Cephalic Group Research Articles

Eviota nigrispina, a New Goby from the Ryukyu Islands, Japan (Teleostei: Gobiidae)

A new species of goby, Eviota nigrispina, is described from the Ryukyu Islands Japan. The species belongs to cephalic sensory-pore pattern group 2 of Lachner and Karnella (1980), has an 8/7 dorsal/anal formula, unbranched pectoral-fin rays. It has a distinct black stripe running along the backbone in live or freshly caught fish, and strong black pigment along scale pockets on the ventral half of the sides when preserved.

Maternal Thyroid Hormones in Early Pregnancy and Risk of Breech Presentation

ObjectiveTo evaluate the relationship between breech presentation at term (≥37 weeks of gestation) and maternal thyroid hormone activity in early gestation. MethodsWe conducted a case–control study of thyroid hormone activity in 179 women who delivered a live term infant in breech presentation (cases) and 849 women who delivered a live term infant in cephalic presentation (control subjects). We used serum samples from prenatal screening at 15 to 16 weeks of gestation in 2006 and 2007 in Edmonton, Alberta. Maternal free thyroxin (fT4) and thyroid-stimulating hormone (TSH) were assayed. Logistic regression was used to estimate the odds of breech presentation in relation to the levels of thyroid hormones while controlling for potential confounders. ResultsThere were no significant differences between the breech and cephalic groups when comparing fT4 levels (OR 0.94 per pmol/L; 95% CI 0.88 to 1.00) or TSH levels (OR 1.16 per mU/L; 95% CI 0.97 to 1.38) levels, after adjustment for all potential confounders. Segregating fT4 and TSH into quintiles showed the same pattern. Neither hypothyroidism nor hyperthyroidism was associated with risk of breech presentation. ConclusionOur results provide evidence that maternal thyroid hormone levels at 15 to 16 weeks of gestation are not related to risk of breech presentation at birth in term infants.

Obstetric Brachial Plexus Palsy: a Comparison of Affected Infants Delivered Vaginally By Breech or Cephalic Presentation

In this retrospective study we compared obstetric brachial plexus palsy (OBPP) in two non-operated groups of newborn babies delivered vaginally by breech or cephalic presentation. There were 35 cases of OBPP in the breech group and 663 cases in the cephalic group. The former group was more likely to develop upper Erb's palsy while the latter group was more likely to develop total palsy. The breech group also had a significantly lower mean birth weight, a significantly higher percentage of bilateral OBPP palsies and concurrent phrenic nerve palsy. Spontaneous recovery of shoulder abduction and elbow flexion in newborn babies with upper Erb's palsy was significantly worse in the breech compared with the cephalic group. It was concluded that OBPP following vaginal breech delivery has several unique demographic features and breech babies with upper Erb's palsy have a worse prognosis for spontaneous recovery than those in the cephalic group.

Study on incidence of phlebitis in patients with PICC through peripheral vein and its nursing effect

Objective To observe the incidence of phlebitis in patients with PICC through peripheral vein and its nursing effect, in order to aLleviate the patients' suffering. Methods The 60 volunteers were divided into three groups randomly, who were received PICC through basilie vein, vena mediana and cephalic vein, the incidence of of phlebitis and therapeutic effieaey were analyzed. Results 2 patients appeared phlebitis in 20 cases received PICC through basilic vein, 3 patients in 20 eases through eubital vein, and all cured;11 patients in 20 eases through cephalic vein, while 9 patients were cured and 2 patients were detubated in cephalic vein group. Conclusions It' s suggested that the prevalence of phlebitis with PICC through cephalic vein is high, with long treat time and low cure rate. It' s likely to reduce the phlebitis occurrence and patients relief from pain through eephalic vein. Key words: PICC; Peripheral vein; Phlebitis

The influence of prenatal breech presentation on neonatal leg posture

The aim of our study was to examine the effect of prenatal breech presentation on postnatal leg posture. Twelve infants were born after breech presentation and nine infants after cephalic presentation participated. At 2, 4, 6, 12 and 18 weeks postnatal age leg posture was examined during general movements in supine and vertical position. Results Transient differences in hip posture between the groups were observed during the first 6 weeks postnatal age, with significantly more hip flexion and less hip extension in the breech group. For knee extension, differences between the groups were not statistically significant. Changing from supine to vertical position, the breech group demonstrated a significant increase in hip extension, with no significant changes in hip posture for the cephalic group. For both groups the vertical condition resulted in a significant increase in knee extension. Continuity from pre- to postnatal life was found for hip posture in both groups and for knee extension only in the breech group. Conclusions Significant differences between breech and cephalic-born infants were found during the first 6 weeks after birth and mainly concerned hip posture and not knee posture. An increase in gravitational force has more impact on leg posture in the breech than in the cephalic group. The observed differences in hip posture between the studied groups were found to be transient, however, in the long term subtle differences still remain between the groups.

