Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0028754 (obesity)
 124,988 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The purpose of this retrospective study is to evaluate the perinatal outcome in cases with birth injuries, suggesting shoulder dystocia. This survey involves 92 cases of live newborns (gestational age between 37 and 42 weeks) with shoulder injuries. Another control group of 120 cases of live mature newborns without any shoulder injuries is studied for comparison. There are no significant differentialities between those two groups, regarding age, parity, weight and height of the parturients. Shoulder dystocia is most frequently found in newborns of 3500-4000 g birthweight. Antepartum, risk factors for shoulder dystocia are: diabetes, obesity of the mother and chronological postterm pregnancy. Intrapartum, the evaluated risk factors prove to be unreliable because the same were found in as many as one half of the non-traumatic vaginal deliveries. In 27% of the cases, shoulder dystocia occurs most probably after the passage of the shoulder through the pelvic inlet. The most frequent type of shoulder injury is fracture of the clavicle (90.2%), followed by paresis of the brachial plexus (7.6%). Severe shoulder dystocia both from obstetrical and neonatological point of view is found in 2-3% of the cases.
 ...
PMID:[Shoulder dystocia--risk factors and fetal outcome]. 1531 34

Fatty liver (i.e., hepatic lipidosis) is a major metabolic disorder of many dairy cows in early lactation and is associated with decreased health status and reproductive performance. In severe cases, milk production and feed intake are decreased. Therefore, a practical preventative or an efficacious treatment of fatty liver could save millions of dollars yearly in treatment, replacement, and production losses for dairy farmers. Fatty liver develops when the hepatic uptake of lipids exceeds the oxidation and secretion of lipids by the liver, which usually is preceded by high concentrations of plasma NEFA mobilized from adipose tissue. Excess lipids are stored as triacylglycerol in the liver and are associated with decreased metabolic functions of the liver. Liver can be categorized into normal liver or mild, moderate, or severe fatty liver; the latter can be subdivided further into nonencephalopathic severe fatty liver and hepatic encephalopathy. Insufficient or unbalanced dietary intake, obesity, and elevated estrogen concentrations are involved in the etiology of fatty liver, which is associated with greater incidence of dystocia, diseases, infections, and inflammations. Because even mild fatty liver is associated with decreased health status and reproductive performance of dairy cows, prevention of fatty liver by supplying cows with sufficient nutrients and a clean and health-promoting environment in the peripartal period would reduce production losses of cows more than would any treatment of fatty liver. This, however, might not be enough for cows that are obese or do not eat well, had calving difficulties or twins, have metabolic or infectious diseases, or are in severe negative energy balance because of high milk production immediately after calving. Potential and commonly used preventatives, as well as treatments, are discussed in the review. Currently, detection of fatty liver is possible only by minor surgery. Ultrasonic techniques offer a potential tool to noninvasively detect fatty liver. Future gene-array and proteomic studies may provide means to detect early molecular events in the etiology of fatty liver plus their connection with immune function and reproductive performance so that more effective treatments and preventatives of fatty liver can be developed. Such advances hopefully will make fatty liver a problem of the past.
 ...
PMID:Invited review: pathology, etiology, prevention, and treatment of fatty liver in dairy cows. 1537 89

In a primipara, 28 years of age and with a BMI of 44 kg/m2, a Zavanelli manoeuvre was performed. Due to uterine atony she had to undergo a hysterectomy. A multipara, 39 years of age and with a BMI of 66 kg/m2, experienced that her weight exceeded the limits of the beds and that local anaesthesia was hard to perform; she suffered from a lesion of the lumbosacral plexus caused by a shoulder dystocia. In the end, both mothers and their babies could go home in a moderate condition. Obesity is becoming more prevalent and brings with it an increase in obstetric risks. During pregnancy and delivery, morbidly obese patients should be monitored by a gynaecologist. Special interest should focus on screening for (gestational) diabetes, hypertension and foetal growth. Ultrasound may detect congenital malformations early; however, the sensitivity of ultrasound is lower in morbidly obese patients. When macrosomia is expected, a clear plan should be made regarding the mode of delivery. It is useful to make a treatment protocol for morbidly obese patients.
 ...
PMID:[Morbid obesity: a risk factor for obstetric complications]. 1570 41

Obstetrical brachial plexus palsy (OBP) complicates a small proportion of births. The incidence is believed to be 0.35 to 5 cases per 1000 live births. Risk factors of OBP included: 1/ large birth weight, 2/ shoulder dystocia and prolonged second stage of labour , 3/ instrumental vaginal delivery (forceps delivery, vacuum extraction), 4/ diabetes mellitus and mother's obesity, 5/ breech presentation, 6/ delivery an infant with OBP in an antecedent delivery. Historically, the cause of OBP was excessive lateral traction applied to the fetal head at delivery, in association with anterior shoulder dystocia. Not all cases of brachial plexus palsy are attributable to traction. Brachial plexus injury may be occurring in the absence of shoulder dystocia, in the posterior arm of infants with anterior shoulder dystocia and can be associated with cesarean delivery. Intrauterine factors may play some role in the etiology of the OBP. Many strategies have been proposed to prevent the occurrence of OBP--control of the birth weight, induction of labour, cesarean delivery, intensified management of gestational diabetes. About 10-20% of patients with injuries of the brachial plexus require surgical intervention for optimal results.
 ...
PMID:[Obstetrical brachial plexus palsy--etiopathogenesis, risk factors, prevention, prognosis]. 1558 15

Obesity has become a major health problem all over the world and during pregnancy is associated with an increased risk of complications, including gestational diabetes, preeclampsia, and delivery complications such as macrosomia, shoulder dystocia and higher rates of cesarean sections and infections. Maternal obesity may also be an independent risk factor for neural tube defects and fetal mortality. This review focuses on the consequences of maternal obesity during pregnancy.
 ...
PMID:Maternal obesity and complications during pregnancy. 1584 56

