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MRI: Brain bleeds in 26% of vaginal births (Looney et al. 2007)
MRI: BRAIN BLEEDS IN 26% OF VAGINAL BIRTHS (LOONEY ET AL. 2007)
Attention LOONEY et al.: Please see the two questions at the very end of this post... My thanks to Kevin Thomas McGann, DC for posting (to the uncensored version of chiro-list) The Boston Globe's reproduction of Thomas H. Maugh II's Jan. 30, 2007 Los Angeles Times article about the recent MRI research by Looney et al. indicating that as many as 26% of babies born vaginally are suffering asymptomatic brain bleeds. Just in case there are readers who are unaware... Because the semisitting and dorsal delivery positions are still being used... Babies are still being forced through birth canals senselessly closed up to 30%. OBs and midwives are still telling women that "squatting opens" as they offer the semisitting and dorsal as delivery position options and fail to state that semisitting and dorsal CLOSE the birth canal - up to 30%. The birth-canal-closing biomechanics of semisitting and dorsal delivery are simple. For a description of the simple grisly biomechanics and for clinical and radiographic references from the medical literature from early last century, see Gastaldo TD. Letter. Birth. 1992;19:230. My comments to Looney et al. are interspersed below #### Here is one abstract of the 2007 paper by Looney et al... Published online before print December 19, 2006, 10.1148/radiol. 2422060133 (Radiology 2007;242:535-541.) © RSNA, 2006 Radiology. 2007 Feb;242(2):535-41. Epub 2006 Dec 19. PMID: 17179400 [PubMed - in process] Intracranial Hemorrhage in Asymptomatic Neonates: Prevalence on MR Images and Relationship to Obstetric and Neonatal Risk Factors1 http://radiology.rsnajnls.org/cgi/co...ract/242/2/535 Christopher B. Looney, BS, J. Keith Smith, MD, PhD, Lisa H. Merck, MD, MPH, Honor M. Wolfe, MD, Nancy C. Chescheir, MD, Robert M. Hamer, PhD and John H. Gilmore, MD 1 From the Department of Psychiatry, CB No. 7160, 7025A Neurosciences Hospital, University of North Carolina School of Medicine, Chapel Hill, NC 27599-7160. From the 2005 RSNA Annual Meeting. Received January 23, 2006; revision requested March 23; revision received June 7; accepted June 21; final version accepted August 21. J.H.G. supported by National Institute of Mental Health grant 1 P50 MH064065. C.B.L. supported by a Distinguished Medical Scholarship from UNC School of Medicine. Address correspondence to J.H.G. (e-mail: ). #### I'll copy Christopher B. Looney et al. via . Purpose: To retrospectively evaluate the prevalence of neonatal intracranial hemorrhage (ICH) and its relationship to obstetric and neonatal risk factors. #### Chris (Looney et al.): TWO QUESTIONS... #### Was the bizarre routine **birth-canal-closing** risk factor considered? #### Were the women who birthed vaginally allowed to open their birth canals the "extra" up to 30%? Materials and Methods: Pregnant women were recruited for a prospective study of neonatal brain development; the study was approved by the institutional review board and complied with HIPAA regulations. #### Regarding approval of your MRI experimentation in obstetrics... #### In 1989, prominent British obstetrician Richard J. Lilford noted that obstetrics "amounts to uncontrolled experimentation." [Lilford RJ. State of the obstetric art. The Lancet (Nov18)1989:1205-1207. Reviewing Chalmers I, Enkin M and Keirse MJNC (eds.). Effective Care in Pregnancy and Childbirth Oxford: Oxford University Press 1989 Pp 1516 (2 vols) ISBN 0-192615580] #### In Lilford's 1989 "Experiment of squatting birth," Lilford apparently forgot to tell women that semisitting ("semi-dorsal") closes - i.e. - he asked women "to recline into a semi-dorsal position at the moment of crowning" - after informing them of the "putative benefits of squatting." [Eur J Obstet Gynecol Reprod Biol 1989a; 30:217-20.] #### Not only is it routine for OBs and midwives to close birth canals up to 30% - it is routine (in an estimated 1 in 10 births) for OBs to KEEP birth canals closed the "extra" up to 30% when babies get stuck and forceps are used. MD-obstetrician experts have been lying to cover-up. #### For the Four OB Lies (they are whoppers)... See Dents in babies' skulls" http://groups.google.com/group/ misc.kids.pregnancy/msg/08abfc7ff242150e Alternate URL: http://health.groups.yahoo.com/group...t/message/3897 #### Looney et al.: Has your institutional review board ruled on this bizarre OB/midwife/uncontrolled/experimental birth-canal-closing behavior toward mothers and babies? After informed consent was obtained from