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perineal protection birth

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https://www.readbyqxmd.com/read/27274869/obesity-may-be-protective-against-severe-perineal-lacerations
#1
Diana Garretto, Brian B Lin, Helen L Syn, Nancy Judge, Karen Beckerman, Fouad Atallah, Arnold Friedman, Michael Brodman, Peter S Bernstein
Objective. To determine if there is an association between BMI and 3rd- or 4th-degree perineal lacerations in normal spontaneous and operative vaginal deliveries. Study Design. We performed a retrospective case control study using a large obstetric quality improvement database over a six-year period. Cases were identified as singleton gestations with third- and fourth-degree lacerations. Controls were obtained randomly from the database of patients without third- or fourth-degree lacerations in a 1 : 1 ratio...
2016: Journal of Obesity
https://www.readbyqxmd.com/read/27124299/pelvic-organ-support-in-animals-with-partial-loss-of-fibulin-5-in-the-vaginal-wall
#2
Kathleen Chin, Cecilia Wieslander, Haolin Shi, Sunil Balgobin, T Ignacio Montoya, Hiromi Yanagisawa, R Ann Word
Compromise of elastic fiber integrity in connective tissues of the pelvic floor is most likely acquired through aging, childbirth-associated injury, and genetic susceptibility. Mouse models of pelvic organ prolapse demonstrate systemic deficiencies in proteins that affect elastogenesis. Prolapse, however, does not occur until several months after birth and is thereby acquired with age or after parturition. To determine the impact of compromised levels of fibulin-5 (Fbln5) during adulthood on pelvic organ support after parturition and elastase-induced injury, tissue-specific conditional knockout (cKO) mice were generated in which doxycycline (dox) treatment results in deletion of Fbln5 in cells that utilize the smooth muscle α actin promoter-driven reverse tetracycline transactivator and tetracycline responsive element-Cre recombinase (i...
2016: PloS One
https://www.readbyqxmd.com/read/27018243/episiotomy-risk-factors-and-outcomes
#3
Anat Shmueli, Rinat Gabbay Benziv, Liran Hiersch, Eran Ashwal, Rami Aviram, Yariv Yogev, Amir Aviram
OBJECTIVE: To identify risk factors for mediolateral episiotomy, and evaluate the risk of obstetrical anal sphincter injury (OASI) among women with an episiotomy. METHODS: A retrospective cohort study of all singletons vaginal deliveries at term between 2007 and 2014. Spontaneous and operative vaginal deliveries were compared separately, as well as nulliparous and multiparous women. RESULTS: Overall, 41,347 women were included in the spontaneous vaginal delivery group: 12,585 (30...
April 19, 2016: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/26924418/does-the-epi-no-%C3%A2-birth-trainer-prevent-vaginal-birth-related-pelvic-floor-trauma-a-multicentre-prospective-randomised-controlled-trial
#4
RANDOMIZED CONTROLLED TRIAL
I Kamisan Atan, K L Shek, S Langer, R Guzman Rojas, J Caudwell-Hall, J O Daly, H P Dietz
OBJECTIVE: Vaginal childbirth may result in levator ani injury secondary to overdistension during the second stage of labour. Other injuries include perineal and anal sphincter tears. Antepartum use of a birth trainer may prevent such injuries by altering the biomechanical properties of the pelvic floor. This study evaluates the effects of Epi-No(®) use on intrapartum pelvic floor trauma. DESIGN: Multicentre prospective randomised controlled trial. SETTING: Two tertiary obstetric units in Australia...
May 2016: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/26602245/association-between-day-of-delivery-and-obstetric-outcomes-observational-study
#5
William L Palmer, A Bottle, P Aylin
STUDY QUESTION: What is the association between day of delivery and measures of quality and safety of maternity services, particularly comparing weekend with weekday performance? METHODS: This observational study examined outcomes for maternal and neonatal records (1,332,835 deliveries and 1,349,599 births between 1 April 2010 and 31 March 2012) within the nationwide administrative dataset for English National Health Service hospitals by day of the week. Groups were defined by day of admission (for maternal indicators) or delivery (for neonatal indicators) rather than by day of complication...
