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Perineal laceration

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https://www.readbyqxmd.com/read/29411072/prospective-evaluation-of-the-safety-and-feasibility-of-a-pelvic-floor-dilator-during-active-labor
#1
Francisco J Orejuela, Rajshi Gandhi, Lauren Mack, Wesley Lee, Haleh Sangi-Haghpeykar, Hans P Dietz, Susan M Ramin
INTRODUCTION AND HYPOTHESIS: The objective was to assess the safety and feasibility of using a pelvic floor dilator during active labor to prevent injuries to the levator ani muscle (LAM) and perineum. METHODS: In a prospective pilot study, a pelvic floor dilator using soft pads was introduced into the vaginal canal to gradually expand the vagina, in 30 nulliparous women and in 10 controls. The primary outcomes were adverse events related to the device. Secondary outcomes were perineal lacerations after delivery, sonographically defined levator ani injury, hiatal area dimensions, and anal sphincter disruption, all at 12-20 weeks postpartum, and maximum pelvic floor dilation, time to achieve maximum dilation, and device retention rate...
February 6, 2018: International Urogynecology Journal
https://www.readbyqxmd.com/read/29395697/sexual-dysfunction-predicts-depressive-symptoms-during-the-first-2-years-postpartum
#2
Shiow-Ru Chang, Wei-An Lin, Ho-Hsiung Lin, Ming-Kwang Shyu, Ming-I Lin
BACKGROUND: The association between sexual function and depression has yet to be examined in a prospective cohort study with prolonged postpartum follow-up. AIM: We investigated whether sexual dysfunction predicted depressive symptoms during the 24-month postpartum period and examined the influence of obstetric factors. METHODS: This prospective 2-year cohort study with repeated measures included 196 participants who were recruited in a medical center in Taipei, Taiwan (2010-2011)...
January 25, 2018: Women and Birth: Journal of the Australian College of Midwives
https://www.readbyqxmd.com/read/29324610/risk-factors-for-the-development-of-obstetric-anal-sphincter-injuries-in-modern-obstetric-practice
#3
Olga Ramm, Victoria G Woo, Yun-Yi Hung, Hsuan-Chih Chen, Miranda L Ritterman Weintraub
OBJECTIVE: To characterize the rate of obstetric anal sphincter injuries and identify key risk factors of obstetric anal sphincter injuries, including duration of the second stage of labor. METHODS: This retrospective cohort study included all singleton, term, cephalic vaginal deliveries within Kaiser Permanente Northern California between January 2013 and December 2014 (N=22,741). Incidence of obstetric anal sphincter injuries, defined as third- or fourth-degree perineal lacerations, was the primary outcome...
February 2018: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29316070/incidence-and-risk-factors-of-severe-lacerations-during-forceps-delivery-in-a-single-teaching-hospital-where-simulation-training-is-held-annually
#4
Yasuko Sano, Chihiro Hirai, Shintaro Makino, Xianglan Li, Jun Takeda, Atsuo Itakura, Satoru Takeda
AIM: This study was conducted to evaluate the incidence of severe lacerations during forceps delivery and the risk factors associated with such delivery in a hospital where simulation training is held annually. METHODS: The medical records of 857 women who underwent forceps delivery at term with singleton cephalic presentation from 2010 to 2015 were reviewed. The relationship between clinical characteristics and birth canal trauma was analyzed. Birth canal trauma included third and fourth degree perineal lacerations...
January 5, 2018: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/29239949/labor-analgesia-as-a-predictor-for-reduced-postpartum-depression-scores-a-retrospective-observational-study
#5
Grace Lim, Lia M Farrell, Francesca L Facco, Michael S Gold, Ajay D Wasan
BACKGROUND: Using labor, epidural analgesia has been linked to a reduced risk of postpartum depression, but the role of labor pain relief in this association remains unclear. The goal of this study was to test the hypothesis that effective epidural analgesia during labor is associated with reduced postpartum depression symptomatology. METHODS: A single, institutional, retrospective, observational cohort design was chosen. The primary outcome was Edinburgh postnatal depression scale (EPDS) score, measured at the 6-week postpartum visit...
December 11, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29238501/the-effect-of-perineal-massage-during-the-second-stage-of-birth-on-nulliparous-women-perineal-a-randomization-clinical-trial
#6
Roonak Shahoei, Farzaneh Zaheri, Lila Hashemi Nasab, Fariba Ranaei
Background: Childbirth and puerperium are of the most important periods in women's lives and can affect different aspects of their lives. Objective: To determine the effect of perineal massage in the second stage of labor on perineal lacerations, episiotomy, and perineal pain in nulliparous women. Methods: This randomization clinical trial was conducted at Be'sat Hospital in Sanandaj, Iran, from 2013 to 2014. A total of 195 nulliparous women were included in the study...