a parent... #### Assuming mothers were placed semisitting or dorsal, did obtaining informed consent include informing mothers of the fact that there is radiologic evidence that semisitting and dorsal close the birth canal up to 30%? .....neonates were imaged with 3.0-T magnetic resonance (MR) imaging without sedation. The images were reviewed by a neuroradiologist with 12 years of experience for the presence of ICH. Medical records were prospectively and retrospectively reviewed... #### Neonates imaged without sedation? MR must be much faster nowadays. Medical records were prospectively and retrospectively reviewed for selected risk factors, which included method of delivery, duration of labor, and evidence of maternal or neonatal birth trauma. Risk factors were assessed for relationship to ICH by using Fisher exact test statistics. #### Sorry to repeat myself but... "Method of delivery" - did you note whether birth-canal-closing delivery methods (semisitting and dorsal delivery) were used? Results: Ninety-seven neonates (mean age at MR imaging, 20.8 days ± 6.9 [standard deviation]) underwent MR imaging between the ages of 1 and 5 weeks. Eighty-eight (44 male and 44 female) neonates (65 with vaginal delivery and 23 with cesarean delivery) completed the MR imaging evaluation. Seventeen neonates with ICHs (16 subdural, two subarachnoid, and six parenchymal hemorrhages) were identified. Seven infants had two or more types of hemorrhages. All neonates with ICH were delivered vaginally, with a prevalence of 26% in vaginal births. ICH was significantly associated with vaginal birth (P .005) but not with prolonged duration of labor or with traumatic or assisted vaginal birth. Conclusion: Asymptomatic ICH following vaginal birth in full-term neonates appears to be common, with a prevalence of 26% in this study. #### Neurologists quoted below indicate that brain bleeds are USUALLY asymptomatic/clinically silent. #### Regarding the 26% prevalence... Chao et al. recently wrote: "Magnetic resonance imaging is the most sensitive modality for evaluating the [four] patterns of brain injury." [Radiographics. 2006 Oct;26 Suppl 1:S159-72. PubMed abstract.] #### There may be blood elsewhere... #### Glen Doman reportedly stated that 9% of human newborns have blood in their spinal fluid visible to the naked eye and 70-85% have such blood visible in the microscope. [See Estabrook KG. Is modern obstetrics responsible for the lower intelligence and higher crime rates of western society? 1989. Citing Doman G. What to do about your brain injured child. NY: Doubleday 1974:229.] #### Further comment below. ----- Original Message ----- From: Dr.KEV To: Sent: Tuesday, January 30, 2007 10:13 AM Subject: dc- Researchers detect brain hemorrhages in some births Women have not been having babies on their backs for millennia, that's for sure. -KEVswr (moderator) #### French surgeon Michel Odent, MD, a keen observer of birth, told me on a break at his presentation in Monterey (?), CA years ago that in most primitive cultures today women spontaneously get off their backs. He also said most don't squat - they crouch on one knee or use some other posture that gets the woman off her sacrum. -- http://www.boston.com/news/nation/ar...some_birth s/ Researchers detect brain hemorrhages in some births By Thomas H. Maugh II, Los Angeles Times | January 30, 2007 #### I'll copy Thomas H. Maugh, II via . http://www.latimes.com/services/site...9615.htmlstory RADIOLOGISTS (LOONEY et al. 2007] WORRY ABOUT COMPRESSION OF THE HEAD DURING DELIVERY... #### LA Times reporter Maugh writes: LOS ANGELES -- A quarter of babies born vaginally suffer small hemorrhages in their brains, perhaps from compression of the head during delivery, according to researchers who performed the first high- resolution magnetic resonance imaging studies on healthy newborns. #### ATTENTION LOONEY et al... #### SPEAKING OF HEAD COMPRESSION... #### BY USING SEMISITTING AND DORSAL DELIVERY... #### MDs ARE JAMMING SACRAL TIPS UP TO 1.5 INCHES (4 CM) INTO FETAL SKULLS (For the biomechanics and radiographic and clinical references, see Gastaldo TD. Birth. 1992;19:230-1.) #### According to John Ogden, MD, "The developing skull, especially in an infant, may be deformed substantially without sustaining an obvious fracture when...compressed (p. 78)... #### GOOD NEWS... "Despite considerable depression of the bone, there may be little brain injury (p. 79)." #### BAD NEWS... "[D]espite the seeming absence of specific osseous injury, severe injury to the brain may occur...