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Obstetric anal sphincter injury

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https://www.readbyqxmd.com/read/28727899/sacral-neuromodulation-for-combined-faecal-and-urinary-incontinence-following-obstetric-anal-sphincter-injury
#1
M Rydningen, Stine Riise, T Wilsgaard, R O Lindsetmo, S Norderval
AIM: The aim of this study was to investigate the efficacy of sacral neuromodulation (SNM) in the treatment of faecal incontinence and concomitant urinary incontinence in women with a history of obstetric anal sphincter injury (OASIS). METHOD: In this prospective study, consecutive women with faecal incontinence following OASIS accepted for SNM were screened for concomitant urinary incontinence. The primary outcome was the change in urinary incontinence score (ICIQ-UI-SF) between baseline and 12 months...
July 20, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28727729/induction-of-labor-versus-expectant-management-of-large-for-gestational-age-infants-in-nulliparous-women
#2
Karolina Moldéus, Yvonne W Cheng, Anna-Karin Wikström, Olof Stephansson
BACKGROUND: There is no apparent consensus on obstetric management, i.e., induction of labor or expectant management of women with suspected large-for-gestational-age (LGA)-fetuses. METHODS AND FINDINGS: To further examine the subject, a nationwide population-based cohort study from the Swedish Medical Birth Register in nulliparous non-diabetic women with singleton, vertex LGA (>90th centile) births, 1992-2013, was performed. Delivery of a live-born LGA infant induced at 38 completed weeks of gestation in non-preeclamptic pregnancies, was compared to those of expectant management, with delivery at 39, 40, 41, or 42 completed weeks of gestation and beyond, either by labor induction or via spontaneous labor...
2017: PloS One
https://www.readbyqxmd.com/read/28721483/the-effectiveness-of-mediolateral-episiotomy-in-preventing-obstetric-anal-sphincter-injuries-during-operative-vaginal-delivery-a-ten-year-analysis-of-a-national-registry
#3
Jeroen van Bavel, Chantal W P M Hukkelhoven, Charlotte de Vries, Dimitri N M Papatsonis, Joey de Vogel, Jan-Paul W R Roovers, Ben Willem Mol, Jan Willem de Leeuw
INTRODUCTION AND HYPOTHESIS: Obstetric anal sphincter injuries (OASIS) are associated with an increased risk of faecal incontinence after vaginal delivery. The aim of this retrospective population-based cohort study was to assess whether mediolateral episiotomy is associated with a reduction in the rate of OASIS during operative vaginal delivery. METHODS: We used data from the Dutch Perinatal Registry (Perined) that includes records of almost all births between 2000 and 2010 in The Netherlands...
July 18, 2017: International Urogynecology Journal
https://www.readbyqxmd.com/read/28718603/-long-term-consequences-of-obstetrical-anal-sphincter-injuries-on-sexual-function
#4
Maud De Rham, Sylvain Meyer, Chahin Achtari, Sandra Fornage
Obstetrical anal sphincter injuries (OASIS) can lead to sexual dysfunction. Literature is poor concerning long-term consequences of OASIS on female sexuality. The objective of this paper is to clarify long-term consequences of OASIS on sexual function. Dyspareunia and lubrication troubles are constantly reported based on articles reviewed in literature through Pubmed. Nevertheless, global sexual function seems not to be influenced by OASIS on a long-term basis. Therefore, sexual dysfunctions must be specifically analysed in women's follow-up after OASIS...
March 15, 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28689239/structure-function-relationship-of-the-human-external-anal-sphincter
#5
Amanda M Stewart, Mark S Cook, Keisha Y Dyer, Marianna Alperin
INTRODUCTION AND HYPOTHESIS: Obstetrical external anal sphincter (EAS) injury and subsequent dysfunction are leading risk factors for female fecal incontinence (FI). Limited knowledge of the EAS structure-function relationship hinders treatment optimization. We directly measured functionally relevant intrinsic parameters of human EAS and tested whether vaginal delivery alters the EAS structure-function relationship. METHODS: Major predictors of in vivo EAS function were compared between specimens procured from vaginally nulliparous (VN, n = 5) and vaginally parous (VP, n = 7) cadaveric donors: operational sarcomere length (Ls), which dictates force-length relationship; physiological cross-sectional area (PCSA), which determines isometric force-generating capacity; fiber length (Lfn), responsible for muscle excursion and contractile velocity; and muscle stiffness...
