The gentlebirth.org website is provided courtesy of
Ronnie Falcao, LM MS, a homebirth midwife in Mountain View, CA
An interactive resource for moms on easy steps they can take to reduce exposure to chemical toxins during pregnancy.
Other excellent resources about avoiding toxins during pregnancy
These are easy to read and understand and are beautifully presented.
Author: BEWLEY-S*; ROBSON-S-C; SMITH-M; GLOVER-A; SPENCER-J-A-D Address: *UNIV COLL & MIDDLESEX SCH MED, DEPT OBSTET & GYNAECOL, 86-96 CHENIES MEWS, LONDON WC1 6AU, ENGLAND UNIV COLL HOSP LONDON, DEPT AUDIT, WC1 LONDON, ENGLAND Country: ENGLAND Source: EUROPEAN JOURNAL OF OBSTETRICS GYNECOLOGY AND REPRODUCTIVE BIOLOGY, vol. 52, issue 2, (DEC 15, 1993) : pp. 89-93. Sections: ClinMed
Abstract: External cephalic version (ECV) at greater-than-or-equal-to 37 weeks' gestation in suitable women with breech presentation was introduced in 1991 as a new management option at a University Teaching Hospital. After 16 months, the policy was audited by analysing a prospectively collected database of women offered ECV at term and by a retrospective review of all breech deliveries during the same period. A total of 52 women had ECV attempted with an immediate success rate of 46%. Four other cases had undergone spontaneous version by the time they attended for ECV. Of the remaining 72 breech deliveries, 49 were known to be breech and were not offered ECV; 39 of these had no contraindication (28% failure to offer ECV). Of the breech presentations, 22 remained undiagnosed until labour (18% of total study group). These results suggest that ECV at term can be introduced safely and without difficulty, with a strict protocol. Whilst the overall impact of ECV at term in clinical practice may be limited, if some vaginal breech deliveries and caesarean sections can be avoided it is a useful addition to the antenatal management of individual women with breech presentation.
Author: GOH-J-T-W*; JOHNSON-C-M; GREGORA-M-G Address: *NAMBOUR HOSP, DEPT OBSTET & GYNAECOL, NAMBOUR, QLD 4560, AUSTRALIA Country: AUSTRALIA Source: AUSTRALIAN & NEW ZEALAND JOURNAL OF OBSTETRICS & GYNAECOLOGY, vol. 33, issue 4, (NOV, 1993) : pp. 364-366.
Abstract: The case notes of women with singleton term (37 weeks' gestation and beyond) breech presentation and delivery were retrospectively reviewed. Thirty-two of the 72 women in the study group had attempted external cephalic version at term, with a success rate of 53% (17 women). The Caesarean section rate was significantly lower in the group which had attempted ECV compared to the group which did not.
Author: SALING-E*; DEALMEIDA-P; SCHWARZENAU-E Address: *INST PERINATALE MED, MARIENDORFER WEG 28, D-12051 BERLIN, GERMANY Country: GERMANY Source: GEBURTSHILFE UND FRAUENHEILKUNDE, vol. 53, issue 9, (SEP, 1993) : pp. 597-602.
Abstract: Results of 1000 external versions of foetuses from breech to vertex presentation under tocolysis were evaluated. The rate of success of the versions was 52%. The success rate improved with gestational age, with increasing parity, with increasing age of the mother and her increasing body weight. The location of the placenta did not play a decisive role. The success rate of the version was remarkably good, even, in cases with small-for-gestational age foetuses and large-for-gestational age foetuses as well as in cases with a previous Caesarean section. The frequency of typical complications and the resulting Caesarean rate of 2.3% are within the acceptable limit. Up to now, from a total of more than 1,500 versions performed at the Department of Obstetrics at the Women's Hospital, Berlin-Neukolln, no death of either mother or child has occurred, which could be related to this procedure. Of course the prerequisite for a safe version is strict adherence to the essential guidelines. The fact, that versions are not practised in all obstetrical departments, is partly due to the embarrassing lack of expert knowledge on the part of some practitioners and clinicians. In numerous cases, a moderately difficult laparotomy - which Caesarean section is in principle - with all the inevitable risks and dangers, could have been prevented, if a version had been performed
Author: NEWMAN-R-B*; PEACOCK-B-S; VANDORSTEN-J-P; HUNT-H-H Address: *MED UNIV S CAROLINA, DEPT OBSTET & GYNECOL, 171 ASHLEY AVE, CHARLESTON, SC 29425 MED UNIV S CAROLINA, DEPT BIOSTAT EPIDEMIOL & STAT SCI, CHARLESTON, SC 29425 ZipCode: 29425 Country: USA Source: AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY, vol. 169, issue 2, suppl 1 (AUG, 1993) : pp. 245-250. Sections: LifeSci; ClinMed
OBJECTIVE: Many authors have identified prognostic factors for external cephalic version success, but there has not been an attempt to integrate these factors into a simple, quantitative scoring system for predicting version success. Nor have any prognostic factors been prospectively tested.
