Because a woman’s birth canal is curved and only a little wider than a fetus’s head, a baby must proceed through the canal in a specific sequence of moves. A failure during the process, such as a head turned the wrong way at the wrong time, can result in difficult labor or dystocia.

Using the new software, called PREDIBIRTH, Dr. Olivier Ami and a team of researchers from the Department of Radiology at Antoine Béclères Hospital, Université Paris Sud, France, processed MR images of 24 pregnant women. The result was a three-dimensional (3-D) reconstruction of both the fetus and pelvis along with 72 possible trajectories of the baby’s head through the birth canal. The program scored each mothers likelihood of a normal birth based on these simulations.

“The mechanics of the human birth canal make for a very complicated delivery process compared to other mammals,” said Dr. Ami in a news release. “We now have computer-simulated childbirth to identify potential problems. The software simulates the properties of potential deliveries.”

For this study, the PREDIBIRTH scores were computed retrospectively and measured against delivery outcomes for the 24 women. Thirteen women had normal deliveries, which had been  scored as highly favorable by the simulator. Three women who had elective cesarean-section (C-section) were scored at high risk for dystocia.

Of the five women who had emergency C-sections, two involved heart rhythm abnormalities and had simulator scores of mildly favorable and favorable. Three involved obstructed labor, all of whom scored at high risk of dystocia. Three women delivered with vacuum extraction and had mildly favorable simulator scores.

Researchers say the results in predicting dystocia were highly accurate and are a notable improvement over pelvimetry, which measures the pelvis manually or by imaging to determine its adequacy for childbirth. While pelvimetry is commonly used, Dr. Ami said it’s not entirely reliable.

“A small pelvis may be able to deliver without problems, and a big pelvis might require mechanical help during childbirth,” he said. “This uncertainty raises the rate of C-sections.”

In the U.S., C-sections account for approximately one-third of all births. In France, the rate of mechanical problems is 30 percent, two-thirds of which are emergency procedures.

“An emergency C-section has six to seven times more morbidity and mortality than a planned C-section,” Dr. Ami said. “With this virtual childbirth software, the majority of C-sections could be planned rather than emergency, and difficult instrumental extractions might disappear in the near future.”

For more on  child safety issues, see the library of articles by Daytona Beach child injury attorney.

Of more concern was the finding that the youngest children had the greatest chance of receiving an overdose, according to lead researcher Dr. William T. Basco Jr., associate professor and director of the Division of General Pediatrics at the Medical University of South Carolina.

“Our goal was to determine the magnitude of overdosing for this high-risk drug class in a high-risk population, and these results are concerning,” Dr. Basco said in a press release.

Narcotics such as codeine and hydrocodone can be dangerous for infants and children because of their sedative effects.

Researchers from South Carolina identified the top 19 narcotic-containing drugs prescribed to children ages 0-36 months who were enrolled in the Medicaid program from 2000-2006.

For each of 50,462 outpatient prescriptions, they calculated the expected daily dose of the narcotic based on an estimate of the child’s weight, age and gender. Then they compared that dosage with the actual amount of painkiller dispensed by the pharmacy.

About 40 percent of children younger than 2 months of age received an overdose amount compared to 3 percent of children older than 1 year. For the average child who had an overdose quantity dispensed, the amount of narcotic drug dispensed was 42 percent greater than would have been expected.

“Almost one in 10 of the youngest infants ages 0-2 months received more than twice the dose that they should have received based on their age, gender and a conservative estimate of their weight,” Dr. Basco said.

“Since we know that parents have difficulty measuring doses of liquid medication accurately,” Dr. Basco concluded, “it is critical to strive for accurate narcotic prescribing by providers and dispensing by pharmacies.”

For more on child medical safety issues, see the library of articles by Daytona Beach child injury attorney.

A recent Archives of Surgery report finds that a group of 6,000 Colorado doctors reported 27,230 unfavorable events over six years 2002-2008. Of those, 25 were the wrong patient getting the wrong surgery and 107 patients were operated on in the wrong place.

Of the 25 patients who received the wrong surgery, five suffered serious medical malpractice injury. Of the 107 patients whose surgery was on the wrong side of their body, 38 suffered serious medical malpractice injury.

Babbling usually begins much earlier than at 12 months and is now thought to be necessary step towards learning to speak. In fact scientists have noted that babies babble in similar ways regardless of where they are born and what language they are learning. Babies begin transforming babble into the distinct sounds of their native tongue later as 2-year-olds.

By 6 or 7 months, babies’ babbling should include both consonants and vowels. If a baby makes only ooo or aaa sounds are not practicing their word formation and are not developing speech as quickly as most. At the latest, this should occur by 12 months.

Interestingly, babies must learn language from people; television and even educational videos do not work. Not only is human interaction crucial, but the type of interaction turns out to be important as well.

The moment a baby is babbling is an important teaching moment. Scientists think that while babies babble their brains are in a focused state of attention and they are primed to learn names of new objects.

A recent study found that showing a baby an object and naming it in response to the baby’s babble allowed the baby to learn the names better. So instead of just repeating the babbling or trying to guess, “Oh do you want your toy?,” we should either show them an object and name it or name the object they’re looking at.

New studies show that cerebral palsy Botox treatments have serious side effects even up to three weeks after the treatment. If your child is experiencing difficulty breathing, difficulty swallowing, muscular weakness, drooping eyelids, constipation, aspiration pneumonia, speech disorder, facial drooping, or double vision, seek immediate emergency medical attention.

This new warning is an update to a 2008 safety review of cerebral palsy Botox treatments and will be included on the label and patient information packet going forward.

Although the FDA never approved Botox for cerebral palsy pediatric patients, it is a very commonly used and widely accepted treatment  across the country. Cerebral palsy Botox treatments involve the injection of large amounts of Botox deep into spastic muscles for the purpose of relaxing them.

The problem noted in the new study is that the Botox spreads well beyond the spastic muscles and has drastic side effects. The most serious side effects include hospitalizations involving ventilatory support and death.

The FDA also requests that all side effects be reported through MedWatch Every report helps the next child.

I’ll be blogging about many issues including lawyer advertising in Florida and why it is so awful (we have the Florida Bar to thank for that). The chilling effect of the Florida Bar’s heavy handed enforcement of its advertising rules is a theme will run though this blog and was the inspiration for its title. In addition to commenting on lawyer advertising, I will also be lobbying the Florida Legislature to reform and improve our laws on child abuse. This blog will follow those efforts closely. Other blog topics will include legal discussions of negligence in nursing homes, accidents and medical settings. Finally, my personal interests will certainly shine through now and again.

That’s all for now. You’ll learn much more about me in the future. For now, I’m headed out for a 70 mile bicycle ride. I’m training for the Florida Ironman. Swim 2.4 miles, Bike 112 miles, Run 26.2 miles, brag for the rest of your life.