(p. 79)" #### Note well Dr. Ogden's words "temporary" and "restoration"... "[Elasticity of the skull]...allows significant TEMPORARY indentation of the skull toward the brain, with RESTORATION of the contour after 'release' of the deforming force... (p. 79, emphasis added) [Ogden J. Skeletal Injury in the Child. Third Edition, NY: Springer 2000] #### Many of these fractures spontaneously disappear. #### Maybe obstetricians are causing some depression skull fractures with instruments? #### Olivier Dupuis, MD et al. wrote in 2005: "...A depressed skull fracture is an inward buckling of the calvarial bones and is referred to as a 'ping-pong' fracture...Fifty depressed skull fractures were associated with an instrument delivery, and 18 depressed skull fractures were classified as 'spontaneous.'" --Olivier Dupuis, MD et al.^^^ ^^^Dupuis O, Silveira R, Dupont C, Mottolese C, Kahn P, Dittmar A, Rudigoz RC. Am J Obstet Gynecol. 2005 Jan;192(1):165-70. PubMed abstract #### Maugh continues... The bleeding heals quickly, the team reported yesterday in the online version of the journal Radiology, and most likely does not produce long-term effects. "After all, women have been delivering vaginally for millions of years," said Dr. Honor M. Wolfe of the University of North Carolina School of Medicine, one of the authors of the report. #### WHAT? Perhaps I am misreading but... "Women have been delivering vaginally for millions of years" is NOT a reason to say that the brain bleeding "most likely does not produce long-term effects." No bleeding was observed during Caesarean deliveries, but the authors cautioned that this should not be taken as an argument to support C- sections. #### C-sections can involve major wrenching of the baby's cervical spine. My bet is that there may be bleeding into the nervous system in some c-sections. "At this point, neither parents nor providers should change their plans for delivery," Wolfe said. #### Parents SHOULD change their plans for delivery - they should change to birth providers who do not close birth canals the "extra" up to 30% (or KEEP birth canals closed the "extra" up to 30% when babies get stuck.) #### Better alternative: All birth providers should stop closing birth canals the "extra" up to 30%. An earlier British study had found similar bleeding in 10 percent of newborn infants, but those studies were conducted somewhat longer after birth using a less-sensitive imager. "The sharpness of the images is the main reason we are seeing more than other studies have found," said Dr. J. Keith Smith, a UNC radiologist who was part of the team. #### UNC radiologist J. Keith Smith may know or know of British consultant radiologist JGB Russell... BRITISH RADIOLOGIST JGB RUSSELL BEGIN excerpt of Dr. Gastaldo's 2005 post http://groups.google.com/group/ misc.kids.pregnancy/msg/a0c50d715eccdb85 In 1991, Australian physicians Gudgeon and Jarrett rubberstamped Lilford and Gupta¹s 1989 verdict that British radiologist JGB Russell must have been a victim of "subconscious observer bias" when he calculated that a "massive" (Lilford and Gupta¹s word) 20-30% of pelvic outlet area is denied when sacroiliac motion is denied... Gudgeon and Jarrett claimed that they had verified that Lilford and Gupta et al. (1989) had "refuted" Russell's "massive" 20-30% figure. [Gudgeon CW, Jarrett J. Pelvimetry: a squatter's view. Aust NZ J Obstet Gynaecol 1991;31(3):221-2. C/O Editor/Professor Norman Beischer, Dept. OB/GYN, Mercy Hospital for Women, Clarendon St., East Melbourne, Victoria, AUSTRALIA 3002] Gudgeon and Jarrett [1991] claimed they had "reproduced" the transverse pelvic outlet diameter study of Russell [1969], "using the radiographic methods described in [Russell's] report"; but except for using Russell's seated positioning, Gudgeon and Jarrett somehow FAILED to use most of the methods described in Russell's report. For example, Gudgeon and Jarrett utterly failed to make reference to how British radiologist JGB Russell mathematically combined Borell and Fernström's 1-2 cm average recumbent "hanging by her knees" sagittal diameter increase (a linear measurement), with his own 7 mm average "sitting...leaning forward" transverse diameter increase (another linear measurement)... Gudgeon and Jarrett failed to make reference to how Russell mathematically calculated that allowing the sacrum and pelvis to move affords a 20-30% potential increase in pelvic outlet AREA: "[T]he outlet increases with moulding by approximately 20-30 per cent." [Russell JGB. Moulding of the pelvic outlet. J Obstet Gynaec Brit Cwlth 1969;76:817-20. Dr. JGB Russell, consultant radiologist, 23 Anson Road, Victoria Park, Manchester M14 5BZ ENGLAND, 