Mode of delivery and pregnancy outcomes in preterm birth: a secondary analysis of the WHO Global and Multi-country Surveys.

Many studies have been conducted to examine whether Caesarean Section (CS) or vaginal birth (VB) was optimal for better maternal and neonatal outcomes in preterm births. However, findings remain unclear. Therefore, this secondary analysis of World Health Organization Global Survey (GS) and Multi-country Survey (MCS) databases was conducted to investigate outcomes of preterm birth by mode of delivery. Our sample were women with singleton neonates (15,471 of 237 facilities from 21 countries in GS; and 15,053 of 239 facilities from 21 countries in MCS) delivered between 22 and <37 weeks of gestation. We assessed association between mode of delivery and pregnancy outcomes in singleton preterm births by multilevel logistic regression adjusted for hierarchical data. The prevalences of women with preterm birth delivered by CS were 31.0% and 36.7% in GS and MCS, respectively. Compared with VB, CS was associated with significantly increased odds of maternal intensive care unit admission, maternal near miss, and neonatal intensive care unit admission but significantly decreased odds of fresh stillbirth, and perinatal death. However, since the information on justification for mode of delivery (MOD) were not available, our results of the potential benefits and harms of CS should be carefully considered when deciding MOD in preterm births.

Diagnóstico, plan de tratamiento y restauración de un diente con el síndrome del diente fisurado: reporte de caso y seguimiento de siete años / Diagnosis, planning, and restoring treatment of cracked syndrome tooth: case report - 7-year follow-up

Se describe y reporta el diagnóstico, tipo de tratamiento y seguimiento de un caso con el síndrome del diente fisurado. Una paciente de 26 años acusaba sensibilidad a los cambios térmicos y a la oclusión en el lado izquierdo de la mandíbula. Al examen clínico se observó dos grietas o fisuras pigmentadas en las superficies bucales y linguales de la pieza 36. La colocación de una restauración directa con resina compuesta resolvió los síntomas y alivió por completo el dolor. Dicha situación persistió incluso en el control realizado 7 años después. El diagnóstico y tratamiento para el caso descrito dio como resultado un completo alivio y mantenimiento de la situación alcanzada siete años después.

This case report describes a cracked tooth syndrome and reports on its diagnosis, type of treatment and monitoring. A 26-year-old female patient complained of thermal and chewing sensitivity in the left side of her mandible. Clinical examination revealed two pigmented cracks on the buccal and lingual surfaces of tooth 36. The choice of a direct restorative treatment with composite resin led to the resolution of symptoms and complete relief of pain, which persisted in a 7-year monitoring period. The diagnosis and treatment of the case described here resulted in complete pain relief and maintenance of normal conditions seven years later.