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Obstetric anal sphincter injury

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https://www.readbyqxmd.com/read/28331968/choice-of-mode-of-delivery-in-a-subsequent-pregnancy-after-oasi-a-survey-among-dutch-gynecologists
#1
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
#2
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-randomised-controlled-trial
#3
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 sub-mucosal 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(®) ...
February 17, 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
#4
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
#5
Jessica Caudwell-Hall, Ixora Kamisan Atan, Andrew Martin, Rodrigo Guzman Rojas, Susanne Langer, Kalai Shek, Hans Peter Dietz
INTRODUCTION: Damage to the pelvic floor during vaginal childbirth is common, and may take the form of levator avulsion or irreversible over-distention 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 patients carrying an uncomplicated singleton pregnancy in the late third trimester were seen for 4D pelvic floor ultrasound and an interview...
January 24, 2017: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/28061422/can-we-predict-obstetric-anal-sphincter-injury
#6
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...
December 23, 2016: 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
#7
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...
December 26, 2016: 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
#8
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
#9
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
https://www.readbyqxmd.com/read/27918340/obstetrical-anal-sphincter-injuries-does-obstetrical-care-provider-matter-a-quality-assurance-study-in-ontario
#10
Katerina Pizzuto, Jessica Pudwell, Graeme N Smith, Marie-Andrée Harvey
OBJECTIVES: We sought to determine the rates of obstetrical anal sphincter tears (OASIS) between types of obstetrical care providers at Kingston General Hospital (KGH) and in Ontario via the Better Outcomes Registry Network (BORN). METHODS: This cross-sectional study collected patient, demographic, and delivery data from all vaginal deliveries at KGH from June 2011 to June 2014 and all vaginal deliveries through the BORN database from June 2012 to June 2014. RESULTS: During this period, 4...
December 1, 2016: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/27865945/episiotomy-in-vacuum-assisted-delivery-affects-the-risk-of-obstetric-anal-sphincter-injury-a-systematic-review-and-meta-analysis
#11
REVIEW
Ninna S Lund, Lisa K G Persson, Hanna Jangö, Ditte Gommesen, Hanne B Westergaard
The risk of obstetric anal sphincter injury (OASIS) is increased in vacuum-assisted delivery. However, it remains unclear whether episiotomy may protect against OASIS in this type of delivery. The objective of this study was to assess whether mediolateral or lateral episiotomy affects the risk of OASIS in vacuum-assisted delivery among primiparous women. Data were found searching The PubMed, Cochrane library and Embase databases electronically. Studies investigating the risk of OASIS in vacuum-assisted delivery with and without the use of mediolateral or lateral episiotomy were considered for inclusion...
December 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/27783118/evaluation-of-training-programme-uptake-in-an-attempt-to-reduce-obstetric-anal-sphincter-injuries-the-support-programme
#12
Nadia Rahman, Latha Vinayakarao, Sangeeta Pathak, Dawn Minden, Louise Melson, Ella Vitue, A Pradhan
INTRODUCTION AND HYPOTHESIS: The objective was to assess the feedback from a quality improvement training programme to reduce obstetric anal sphincter injuries (OASIS). METHODS: Training sessions were organised that included evidence-based information on OASIS risk factors and training on models to measure perineal body length (PBL), perform episiotomies with standard and 60° fixed angle scissors (EPISCISSORS-60®), and measure post-delivery episiotomy suture angles with protractor transparencies...
October 25, 2016: International Urogynecology Journal
https://www.readbyqxmd.com/read/27761586/reducing-obstetric-anal-sphincter-injuries-using-perineal-support-our-preliminary-experience
#13
Madhu Naidu, Abdul H Sultan, Ranee Thakar
INTRODUCTION AND HYPOTHESIS: Obstetric anal sphincter injuries (OASIs) are associated with significant short-term and long-term morbidity. Over the past decade, there has been a steady rise in the rate of OASIs. There is therefore a compelling need to identify strategies to minimize OASIs. The objective of this study was to determine if perineal support at the time of vaginal delivery can reduce the incidence and severity of OASIs. METHODS: All labour ward staff including midwives and doctors were invited to train in the technique of perineal support during vaginal delivery...
March 2017: International Urogynecology Journal
https://www.readbyqxmd.com/read/27682743/can-anal-sphincter-defects-be-identified-by-palpation
#14
Ka Lai Shek, Ixora Kamisan Atan, Hans Peter Dietz
OBJECTIVES: The aim of this study was to correlate clinical findings of anal sphincter defects and function with a sonographic diagnosis of significant sphincter defects. METHODS: This is an observational cross-sectional study on women seen 6 to 10 weeks after primary repair of obstetric anal sphincter injuries (OASIs). All patients underwent a standardized interview including the St Mark incontinence score, a digital rectal examination, and 3-/4-dimensional transperineal ultrasound imaging...
