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Distal Humerus Physeal Separation: Diagnostic Challenges and Implications.
Cureus
December 2024
Orthopaedics and Traumatology, Universiti Putra Malaysia, Serdang, MYS.
Distal humerus physeal separation is an uncommon and often misdiagnosed injury in infants and young children, frequently resulting in delayed treatment. We report three cases of distal humerus physeal separation that presented with different clinical scenarios with different management approaches. The first case describes a nine-month-old girl who was initially treated for presumed elbow cellulitis before presentation to our centre six weeks later.
View Article and Find Full Text PDFFetal-to-Neonatal Transition of an Infant with Transposition of the Great Arteries and Intact Ventricular Septum: A Case Report.
Biomed Hub
December 2024
Division of Paediatric Cardiology, Department of Paediatrics, Willem-Alexander Children's Hospital, Leiden University Medical Centre (LUMC), Leiden, The Netherlands.
Introduction: Transposition of the great arteries (TGA), especially with intact ventricular septum (TGA-IVS), presents unique challenges during fetal-to-neonatal transition, which can contribute to developing persistent pulmonary hypertension of the newborn (PPHN).
Case Presentation: A male newborn with TGA-IVS, delivered via caesarean section, presented with hypoxemia and tachycardia immediately after birth (preductal SpO: 50-60%, post-ductal SpO: 70-75%). Echocardiography revealed a floppy interatrial septum and two interatrial connections with bidirectional shunting.
Evidence-based cesarean delivery: intraoperative management from skin incision until placental delivery (Part 8).
Am J Obstet Gynecol MFM
December 2024
Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Thomas Jefferson University, Philadelphia, PA (Berghella). Electronic address:
The goal of standardizing the technique of the routine, uncomplicated cesarean delivery (CD) is to decrease maternal morbidity while optimizing neonatal outcomes. During the procedure, a family-oriented CD is recommended. The low transverse cesarean skin incision (created with either scalpel or diathermy) is preferred with either the Joel-Cohen or Pfannenstiel methods being acceptable.
View Article and Find Full Text PDFA 35-Year-Old Woman With Placenta Previa and Postpartum Cardiovascular Collapse.
Chest
August 2024
Division of Pulmonary, Critical Care, and Sleep Medicine, University of Florida, Gainesville, FL. Electronic address:
Article Synopsis
- A 35-year-old pregnant woman with complete anterior placenta previa at 36 weeks gestation came for a routine check-up, reporting increased fatigue but no major concerns like bleeding or pain.
- During evaluation, her fetal heart rate was concerning, leading to a hospital referral, where a scan confirmed the same conditions without hemorrhage.
- After receiving antenatal steroids, she underwent a cesarean section with a smooth delivery, but experienced sudden cardiovascular collapse post-delivery due to hypotension and bradycardia.
Ethnicity, socio-economic deprivation and postpartum outcomes following caesarean delivery: a multicentre cohort study.
Anaesthesia
May 2024
Department of Anesthesiology, Peri-operative and Pain Medicine, Stanford University School of Medicine, Stanford, CA, USA.
Article Synopsis
- Disparities in postpartum recovery outcomes among different socio-economic and racial/ethnic groups are not well-researched, prompting an analysis of a cohort of patients who underwent caesarean delivery.
- The study included data from 1000 patients, revealing that those of Asian, Black, and mixed ethnicities were more often in deprived socio-economic groups, and had longer postpartum hospital stays compared to White patients.
- At day 30 postpartum, Asian patients demonstrated significantly higher risks for moderate to severe pain, highlighting the influence of ethnic background on recovery experiences, regardless of socio-economic status.
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