Lucashovmand2048

Objectives Measurement of birth length and birth head circumference is part of the newborn assessment. Both measurements aid in distinguishing between proportionate and disproportionate small and large for gestational age newborns. It had been shown that birth weight is related to maternal height and weight. This study aims to analyze birth length and birth head circumference percentiles based on maternal stature. Methods This observational study analyzed birth length and birth head circumference percentiles of 2.3 million newborns stratified by maternal height and weight from the first obstetric assessment. Percentiles were calculated for sex and 22-43 gestational weeks for all infants. Eighteen subgroups based on six maternal height and three weight strata were defined and percentiles calculated from 32 to 42 gestational weeks using GAMLSS package for R. Results Newborns of mothers with height 79 kg). Small stature mothers were 1.7 years younger. Birth length differed by several centimeters for the same percentiles between groups of short and tall stature mothers, whereas birth head circumference differed up to 1.2 cm. The largest deviation of birth length was between the 97th percentiles. For male newborns born at term, birth length at the 97th percentile differed by 3.2 cm, at the 50th percentile by 2.7 cm and at the third percentile by 2.5 cm. Conclusions Birth length and birth head circumference are related to maternal height and weight. To more completely assess newborns, the maternal size should be considered.Objectives Post-cesarean section scar diverticulum (PCSD) is a long-term sequela of cesarean section (CS). The aim of this study was to evaluate the clinical utility of PCSD scoring criteria, and also retrospectively investigate the efficacy and fertility of two different surgical methods in 304 patients with PCSD. Methods A total of 304 PCSD patients who underwent hysteroscopy or combined hysteroscopy and laparoscopy (referred to as laparoscopy) in our hospital from 2016 to 2018 were retrospectively analyzed. Preoperative condition was analyzed by the PCSD scoring criteria and its influencing factors were explored. The efficacy, its influencing factors and pregnancy success rate of the two different surgical methods on PCSD was also analyzed after 6- and 12-months follow-up. Results PCSD was more severe (high score) in patients who experienced caesarean section with one of the following conditions age >30 years old, without medical indications or retroflexed uterus. The postoperative efficacy of patients subjected to hysteroscopy or laparoscopy was 81.25 and 89.47% (after 6 months), and 79.53 and 87.50% (after 12 months), respectively. Hysteroscopic surgery was better for PCSD patients who had fewer CS and thicker residual muscle layer and worse for PCSD patients with a longer distance of incision defect to the end of the cervix. Postoperative fertilization showed that pregnancy success rate of patients subjected to hysteroscopy or laparoscopy was 56.2 and 50%, respectively. Conclusions The PCSD scoring is an effective method for assessing the severity of PCSD, and hysteroscopy and laparoscopy are effective modalities for PCSD. Hysteroscopy is also an option for patients with fertility needs.Objectives Furcate cord insertion is a rare abnormality affecting approximately 0.1% of all pregnancies. Macroscopically, the umbilical vessels separate before reaching the placenta, lose their Wharton's jelly, and insert at the placenta centrally, eccentrically, or marginally. The aim of this retrospective study was to determine the prevalence of furcate cord insertion more accurately, the pathological characteristics, and clinical outcomes. Methods We conducted a retrospective study of 132 cases of furcate insertion of the umbilical cord using the pathological database of the Charité University Hospital Berlin, Germany, between 1993 and 2016. This included 99 cases, including one termination of pregnancy within our institution and 33 cases from external hospitals. Cyclopamine Hedgehog antagonist An analysis of the pathological features of the 132 cases and the perinatal outcome of the 98 cases within our institution were performed. Results Furcate cord insertion occurred in 0.16% pregnancies. Of the 132 cases, seven cases of intrauterine fetal deaths were observed. Three of those could be linked to the furcate cord insertion. In two of those cases, single umbilical vessel rupture was identified as the cause of fetal death. Conclusions In most cases of furcate cord insertion, the outcome is good; however, intrauterine fetal death occurs in approximately 1.02% of cases.Objectives To determine whether there is a cut off value of serum C-reactive protein (CRP) associated with a higher risk of meningitis in suspected early onset sepsis (EOS) (onset birth to 7 days of life). Methods A retrospective cohort study on neonates admitted in neonatal intensive care unit at McMaster Children's Hospital from January 2010 to 2017 and had lumbar puncture (LP) and CRP for workup of EOS. Included subjects had either (a) non-traumatic LP or (b) traumatic LP with cerebral spinal fluid (CSF) polymerase chain reaction or gram stain or culture-positive or had received antimicrobials for 21 days. Excluded were CSF done for metabolic errors, before cytomegalovirus (CMV) treatment; from ventriculo-peritoneal (VP) shunts; missing data and contamination. Neonates were classified into definite and probable meningitis and on the range of CRP. We calculated sensitivity, specificity, and likelihood ratios for CRP values; and area under the receiver operating characteristic (AUROC) curve. Results Out of 609 CSF samples, 184 were eligible (28 cases of definite or probable meningitis and 156 controls). Sensitivity, specificity, predictive values, likelihood ratios, and AUROC were too low to be of clinical significance to predict meningitis in EOS. Conclusions Serum CRP values have poor discriminatory power to distinguish between subjects with and without meningitis, in symptomatic EOS.Stein-type shrinkage techniques are applied to the parametric components of a semi-nonparametric regression model recently proposed by (Ma et al. 2015 285-303). On the basis of an uncertain prior information (restrictions) about the parameters of interest, shrinkage techniques are shown to improve the accuracy of the model. The effectiveness of the proposed estimators are corroborated by a simulation study.