Intrapartum ultrasonographic depiction of fetal malpositioning and mild parietal bone compression in association with large lower segment uterine leiomyoma.

With normal flexion of the fetal head prior to and during early normal labor, the fetal biparietal diameter becomes engaged in (and subsequently traverses) the anterior posterior aspect of the pelvic inlet. Thus, the biparietal diameter (characterized sonographically by depiction of the falx cerebri, thalami, and cavum septum pellucidum) will be obtainable upon transverse suprapubic placement of the ultrasound transducer during the first stage of labor. Deflexion, or extension, of the fetal head may be demonstrated sonographically at the level of the cervical spine. Recently, during intrapartum ultrasonographic assessment of a nulliparous patient with a known, large, lower-segment, uterine fibroid, exhibiting poor progress of labor, the fetal biparietal diameter was documented upon midsagittal suprapubic placement of the transducer. In addition, mild compression of the distal parietal fetal bone was demonstrated and considered consistent with compression by the leiomyoma. Following abdominal delivery, due to fetal distress and arrest of descent, significant deflexion of the fetal head (not suspected by intrapartum cervical examinations) and mild parietal bone depression, consistent with the ultrasonographic examination, were noted.

Short labor: characteristics and outcome.

OBJECTIVE: To determine the characteristics and consequences of short labor. METHODS: Ninety-nine term pregnancies with singleton vertex presentation and labor lasting 3 hours or less were compared with controls with longer labor, matched to the index cases by maternal age, parity, and birth weight. RESULTS: Short labor occurred mostly in multiparas. Both the first and second stages of labor were found to be shortened in these cases. There was significantly more placental abruption, uterine tachysystole, and maternal cocaine use among short-labor cases. Major perineal lacerations, postpartum hemorrhage, birth trauma, and low Apgar scores were distributed approximately equally between cases and controls. A preponderance of the bad outcomes in the short labors occurred in the subgroup of those with rates of dilatation and descent that exceeded established 95th percentile limits. CONCLUSIONS: Labors of 3 hours or less in duration were strongly associated with placental abruption, but were otherwise not major contributors to maternal and fetal morbidity.

CSF homovanillic acid in schizotypal personality disorder.

CSF concentrations of homovanillic acid (HVA) were measured in 10 patients with schizotypal personality disorder and 14 patients with other personality disorders. The patients with schizotypal personality disorder had higher CSF HVA concentrations than the patients with other personality disorders. Furthermore, the psychotic-like schizotypal symptoms correlated positively with the CSF HVA concentrations. These results suggest a central dopaminergic dysfunction associated with the psychotic-like symptoms of schizotypal personality disorder.

Eye tracking, schizophrenic symptoms, and schizotypal personality disorder.

Schizophrenic patients and patients with schizotypal personality disorder were significantly more likely than normal controls to demonstrate impaired eye tracking performance. Fifteen of 27 schizophrenics and 15 of 27 schizotypals had impaired eye tracking, compared with 11 of 39 normal controls. In the schizophrenic group, including 10 out-patients in a stable state of relative remission, impaired eye tracking was associated with more severe formal thought disorder and more time spent in psychiatric hospitals. Among stable schizophrenic out-patients, poor eye tracking was related to more severe formal thought disorder and greater overall psychopathology. This pattern of results suggests a possible relation between eye tracking impairment and more severe enduring symptoms across the spectrum of schizophrenic and schizophrenia-related disorders.