October 2017: Electronic Physician
https://www.readbyqxmd.com/read/29131385/rural-community-birth-maternal-and-neonatal-outcomes-for-planned-community-births-among-rural-women-in-the-united-states-2004-2009
#7
Elizabeth Nethery, Wendy Gordon, Marit L Bovbjerg, Melissa Cheyney
BACKGROUND: Approximately 22% of women in the United States live in rural areas with limited access to obstetric care. Despite declines in hospital-based obstetric services in many rural communities, midwifery care at home and in free standing birth centers is available in many rural communities. This study examines maternal and neonatal outcomes among planned home and birth center births attended by midwives, comparing outcomes for rural and nonrural women. METHODS: Using the Midwives Alliance of North America Statistics Project 2...
November 13, 2017: Birth
https://www.readbyqxmd.com/read/29117015/racial-ethnic-differences-in-perineal-lacerations-in-a-diverse-urban-healthcare-system
#8
Amanda Williams, Beverly Gonzalez, Colleen Fitzgerald, Cynthia Brincat
OBJECTIVES: The aim of the study was o determine whether variations exist between races/ethnicities in perineal laceration at first vaginal delivery. METHODS: We assessed first vaginal deliveries greater than 35 weeks gestation, for a four-year period, in our diverse urban healthcare system. Predictor variable was race/ethnicity with outcome variable of none, first-, second-, third-, or fourth-degree perineal laceration. Race and ethnicity were self-reported and combined into one variable to facilitate analysis...
November 7, 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/29037544/effects-of-pushing-techniques-during-the-second-stage-of-labor-a%C3%A2-randomized-controlled-trial
#9
Refika Genç Koyucu, Nurdan Demirci
OBJECTIVE: Spontaneous pushing is a method that is used in the management of the second stage of labor and suggested to be more physiological for the mother and infant. The present study aims to evaluate the effects of pushing techniques on the mother and newborn. MATERIALS AND METHODS: This randomized prospective study was performed between June 2013-March 2014 in a tertiary maternity clinic in Istanbul. 80 low risk, nulliparous cases were randomized to pushing groups...
October 2017: Taiwanese Journal of Obstetrics & Gynecology
https://www.readbyqxmd.com/read/29037175/a-ten-year-study-of-midwife-led-care-at-an-austrian-tertiary-care-center-a-retrospective-analysis-with-special-consideration-of-perineal-trauma
#10
Barbara Bodner-Adler, Oliver Kimberger, Julia Griebaum, Peter Husslein, Klaus Bodner
BACKGROUND: In contrast to other countries, Austria rarely offers alternative models to medical led-care. In an attempt to improve the facilities, a midwife-led care service was incorporated within the Department of Obstetrics and Fetomaternal Medicine. The aim of the present study was to analyze the maternal and neonatal outcomes of this approach. METHODS: Over a 10-years period, a total of 2123 low-risk women receiving midwife-led care were studied. Among these women, 148 required obstetric referral...
October 16, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28953570/the-association-between-learning-climate-and-adverse-obstetrical-outcomes-in-16-nontertiary-obstetrics-gynecology-departments-in-the-netherlands
#11
Alina Smirnova, Anita C J Ravelli, Renée E Stalmeijer, Onyebuchi A Arah, Maas Jan Heineman, Cees P M van der Vleuten, Joris A M van der Post, Kiki M J M H Lombarts
PURPOSE: To investigate the association between learning climate and adverse perinatal and maternal outcomes in obstetrics-gynecology departments. METHOD: The authors analyzed 23,629 births and 103 learning climate evaluations from 16 nontertiary obstetrics-gynecology departments in the Netherlands in 2013. Multilevel logistic regressions were used to calculate the odds of adverse perinatal and maternal outcomes, by learning climate score tertile, adjusting for maternal and department characteristics...
September 26, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28948341/the-impact-of-a-new-standard-labor-protocol-on-maternal-and-neonatal-outcomes
#12
Dingran Wang, Shenglong Ye, Liyuan Tao, Yongqing Wang
PURPOSE: To analyze the clinical outcomes following the implementation of a new standard labor procedure. METHODS: This was a retrospective analysis that included a study group consisting of patients managed based on a new standard labor protocol and a control group comprising patients managed under an old standard labor protocol. The following maternal and perinatal outcomes were compared in the two groups: the indications for a cesarean section and the incidence of cesarean section, postpartum hemorrhage, fetal distress, neonatal asphyxia and pediatric intervention...
September 25, 2017: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/28923011/nurse-midwives-ability-to-diagnose-acute-third-and-fourth-degree-obstetric-lacerations-in-western-kenya
#13
Leeya F Pinder, Kelsey H Natsuhara, Thomas F Burke, Svjetlana Lozo, Monica Oguttu, Leah Miller, Brett D Nelson, Melody J Eckardt
BACKGROUND: Obstetric fistula devastates the lives of women and is found most commonly among the poor in resource-limited settings. Unrepaired third- and fourth-degree perineal lacerations have been shown to be the source of approximately one-third of the fistula burden in fistula camps in Kenya. In this study, we assessed potential barriers to accurate identification by Kenyan nurse-midwives of these complex perineal lacerations in postpartum women. METHODS: Nurse-midwife trainers from each of the seven sub-counties of Siaya County, Kenya were assessed in their ability to accurately identify obstetric lacerations and anatomical structures of the perineum, using a pictorial assessment tool...
