Science.gov (United States)

    Yao, Lihua

    2011-01-01

    The No Child Left Behind Act requires state assessments to report not only overall scores but also domain scores. To see the information on students' overall achievement, progress, and detailed strengths and weaknesses, and thereby identify areas for improvement in educational quality, students' performances across years or across forms need to be…

  8. Analysis of WAIS-IV Index Score Scatter Using Significant Deviation from the Mean Index Score

    Science.gov (United States)

    Gregoire, Jacques; Coalson, Diane L.; Zhu, Jianjun

    2011-01-01

    The Wechsler Adult Intelligence Scale-Fourth Edition (WAIS-IV) does not include verbal IQ and performance IQ scores, as provided in previous editions of the scale; rather, this edition provides comparisons among four index scores, allowing analysis of an individual's WAIS-IV performance in more discrete domains of cognitive ability. To supplement…

  9. The influence of quality maternity waiting homes on utilization of facilities for delivery in rural Zambia.

    Science.gov (United States)

    Henry, Elizabeth G; Semrau, Katherine; Hamer, Davidson H; Vian, Taryn; Nambao, Mary; Mataka, Kaluba; Scott, Nancy A

    2017-05-30

    Residential accommodation for expectant mothers adjacent to health facilities, known as maternity waiting homes (MWH), is an intervention designed to improve access to skilled deliveries in low-income countries like Zambia where the maternal mortality ratio is estimated at 398 deaths per 100,000 live births. Our study aimed to assess the relationship between MWH quality and the likelihood of facility delivery in Kalomo and Choma Districts in Southern Province, Zambia. We systematically assessed and inventoried the functional capacity of all existing MWH using a quantitative facility survey and photographs of the structures. We calculated a composite score and used multivariate regression to quantify MWH quality and its association with the likelihood of facility delivery using household survey data collected on delivery location in Kalomo and Choma Districts from 2011-2013. MWH were generally in poor condition and composite scores varied widely, with a median score of 28.0 and ranging from 12 to 66 out of a possible 75 points. Of the 17,200 total deliveries captured from 2011-2013 in 40 study catchment area facilities, a higher proportion occurred in facilities where there was either a MWH or the health facility provided space for pregnant waiting mothers compared to those with no accommodations (60.7% versus 55.9%, p facilities had an MWH, those women with MWHs in their catchment area that were rated medium or high quality had a 95% increase in the odds of facility delivery than those whose catchment area MWHs were of poor quality (OR: 1.95, 95% CI 1.76, 2.16). Improving both the availability and the quality of MWH represents a potentially useful strategy to increasing facility delivery in rural Zambia. The Zambia Chlorhexidine Application Trial is registered at Clinical Trials.gov (identifier: NCT01241318).

  10. Lower bounds to the reliabilities of factor score estimators

    NARCIS (Netherlands)

    Hessen, D.J.|info:eu-repo/dai/nl/256041717

    2017-01-01

    Under the general common factor model, the reliabilities of factor score estimators might be of more interest than the reliability of the total score (the unweighted sum of item scores). In this paper, lower bounds to the reliabilities of Thurstone’s factor score estimators, Bartlett’s factor score

  11. Optimal cutting scores using a linear loss function

    NARCIS (Netherlands)

    Linden, van der Wim J.; Mellenbergh, Gideon J.

    1977-01-01

    The situation is considered in which a total score on a test is used for classifying examinees into two categories: "accepted (with scores above a cutting score on the test) and "not accepted" (with scores below the cutting score). A value on the latent variable is fixed in advance; examinees above

  12. Effects of using a scoring guide on essay scores: generalizability theory.

    Science.gov (United States)

    Kan, Adnan

    2007-12-01

    This study was conducted to test the effect of task level and item consistency when two conditions, with and without the assistance of a scoring guide, were used to score essays. The use of generalization theory was proposed as a framework for examining the effect of task variability and use of the scoring guide on achievement measures. Participants were 21 students in Grade 9 enrolled in regular Turkish language and literature classes. Of these students 11 were men and 10 were women. Ten teachers from the city were raters. In the past, raters of essays have given varied judgements of writing quality. Utilizing decision and generalizability theories, variation in scores was evaluated using a three-way (person x rater x task) analysis of variance design. The scoring guide was beneficial in reducing variability of evaluating grammar and reading comprehension but not as helpful when assessing knowledge of concepts.

