The Epiaortic Ultrasound Diagnosis of Iatrogenic Subadventitial Hematoma.

Iatrogenic aortic injury is a rare but potentially lethal complication of cardiac surgery. While sometimes resulting in aortic dissection or intramural hematoma, injury more frequently results in subadventitial hematoma, a more benign pathology. Here, we describe a case where intraoperative transesophageal echocardiography (TEE) identified such a hematoma but was unable to rule out dissection.

Comparing mechanical fetal response during descent, crowning, and restitution among deliveries with and without shoulder dystocia.

Objective: Previous computer simulations of shoulder dystocia (SD) explored the effect of SD itself on the mechanical response of the fetus. Our objective was to perform a mechanical simulation study to explore the variations in fetal response during routine, unilateral SD (USD), and bilateral SD (BSD) deliveries.

Study Design: Using a biofidelic birthing simulator, we performed 30 experiments mimicking passage of the fetus through the pelvis.