Conservative management in breech deliveries leads to similar results compared with cephalic deliveries

Objective. To compare the difference in neonatal mortality and morbidity between breech and cephalic presentations at term.Methods. This was a retrospective matched cohort study in two centers between July 1998 and April 2000, including all breech deliveries between 37+0 and 41+6 weeks, except cases with multiple gestations and antepartum intrauterine deaths. All breech presentations were matched with two cephalic presentations. Onset of labor and route of delivery were recorded, and neonatal data were categorized into variables belonging to serious morbidity or moderate morbidity.Results. One thousand one hundred and nineteen deliveries were included. Three hundred and seventy-three babies were in breech position and 746 in cephalic position. The gestational age and birth weight of the babies in the breech group were lower than in the cephalic group (p < 0.001). Congenital abnormalities occurred more often in the breech group (p < 0.005). An elective cesarean section was performed in 23.3% of breech presentations versus 3.5% of cephalic presentations (p < 0.001). Emergency cesarean sections were done in 29.2% of breech presentations versus 8.8% of cephalic presentations (p < 0.001). Children born in breech presentation had lower Apgar scores after 1 minute (p < 0.0001), but 5-minute Apgar scores were the same in both groups (p = 0.22). Children born in breech presentation received significantly more resuscitation than children born in cephalic presentation (p < 0.001). In both groups no perinatal mortality occurred. No differences were observed in percentages of children with serious or moderate neonatal morbidity between the breech and cephalic lies.Conclusions. Although the numbers are small, this study shows that the conservative (vaginal) approach in selected fetuses in breech position can be safely pursued with neonatal results similar to fetuses in cephalic presentation.

Silent versus cranial giant cell arteritis. Initial presentation and outcome of 50 biopsy-proven cases

Background The objective of the present study was to compare the silent form of giant cell arteritis (GCA) to the classic cephalic form of the disease. Methods We conducted a retrospective study based on a chart review of 50 consecutive, biopsy-proven GCA, recorded at a department of internal medicine. We sought to distinguish a silent form, defined by a prolonged inflammatory syndrome or fever of unknown origin with the absence of cephalic signs, polymyalgia rheumatica, or large artery involvement, from an overt “classic” cranial temporal arteritis. Results The prevalence of the silent form of GCA was 46% in our study. Abnormal temporal arteries were more frequent in the cephalic group. The silent GCA group had higher C-reactive protein levels ( p < 0.05), a higher platelet count ( p < 0.05), and lower serum albumin ( p < 0.05). There was no significant difference in temporal artery specimens in the two groups. Clinical relapses tended to be more frequent, and patients free of corticosteroids tended to be less frequent, in the cephalic group, though the difference was not statistically significant. Conclusions The silent and cephalic forms of GCA could have distinct clinical and biological patterns and different outcomes. The limitation of our study was its retrospective design. Further studies are required to determine if this distinction is useful in treating GCA patients.

Influence of breech presentation on the development of fetal arm posture

Background In previous research, an age-related developmental trend towards increasing arm flexion has been found for cephalic fetuses. Aim To determine if the development of arm posture in breech fetuses is comparable to that of cephalic ones. Subjects and methods Fetal arm posture was studied longitudinally by means of real-time ultrasound in 13 healthy breech and 10 healthy cephalic fetuses. Observations started from 33 weeks gestational age until birth and were performed weekly in the breech group and every 2 weeks in the cephalic group. Results No difference could be found in arm posture between the left and the right arm in either group. Both breech and cephalic fetuses showed a clear preference for flexion in elbow and finger joints at all studied ages. After 36 weeks gestational age, the breech group showed significantly less wrist flexion when compared to the cephalic group ( p=0.037). A clear preference for location of the fetal hands near the fetal head could be observed for both groups. Conclusions As there is no evidence for an abnormal neuromotor development in healthy breech fetuses, the observed difference in wrist flexion is probably due to differences in intrauterine environment. Because of the preference for location of the hands in the vicinity of the fetal head, breech fetuses probably experience a less restricted environment (in the upper part of the uterus) than cephalic fetuses (in the lower part of the uterus).

Six hundred and ten breech versus 12,405 cephalic deliveries at term: is there any difference in the neonatal outcome?

Objectives: To compare neonatal morbidity of breech and cephalic deliveries at term. Study design: Cohort study of 610 consecutive singleton breech presentations and 12,405 consecutive singleton cephalic presentations in term between 1992–1998. Five hundred and fourteen breech and 11,989 cephalic presentations were candidates for vaginal delivery, of which 407 (79%) breeches and 11,265 (94%) cephalic delivered vaginally. Results: Neonatal intensive care admissions were significantly greater for breech than cephalic vaginal deliveries (2.7% versus 0.25%, P=0.000), but newborn intensive care admission and mortality were equally distributed between the two groups. Conclusions: A low caesarean rate is possible (21% beech and 6% cephalic). Neonatal morbidity was equal in the two populations. Admission to neonatal intensive care was significantly more frequent for caesarean section than for vaginal delivery in the cephalic group and equal in the breech group. This study justifies our obstetrical policy and the realisation of a trial in several centres similar in terms of perinatal management.

