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Perineal laceration

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https://www.readbyqxmd.com/read/28282772/does-meperidine-analgesia-affect-the-incidence-of-obstetric-lacerations-at-vaginal-delivery
#1
Yossi Mizrachi, Sophia Leytes, Michal Levy, Shimon Ginath, Jacob Bar, Tiberiu Ezri, Michal Kovo
PURPOSE: To study whether meperidine analgesia affects the incidence of obstetric lacerations at normal vaginal deliveries. MATERIALS AND METHODS: A retrospective cohort study of all women with term vertex singleton pregnancies, who underwent normal vaginal deliveries, in a single tertiary hospital, between 2011 and 2015, was performed. The incidence of various obstetric lacerations was compared between deliveries with meperidine analgesia and deliveries with no analgesia...
February 28, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28282770/using-a-multifaceted-quality-improvement-initiative-to-reverse-the-rising-trend-of-cesarean-births
#2
Dotun Ogunyemi, Sara McGlynn, Anne Ronk, Patricia Knudsen, Tonyie Andrews-Johnson, Angeline Raczkiewicz, Andrew Jovanovski, Sangeeta Kaur, Mark Dykowski, Mark Redman, Ray Bahado-Singh
PURPOSE: National efforts exist to safely reduce the rate of cesarean delivery, a major source of increased morbidity and healthcare costs. This is a report of a quality improvement study targeting reduction of primary cesarean deliveries. MATERIALS AND METHODS: From March 2014 to March 2016, interventions included a nested case-control review of local risk factors, provider and patient education, multidisciplinary reviews based on published guidelines with feedback, provider report cards, commitment to labor duration guidelines, and a focus on natural labor...
February 28, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28222704/duration-of-second-stage-of-labor-and-instrumental-delivery-as-risk-factors-for-severe-perineal-lacerations-population-based-study
#3
Marija Simic, Sven Cnattingius, Gunnar Petersson, Anna Sandström, Olof Stephansson
BACKGROUND: We sought to investigate the impact of the duration of second stage of labor on risk of severe perineal lacerations (third and fourth degree). METHODS: This population based cohort study was conducted in the Stockholm/Gotland region, Sweden, 2008-2014. Study population included 52 211 primiparous women undergoing vaginal delivery with cephalic presentation at term. Unconditional logistic regression analysis was used to calculate crude and adjusted odds ratios (OR), using 95% confidence intervals (CI)...
February 21, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28178050/filled-prescriptions-for-opioids-after-vaginal-delivery
#4
Marian Jarlenski, Lisa M Bodnar, Joo Yeon Kim, Julie Donohue, Elizabeth E Krans, Debra L Bogen
OBJECTIVE: To estimate the prevalence of filled opioid prescriptions after vaginal delivery. METHODS: We conducted a retrospective cohort study of 164,720 Medicaid-enrolled women in Pennsylvania who delivered a liveborn neonate vaginally from 2008 to 2013, excluding women who used opioids during pregnancy or who had an opioid use disorder. We assessed overall filled prescriptions as well as filled prescriptions in the presence or absence of the following pain-inducing conditions: bilateral tubal ligation, perineal laceration, or episiotomy...
March 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28164285/antepartum-or-intrapartum-deinfibulation-for-childbirth-in-women-with-type-iii-female-genital-mutilation-a-systematic-review-and-meta-analysis
#5
Ekpereonne Esu, Atim Udo, Babasola O Okusanya, David Agamse, Martin M Meremikwu
BACKGROUND: There remains no consensus on the best timing of deinfibulation in women with type III female genital mutilation (FGM). OBJECTIVES: To conduct a systematic review of the effects of antepartum or intrapartum deinfibulation on childbirth outcomes in women with type III FGM. SEARCH STRATEGY: The following major databases were searched: Cochrane Central Register for Controlled Trials (CENTRAL), MEDLINE, Scopus, Web of Science, and ClinicalTrials...