061-224-0006.] Given that Gudgeon and Jarrett blindly accepted Gupta and Lilford's 1989 fraudulent AP outlet increase figures ("Russell's suggested degree of increase in outlet area was...refuted by Lilford et al."), it is no surprise that Gudgeon and Jarrett concluded that their findings were consistent with those of Lilford et al.: "Increases of 1-2% only have been found in this and other series quoted in this study, our findings being consistent with those of Lilford et al. in their larger series." Garbage in; garbage out. Gudgeon and Jarrett somehow also failed to mention that, in 1973, Ohlsén studied Borell and Fernström¹s original "hanging by her knees" (1957) x-rays and verified Russell¹s 20% figure. [Ohlsén H. Moulding of the pelvis during labour. Acta Radiol Diag 1973;14:417-434] More garbage: Gudgeon and Jarrett did not quote the "other series" that they claimed to have quoted; and oddly, Gudgeon and Jarrett graciously excused Russell for having used "the posterior sagittal diameter measurement...[which was]...the standard teaching at that time...and has been replaced by the pubosacral measurement...used by Lilford et al." In fact, Russell did not mention, in any papers cited by Gudgeon and Jarrett, a "posterior sagittal diameter measurement." Russell did, however, openly cite Borell and Fernström who used a pubosacral measurement. "The question remains," wrote Gudgeon and Jarrett, "from where could the suggested increases of 20-30% come?" Where indeed. IS JGB RUSSELL THE PROBLEM? http://groups.google.com/group/sci.m...498ea4d4def6a6 In 1982, Russell suggested that the minor transverse sacroiliac "rocking" motion he had demonstrated in 1969 (7mm) was more important than Borell and Fernström's rotational motion (1-2 cm). This highly questionable suggestion augmented Russell's equally questionable 1969 inference that women sitting on their tailbones could offer "all the diameters" (the "extra" 30% of pelvic outlet area) just by pulling back on their legs. ("The mother who pulls hard her knees cranially...and the midwife who pushes on the mother's feet are increasing all the diameters of the outlet." [Russell 1969]) If Russell meant to state that women should pull on their knees cranially sufficiently to roll themselves off their sacra, he should have said so specifically. His lack of clarity on this point - and his failure to cite Borell and Fernström in his oft-cited 1982 paper - are perhaps the most important reasons semi-sitting has been thought (erroneously) to fully open the birth canal. In this latter regard... British obstetricians Liu (Univ. Nottingham) and Fairweather (Univ. College, London) erroneously suggest that sitting/lying on the sacrum ("lithotomy position propped up with pillows") is like squatting and allows maximal sagittal outlet diameter: "The squatting posture is well suited to delivery. A patient adopting the lithotomy position propped up with pillows and legs drawn back essentially achieves this posture..." [Liu DTY and Fairweather DVI. Labour Ward Manual. 2nd ed., 1991, Butterworth Heinemann Ltd., Linacre House, Jordan Hill, Oxford 0X2 8DP, p. 27] http://groups.google.com/group/sci.m...498ea4d4def6a6 Norman Beischer, MD, who published Gudgeon and Jarrett, once guessed that 10 to 15% of stillbirths are just fine right before delivery... In reply, Britain's evidence-based medicine guru Sir Iain Chalmers took Norman to task for guessing about such things... Interestingly, Chalmers stated in Guide to Effective Care in Pregnancy and Childbirth (1992) that radiographic evidence indicates that squatting increases pelvic outlet diameter... But after Chalmers (and his co-author Enkin) were informed by me that the radiographic evidence more clearly indicates that standard delivery positions CLOSE the pelvic outlet, mention of these radiographic studies was eliminated from the 1995 edition of Guide to Effective Care in Pregnancy and Childbirth. When I noted for Enkin that no one squatted in the 1957 study by Borell and Fernström - and that the 1957 study by Borell and Fernström actually in effect demonstrated that standard medical delivery positions jam the sacral tip up to 4 cm into the fetal skull - Enkin responded by telling me that "the Lilford group" - (as noted above, Gupta and Lilford offered women "the pututive benefits of squatting" and then squashed fetal skulls in a 1989 trial of squatting) - had refuted Borell and Fernström's "radiological reports...of an increased sagittal diameter." Ultimately, Enkin deleted mention of the radiological reports from the 1995 edition of Guide to Effective Care in Pregnancy and Childbirth. When