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Obstetric anal sphincter injury

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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
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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...
April 11, 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
#7
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
#8
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...
April 13, 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
#9
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
#10
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
https://www.readbyqxmd.com/read/28342158/the-incidence-of-and-risk-factors-for-a-repeat-obstetric-anal-sphincter-injury-oasis-in-the-vaginal-birth-subsequent-to-a-first-episode-of-oasis-a-hospital-based-cohort-study
#11
Angeliki Antonakou, Dimitrios Papoutsis, Karen Henderson, Zahid Qadri, Andrew Tapp
PURPOSE: To identify the incidence of and risk factors for a repeat obstetric anal sphincter injury (OASIS) in women who sustained an OASIS in their first vaginal delivery and have a subsequent vaginal birth. METHODS: Data were collected retrospectively for women having had singleton cephalic presentation vaginal deliveries between 2007 and 2015. Women with breech deliveries, stillbirths, foetal congenital abnormalities and multiple pregnancies were excluded. RESULTS: Over the study period, we identified 11,191 women who had a first vaginal birth, of which 603 (5...
March 24, 2017: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/28331968/choice-of-mode-of-delivery-in-a-subsequent-pregnancy-after-oasi-a-survey-among-dutch-gynecologists
#12
Judith J A E Donners, Kirsten B Kluivers, Jan W de Leeuw, Jeroen van Dillen, Sander M J van Kuijk, Mirjam Weemhoff
INTRODUCTION AND HYPOTHESIS: National and international guidelines do not provide clear recommendations on the mode of delivery in a subsequent pregnancy after obstetric anal sphincter injury (OASI). The aim of this study was to investigate the opinion of gynecologists in The Netherlands on this choice and the extent to which this choice is affected by the gynecologist's characteristics. METHODS: Of 973 gynecologists sent a questionnaire seeking their opinion on the mode of delivery in 16 different case descriptions, 234 (24%) responded...
March 22, 2017: International Urogynecology Journal
https://www.readbyqxmd.com/read/28321472/feasibility-and-benefits-of-the-ewe-as-a-model-for-vaginal-surgery-training
#13
Yohan Kerbage, Géraldine Giraudet, Chrystèle Rubod, Charles Garabedian, Géraldine Rivaux, Michel Cosson
INTRODUCTION AND HYPOTHESIS: The objective was to evaluate the ewe as an animal model for teaching and training in vaginal surgery. METHODS: Twenty-nine postgraduate surgeons attended a training course on vaginal prolapse surgery. After a review of human and sheep anatomy, the participants performed transvaginal meshes, vaginal hysterectomy, SSLF (Richter), and OAS repair in ewes and human cadavers. Participants completed questionnaires on the whole course. RESULTS: Questionnaires showed the significant superiority of ewes over human cadavers for all items evaluated regarding surgical dissections...
March 20, 2017: International Urogynecology Journal
https://www.readbyqxmd.com/read/28211186/sacral-neuromodulation-compared-with-injection-of-bulking-agents-for-faecal-incontinence-following-obstetric-anal-sphincter-injury-a-randomized-controlled-trial
#14
M Rydningen, T Dehli, T Wilsgaard, A Rydning, M Kumle, R O Lindsetmo, S Norderval
AIM: The purpose of this trial was to compare the effectiveness of sacral neuromodulation (SNM) with a submucosal injection of collagen (Permacol®) in women with faecal incontinence following obstetric anal sphincter injury (OASIS). METHOD: This single-blinded randomized controlled trial at two hospital units in Norway included women with faecal incontinence following OASIS. Eligible women who had had a successful percutaneous nerve evaluation were randomly assigned to SNM or Permacol®...
May 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28202245/recurrent-obstetric-anal-sphincter-injury-and-the-risk-of-long-term-anal-incontinence
#15
Hanna Jangö, Jens Langhoff-Roos, Susanne Rosthøj, Abelone Sakse
BACKGROUND: Women with an obstetric anal sphincter injury are concerned about the risk of recurrent obstetric anal sphincter injury in their second pregnancy. Existing studies have failed to clarify whether the recurrence of obstetric anal sphincter injury affects the risk of anal and fecal incontinence at long-term follow-up. OBJECTIVE: The objective of the study was to evaluate whether recurrent obstetric anal sphincter injury influenced the risk of anal and fecal incontinence more than 5 years after the second vaginal delivery...