September 26, 2016: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/27643513/over-diagnosis-and-rising-rates-of-obstetric-anal-sphincter-injuries-oasis-time-for-reappraisal
#15
Dimos Sioutis, Ranee Thakar, Abdul H Sultan
OBJECTIVES: To identify the accuracy of clinically diagnosed OASIS using 3D endoanal ultrasound and compare symptoms and anal manometry measurements between those whose anal sphincters were adequately repaired to those who had persistent anal sphincter defects. METHODS: The endoanal scan images of women who sustained OASIS and attended the perineal clinic over a 10 year period (2003 - 2013) were re-analysed from data entered prospectively of women with clinically diagnosed and repaired OASIS...
September 19, 2016: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/27613623/residual-defects-after-repair-of-obstetric-anal-sphincter-injuries-and-pelvic-floor-muscle-strength-are-related-to-anal-incontinence-symptoms
#16
Cristina Ros Cerro, Eva Martínez Franco, Giulio Aniello Santoro, Maria José Palau, Pawel Wieczorek, Montserrat Espuña-Pons
INTRODUCTION AND HYPOTHESIS: The aim was to analyze the correlation between residual anal sphincter (AS) defects and pelvic floor muscle (PFM) strength on anal incontinence (AI) in patients with a history of obstetric AS injuries (OASIS). METHODS: From September 2012 to February 2015, an observational study was conducted on a cohort of females who underwent repair of OASIS intrapartum. The degree of OASIS was scored intrapartum according to Sultan's classification...
September 9, 2016: International Urogynecology Journal
https://www.readbyqxmd.com/read/27589856/an-obstetric-sphincter-injury-risk-identification-system-osiris-is-this-a-clinically-useful-tool
#17
Sara S Webb, Karla Hemming, Madhi Y Khalfaoui, Tine Brink Henriksen, Sara Kindberg, Stine Stensgaard, Christine Kettle, Khaled M K Ismail
INTRODUCTION AND HYPOTHESIS: To establish the contribution of maternal, fetal and intrapartum factors to the risk of incidence of obstetric anal sphincter injuries (OASIS) and assess the feasibility of an OASIS risk prediction model based on variables available to clinicians prior to birth. METHODS: This was a population-based, retrospective cohort study using single-site data from the birth database of Aarhus University Hospital, Denmark. The participants were all women who had a singleton vaginal birth during the period 1989 to 2006...
March 2017: International Urogynecology Journal
https://www.readbyqxmd.com/read/27557074/-incontinence-etiology-diagnostics-and-therapy
#18
Thomas Frieling
Fecal incontinence is defined by the unintentional loss of solid or liquid stool, and anal incontinence includes leakage of gas and / or fecal incontinence. Anal-fecal incontinence is not a diagnosis but a symptom. Many patients hide the problem from their families, friends, and even their doctors. Epidemiologic studies indicate a prevalence between 7-15 %, up to 30 % in hospitals and up to 70 % in longterm care settings. Anal-fecal incontinence causes a significant socio-economic burden. There is no widely accepted approach for classifying anal-fecal incontinence available...
August 2016: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/27497647/factors-associated-with-timing-of-return-to-intercourse-after-obstetric-anal-sphincter-injuries
#19
Alix Leader-Cramer, Kimberly Kenton, Bhumy Davé, Dana R Gossett, Margaret Mueller, Christina Lewicky-Gaupp
INTRODUCTION: The impact of obstetric perineal trauma on timing of return to intercourse is unclear, although sexual desire is clearly decreased in these women. In addition, studies examining timing of return to intercourse are cross-sectional and therefore cannot delineate potential reasons that patients might delay return to intercourse. AIM: To identify factors associated with delayed return to intercourse after obstetric anal sphincter injuries. METHODS: This was a planned secondary analysis of a prospective cohort study of women sustaining obstetric anal sphincter injuries during delivery of a full-term singleton infant...
October 2016: Journal of Sexual Medicine
https://www.readbyqxmd.com/read/27463362/sacral-neuromodulation-for-faecal-incontinence-following-obstetric-sphincter-injury-outcome-of-percutaneous-nerve-evaluation
#20
Mona B Rydningen, Trond Dehli, Tom Wilsgaard, Rolv O Lindsetmo, Merethe Kumle, Mona Stedenfeldt, Stig Norderval
AIM: The purpose of this study was to assess the efficacy of percutaneous nerve evaluation (PNE) in women with faecal incontinence (FI) following obstetric anal sphincter injury and relate the outcomes to baseline factors with special emphasis on the extent of sphincter defect. METHOD: This was a prospective study at a tertiary colorectal referral unit at the University Hospital of North Norway conducted from 2012-2014. Sixty-three women underwent a three-week PNE using a tined lead and the Verify(®) external neurostimulator...
July 27, 2016: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
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