I called Chalmers to complain about Enkin's behavior, Chalmers told me that until there is scientific evidence that it is beneficial to inform women of the radiographic evidence that sacral tips are being jammed up to 4 cm into fetal skulls, women should not be informed of this evidence. Additionally, Chalmers pointed out that he was no longer an editor of Guide to Effective Care in Pregnancy and Childbirth. END excerpt of Dr. Gastaldo's 2005 post http://groups.google.com/group/ misc.kids.pregnancy/msg/a0c50d715eccdb85 #### Back to LA Times reporter Maugh's discussion of Looney et al. The Carolina researchers studied 88 newborns, an average of three weeks after birth. Seventeen of the 65 who underwent vaginal delivery suffered small hemorrhages in the brain, but none did of the 23 who had C-sections. "Neither the size of the baby or the baby's head, the length of the labor, nor the use of vacuum or forceps to assist the delivery caused the bleeds," said Dr. John H. Gilmore of UNC, lead author. "It's just the process of being born," he said. The skull has not yet become solid, and the bone plates overlap with each other. Passage through the birth canal compresses the plates, tearing small blood vessels, he said.... WHAT?! #### I don't get Dr. John H. Gilmore's logic. If John thinks that skull compression is causative, then skull size - and size of the PELVIS - likely play a role in the brain injury. Most of the bleeds occurred in the lower, rear part of the brain. But, he added, "there was no evidence clinically to indicate that anything had happened to the babies' brains." #### Most neonatal brain bleeds are asymptomatic/clinically silent, according to neurologists quoted below. The team will examine the babies again at ages 1 and 2 to look for any possible long-term effects. REGARDING POSSIBLE LONG-TERM EFFECTS... BEGIN excerpt of http://groups.google.com/group/ alt.circumcision/msg/184b0a0be392766d #### Menkes, in his Textbook of Child Neurology [1995], begins his section on cerebral palsy diagnosis by emphasizing "perinatal asphyxia" (p. 353)...and he begins his section on treatment by stating, "the prevention of perinatal trauma and asphyxia is largely the task of the obstetrician..." (p. 357) #### Berg writes: "In infants, subarachnoid and/or intraventricular blood can result from...disproportion in the size of the fetal head." [Berg BO(ed). Principles of Child Neurology NY: McGraw-Hill 1996:942-3] #### Volpe writes: "[D]eformations of the particularly compliant premature skull are likely to accentuate the increases in venous pressure caused by normal labor...the inconsistency of reported data need not rule out a contributory role for intrapartum events in causation of IVH [intraventricular hemorrhage]..." [Volpe JJ. Neurology of the Newborn Philadelphia: W.B. Saunders 1995:415] #### Just as most brain bleeds in term neonates are asymptomatic [Menkes Textbook of Child Neurology 1995]; most brain bleeds in premature babies are "clinically silent." [Volpe 1995:421] ##### Similarly, just as "perceptual difficulties and impaired motor abilities bec[o]me noticeable only after 3 to 4 years of age" (in term neonates with asymptomatic brain bleeds [Bergman et al. 1985; cited above]); it is plausible that "clinically silent" brain bleeding will similarly become clinically noticeable after 3 to 4 years of age in premature babies. END excerpt of http://groups.google.com/group/ alt.circumcision/msg/184b0a0be392766d Even if closing the birth canal the "extra" up to 30% does NOT cause brain bleeds, MD-obstetricians have no business closing birth canals - or KEEPING them closed when babies get stuck - or LYING to cover-up. Again: For the Four OB Lies (they are whoppers)... See Dents in babies' skulls" http://groups.google.com/group/ misc.kids.pregnancy/msg/08abfc7ff242150e Alternate URL: http://health.groups.yahoo.com/group...t/message/3897 Thanks for reading. Sincerely, Todd Dr. Gastaldo Hillsboro, Oregon USA AGAIN Looney et al.'s stated Purpose was: "To retrospectively evaluate the prevalence of neonatal intracranial hemorrhage (ICH) and its relationship to obstetric and neonatal risk factors." Again those TWO QUESTIONS for Looney et al.: Was the bizarre routine **birth-canal-closing** risk factor considered? Were the women who birthed vaginally allowed to open their birth canals the "extra" up to 30%? I'm copying Looney et al. via This post will be archived for global access in the Google usenet archive. Search http://groups.google.com for "MRI: Brain bleeds in 26% of vaginal births (Looney et al. 2007) |
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