  13. Characterisation of zinc delivery from a nipple shield delivery system using a breastfeeding simulation apparatus

    National Research Council Canada - National Science Library

    Scheuerle, Rebekah L; Bruggraber, Sylvaine F. A; Gerrard, Stephen E; Kendall, Richard A; Tuleu, Catherine; Slater, Nigel K. H

    2017-01-01

      Zinc delivery from a nipple shield delivery system (NSDS), a novel platform for administering medicines to infants during breastfeeding, was characterised using a breastfeeding simulation apparatus...

  14. Preparing and evaluating delivery systems for proteins

    DEFF Research Database (Denmark)

    Jorgensen, L; Moeller, E H; van de Weert, M

    2006-01-01

    From a formulation perspective proteins are complex and therefore challenging molecules to develop drug delivery systems for. The success of a formulation depends on the ability of the protein to maintain the native structure and activity during preparation and delivery as well as during shipping...... and long-term storage of the formulation. Therefore, the development and evaluation of successful and promising drug delivery systems is essential. In the present review, some of the particulate drug delivery systems for parenteral delivery of protein are presented and discussed. The challenge...... for incorporation of protein in particulate delivery systems is exemplified by water-in-oil emulsions....

  15. Investigating the Utility of Analytic Scoring for the TOEFL Academic Speaking Test (TAST). TOEFL iBT Research Report. TOEFL iBT-01. ETS RR-06-07

    Science.gov (United States)

    Xi, Xiaoming; Mollaun, Pam

    2006-01-01

    This study explores the utility of analytic scoring for the TOEFL® Academic Speaking Test (TAST) in providing useful and reliable diagnostic information in three aspects of candidates' performance: delivery, language use, and topic development. G studies were used to investigate the dependability of the analytic scores, the distinctness of the…

  16. [Parametrial hematoma after forceps delivery].

    Science.gov (United States)

    Winkler, M; Gans, A; Fendel, H

    1991-01-01

    We report on a large intraligamentous haematoma developed after low forceps delivery. The diagnosis was made from symptoms and signs, rectal examination, and sonographic findings. The haematoma was incised and clots were evacuated by laparotomy. The bleeding vessel could be ligated. The 31-year-old woman left our hospital on the 12th postoperative day.

  17. Software Build and Delivery Systems

    Energy Technology Data Exchange (ETDEWEB)

    Robey, Robert W. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2016-07-10

    This presentation deals with the hierarchy of software build and delivery systems. One of the goals is to maximize the success rate of new users and developers when first trying your software. First impressions are important. Early successes are important. This also reduces critical documentation costs. This is a presentation focused on computer science and goes into detail about code documentation.

  18. Extracellular vesicles for drug delivery

    NARCIS (Netherlands)

    Vader, Pieter; Mol, Emma A; Pasterkamp, Gerard; Schiffelers, Raymond M

    2016-01-01

    Extracellular vesicles (EVs) are cell-derived membrane vesicles, and represent an endogenous mechanism for intercellular communication. Since the discovery that EVs are capable of functionally transferring biological information, the potential use of EVs as drug delivery vehicles has gained consider

  19. The accuracy rate of Alvarado score, ultrasonography, and ...

    African Journals Online (AJOL)

    2013-09-30

    Sep 30, 2013 ... the patients have atypical clinical and laboratory findings. In ... recorded on the study form for data collection. The Alvarado score was calculated as described in the literature.[5] The Alvarado score is a 10-point scoring system.

  20. Application of decision trees in credit scoring

    Directory of Open Access Journals (Sweden)

    Ljiljanka Kvesić

    2013-12-01

    Full Text Available Banks are particularly exposed to credit risk due to the nature of their operations. Inadequate assessment of the borrower directly causes losses. The financial crisis the global economy is still going through has clearly shown what kind of problems can arise from an inadequate credit policy. Thus, the primary task of bank managers is to minimise credit risk. Credit scoring models were developed to support managers in assessing the creditworthiness of borrowers. This paper presents the decision tree based on exhaustive CHAID algorithm as one such model. Since the application of credit scoring models has not been adequately explored in the Croatian banking theory and practice, this paper aims not only to determine the characteristics that are crucial for predicting default, but also to highlight the importance of a quantitative approach in assessing the creditworthiness of borrowers.