Hip Joint Instability in Breech Pregnancy

Luterkort, Marie; Persson, Per‐Håkan; Polberger, Staffan; Bjerre, Ingrid

doi:10.1111/j.1651-2227.1986.tb10303.x

Cited by 25 publications

(11 citation statements)

References 12 publications

(13 reference statements)

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“…3 They have also not explored the difference between elective and emergency caesarean section nor used a multivariate analysis on all available data: conflicting results concerning the prevalence of DDH among vaginally delivered compared with caesarean delivered breech babies have been reported,12 16 28 some studies being limited by small numbers.…”

Section: Discussionmentioning

confidence: 99%

Perinatal risk factors for developmental dysplasia of the hip

Chan

McCaul

Cundy

et al. 1997

Archives of Disease in Childhood - Fetal and Neonatal Edition

180

162

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Aims-To identify perinatal risk factors for developmental dysplasia of the hip (DDH) and define the risk for each factor. Methods-In this case control study, using logistic regression analysis, all 1127 cases of isolated DDH live born in South Australia in 1986-93 and notified to the South Australian Birth Defects Register were included; controls comprised 150 130 live births in South Australia during the same period without any notified congenital abnormalities. Results-Breech presentation, oligohydramnios, female sex and primiparity were confirmed as risk factors for DDH. Significant findings were an increased risk for vaginal delivery over caesarean section for breech presentation (as well as an increased risk for emergency section over elective section), high birthweight (>4000 g), postmaturity and older maternal age; multiple births and preterm births had a reduced risk. There was no increased risk for caesarean section in the absence of breech presentation. For breech presentation, the risk of DDH was estimated to be at least 2.7% for girls and 0.8% for boys; a combination of factors increased the risk. Conclusions-It is suggested that the risk factors identified be used as indications for repeat screening at 6 weeks of age and whenever possible in infancy. Other indications are family history and associated abnormalities. (Arch Dis Child 1997;76:F94-F100)

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Section: Discussionmentioning

confidence: 99%

Perinatal risk factors for developmental dysplasia of the hip

Chan

McCaul

Cundy

et al. 1997

Archives of Disease in Childhood - Fetal and Neonatal Edition

180

162

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“…The authors found that foetal breech position, rather than breech delivery, is a risk factor for hip instability. Extended breech was found to be worst for hip dysplasia (Luterkort et al, 1986). Foetal breech position has also been shown to have effects on limb movements and positioning after birth.…”

Section: Foetal Positionmentioning

confidence: 99%

“…2; extended (also known as frank) breech where the hips are in flexion and the knees in extension, flexed (or complete) breech where both hips and knees are flexed, and footling breech, where one or both feet come first. Luterkort et al (1986) performed repeated ultrasound scans on 222 foetuses in the breech position at 33, 35 and 38 weeks, and correlated leg positioning and delivery mode with hip instability. The authors found that foetal breech position, rather than breech delivery, is a risk factor for hip instability.…”

Section: Foetal Positionmentioning

confidence: 99%

Biomechanics of foetal movement

Nowlan¹

2015

eCM

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Foetal movements commence at seven weeks of gestation, with the foetal movement repertoire including twitches, whole body movements, stretches, isolated limb movements, breathing movements, head and neck movements, jaw movements (including yawning, sucking and swallowing) and hiccups by ten weeks of gestational age. There are two key biomechanical aspects to gross foetal movements; the first being that the foetus moves in a dynamically changing constrained physical environment in which the freedom to move becomes increasingly restricted with increasing foetal size and decreasing amniotic fluid. Therefore, the mechanical environment experienced by the foetus affects its ability to move freely. Secondly, the mechanical forces induced by foetal movements are crucial for normal skeletal development, as evidenced by a number of conditions and syndromes for which reduced or abnormal foetal movements are implicated, such as developmental dysplasia of the hip, arthrogryposis and foetal akinesia deformation sequence. This review examines both the biomechanical effects of the physical environment on foetal movements through discussion of intrauterine factors, such as space, foetal positioning and volume of amniotic fluid, and the biomechanical role of gross foetal movements in human skeletal development through investigation of the effects of abnormal movement on the bones and joints. This review also highlights computational simulations of foetal movements that attempt to determine the mechanical forces acting on the foetus as it moves. Finally, avenues for future research into foetal movement biomechanics are highlighted, which have potential impact for a diverse range of fields including foetal medicine, musculoskeletal disorders and tissue engineering.Keywords: Foetal movement, fetal movement, bone development, joint development, developmental dysplasia of the hip, arthrogryposis, biomechanical models, computational simulation, mechanical properties of foetal tissues, mechanical properties of fetal tissues.

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“…The femoral head pressure acting against an immature fetal acetabulum may occur first. This may explain the high frequency of dislocations during postural abnormalities (breech, oligohydramnios, large for gestational age babies) [26,27].…”

Section: Discussionmentioning

confidence: 99%

Neonatal hip: from anatomy to cost-effective sonography

Gomes¹,

Ouédraogo²,

Avisse³

et al. 1998

European Radiology

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Therapeutic success in treating congenital dysplasia of the hip is associated with early diagnosis, but the specific neonatal anatomy makes screening difficult. The purpose of this study was to determine whether this specific neonatal anatomy is taken into account by current ultrasound (US) techniques. Anatomic studies were performed on 22 hips, US examinations on 7750 neonatal hips; 2370 untreated hips were reexamined at 1 month by US and at 3 months by X-ray. The transformation of the neonatal cartilaginous acetabulum into an osseous cavity is dependent on harmonious metaphyseal growth and a properly seated femoral head. Defects in the acetabular roof, together with displacement of the femoral head, cause an abnormal anatomical relationship which leads to further deformities. The described sonographic techniques give only partial information on these specific abnormalities. The sonographic monoplanar methods as used in Graf's technique, which relies largely on acetabular development, lead to difficulties in assessing posterior coverage of the femoral head and difficulties in assessing alignment of the metaphyseal weight-bearing surface with the femoral head. Combining Graf's morphological analysis with Novick's dynamic technique enables one to more accurately define the relationship of the femoral head and the acetabulum and increases the reliability and predictive value of the examination, while reducing the number of doubtful cases. This makes screening cost effective.

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Hip Joint Instability in Breech Pregnancy

Cited by 25 publications

References 12 publications

Perinatal risk factors for developmental dysplasia of the hip

Perinatal risk factors for developmental dysplasia of the hip

Biomechanics of foetal movement

Neonatal hip: from anatomy to cost-effective sonography

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