February 2017: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/28099786/labor-intervention-and-outcomes-in-women-who-are-nulliparous-and-obese-comparison-of-nurse-midwife-to-obstetrician-intrapartum-care
#6
Nicole S Carlson, Elizabeth J Corwin, Nancy K Lowe
BACKGROUND: Women who are obese have slower labors than women of normal weight, and show reduced response to interventions designed to speed labor progress like oxytocin augmentation and artificial rupture of membranes. The optimal labor management for these women has not been described. METHODS: This retrospective cohort study compared 2 propensity score-matched groups of women (N = 360) who were healthy, nulliparous, spontaneously laboring, and obese (body mass index ≥ 30 kg/m(2) )...
January 2017: Journal of Midwifery & Women's Health
https://www.readbyqxmd.com/read/28099742/does-breech-delivery-in-an-upright-position-instead-of-on-the-back-improve-outcomes-and-avoid-cesareans
#7
Frank Louwen, Betty-Anne Daviss, Kenneth C Johnson, Anke Reitter
OBJECTIVE: To compare breech outcomes when mothers delivering vaginally are upright, on their back, or planning cesareans. METHODS: A retrospective cohort study was undertaken of all women who presented for singleton breech delivery at a center in Frankfurt, Germany, between January 2004 and June 2011. RESULTS: Of 750 women with term breech delivery, 315 (42.0%) planned and received a cesarean. Of 269 successful vaginal deliveries of neonates, 229 in the upright position were compared with 40 in the dorsal position...
February 2017: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/28099290/increased-perinatal-morbidity-and-mortality-among-asian-american-and-pacific-islander-women-in-the-united-states
#8
Maryam Siddiqui, Mohammed Minhaj, Ariel Mueller, Avery Tung, Barbara Scavone, Sarosh Rana, Sajid Shahul
BACKGROUND: Asian American/Pacific Islanders (AAPIs) are the fastest-growing racial group in the United States. Despite a higher socioeconomic status, AAPI women experience higher rates of maternal morbidity and mortality. METHODS: Using the National Inpatient Sample, we performed a retrospective cohort analysis of women who were hospitalized for delivery from 2002 to 2013. The primary outcome variable was inpatient mortality rate, and the presence of severe maternal morbidities was estimated using the Bateman Comorbidity Index, a validated tool for predicting obstetric morbidity...
March 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28027700/management-of-persistent-occiput-posterior-position-a-substantial-role-of-instrumental-rotation-in-the-setting-of-failed-manual-rotation
#9
Paul Guerby, Mickael Allouche, Caroline Simon-Toulza, Christophe Vayssiere, Olivier Parant, Fabien Vidal
INTRODUCTION: To compare the maternal and neonatal outcomes associated with Instrumental Rotation (IR) to operative vaginal delivery in occiput posterior (OP) position with Thierry's spatulas (TS), in the setting of failed manual rotation (MR). STUDY DESIGN: We led a prospective observational cohort study in a tertiary referral hospital in Toulouse, France. All women presenting in labor with persistent OP position at full cervical dilatation and who delivered vaginally after failed MR and with IR or OP assisted delivery were included from January 2014 to December 2015...
January 23, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/27998899/effect-of-the-type-of-maternal-pushing-during-the-second-stage-of-labour-on-obstetric-and-neonatal-outcome-a-multicentre-randomised-trial-the-eole-study-protocol
#10
Chloé Barasinski, Françoise Vendittelli
INTRODUCTION: The scientific data currently available do not allow any definitive conclusion to be reached about what type of pushing should be recommended to women during the second stage of labour. The objective of this trial is to assess and compare the effectiveness of directed open-glottis pushing versus directed closed-glottis pushing. Secondary objectives are to assess, according to the type of pushing: immediate maternal and neonatal morbidity, intermediate-term maternal pelvic floor morbidity, uncomplicated birth, and women's satisfaction at 4 weeks post partum...
