Re: OB: Study Finds Brain Bleeding with Vaginal Births
From: art fougner, md (evsono@pipeline.com)
Wed Jan 31 10:35:08 2007
John
For some reason, your server bounces my emails.
I've emailed the authors who responded. Some, but not all, of the
sections were performed for various indications arising in labor. They
did not have the breakdown of labor vs no labor.
Art
At Tue, 30 Jan 2007, johnprov@sympatico.com wrote:
>
>At Tue, 30 Jan 2007, art fougner, md wrote:
>>
>>John
>>
>>whether or not the moms delivered abdominally labored or not is unclear.
>>I have emailed the authors.
>>
>>If you email me, I can send you a copy of the article.
>>
>>Art
>>
>>The abstract doesn't help much, sounds like its a chart review and they patients entered after delievery when they went for thier MRI and signed a cosent.
>
>http://radiology.rsnajnls.org/cgi/content/abstract/242/2/535
>
>Intracranial Hemorrhage in Asymptomatic Neonates: Prevalence on MR
>Images and Relationship to Obstetric and Neonatal Risk Factors1
>Christopher B. Looney, BS, J. Keith Smith, MD, PhD, Lisa H. Merck,
>MD, MPH, Honor M. Wolfe, MD, Nancy C. Chescheir, MD, Robert M. Hamer,
>PhD and John H. Gilmore, MD
>1 From the Department of Psychiatry, CB No. 7160, 7025A Neurosciences
>Hospital, University of North Carolina School of Medicine, Chapel Hill,
>NC 27599-7160. From the 2005 RSNA Annual Meeting. Received January 23,
>2006; revision requested March 23; revision received June 7; accepted
>June 21; final version accepted August 21. J.H.G. supported by
>National Institute of Mental Health grant 1 P50 MH064065. C.B.L.
>supported by a Distinguished Medical Scholarship from UNC School of
>Medicine. Address correspondence to J.H.G. (e-mail:
>jgilmore@med.unc.edu).
>
>Purpose: To retrospectively evaluate the prevalence of neonatal
>intracranial hemorrhage (ICH) and its relationship to obstetric and
>neonatal risk factors.
>
>Materials and Methods: Pregnant women were recruited for a prospective
>study of neonatal brain development; the study was approved by the
>institutional review board and complied with HIPAA regulations. After
>informed consent was obtained from a parent, neonates were imaged with
>3.0-T magnetic resonance (MR) imaging without sedation. The images were
>reviewed by a neuroradiologist with 12 years of experience for the
>presence of ICH. Medical records were prospectively and retrospectively
>reviewed for selected risk factors, which included method of delivery,
>duration of labor, and evidence of maternal or neonatal birth trauma.
>Risk factors were assessed for relationship to ICH by using Fisher exact
>test statistics.
>
>Results: Ninety-seven neonates (mean age at MR imaging, 20.8 days ± 6.9
>[standard deviation]) underwent MR imaging between the ages of 1 and 5
>weeks. Eighty-eight (44 male and 44 female) neonates (65 with vaginal
>delivery and 23 with cesarean delivery) completed the MR imaging
>evaluation. Seventeen neonates with ICHs (16 subdural, two
>subarachnoid, and six parenchymal hemorrhages) were identified. Seven
>infants had two or more types of hemorrhages. All neonates with ICH
>were delivered vaginally, with a prevalence of 26% in vaginal births.
>ICH was significantly associated with vaginal birth (P < .005) but not
>with prolonged duration of labor or with traumatic or assisted vaginal
>birth.
>
>Conclusion: Asymptomatic ICH following vaginal birth in full-term
>neonates appears to be common, with a prevalence of 26% in this study.
>
>The good thing about the study it so no difference with assited vaginal
>birth.
--
art fougner, md
"May The Wings of Liberty Never Lose a Feather." - Jack Burton
