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Perineal laceration

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https://www.readbyqxmd.com/read/28624920/interobserver-agreement-in-perineal-ultrasound-measurement-of-the-anovaginal-distance-a-methodological-study
#1
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
https://www.readbyqxmd.com/read/28594760/an-initiative-to-reduce-the-episiotomy-rate-association-of-feedback-and-the-hawthorne-effect-with-leapfrog-goals
#2
Kathy Zhang-Rutledge, Steven L Clark, Stacie Denning, Audra Timmins, Gary A Dildy, Manisha Gandhi
OBJECTIVE: To assess the association of education, performance feedback, and the Hawthorne effect with a reduction in the episiotomy rate in a large academic institution. METHODS: We describe a prospective observational study of a project conducted between March 2012 and February 2017 to assist clinicians in meeting the Leapfrog Group (www.leapfroggroup.org) target rates for episiotomy. Phases of this project included preintervention (phase 1, March 2012 to April 2014), education and provision of collective department episiotomy rates (phase 2, May 2014 to December 2014), ongoing education with emphasis on a revised Leapfrog target rate (phase 3, January 2015 to February 2016), and provision of individual episiotomy rates to practitioners on a monthly basis (phase 4, March 2016 to February 2017)...
June 6, 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28422365/successful-vaginal-delivery-at-term-after-vaginal-reconstruction-with-labium-minus-flaps-in-a-patient-with-vaginal-atresia-a-rare-case-report
#3
Yu Liu, Yi-Feng Wang
We report a case of successful vaginal delivery after vaginal reconstruction with labium minus flaps in a 23-year-old patient with congenital vaginal atresia. The patient primarily presented with amenorrhea and cyclic abdominal pain; transabdominal ultrasonography revealed an enlarged uterus due to hematometra and absence of the lower segment of the vagina. Eight years ago, she had undergone an unsuccessful attempt at canalization at a local hospital. Upon referral to our hospital, she underwent vaginal reconstruction with labium minus flaps...
April 19, 2017: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/28405063/perineal-body-length-and-perineal-lacerations-during-delivery-in-primigravid-patients
#4
T Lance Lane, Christopher P Chung, Paul M Yandell, Thomas J Kuehl, Wilma I Larsen
This study assessed the relation between perineal body length and the risk of perineal laceration extending into the anal sphincter during vaginal delivery in primigravid patients at an institution with a low utilization of episiotomy. This was a prospective study of primigravid patients in active labor. Primigravid women with singleton pregnancies who were in the first stage of labor at 37 weeks gestation or greater were recruited, and the admitting physician measured the length of the perineal body. The degree of perineal laceration and other delivery characteristics were recorded...
April 2017: Proceedings of the Baylor University Medical Center
https://www.readbyqxmd.com/read/28403314/implementation-of-care-practices-to-prevent-and-repair-perineal-trauma-in-childbirth
#5
Rafael Cleison Silva Dos Santos, Maria Luiza Gonzalez Riesco
Objective: To implement care practices for perineal trauma prevention and repairing in normal birth. Method: Quasi-experimental study conducted at Hospital da Mulher Mãe-Luzia, in Macapá, AP, Brazil. Seventy-four (74) nurses and obstetricians and 70 post-partum women were interviewed and the records of 555 patients were analyzed. The study was conducted in three stages: pre-audit and baseline audit (phase 1); educational intervention and implementation of best practices (phase 2); post-implementation audit (phase 3)...
April 6, 2017: Revista Gaúcha de Enfermagem
https://www.readbyqxmd.com/read/28371359/maternal-and-neonatal-outcomes-in-birth-centers-versus-hospitals-among-women-with-low-risk-pregnancies-in-japan-a-retrospective-cohort-study
#6
Yaeko Kataoka, Yuko Masuzawa, Chiho Kato, Hiromi Eto
AIM: In order for low-risk pregnant women to base birth decisions on the risks and benefits, they need evidence of birth outcomes from birth centers. The purpose of this study was to describe and compare the maternal and neonatal outcomes of low-risk women who gave birth in birth centers and hospitals in Japan. METHODS: The participants were 9588 women who had a singleton vaginal birth at 19 birth centers and two hospitals in Tokyo. The data were collected from their medical records, including their age, parity, mode of delivery, maternal position at delivery, duration of labor, intrapartum blood loss, perineal trauma, gestational weeks at birth, birth weight, Apgar score, and stillbirths...
March 29, 2017: Japan Journal of Nursing Science: JJNS
https://www.readbyqxmd.com/read/28349526/pushing-bearing-down-methods-for-the-second-stage-of-labour
#7
REVIEW
Andrea Lemos, Melania Mr Amorim, Armele Dornelas de Andrade, Ariani I de Souza, José Eulálio Cabral Filho, Jailson B Correia
BACKGROUND: Maternal pushing during the second stage of labour is an important and indispensable contributor to the involuntary expulsive force developed by uterine contraction. There is no consensus on an ideal strategy to facilitate these expulsive efforts and there are contradictory results about the influence on the mother and fetus. OBJECTIVES: To evaluate the benefits and possible disadvantages of different kinds of techniques regarding maternal pushing/breathing during the expulsive stage of labour on maternal and fetal outcomes...
March 26, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28282772/does-meperidine-analgesia-affect-the-incidence-of-obstetric-lacerations-at-vaginal-delivery
#8
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
#9
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
#10
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
#11
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
#12
REVIEW
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
#13
COMPARATIVE STUDY
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
#14
COMPARATIVE STUDY
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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