February 13, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28117880/intrapartum-predictors-of-maternal-levator-ani-injury
#16
MULTICENTER STUDY
Jessica Caudwell-Hall, Ixora Kamisan Atan, Andrew Martin, Rodrigo Guzman Rojas, Susanne Langer, Kalai Shek, Hans P Dietz
INTRODUCTION: Damage to the pelvic floor during vaginal childbirth is common, and may take the form of levator avulsion or irreversible overdistension of the levator hiatus (microtrauma). Such trauma is a major risk factor for pelvic organ prolapse later in life. In this study we aimed to identify intrapartum risk factors for levator trauma. MATERIAL AND METHODS: This is a retrospective analysis of data obtained in two perinatal studies on primiparous women. Between 2005 and 2014, 1148 women carrying an uncomplicated singleton pregnancy in the late third trimester were seen for 4D pelvic floor ultrasound and an interview...
April 2017: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/28061422/can-we-predict-obstetric-anal-sphincter-injury
#17
Kristina Drusany Starič, Petra Bukovec, Katja Jakopič, Eftim Zdravevski, Vladimir Trajkovik, Adolf Lukanović
OBJECTIVE: The aim of the study was to identify primiparous pregnant women with a higher risk for obstetric anal sphincter injuries (OASIS) based on obstetric characteristics (risk factors). STUDY DESIGN: In the retrospective case control study primiparous women were examined using endoanal ultrasonography (EUS) for OASIS identification 6-12 weeks after delivery. Obstetric characteristics for OASIS were collected from the mothers' medical records. The univariate analysis of maternal (age at delivery, maternal height, weight, BMI), infant (length, weight and head circumference) and birth (pregnancy duration, labour and delivery duration, episiotomy, vacuum extraction and oxytocin augmentation) risk factors, Pearson correlations and information gain were carried out...
March 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28025682/impact-of-subsequent-birth-and-delivery-mode-for-women-with-previous-oasis-systematic-review-and-meta-analysis
#18
REVIEW
Sara S Webb, Derick Yates, Margarita Manresa, Matthew Parsons, Christine MacArthur, Khaled M K Ismail
INTRODUCTION AND HYPOTHESIS: Obstetric anal sphincter injuries (OASIS) are serious complications of vaginal birth. In a pregnancy following OASIS women may be keen to avoid an elective caesarean section, yet cautious about pursuing another vaginal birth that may result in further damage to the pelvic floor and possible long-term anal incontinence. This review aimed to evaluate the impact of subsequent birth and its mode on anal incontinence (AI) and/or quality of life (QoL), for women with previous OASIS...
April 2017: International Urogynecology Journal
https://www.readbyqxmd.com/read/27992292/obstetric-outcomes-in-adolescents-related-to-body-mass-index-and-compared-with-low-risk-adult-women
#19
Anna Ramö Isgren, Preben Kjølhede, Marie Blomberg
OBJECTIVE: To evaluate in adolescents the association between body mass index (BMI) and obstetric outcomes and to determine whether the outcomes in the BMI groups of adolescents differ from those of a low-risk population of adult women. MATERIALS AND METHODS: This is a nationwide population-based register study. Obstetric outcomes of 31,386 singleton primiparous adolescents were evaluated in relation to BMI classes. Furthermore, the outcomes of the adolescents and 178,844 normal weight, nonsmoking, singleton primiparous women, 25-29 years old with no known comorbidity, defined as standard women, were compared...
December 19, 2016: Journal of Women's Health
https://www.readbyqxmd.com/read/27986182/episiotomy-technique-and-management-of-anal-sphincter-tears-a-survey-of-clinical-practice-and-education
#20
Rebecca Menzies, Marian Leung, Nirmala Chandrasekaran, Andrea Lausman, Michael Geary
OBJECTIVE: To ascertain current techniques of episiotomy used by obstetrics and gynaecology faculty members and residents in an academic department and to determine the current management strategies for third and fourth degree tears. METHOD: A 14-question anonymous online survey was circulated to all faculty members and residents in the University of Toronto Department of Obstetrics and Gynaecology between October 2015 and March 2016. Results were analyzed descriptively or with Fisher exact test...
December 2016: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
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