Shoulder dystocia and brachial plexus injury occur in 0.5% to 1.5% of all births. Risk factors for both include maternal obesity, excessive prenatal weight gain, maternal diabetes, protracted labor, and fetal macrosomia. These factors are involved in only about 50% of births complicated by shoulder dystocia or brachial plexus injury. Shoulder dystocia has a low recurrence rate (9.8%-16.7%), although history of previous shoulder dystocia is the most reliable predictor of occurrence. Brachial plexus injury is the most common morbidity associated with shoulder dystocia, but 50% of newborns who present with this injury were not subject to shoulder dystocia at birth. Most brachial plexus injuries are transient, although 5% to 22% become permanent. Shoulder dystocia followed by permanent brachial plexus injury or mental impairment is one of the leading causes of malpractice allegations. Prompt assessment and management of shoulder dystocia and preparation to maximize the efficiency of shoulder dystocia maneuvers are critical. Documentation of the appropriate use of maneuvers to relieve shoulder dystocia demonstrates standard of care practice, thereby decreasing the potential for successful malpractice allegations.
 ...
PMID:Shoulder dystocia: etiology, common risk factors, and management. 1626 Mar 63

Compared to normal-weight women, obese women have an increased risk of infertility and pregnancy complications. The most consistently described pregnancy complications are hypertensive disorders, gestational diabetes mellitus, thromboembolic events, and cesarean section. Fetal and neonatal complications may include congenital malformations, macrosomia, and shoulder dystocia. The literature suggests that women with a body mass index (BMI) >or=30 have approximately double the risk of having a child with a neural tube defect (NTD) compared to normal-weight women, and the increased risk associated with higher maternal body weight does not appear to be modified by folic acid supplementation. The Public Affairs Committee of the Teratology Society supports the public health initiatives identified by the U.S. Food and Drug Administration in 2004 and the research initiatives identified by the National Institutes of Health in 2004. The Public Affairs Committee recommends that clinicians counsel women about appropriate caloric intake and exercise and that health-care providers educate parents about appropriate childhood nutrition. Breast-feeding should be encouraged based on evidence of a protective effect against childhood obesity, as well as other health advantages.
 ...
PMID:Teratology Public Affairs Committee position paper: maternal obesity and pregnancy. 1646 72

Obesity, one of the most common civilization diseases, is currently one of the major health problems in the society. It is estimated that in industrialized countries excessive weight appears in more than 30% of adult population, with adult women comprising 50% of the group. Considerable amount of attention is paid to the course, delivery and puerperium in women with excessive weight and obesity during pregnancy. A close correlation to fetal macrosomia, increased ratio of caesarean sections and perinatal death of fetuses has been indicated in this group. Spontaneous birth increases the risk of shoulder dystocia and brachial plexus injury in newborns. Much attention is also paid to higher risk of anesthesiological complications (difficulties in intubation, necessity of high dosages of anesthetic medication administration, problems with subarachnoideal and epidural anesthesia). An increased risk of endometritis in puerperium, thrombosis, vulvitis and infections of urinary tract have been observed in obese women. Maternal obesity is correlated with decreased percentage of breast-feeding women. Particular medical care and long-term observation should be applied in case of children of obese women, as the former are at a high risk of obesity in puberty and in adult life. Nowadays, it is suggested that maternal excessive body mass should be regulated before conception and the course of pregnancy in obese women should be closely monitored. Above-mentioned arguments seem to be reason enough for future investigations of etiology and treatment of obesity in pregnancy.
 ...
PMID:[Obesity in pregnant women as a problem in obstetrics]. 1765 Sep 7

Shoulder dystocia has no consensus definition or management algorithm. Its incidence ranges from 0.2% to 3% and its occurrence is unpredictable. Risk factors for shoulder dystocia may include macrosomia, maternal diabetes, operative vaginal delivery, history of macrosomic infant or shoulder dystocia, labor abnormalities, post-term pregnancy, maternal obesity, advanced maternal age, fetal anthropometric variations, and male fetal gender. Once identified, multiple maneuvers can be applied in a stepwise fashion in an attempt to alleviate the dystocia. While training clinicians to manage shoulder dystocia is difficult because of its rare occurrence and lack of standardized management, all clinicians must be able to manage shoulder dystocia at any time.
 ...
PMID:Shoulder dystocia: an update. 1792 Oct 12

Shoulder dystocia is a birth emergency that occurs in approximately 1% of all births. Shoulder dystocia can be followed by broken clavicle or humerus, brachial plexus injury, fetal hypoxia, or death. Although risk factors for shoulder dystocia include previous birth complicated by shoulder dystocia, maternal obesity, excessive prenatal weight gain, fetal macrosomia, gestational diabetes, and instrumental delivery, shoulder dystocia is not predictable. Perinatal nurses can reduce the risk for shoulder dystocia by teaching mothers about optimal weight gain in pregnancy and assisting mothers with diabetes to prevent hyperglycemia through diet management and medication use. During childbirth preparation or early labor, nurses can educate mothers about position changes and maneuvers used for shoulder dystocia. Nurses play a vital role in obtaining assistance during a shoulder dystocia, keeping time, assisting with maneuvers such as suprapubic pressure, and documenting the dystocia management. Nurses can assist mothers and families to review the shoulder dystocia and any newborn injuries in the postpartum period, thereby reducing confusion and anxiety. Regular drills and case reviews help build nursing shoulder dystocia management skills.
 ...
PMID:Shoulder dystocia: nursing prevention and posttrauma care. 1828 97


<< Previous 1 2 3 4 5 6 7 Next >>