December 20, 2016: BMJ Open
https://www.readbyqxmd.com/read/27935148/customized-versus-population-based-growth-charts-to-identify-neonates-at-risk-of-adverse-outcomes-a-systematic-review-and-bayesian-meta-analysis-of-observational-studies
#11
REVIEW
Giuseppe Chiossi, Claudia Pedroza, Maged M Costantine, Van Thi Thanh Truong, Giancarlo Gargano, George R Saade
OBJECTIVE: To compare the effectiveness of customized versus population-based growth charts for prediction of adverse pregnancy outcomes. METHODS: we searched MEDLINE, http://ClinicalTrials.gov and the Cochrane library up to May 31(st) 2016 to identify interventional and observational studies comparing adverse outcomes among large (LGA) and small (SGA) for gestational age neonates, when classified with customized versus population-based growth charts. We studied perinatal mortality and NICU admission among both SGA and LGA neonates, IUFD and neonatal mortality among SGA, shoulder dystocia, 3(rd) and 4(th) degree perineal lacerations, as well as neonatal hypoglycemia among LGA...
December 9, 2016: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/27924373/female-sexual-function-following-different-degrees-of-perineal-tears
#12
Waleed Ali Sayed Ahmed, Eman Ahmed Kishk, Rasha Imam Farhan, Rasha Elsayed Khamees
INTRODUCTION AND HYPOTHESIS: Perineal tears may have a negative impact on female sexual function (FSF). The aim of the study was to assess the effect of different degrees of perineal tears sustained during delivery on subsequent FSF. METHODS: This prospective cohort study assessed women with third- or fourth-degree perineal tears following vaginal delivery (study group) and compared them with women who underwent episiotomy or had minor lacerations (control group)...
December 6, 2016: International Urogynecology Journal
https://www.readbyqxmd.com/read/27802555/promote-study-safety-of-osteopathic-manipulative-treatment-during-the-third-trimester-by-labor-and-delivery-outcomes
#13
Kendi L Hensel, Brandy M Roane, Anita Vikas Chaphekar, Peggy Smith-Barbaro
BACKGROUND: Few quality data exist on the safety of osteopathic manipulative treatment (OMT) during pregnancy. The Pregnancy Research on Osteopathic Manipulation Optimizing Treatment Effects (PROMOTE) study was a randomized controlled clinical trial that studied the application of an OMT protocol to manage pain and dysfunction in pregnant patients during their third trimester. OBJECTIVE: To evaluate the safety of an OMT protocol applied during the third trimester of pregnancy by analyzing incidence of high-risk status and labor and delivery outcomes...
November 1, 2016: Journal of the American Osteopathic Association
https://www.readbyqxmd.com/read/27797099/the-effect-of-perineal-lacerations-on-pelvic-floor-function-and-anatomy-at-6-months-postpartum-in-a-prospective-cohort-of-nulliparous-women
#14
Lawrence Leeman, Rebecca Rogers, Noelle Borders, Dusty Teaf, Clifford Qualls
OBJECTIVE: To determine the effect of perineal lacerations on pelvic floor outcomes, including urinary and anal incontinence, sexual function, and perineal pain in a nulliparous cohort with low incidence of episiotomy. METHODS: Nulliparous women were prospectively recruited from a midwifery practice. Pelvic floor symptoms were assessed with validated questionnaires, physical examination, and objective measures in pregnancy and 6 months postpartum. Two trauma groups were compared, those with an intact perineum or only 1st degree lacerations and those with second-, third-, or fourth-degree lacerations...
