ABSTRACT
Correct understanding of the geometry of the glenoid (the socket of the shoulder joint) is key to successful planning of shoulder replacement surgery. This surgery typically involves placing an implant in the shoulder joint to restore joint function. The most relevant geometry is the glenoid version, which is the angular orientation of the glenoid surface relative to the long axis of the scapula in the axial plane. However, measuring the glenoid version is not straightforward and there are multiple measurement methods in the literature and used in commercial planning software. In this paper we introduce SciKit-SurgeryGlenoid, an open source toolkit for the measurement of glenoid version. SciKit-SurgeryGlenoid contains implementations of the 4 most frequently used glenoid version measurement algorithms enabling easy and unbiased comparison of the different techniques. We present the results of using the software on 10 sets of pre-operative CT scans taken from patients who have subsequently undergone shoulder replacement surgery. We further compare these results with those obtained from a commercial implant planning software. SciKit-SurgeryGlenoid currently requires manual segmentation of the relevant anatomical features for each method. Future work will look at automating the segmentation process to build an automatic and repeatable pipeline from CT or radiograph to quantitative glenoid version measurement.
ABSTRACT
INTRODUCTION: Rates of induction of labor (IOL) in Iceland and most neighboring countries have increased. Recent literature on IOL provided contradicting effects on mode of delivery, maternal and neonatal outcome. MATERIAL AND METHODS: The aim of this study was to evaluate the impact of IOL in late term pregnancies (≥41 weeks) on mode of delivery, maternal and neonatal outcome. A retrospective cohort study of deliveries after 41 weeks of pregnancy was conducted for all deliveries in Landspitali in the period 2013-2016, comparing outcomes of IOL deliveries to spontaneous labor deliveries. Logistic regression analysis was performed to determine the impact of the independent variables on the outcome. RESULTS: Of the 2419 women cohort, 61.8% had a spontaneous onset of labor and 38.2% had IOL. The results show that IOL increases probability of caesarean section in primiparas women (p<0.01). IOL increases the use of epidural anesthesia in labor, both for primiparas (p<0.001) and multiparas (p<0.05). Similar results where observed in the neonatal outcome in both groups. Gestational age increases the probability of instrumental delivery (p<0.05), caesarean section (p<0.01), use of epidural anesthe-sia (p<0.01), Apgar <7 at 5 minutes (p<0.01) and fetal distress (p<0.01). CONCLUSION: Induction of labor has some negative impact on maternal outcome but leads at the same time to a shorter preg-nancy, which again decreases negative impact of prolonged pregnancy. It is important to evaluate the advantages and disadvantages of induction of labor before making a decision when to induce labor.