2015: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/26336757/hands-on-or-hands-poised-what-does-the-evidence-say
#6
Petra Petrocnik, Jayne Marshall
A majority of women will experience some degree of perineal trauma during vaginal birth. The morbidity of women related to perineal trauma can reveal in perineal pain, urinary or faecal incontinence and dyspareunia. Midwives can adopt many techniques to protect the perineum from injury. However, there are still no clear guidelines regarding the hands-on and hands-poised approaches of perineal management during the second stage of labour. The current evidence remains contradictory, so which technique should midwives adopt?...
July 2015: Practising Midwife
https://www.readbyqxmd.com/read/26224381/risk-factors-for-severe-obstetric-perineal-lacerations
#7
Marilene Vale de Castro Monteiro, Gláucia M Varella Pereira, Regina Amélia Pessoa Aguiar, Rodrigo Leite Azevedo, Mário Dias Correia-Junior, Zilma Silveira Nogueira Reis
INTRODUCTION AND HYPOTHESIS: The aim of this study was to assess the occurrence of severe perineal lacerations in vaginal delivery and its relationship with predisposing clinical and obstetric factors. METHODS: A retrospective cohort analysis using an electronic clinical database at a University Referral Center for high-risk pregnancies was performed. A total of 941 vaginal deliveries were analyzed, over 10 consecutive months in 2013 and 2014. The relationship between obstetric and clinical characteristics and lacerations, especially severe forms, was analyzed...
January 2016: International Urogynecology Journal
https://www.readbyqxmd.com/read/26044264/perineal-management-techniques-among-midwives-at-five-hospitals-in-new-south-wales-a-cross-sectional-survey
#8
Amanda J Ampt, Michelle de Vroome, Jane B Ford
BACKGROUND: Midwives are reported to have changed from 'hands on' to 'hands poised or off' approaches to birth at the same time as obstetric anal sphincter injuries (OASIs) are increasing. As perineal management details are not routinely collected, it is difficult to quantify practice. AIMS: To determine which perineal protections techniques midwives prefer for low-risk non-water births; whether preference is associated with technique taught or with other characteristics; and whether midwives change preference according to clinical scenario...
June 2015: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/25976557/manual-perineal-support-at-the-time-of-childbirth-a-systematic-review-and-meta-analysis
#9
REVIEW
S Bulchandani, E Watts, A Sucharitha, D Yates, K M Ismail
BACKGROUND: Genital tract trauma is common with vaginal births and is associated with significant morbidity, particularly with obstetric anal sphincter injuries (OASIS). Debate continues regarding the effectiveness of perineal support during childbirth in reducing the risk of trauma. OBJECTIVES: This review aimed to assess the effect of routine 'hands on'/manual perineal support (MPS) during childbirth, versus ad hoc/no perineal support ('hands off/poised'), on the risk and degree of perineal trauma...
August 2015: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/25748527/complete-female-epispadia-the-case-for-perineal-approach
#10
Antonio Macedo, Marcela Leal da Cruz, Rodrigo Trivelato, Gilmar Garrone, Bruno Leslie, Diego Estevam Oliveira, Geórgia Rubiane Souza, Valdemar Ortiz
INTRODUCTION: Complete female epispadia (CFE) is a rare congenital anomaly occurring in 1 of 500,000 live births. The goals of CFE management include achieving continence, while protecting the kidneys, and creating functional, cosmetic external genitalia. PATIENT AND METHODS: We demonstrate in this video the steps of the surgery and present midterm follow-up of a 6-year-old child with CFE. RESULTS AND DISCUSSION: The patient had an excellent cosmetic result, and reported continence of 3 h period with mild leakage...
