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perineal protection birth

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https://www.readbyqxmd.com/read/29648935/episiotomy-and-perineal-tear-risk-factors-in-a-group-of-4493-women
#1
Grażyna Gebuza, Marzena Kaźmierczak, Alicja Gdaniec, Estera Mieczkowska, Małgorzata Gierszewska, Agnieszka Dombrowska-Pali, Mariola Banaszkiewicz, Marek Maleńczyk
Episiotomy belongs to the most frequent procedures carried out during delivery. Performing episiotomy should be reduced as there is scientific evidence indicating that it can cause pain, sexual problems, and serious, long-term health consequences. The aim of the researchers is to identify factors associated with episiotomy and the perineal tear. Analyses were performed using a model of a logistic regression. The study involved 4493 women. The episiotomy risk was related to: a birth weight exceeding 3500 grams, an instrumental delivery by means of forceps or vacuum extraction...
April 12, 2018: Health Care for Women International
https://www.readbyqxmd.com/read/29575180/sonographic-assessment-of-the-anal-sphincter-after-obstetric-anal-sphincter-injury-oasi-using-transperineal-ultrasound-tpus
#2
EDITORIAL
Vered H Eisenberg, Dan V Valsky, Simcha Yagel
Obstetric anal sphincter injury (OASI) is the most common cause of anal incontinence and ano-rectal symptoms in women1 . Reported rates of anal incontinence following primary repair of OASI range between 15-61%, with a mean of 39%2, 3 . Other possible complications of OASI include perineal pain, dyspareunia, and less commonly, abscess formation, wound breakdown, and rectovaginal fistulae. Symptom onset may occur immediately, several years postpartum, or only late in life when aging of tissues adds to the delivery insult...
March 24, 2018: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/29571123/implementation-of-the-rcog-guidelines-for-prevention-of-obstetric-anal-sphincter-injuries-oasis-at-two-london-hospitals-a-time-series-analysis
#3
Henna Mohiudin, Sajjad Ali, Pradyna N Pisal, Rose Villar
OBJECTIVE: To audit the impact of implementation of the RCOG guidelines for prevention of Obstetric anal sphincter injuries (OASIS) by introducing antenatal perineal massage, manual perineal protection, and cutting episiotomies at 60° to the midline at the time of crowning. DESIGN: Time series analysis; Setting - Two London teaching hospitals; Royal Free London (RFL) and Barnet; Population or Sample - All nulliparous women undergoing vaginal birth; Methods - Training was provided for above techniques...
March 15, 2018: European Journal of Obstetrics, Gynecology, and Reproductive Biology
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...
April 2018: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/29288489/waterbirth-in-sweden-a-comparative-study
#5
Hanna Ulfsdottir, Sissel Saltvedt, Susanne Georgsson
INTRODUCTION: The literature describes advantages for mothers giving birth in water, but waterbirth is controversial in Sweden and has not been offered at hospitals until recently. This study aimed to describe and compare the characteristics and outcome of waterbirths with those of spontaneous vaginal births at the same clinics. MATERIAL AND METHODS: A retrospective cohort study was conducted on all waterbirths at two maternity units in Sweden from March 2014 to November 2015 (n = 306), and a consecutively selected comparison group of 306 women having conventional spontaneous vaginal births...
March 2018: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/29178349/effect-of-body-mass-index-on-the-incidence-of-perineal-trauma
#6
Constantin M Durnea, Ali E Jaffery, Nivedita Gauthaman, Stergios K Doumouchtsis
OBJECTIVE: To investigate the association between perineal trauma at childbirth and maternal body mass index (BMI), and estimate the risk of perineal trauma among different BMI groups. METHODS: Data were retrospectively assessed from all vaginal deliveries in a UK tertiary maternity unit between 1999 and 2014. Associations between BMI at booking and first- and second-degree tears (minor perineal trauma), third- and fourth-degree tears (obstetric anal sphincter injuries [OASIS]), and frequency of instrumental deliveries were assessed...
November 27, 2017: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/28889406/intrapartum-transperineal-ultrasound-used-to-predict-cases-of-complicated-operative-vacuum-and-forceps-deliveries-in-nulliparous-women
#7
José A Sainz, José A García-Mejido, Adriana Aquise, María J Bonomi, Carlota Borrero, Paloma De La Fuente, Ana Fernández-Palacín
INTRODUCTION: The objective of this study was to investigate the predictive value of intrapartum transperineal ultrasound in the identification of complicated operative (vacuum or forceps) deliveries in nulliparous women. MATERIAL AND METHODS: Prospective observational study of nulliparous women with an indication for operative delivery who underwent intrapartum transperineal ultrasound before fetal extraction. Managing obstetricians were blinded to the ultrasound data...
December 2017: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/28608597/perineal-techniques-during-the-second-stage-of-labour-for-reducing-perineal-trauma
#8
REVIEW
Vigdis Aasheim, Anne Britt Vika Nilsen, Liv Merete Reinar, Mirjam Lukasse
BACKGROUND: Most vaginal births are associated with trauma to the genital tract. The morbidity associated with perineal trauma can be significant, especially when it comes to third- and fourth-degree tears. Different interventions including perineal massage, warm or cold compresses, and perineal management techniques have been used to prevent trauma. This is an update of a Cochrane review that was first published in 2011. OBJECTIVES: To assess the effect of perineal techniques during the second stage of labour on the incidence and morbidity associated with perineal trauma...
June 13, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28551104/-what-measures-of-perineal-protection-at-birth-are-consensual-in-france-results-of-a-delphi-survey
#9
R de Tayrac, L Carligny, R Zimmerman, S Huberlant, V Letouzey
OBJECTIVE: To evaluate expert's opinion in order to obtain a consensus on the different measures of perineal protection at the time of vaginal delivery. METHODS: A survey using the Delphi method was carried out with a panel of French obstetricians, urogynecologists and midwives. The questionnaire included 22 questions grouped into four groups: expulsive efforts, indications of episiotomy, episiotomy repair and other forms of perineal protection. The experts had to answer on a 9-point scale, both on the validity and the clarity of each proposal...
May 24, 2017: Progrès en Urologie
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
RANDOMIZED CONTROLLED TRIAL
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/27274869/obesity-may-be-protective-against-severe-perineal-lacerations
#11
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
#12
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
#13
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...
February 2017: 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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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