STUDY DESIGN: We examined the clinical characteristics of 108 consecutive breech versions performed between 1984 and 1986. These characteristics were evaluated by stepwise linear regression and discriminate analysis to identify those factors associated with success. Five factors explained the majority of the variability in outcome (parity, placental location dilation, station, and estimated fetal weight). A model was developed to incorporate the trends identified among these five variables to create a scoring system similar to that of Bishop. This scoring system was then applied to 286 women undergoing external cephalic version since October 1986.
RESULTS: There was a positive relationship between a rising version score and the likelihood of successful breech version. No versions were successful with a score less-than-or-equal-to 2, and all breech versions were successful with a score of 9 or 10. The results of the version score may have significantly altered physician recommendations in more than one third of cases.
CONCLUSION: We believe that this simple, quantifiable scoring system is a refinement in our ability to predict the likelihood of external cephalic version success.
Author: ZHANG-J*; BOWES-W-A; FORTNEY-J-A Address: *UNIV N CAROLINA, DEPT EPIDEMIOL, CAROLINA POPULAT CTR, CB 8120, 207 UNIV SQ E, CHAPEL HILL, NC 27516 UNIV N CAROLINA, DEPT OBSTET & GYNECOL, CHAPEL HILL, NC 27516 FAMILY HLTH INT, RES TRIANGLE PK, NC 00000 ZipCode: 27516 Country: USA Source: OBSTETRICS AND GYNECOLOGY, vol. 82, issue 2, (AUG, 1993) : pp. 306-312. Sections: LifeSci; ClinMed
Objective: To assess the efficacy of external cephalic version, including safety, cost-benefit analysis, and impact on the cesarean delivery rate.
Data sources: A MEDLINE search was conducted to identify all articles published in English between 1980-1991 on external cephalic version. References were also cross-checked for all reports. Methods of study selection: We reviewed only those articles providing sufficiently detailed data to determine actual numbers of subjects. In cases of duplicate results, only the latest publication was used. Rates of successful version, cesarean delivery, and fetal and maternal complications were presented Data extraction and synthesis: Among the United States trials, the success rate was approximately 65% (range 48-77%), and once version succeeded, almost all the fetuses stayed in the vertex position until birth. Among those in whom external version was performed, the mean cesarean delivery rate was 37%, compared with 83% in controls (P < .001). External version would also save 12.3% of the costs of delivering breech patients overall Conclusion: External cephalic version is safe and cost-effective. It substantially reduces the cesarean delivery rate among breech presentations, decreases the risk related to breech delivery, and avoids cesarean delivery in subsequent pregnancies. However, external version will not have a major impact on the high overall cesarean birth rate
Source: GEBURTSHILFE UND FRAUENHEILKUNDE, vol. 53, issue 2, (FEB, 1993) : pp. 135-136.
Abstract: This is a report on the clinical course of a severe right-sided urinary retention in 21-year old patient, treated from the 24th week of pregnancy onwards. The special importance of the mechanical component involved in the genesis of this retention of urine is discussed on the occasion of the transitory spontaneous remission, observed, when the foetus turned to breech presentation.
Author: ENGEL-K*; GERKEENGEL-G; GERHARD-I; BASTERT-G; KEMPE-T* Address: *UNIV HEIDELBERG, FRAUENKLIN, FRAUENHEILKUNDE POLIKLIN, ALLG GEBURTSHILFE ABT, VOSSSTR 9, W-6900 HEIDELBERG, GERMANY UNIV HEIDELBERG, FRAUENKLIN, GYNAKOL ENDOKRINOL ABT, W-6900 HEIDELBERG, GERMANY Country: GERMANY Source: GEBURTSHILFE UND FRAUENHEILKUNDE, vol. 52, issue 4, (APR, 1992) : pp. 241-243. Sections: ClinMed
Abstract: In a primigravida with a fundal/anterior wall placenta, a successful cephalic version was noted at 39 weeks after repeated moxibustion of the point Zhiyin (bl 67). Since routine foetal heart rate monitoring showed a sinusoidal pattern with severe decelerations, immediate Caesarean section was performed. Foetomaternal macrotransfusion of about 300 ml of blood was found. In view of this complication, possible risks of the method are discussed. Moxibustion does not seem to be suitable as self-therapy without close medical follow-up.
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