July 8, 2017: International Urogynecology Journal
https://www.readbyqxmd.com/read/28688109/root-causes-and-social-consequences-of-birth-injuries-in-western-uganda
#6
Jennifer N Angell, Priscilla Busingye, Gabriel Y-K Ganyaglo, Cheryl A Moyer
Incontinence-inducing delivery injuries, such as obstetric fistula and anal-sphincter tears, are devastating sequelae of prolonged and obstructed labor, and can only be repaired through surgery. Such injuries are most prevalent in settings where delays and limitations in accessing emergency obstetric services are common [1, 2]. The 2011 Demographic and Health Survey of Uganda [3] estimated that 2% of Ugandan women have experienced obstetric fistula and resulting trans-vaginal urine or fecal incontinence. This article is protected by copyright...
July 8, 2017: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/28685224/a-retrospective-review-of-1495-patients-with-obstetric-anal-sphincter-injuries-referred-for-assessment-of-function-and-endoanal-ultrasonography
#7
G P Thomas, L E Gould, F Casunuran, D A Kumar
AIM: Obstetric anal sphincter injuries are a significant risk factor for faecal incontinence. Correct identification and successful primary repair are important. The aim of this study was to review the outcome of all patients, with an obstetric anal sphincter injury, referred to our unit. METHOD: This is a retrospective review of 1495 patients over a 12-year period. All had a third or fourth degree tear and were referred at 4-months postpartum. RESULTS: Endoanal ultrasonography demonstrated residual sphincter defect in 792 (53%) and normal sphincters, with no evidence of repair, in 661 (44%)...
July 7, 2017: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/28681174/risk-factors-for-obstetric-anal-sphincter-injuries-oasi-at-a-tertiary-centre-in-south-india
#8
Sirisha Rao Gundabattula, Kameswari Surampudi
INTRODUCTION AND HYPOTHESIS: Despite several studies that have reported risk factors for obstetric anal sphincter injuries (OASI), data from the Indian subcontinent are scarce. The purpose of this study was to identify risk factors for these sphincter injuries in an Indian population. METHODS: This was a case-control study within a retrospective cohort of vaginal deliveries at a tertiary care facility. All vaginal births beyond 24 completed weeks of gestation and birth weight ≥500 g from January 2008 to December 2012 were identified from the hospital electronic database...
July 5, 2017: International Urogynecology Journal
https://www.readbyqxmd.com/read/28626856/delivery-parameters-neonatal-parameters-and-incidence-of-urinary-incontinence-six-months-postpartum-a-cohort-study
#9
Stian Langeland Wesnes, Yngvild Hannestad, Guri Rortveit
INTRODUCTION: Contradictory results have been reported regarding most delivery parameters as risk factors for urinary incontinence. We investigated the association between the incidence of urinary incontinence six months postpartum and single obstetric risk factors as well as combinations of risk factors. MATERIAL AND METHODS: This study was based on the Norwegian Mother and Child Cohort Study, conducted by the Norwegian Institute of Public Health during 1998-2008...
June 19, 2017: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/28544989/impact-of-mediolateral-episiotomy-on-incidence-of-obstetrical-anal-sphincter-injury-diagnosed-by-endoanal-ultrasound
#10
Kristina Drusany Staric, Adolf Lukanovic, Petra Petrocnik, Vita Zacesta, Corrado Cescon, Miha Lucovnik
OBJECTIVE: to examine potential association between mediolateral episiotomy and reduced incidence of obstetrical anal sphincter injuries (OASIS) diagnosed by endoanal ultrasound. DESIGN: prospective cohort study. SETTING: tertiary referral university hospital. PARTICIPANTS: sixty nulliparous women at 28-33 weeks of gestation with singleton pregnancies were included between 2010 and 2012. MEASUREMENTS AND FINDINGS: participants were examined with endoanal ultrasound at 28-33 weeks gestation and at 6-7 weeks post-partum...
