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MRI: Brain bleeds in 26% of vaginal births (Looney et al. 2007)



 
 
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Old February 2nd 07, 04:08 PM posted to sci.med,misc.kids.pregnancy,misc.health.alternative
Todd Gastaldo
external usenet poster
 
Posts: 188
Default 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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