September 18, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28885403/postpartum-management-after-obstetric-anal-sphincter-injuries
#14
Allison Eubanks, Scott M Petersen
A 26-year-old woman, gravida 1 para 1, experiences a severe perineal laceration that extends through the rectal mucosa after a vaginal delivery. She asks you, "What can be done to optimize my recovery?"
October 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28800671/-outcomes-of-planned-out-of-hospital-and-low-risk-hospital-births-in-lower-saxony
#15
Antje Petersen, Lea-Marie Köhler, Christiane Schwarz, Bernhard Vaske, Mechthild M Gross
Introduction Internationally, there is debate on the safety of different birth settings inside and outside of hospitals. Low-risk women in Germany can choose where they give birth, and out-of-hospital births are especially necessary in regions lacking infrastructure. To date, national studies are required. Materials and Methods We investigated planned out-of-hospital (OH) and hospital births in Lower Saxony, Germany, in 2005. Women with a singleton fetus in the vertex position were included once they reached 34+0 gestational weeks...
August 2017: Zeitschrift Für Geburtshilfe und Neonatologie
https://www.readbyqxmd.com/read/28754057/risk-assessments-of-epidural-analgesia-during-labor-and-delivery
#16
Antonio Herrera-Gómez, Elvira De Luna-Bertos, Javier Ramos-Torrecillas, Francisco M Ocaña-Peinado, Concepción Ruiz, Olga García-Martínez
Epidural analgesia (EA) is one of the methods of choice for labor pain relief, but its adverse effects on the mother and child remain controversial. The objective of this study was to determine whether there is an association between the use of EA and different aspects of labor. The author(s) analyzed the effect of EA on different aspects of labor in a retrospective cohort observational study of deliveries in a public Spanish hospital during a 3-year period. Women with EA administration were found to increase the risk of stimulated labor, reduce the percentage of spontaneous deliveries, increase the risk of instrumental labor due to stalled labor or loss of fetal well-being, and increase the percentage of episiotomies...
July 1, 2017: Clinical Nursing Research
https://www.readbyqxmd.com/read/28705534/neuraxial-labor-analgesia-is-not-an-independent-predictor-of-perineal-lacerations-after-vaginal-delivery-of-patients-with-intrauterine-fetal-demise
#17
J H Lee, F M Peralta, A Palatnik, C L Gaupp, R J McCarthy
INTRODUCTION: The role of neuraxial labor analgesia in perineal trauma following live births is controversial, and no studies have assessed the association in women delivering an intrauterine fetal demise. We evaluated the relationship between neuraxial labor analgesia and perineal laceration in these patients. METHODS: This was a retrospective case-control study of women with a diagnosis of fetal death after 20weeks of gestation, a vaginal delivery, and an Apgar score of 0 at delivery, during the period from January 2007 through December 2015...
November 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28670865/robotic-radical-perineal-cystectomy-and-extended-pelvic-lymphadenectomy-initial-investigation-using-a-purpose-built-single-port-robotic-system
#18
Matthew J Maurice, Jihad H Kaouk
OBJECTIVES: To assess the feasibility of radical perineal cystoprostatectomy using the latest generation purpose-built single-port robotic surgical system. MATERIALS AND METHODS: In two male cadavers the da Vinci® SP1098 Surgical System (Intuitive Surgical, Sunnyvale, CA, USA) was used to perform radical perineal cystoprostatectomy and bilateral extended pelvic lymph node dissection (ePLND). New features in this model include enhanced high-definition three-dimensional optics, improved instrument manoeuvrability, and a real-time instrument tracking and guidance system...
December 2017: BJU International
https://www.readbyqxmd.com/read/28665832/fourth-degree-perineal-laceration-in-nonconsenual-fisting-a-case-report-brief-review-of-the-literature-and-medicolegal-issues
#19
REVIEW
Simone Cappelletti, Paola Antonella Fiore, Edoardo Bottoni, Mariarosaria Aromatario
We present the case of an 18-year-old girl who was sexually assaulted with transanal forearm penetration resulting in a fourth-degree perineal laceration. Fisting is an uncommon sexual practice consisting in the penetration of the vagina, anus, or both of them with fingers, hand (fist) or forearm.Perineal lacerations are a relatively common finding in both consensual and nonconsensual fisting victims. Even though cases of fisting with first-, second-, and third-degree lacerations have been reported in literature, only one previous case of fourth-degree perineal laceration has been described in a woman, who died after anal fisting...
September 2017: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/28624920/interobserver-agreement-in-perineal-ultrasound-measurement-of-the-anovaginal-distance-a-methodological-study
#20
Sofia Pihl, Eva Uustal, Linda Hjertberg, Marie Blomberg
INTRODUCTION AND HYPOTHESIS: Objective outcome measures of the extent of laceration at delivery are needed. In this study we evaluated and describe here a method for learning perineal ultrasound measurement of the anovaginal distance (AVD). The learning period needed for examiners proficient in vaginal ultrasound examination and the interobserver agreement after reaching proficiency in AVD measurement were determined. The hypothesis was that the method is feasible to learn and reproducible for use in further research...
June 17, 2017: International Urogynecology Journal
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