February 2015: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/25476878/risk-factors-for-severe-perineal-trauma-during-vaginal-childbirth-a-western-australian-retrospective-cohort-study
#11
Yvonne L Hauck, Lucy Lewis, Elizabeth A Nathan, Christine White, Dorota A Doherty
AIM: To determine rates and risk factors for third and fourth degree perineal tears (severe perineal trauma) in a Western Australian context. DESIGN AND SETTING: A retrospective hospital-based cohort study was performed using computerised data for 10,408 singleton vaginal deliveries from 28 weeks gestation. METHODS: Women with severe perineal trauma were compared to those without. Logistic regression analysis, stratified by parity, was used to assess demographic and obstetric factors associated with perineal trauma...
March 2015: Women and Birth: Journal of the Australian College of Midwives
https://www.readbyqxmd.com/read/25467599/hands-poised-technique-the-future-technique-for-perineal-management-of-second-stage-of-labour-a-modified-systematic-literature-review
#12
REVIEW
Petra Petrocnik, Jayne E Marshall
BACKGROUND: vaginal birth is often accompanied with perineal trauma that affects postpartum morbidity. There are many techniques for protecting the perineum from injury during childbirth. The Hands-On or Hands Poised (HOOP) study (McCandlish et al., 1998) was the first trial that compared different techniques of perineal protection during the second stage of labour with very little research subsequently being undertaken. OBJECTIVES: to systematically review all available literature that compares the hands-on and hands-poised techniques of perineal management during the second stage of labour...
February 2015: Midwifery
https://www.readbyqxmd.com/read/25421298/perineal-support-and-risk-of-obstetric-anal-sphincter-injuries-a-delphi-survey
#13
MULTICENTER STUDY
Khaled M K Ismail, Elena Paschetta, Dimitrios Papoutsis, Robert M Freeman
OBJECTIVE: To explore the views of a multidisciplinary group of experts and achieve consensus on the importance of perineal support in preventing obstetric anal sphincter injuries (OASIS). DESIGN: A three-generational Delphi survey. SETTING: A UK-wide survey of experts. POPULATION: A panel of 20 members consisting of obstetricians, midwives and urogynecologists recommended by UK professional bodies. METHODS: A 58-item web-based questionnaire was sent to all participants who were asked to anonymously rate the importance of each item on a six-point Likert scale...
February 2015: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/25377101/skin-care-product-evaluation-in-a-group-of-critically-ill-premature-neonates-a-descriptive-study
#14
Daniel L Young, Debashish Chakravarthy, Edward Drower, Roxana Reyna
PURPOSE: Cleansing, moisturizing, and protecting neonatal skin is important, but literature evaluating specific product lines is limited. The purpose of this study was to measure the influence of a skin care product line on overall skin condition, perineal erythema, and pain when applied to neonates in a neonatal intensive care unit (NICU). DESIGN: This was an open label, descriptive study. Comparisons were made between measurements taken at the beginning of the study to those at the end, on the same subjects...
November 2014: Journal of Wound, Ostomy, and Continence Nursing
https://www.readbyqxmd.com/read/25218546/identification-of-women-at-high-risk-for-severe-perineal-lacerations
#15
Thomas Schmitz, Corinne Alberti, Béatrice Andriss, Constance Moutafoff, Jean-François Oury, Olivier Sibony
OBJECTIVES: To evaluate the frequency and to identify the risk factors of severe perineal lacerations and the subgroup of women exposed to the highest risk for these complications. STUDY DESIGN: We conducted a case-control study in a large cohort of women for which vaginal delivery management consisted in systematic perineal support and restrictive use of mediolateral episiotomy. The case group comprised women with severe perineal lacerations while the control group comprised women without severe perineal lacerations...