A comparison of fetal behaviour in breech and cephalic presentations at term.

To evaluate fetal behaviour in breech and cephalic fetuses at term, using a computerised fetal behaviour program. An observational study. Pregnancy Assessment Centre, University Hospital, Nottingham. Twenty-six breech and 58 cephalic fetuses between 36 and 41 weeks. Behaviour (fetal heart rate and activity) was recorded with the use of Doppler ultrasound. The duration of recording was 60 minutes or more in all but four recordings (minimum 49 minutes). Behavioural criteria studied were 1. the relative percentage time spent in low and high variation fetal heart rate patterns; 2. the duration and recurrence of fetal activity; 3. the number of accelerations in low and high fetal heart rate variation; and 4. the number of fetal behavioural state transitions. Breech fetuses differed from the cephalic group in that they were lighter than the cephalic fetuses (median 3105 g vs 3400 g; P < 0.01) and were born to older mothers (median maternal age 30 years vs 28 years; P < 0.01). No significant differences were found in rates of movement, numbers of accelerations and time exhibiting low and high fetal heart rate variation. However, breech fetuses exhibited significantly more state transitions (median 5.2/h vs 3.69/h; P = 0.01). This study shows that breech fetuses are neurologically different from their cephalic counterparts in otherwise healthy pregnancies, and that subtle behavioural differences can be demonstrated in utero using this computerised method.

Relation between perinatal factors and outcome of very low birth weight infants.

In order to better understand the effect of obstetric management on the prognosis of very low birth weight (VLBW) fetuses, we retrospectively studied perinatal factors and the outcome of two hundred twenty-eight VLBW infants without major anomaly excluding cases of multiple pregnancy. The frequency of malpresentation were significantly high in the early neonatal death group (p < 0.05) and in the cerebral palsy/mental retardation (CP/MR) group (p < 0.01). A stepwise regression analysis for the CP/MR detected dependent variables as malpresentation, use of tocolytic agents (beta(2)-stimulant plus MgSO4) and pH < 7.20 in cord artery. Delivery method was not a dependent variable for the early neonatal death or the CP/MR. We analyzed a relation between fetal presentation-delivery method, and the prognosis. Among four groups (cephalic-vaginal, cephalic-cesarean, breech-vaginal, breech-cesarean), the cephalic-vaginal group had the lowest incidence of the poor prognosis (death and major handicap) where the breech-vaginal had the highest incidence. Breech groups (vaginal plus cesarean) had significantly high incidence of the poor prognosis when compared with that of cephalic groups (vaginal plus cesarean) (p < 0.05). Significant difference of the prognosis between the cephalic-vaginal group and the cephalic-cesarean group was not observed. These findings suggest that the delivery method is not a risk factor, but the malpresentation itself may be a risk factor for the poor prognosis of VLBW infants.

Intracranial hemorrhage in low-birth-weight twins during neonatal period.

Since twins have a higher incidence of premature birth, fetal distress, asphyxia and other pre- and intrapartum high-risk factors, it is reasonable to expect that they may be vulnerable to intracranial hemorrhage. Forty-seven pairs of low-birth-weight twins were studied during the newborn period by serial cranial ultrasound. The comparisons of groups, based on birth order, relative size of the neonates, and the mode of delivery, showed no significant differences in the incidence of intracranial hemorrhage between first and second twins, smaller and larger twins, or vaginal and cesarean delivery. However, the comparison based on the presentation of the infant revealed a significantly higher number of intracranial hemorrhages within the first week of life in the breech group than in the cephalic presentation group. The adverse effect of breech presentation on intracranial hemorrhage did not appear to be mediated by the well recognized risk factors such as lower gestational age, lower Apgar scores, and higher incidence of respiratory distress syndrome and assisted ventilation. Since most of the twins with ICH had breech presentation and were delivered by cesarean section, this mode of delivery does not seem to protect the twins with breech presentation from intracranial hemorrhage.

Vaginal prostaglandin E 2 gel and breech presentation

Intravaginal prostaglandin (PG) E 2 has been shown to ripen the cervix before induction and to shorten labor when the fetal presentation is cephalic. This study reports the influence of PGE 2 gel on induction and labor in 13 primigravid patients with unfavorable cervixes and breech presentation. The results were compared with 25 similarly treated primigravidae with cephalic presentations. Comparable cervical ripening was achieved in the breech and cephalic groups; labors were of similar duration and the incidence of cesarean section was not significantly different in the breech patients. There were no unwanted fetal or maternal effects associated with the gel. PGE 2 gel is an effective aid to induction of labor when the cervix is unfavorable and the breech presents in otherwise uncomplicated pregnancies.