Background and Purpose-The characteristics of intracerebral hemorrhage (ICH) may vary by ICH location because of differences in the distribution of underlying cerebral small vessel diseases. Therefore, we investigated the incidence, characteristics, and outcome of lobar and nonlobar ICH. Methods-In a population-based, prospective inception cohort study of ICH, we used multiple overlapping sources of case ascertainment and follow-up to identify and validate ICH diagnoses in 2010 to 2011 in an adult population of 695 335. Results-There were 128 participants with first-ever primary ICH. The overall incidence of lobar ICH was similar to nonlobar ICH (9.

AND SummaryA comparison between data derived from changes in fetal heart rate and p H of fetal blood in 279 high-risk patients is described. 'The incidence of fetal acidosis was low when the continuous record of FHR showed good beat-to-beat variation in rhythm and no slowing during uterine contractions. The incidence of fetal acidosis accompanying fetal tachycardia or bradycardia was low if the rate remained unaltered during contractions. Decelerations of fetal heart rate accompanied by baseline tachycardia and/or loss of beat-to-beat variation were the changes most commonly associated with fetal acidosis and hence, by inference, with fetal asphyxia. Deep and/or delayed decelerations were also suggestive of fetal asphyxia. Late decelerations, although at first sight innocuous, were frequently found to be a sign of severe fetal asphyxia.

AND SummaryA comparison between data derived from changes in fetal heart rate and p H of fetal blood in 279 high-risk patients is described. 'The incidence of fetal acidosis was low when the continuous record of FHR showed good beat-to-beat variation in rhythm and no slowing during uterine contractions. The incidence of fetal acidosis accompanying fetal tachycardia or bradycardia was low if the rate remained unaltered during contractions. Decelerations of fetal heart rate accompanied by baseline tachycardia and/or loss of beat-to-beat variation were the changes most commonly associated with fetal acidosis and hence, by inference, with fetal asphyxia. Deep and/or delayed decelerations were also suggestive of fetal asphyxia. Late decelerations, although at first sight innocuous, were frequently found to be a sign of severe fetal asphyxia.

Background Hospital-based studies have reported variable associations between outcome after spontaneous intracerebral hemorrhage and peri-hematomal edema volume. Aims In a community-based study, we aimed to investigate the existence, strength, direction, and independence of associations between intracerebral hemorrhage and peri-hematomal edema volumes on diagnostic brain CT and one-year functional outcome and long-term survival. Methods We identified all adults, resident in Lothian, diagnosed with first-ever, symptomatic spontaneous intracerebral hemorrhage between June 2010 and May 2013 in a community-based, prospective inception cohort study. We defined regions of interest manually and used a semi-automated approach to measure intracerebral hemorrhage volume, peri-hematomal edema volume, and the sum of these measurements (total lesion volume) on first diagnostic brain CT performed at ≤3 days after symptom onset. The primary outcome was death or dependence (scores 3–6 on the modified Rankin Scale) at one-year after intracerebral hemorrhage. Results Two hundred ninety-two (85%) of 342 patients (median age 77.5 y, IQR 68–83, 186 (54%) female, median time from onset to CT 6.5 h (IQR 2.9–21.7)) were dead or dependent one year after intracerebral hemorrhage. Peri-hematomal edema and intracerebral hemorrhage volumes were colinear ( R2 = 0.77). In models using both intracerebral hemorrhage and peri-hematomal edema, 10 mL increments in intracerebral hemorrhage (adjusted odds ratio (aOR) 1.72 (95% CI 1.08–2.87); p = 0.029) but not peri-hematomal edema volume (aOR 0.92 (0.63–1.45); p = 0.69) were independently associated with one-year death or dependence. 10 mL increments in total lesion volume were independently associated with one-year death or dependence (aOR 1.24 (1.11–1.42); p = 0.0004). Conclusion Total volume of intracerebral hemorrhage and peri-hematomal edema, and intracerebral hemorrhage volume alone on diagnostic brain CT, undertaken at three days or sooner, are independently associated with death or dependence one-year after intracerebral hemorrhage, but peri-hematomal edema volume is not. Data access statement Anonymized summary data may be requested from the corresponding author.

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Summary In a retrospective study of 13656 single births 663 patients had antepartum haemorrhage (4·8 per cent). The incidences of accidental haemorrhage, placenta praevia and “other antepartum haemorrhage” were 2·05, 0·43 and 2·34 per cent respectively. In cases complicated by antepartum haemorrhage there were 66 perinatal deaths; accidental haemorrhage accounted for 65·2 per cent, placenta praevia only 7·6 per cent and “other antepartum haemorrhage” 27·2 per cent. The high perinatal loss in cases of “other antepartum haemorrhage” is particularly associated with prematurity. These findings indicate that patients with painless bleeding in late pregnancy should not be discharged early from hospital simply because the placenta is found to be normally situated. It is suggested that in such patients, rest and observation in hospital should be continued for not less than two weeks after the bleeding has ceased.

Abstract. Percutaneous transhepatic cholangiography using a very thin needle has been performed in 885 patients with a variety of underlying hepatic, biliary, and pancreatic disorders. The procedure was successful in 99% of the patients with dilated intrahepatic bile ducts and in 85% of those with non-dilated ducts. Complications which required surgical intervention occurred only in two cases (0.2%). In patients with obstructive jaundice, external bile drainage was performed immediately after visualization of the bile duct. Percutaneous transhepatic cholangiography is an extremely useful and safe method for investigating disorders of the biliary tract, for localizing the cause of obstructive jaundice, and for reducing the degree of jaundice and improving the general status of patients with obstructive jaundice.