November 2014: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/25126978/a-perineal-protection-device-designed-to-protect-the-perineum-during-labor-a-multicenter-randomized-controlled-trial
#16
RANDOMIZED CONTROLLED TRIAL
Tony Lavesson, Inger D Griph, Anna Skärvad, Ann-Sofi Karlsson, Helen B Nilsson, Margareta Steinvall, Knut Haadem
OBJECTIVE: The objective of this study was to evaluate the protective effects of a new device for reducing perineal tears during vaginal childbirth. STUDY DESIGN: A multicenter open randomized controlled trial (RCT) was performed in Helsingborg, Lund and Malmö, Sweden consisting of 1148 women. Women anticipating a vaginal delivery were either randomized to the intervention group (n=574 in which the perineal protection device was used, or a control group (n=574), in which the perineal protection device was not used...
October 2014: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/23807984/-application-of-gynofit-in-obsetrics
#17
RANDOMIZED CONTROLLED TRIAL
R Velev, M Mircheva
Childbirth can be a fantastic experience for the future mother, but it holds risks for mothers and newborns. Vaginal birth is a result of uterine contractions, minus elastic forces, minus friction force. The objective of this study is to evaluate labor duration, perineal outcomes and safety when applying Gynofit in second stage of labor. Study duration was four months, 120 women were included and randomized in four groups. Two doses of Gynofit were applicated (vaginal and perineal dose) and the duration of second stage of labor was read by electronic chronometer...
2013: Akusherstvo i Ginekologii︠a︡
https://www.readbyqxmd.com/read/23747293/management-of-type-iii-female-genital-mutilation-in-birmingham-uk-a-retrospective-audit
#18
Priya Paliwal, Sarah Ali, Sally Bradshaw, Alison Hughes, Kate Jolly
OBJECTIVES: to audit clinical management of women with type III female genital mutilation (FGM) according to local guidelines. Secondary objectives were to describe the population that uses the service and compare obstetric outcomes of intrapartum deinfibulation and antenatal deinfibulation. DESIGN: retrospective audit. SETTING: a hospital midwifery-led FGM specialist service in Birmingham, UK. PARTICIPANTS: 253 women with type III FGM who gave birth between January 2008 and December 2009 METHODS: retrospective case analysis using patient records...
March 2014: Midwifery
https://www.readbyqxmd.com/read/23570446/can-we-find-the-perfect-oil-to-protect-the-perineum-a-randomized-controlled-double-blind-trial
#19
RANDOMIZED CONTROLLED TRIAL
Avi Harlev, Gali Pariente, Roy Kessous, Barak Aricha-Tamir, Adi Y Weintraub, Tamar Eshkoli, Doron Dukler, Saviona Ben Ayun, Eyal Sheiner
OBJECTIVE: To determine whether perineal massage during the second stage of labor using oil enriched with vitamins, increases the chances of delivering with an intact perineum as compared to perineal massage using pure liquid wax. METHOD: A prospective, randomized, double-blind study was conducted. Women were assigned to liquid wax (jojoba oil) versus purified formula of almond and olive oil, enriched with vitamin B1, B2, B6, E and fatty acids. The caregivers used the oils during the second stage of labor...
September 2013: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/23281859/maternal-position-and-other-variables-effects-on-perineal-outcomes-in-557-births
#20
Inge Meyvis, Bart Van Rompaey, Karine Goormans, Steven Truijen, Sabine Lambers, Eveline Mestdagh, Wilhelm Mistiaen
BACKGROUND: Damage to the perineum is common after vaginal delivery, and it can be caused by laceration, episiotomy, or both. This study investigated the effects of maternal position (lateral vs lithotomy) and other variables on the occurrence of perineal damage. METHODS: A retrospective study included the examination of hospital records from 557 women. The effects of demographic characteristics, gravidity, parity, duration of pregnancy, reason for admission, and mode of labor on perineal outcomes were investigated through univariate (independent sample t test, chi-square test) and multivariate analysis (logistic regression analysis)...
June 2012: Birth
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