May 18, 2017: Midwifery
https://www.readbyqxmd.com/read/28523401/functional-and-quality-of-life-outcomes-following-obstetric-anal-sphincter-injury-oasi-does-the-grade-of-injury-affect-outcomes
#11
Lisa Ramage, Clarence Yen, Shengyang Qiu, Constantinos Simillis, Christos Kontovounisios, Paris Tekkis, Emile Tan
INTRODUCTION AND HYPOTHESIS: The aim of this study was to compare functional and quality of life data in patients with increasing grades of obstetric anal sphincter injury (OASI) presenting to a tertiary colorectal pelvic floor clinic within 24 months of delivery. METHODS: Prospective data were collected from the patients for the period 2009-2016 and included data on functional outcomes and motor anorectal manometry parameters. The instruments used for the evaluation of functional outcomes were the Birmingham Bowel and Urinary Symptoms Questionnaire, the Wexner Incontinence Score, Short Form 36, and the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire...
May 18, 2017: International Urogynecology Journal
https://www.readbyqxmd.com/read/28523399/anal-sphincter-injury-in-vaginal-deliveries-complicated-by-shoulder-dystocia
#12
Mark P Hehir, Zachary Rubeo, Karen Flood, Anne H Mardy, Colm O'Herlihy, Peter C Boylan, Mary E D'Alton
INTRODUCTION AND HYPOTHESIS: Shoulder dystocia is an obstetric emergency that occurs in 0.2-3% of all cephalic vaginal deliveries. We hypothesized that because of the difficult nature of deliveries complicated by shoulder dystocia, the condition may be associated with anal sphincter injury. We sought to identify risk factors for obstetric anal sphincter injury in women with shoulder dystocia. METHODS: This retrospective analysis included all cases of shoulder dystocia from 2007 to 2011 at two large tertiary referral centers, in the USA and Ireland...
May 18, 2017: International Urogynecology Journal
https://www.readbyqxmd.com/read/28489924/neonatal-and-maternal-outcomes-of-successful-manual-rotation-to-correct-malposition-of-the-fetal-head-a-retrospective-and-prospective-observational-study
#13
Nicola Tempest, Naomi McGuinness, Steven Lane, Dharani K Hapangama
OBJECTIVE: To evaluate the neonatal and maternal outcomes associated with successful operative vaginal births assisted by manual rotation. DESIGN: Prospective and retrospective observational study. SETTING: Delivery suite in a tertiary referral teaching hospital in England. POPULATION: A cohort of 2,426 consecutive operative births, in the second stage of labour, complicated with malposition of the fetal head during 2006-2013...
2017: PloS One
https://www.readbyqxmd.com/read/28477150/the-optimal-angle-of-the-mediolateral-episiotomy-at-crowning-of-the-head-during-labor
#14
Shimon Ginath, Osnat Elyashiv, Eran Weiner, Ron Sagiv, Jacob Bar, Joseph Menczer, Michal Kovo, Alexander Condrea
INTRODUCTION AND HYPOTHESIS: The aim of the mediolateral episiotomy incision is to increase the diameter of the soft tissue of the vaginal outlet to facilitate birth and to prevent vaginal tears. Episiotomy angles that are too narrow and close to the midline increase the risk of obstetric anal sphincter injuries. In order to determine the optimal angle of the episiotomy, we assessed the changes in the angles of episiotomy lines marked during the first stage of labor and measured at the time of crowning of the head...
May 5, 2017: International Urogynecology Journal
https://www.readbyqxmd.com/read/28467760/obstetric-anal-sphincter-injuries-oasis-in-israel-a-review-of-the-incidence-and-risk-factors
#15
REVIEW
Shimon Ginath, Yossi Mizrachi, Jacob Bar, Alexander Condrea, Michal Kovo
Obstetric anal sphincter injuries (OASIs) following vaginal deliveries are the main reason for subsequent development of anal incontinence in women. The diagnosis of such tears is crucial for treating and preventing such a grave sequela. The reported rate of OASIs in Israel was between 0.1% and 0.6%, out of all vaginal births, which is 10-fold lower than that reported in Europe and the United States. Structured hands-on training in repair of OASIs in seven medical centers in Israel significantly increased the detection rate of third-degree perineal tears...