December 2016: Birth
https://www.readbyqxmd.com/read/27752911/prevalence-and-risk-factors-of-urinary-incontinence-among-perimenopausal-women-in-wuhan
#15
Shi Lu, Hong-Ling Zhang, Ya-Jun Zhang, Qing-Chun Shao
This study investigated the prevalence and risk factors of urinary incontinence (UI) among perimenopausal women in Wuhan. A cross-sectional survey was performed on 1067 women aged 40-65 years sampled in Wuhan urban area from April to October 2014. Information about demographic characteristics, menstruation, parity and UI symptoms was collected using a questionnaire. The data were evaluated by Chi-square test and multiple Logistic regression analysis. The prevalence rate of UI was 37.2%, with stress UI (32.2%) being more prevalent than urgency UI (21...
October 2016: Journal of Huazhong University of Science and Technology. Medical Sciences
https://www.readbyqxmd.com/read/27751429/repair-of-old-perineal-laceration-accompanied-by-rectovaginal-fistula-using-levator-ani-muscle-interposition
#16
Shintaro Makino, Jun Takeda, Satoru Takeda
No abstract text is available yet for this article.
October 2016: Taiwanese Journal of Obstetrics & Gynecology
https://www.readbyqxmd.com/read/27582577/induction-of-labour-in-late-and-postterm-pregnancies-and-its-impact-on-maternal-and-neonatal-outcome
#17
F Thangarajah, P Scheufen, V Kirn, P Mallmann
INTRODUCTION: This study aimed to determine the effects of induction of labour in late-term pregnancies on the mode of delivery, maternal and neonatal outcome. METHODS: We retrospectively analyzed deliveries between 2000 and 2014 at the University Hospital of Cologne. Women with a pregnancy aged between 41 + 0 to 42 + 6 weeks were included. Those who underwent induction of labour were compared with women who were expectantly managed. Maternal and neonatal outcomes were evaluated...
July 2016: Geburtshilfe und Frauenheilkunde
https://www.readbyqxmd.com/read/27549862/episiotomy-and-the-risk-of-severe-perineal-injuries-among-korean-women
#18
Ha Yan Kwon, Hyun Soo Park
PURPOSE: We examined the frequency of severe perineal injuries according to the use of episiotomy in vaginal deliveries of Korean women. MATERIALS AND METHODS: This is a retrospective cohort study in which 358 consecutive parturients were included. Women were divided into episiotomy (n = 115) and no episiotomy (n = 243) groups. The main outcome was the occurrence of severe (third or fourth degree) perineal injuries. Delivery records and medical documents were reviewed to collect the data...
September 8, 2016: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/27549142/fetal-macrosomia-as-a-risk-factor-for-shoulder-dystocia-during-vacuum-extraction
#19
Shmuel Herzberg, Doron Kabiri, Tzlil Mordechai, Rani Haj Yahya, Henry Chill, Lorinne Levitt, Hagai Amsalem, Yossef Ezra
OBJECTIVE: Vacuum extraction of a macrosomic fetus is considered a risk factor for shoulder dystocia (SD). We evaluated maternal and fetal outcomes following vacuum extraction of macrosomic infants. METHODS: A retrospective cohort study conducted in two large teaching hospitals. All deliveries of macrosomic infants by vacuum extraction and vaginal delivery were compared. The primary outcome measure was SD. Secondary outcome measures were severe perineal lacerations and postpartum hemorrhage...
September 5, 2016: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/27548421/committee-opinion-no-647-limitations-of-perineal-lacerations-as-an-obstetric-quality-measure
#20
(no author information available yet)
Perineal lacerations are a common occurrence with vaginal delivery. Although perineal lacerations are tracked easily from coding data, there are a variety of problems with using rates of such tears as a quality measure. The rate of severe perineal lacerations should not be used as a measure of obstetric quality for the following three reasons: 1) third-degree and fourth-degree perineal lacerations may not be defined uniformly; 2) severe perineal lacerations are associated strongly with nonmodifiable risk factors; and 3) diminishing the use of operative vaginal delivery, in an effort to decrease severe perineal lacerations, likely would result in an increased rate of cesarean delivery...
May 2016: Obstetrics and Gynecology
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