Malpositions in labour in a vertex-presenting fetus are known to be associated with increased risks of operative delivery A retrospective analysis of all deliveries over 4 years in a university teaching obstetric unit was performed using the available obstetric database. All cases of live births with cephalic presenting babies after 36 completed gestational weeks were analysed, and included 17,533 out of 20,533 total deliveries over the study period. The study group included those cases with occipital posterior and transverse positions, based on the documentation of the position of the vertex at the time of delivery, or at the last clinical examination before obstetric intervention, while occipital anterior cases constituted the control group. The overall incidence of malpositions was 14%, and operative delivery rate in the study group was 82.5% versus 20.7% in the control group. After excluding cases of operative delivery for non-mechanical indications, such as fetal distress, the adjusted odds ratio for the malposition group was 9.8 (95% CI 8.91-10.8) for total assisted delivery and 30.2 (95% CI 25.6-35.5) for Caesarean section compared to the occipital anterior group. Malpositions are definitely associated with a marked increase in the risk of operative delivery including Caesarean section. Labour complicated by malposition should be considered high risk, and should warrant due preparation for obstetric intervention.
ObjectivesA lack of understanding in menopausal and postmenopausal women's (PMW) risk perception towards osteoporosis and breast cancer still exists, which is explored in this study. This information might allow health professionals to conduct interventions to improve health behaviors before menopause-related diseases are imminent.MethodsBetween 10 December 2015 and 31 January 2016, 573 menopausal or PMW were successfully interviewed on 17 questions, comprising separate sections for osteoporosis and breast cancer. The target respondents were menopausal or PMW aged 45 to 60 years, with no previous diagnosis of osteoporosis or breast cancer, who attended private clinics across Hong Kong for annual physical examination.ResultsRegarding menopausal issues, the top three concerns were osteoporosis and fracture (72%), breast cancer (44%), and sleep disorder/insomnia/headache (40%). Among 314 respondents (55%) who tried to prevent osteoporosis, 74% of them began to do it after they were 40 years old. On the other hand, 65% of respondents never had a bone density test. For respondents who said “I'm too young, so I don't need to check”, their mean age was 52 years old. Ninety percent of respondents mistakenly believed that regular breast examination, regular breast massage, drink soy milk, or vaccine can prevent breast cancer.ConclusionsThis survey revealed osteoporosis and breast cancer as the top concerns among menopausal and PMW in Hong Kong. Inadequate health behaviors and misconceptions still exist despite widespread health education in the recent years.
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