April 28, 2017: Rambam Maimonides Medical Journal
https://www.readbyqxmd.com/read/28445798/episiotomy-what-angle-do-you-cut-to-the-midline
#16
Kenneth Ma, Louise Byrd
OBJECTIVE: Although episiotomies are the commonest obstetric procedure performed the technique of performing one varies amongst obstetricians and midwives. The angle of episiotomy to the midline in particular has been shown to influence the risk of developing obstetric anal sphincter injuries (OASIS). In order to identify the differences in technique and to identify targets for training we undertook a practice survey of episiotomies to analyse the differences in technique between grades of obstetricians and midwives...
June 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28430725/awareness-regarding-perineal-protection-obstetric-anal-sphincter-injury-and-episiotomy-among-obstetrics-and-gynecology-residents-effects-of-an-educational-workshop
#17
Anna M Stecher, Jennifer Yeung, Catrina C Crisp, Rachel N Pauls
OBJECTIVES: Appropriate perineal protection may reduce rates of obstetric anal sphincter injuries (OASIS). We sought to investigate the knowledge and attitudes of obstetrics and gynecology residents concerning perineal protection, OASIS, and episiotomy before and after an educational workshop. METHODS: This was an institutional review board-approved cross-sectional survey study of obstetrics and gynecology residents. Two experts in perineal protection, whose methods have been shown to reduce OASIS by 50%, provided 1 week of education...
April 20, 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/28409235/anal-incontinence-after-two-vaginal-deliveries-without-obstetric-anal-sphincter-rupture
#18
Lisa K G Persson, Abelone Sakse, Jens Langhoff-Roos, Hanna Jangö
PURPOSE: To evaluate prevalence and risk factors for long-term anal incontinence in women with two prior vaginal deliveries without obstetric anal sphincter injury (OASIS) and to assess the impact of anal incontinence-related symptoms on quality of life. METHODS: This is a nation-wide cross-sectional survey study. One thousand women who had a first vaginal delivery and a subsequent delivery, both without OASIS, between 1997 and 2008 in Denmark were identified in the Danish Medical Birth Registry...
June 2017: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/28389490/diagnosis-and-repair-of-perineal-injuries-knowledge-before-and-after-expert-training-a-multicentre-observational-study-among-palestinian-physicians-and-midwives
#19
Kaled Zimmo, Katariina Laine, Åse Vikanes, Erik Fosse, Mohammed Zimmo, Hadil Ali, Ranee Thakar, Abdul H Sultan, Sahar Hassan
OBJECTIVE: To assess whether a 2 days training with experts teaching on diagnosis and repair of perineal injuries among Palestinian midwives and physicians could change their level of knowledge towards the correct diagnosis and treatment. STUDY DESIGN: Multicentre observational study. SETTING: Obstetric departments in 6 government Palestinian hospitals. PARTICIPANTS: All physicians and midwives who attended the training...
April 7, 2017: BMJ Open
https://www.readbyqxmd.com/read/28363187/the-impact-of-anal-sphincter-injury-on-perceived-body-image
#20
David Iles, Rabia Khan, Kristina Naidoo, Rohna Kearney, Jenny Myers, Fiona Reid
OBJECTIVE: Obstetric anal sphincter injury is common but the effect on body image is unreported. The aim of this study was to explore patient perceived changes in body image and other psychological aspects in women attending a perineal follow-up clinic. STUDY DESIGN: This retrospective study analysed women's responses to a self-reported questionnaire. Consecutive women with anal sphincter injury who attended a United Kingdom Maternity Hospital perineal follow-up clinic between January 1999 and January 2012 were identified and the records obtained and reviewed...
May 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
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