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Obstetric anal sphincter injury

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https://www.readbyqxmd.com/read/29155140/pregnancy-and-parturition-negatively-impact-vaginal-angle-and-alters-expression-of-vaginal-mmp-9
#1
Sallie Oliphant, Timothy Canavan, Stacy Palcsey, Leslie Meyn, Pamela Moalli
BACKGROUND: Parity is the greatest risk factor for the development of pelvic organ prolapse. The normally supported vagina is pulled up and back over the levator ani. Loss of vaginal angulation has been associated with prolapse and may represent injury to the vaginal supportive tissues. OBJECTIVE: We propose that 1) pregnancy and delivery impact support to the vagina leading to loss of vaginal angle; 2) vaginal angulation is restored postpartum; and 3) uncomplicated vaginal delivery (VD) is associated with accelerated remodeling of the vaginal fibrillar matrix...
November 16, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29155037/long-term-anal-incontinence-after-obstetric-anal-sphincter-injury-does-grade-of-tear-matter
#2
Hanna Jangö, Jens Langhoff-Roos, Susanne Rosthøj, Abelone Sakse
BACKGROUND: Anal incontinence is a major concern following delivery with obstetric anal sphincter injury and has been related to the degree of sphincter tear. OBJECTIVES: To 1) evaluate whether women with a fourth degree obstetric anal sphincter injury in the first delivery have an increased risk of long-term anal- and fecal incontinence after a second delivery and 2) assess the impact of mode of second delivery on anal incontinence and related symptoms in these patients...
November 15, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29117015/racial-ethnic-differences-in-perineal-lacerations-in-a-diverse-urban-healthcare-system
#3
Amanda Williams, Beverly Gonzalez, Colleen Fitzgerald, Cynthia Brincat
OBJECTIVES: The aim of the study was o determine whether variations exist between races/ethnicities in perineal laceration at first vaginal delivery. METHODS: We assessed first vaginal deliveries greater than 35 weeks gestation, for a four-year period, in our diverse urban healthcare system. Predictor variable was race/ethnicity with outcome variable of none, first-, second-, third-, or fourth-degree perineal laceration. Race and ethnicity were self-reported and combined into one variable to facilitate analysis...
November 7, 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/29046273/upright-versus-lying-down-position-in-second-stage-of-labour-in-nulliparous-women-with-low-dose-epidural-bumpes-randomised-controlled-trial
#4
RANDOMIZED CONTROLLED TRIAL
(no author information available yet)
Objective To determine whether being upright in the second stage of labour in nulliparous women with a low dose epidural increases the chance of spontaneous vaginal birth compared with lying down.Design Multicentre pragmatic individually randomised controlled trial.Setting 41 UK hospital labour wards.Participants 3093 nulliparous women aged 16 or older, at term with a singleton cephalic presentation and in the second stage of labour with epidural analgesia.Interventions Women were allocated to an upright or lying down position, using a secure web based randomisation service, stratified by centre, with no masking of participants or clinicians to the trial interventions...
October 18, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/29022787/does-a-missed-obstetric-anal-sphincter-injury-at-time-of-delivery-affect-short-term-functional-outcome
#5
L Ramage, C Yen, S Qiu, C Simillis, C Kontovounisios, E Tan, P Tekkis
Introduction This study aimed to ascertain whether missed obstetric anal sphincter injury at delivery had worse functional and quality of life outcomes than primary repair immediately following delivery. Materials and methods Two to one propensity matching was undertaken of patients presenting to a tertiary pelvic floor unit with ultrasound evidence of missed obstetric anal sphincter injury within 24 months of delivery with patients who underwent primary repair at the time of delivery by parity, grade of injury and time to assessment...
September 15, 2017: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/28969732/delayed-reconstruction-of-a-traumatic-cloaca-following-obstetric-anal-sphincter-rupture
#6
Ali Ezer, Alper Parlakgumus
Permanent communication between the rectum and the vagina along with full thickness of anal sphincter faults can be a result of an unsuccessful primary repair of fourth degree obstetric trauma. This results into complete fecal incontinence and impaired quality of life. Anterior overlapping sphincteroplasty can be chosen as a method of treatment for fecal incontinence due to obstetric injuries. However, large perineal body reconstructions are generally pretty challenging tasks for surgeons. What we will describe here for the repair of a traumatic cloaca, occurred 23 years ago during vaginal delivery, is the use of a transpositional flap following overlapping sphincteroplasty...
September 2017: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/28915858/risk-of-obstetric-anal-sphincter-injury-increases-with-maternal-age-irrespective-of-parity-a-population-based-register-study
#7
Ulla Waldenström, Cecilia Ekéus
BACKGROUND: Obstetric anal sphincter injury (OASI) is a rare but serious outcome of vaginal birth. Based on concerns about the increasing number of women who commence childbearing later than previous generation, this study aimed at investigating age-related risk of OASI in women of different parity. METHODS: A population-based register study including 959,559 live singleton vaginal births recorded in the Swedish Medical Birth Register 1999 to 2011. In each parity group risks of OASI at age 25-29 years, 30-34 years, and ≥35 years compared with age < 25 years were investigated by logistic regression analyses, adjusted for year of birth, education, region of birth, smoking, Body Mass Index, infant birthweight and fetal presentation; and in parous women, history of OASI and cesarean section...
September 15, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28914706/long-term-sexual-function-after-obstetric-anal-sphincter-injuries
#8
Michele S OʼShea, Christina Lewicky-Gaupp, Dana R Gossett
OBJECTIVES: Obstetric anal sphincter injuries (OASIS) are associated with severe short and long-term morbidities, although little is known about the long-term sexual function or satisfaction of women and partners of women with history of OASIS. The objective of this study was to describe the long-term sexual function and satisfaction of women who previously sustained OASIS and to assess sexual satisfaction among their male partners. METHODS: This was a follow-up study of participants enrolled in the For Optimal Recovery: Care After Severe Tears (FORCAST) prospective cohort study of women with a history of OASIS after delivery of a full-term singleton infant between 2011 and 2013...
September 13, 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/28913133/the-relationship-between-fecal-incontinence-and-vaginal-delivery-in-the-postmenopausal-stage
#9
Süleyman Kargın, Sami Çifçi, Adnan Kaynak, Hüseyin Ataseven, Cengiz Kadıyoran, Murat Çakır
OBJECTIVE: Obstetric anal sphincter injuries are one of the most significant complications of vaginal delivery that give way to fecal incontinence, which is defined as the involuntary leakage of gas, fluid or solid stool. Although sphincter injuries are seen in 0.5-9% of all deliveries. It has been reported that 20-41% of women who had vaginal deliveries had occult anal sphincter injuries as endoanal ultrasonography began to be used by physicians. The aim of our study was to investigate the relationship between fecal incontinence, whose incidence increases dramatically during the postmenopausal stage, and occult anal sphincter injuries...
March 2017: Turk J Obstet Gynecol
https://www.readbyqxmd.com/read/28885403/postpartum-management-after-obstetric-anal-sphincter-injuries
#10
Allison Eubanks, Scott M Petersen
A 26-year-old woman, gravida 1 para 1, experiences a severe perineal laceration that extends through the rectal mucosa after a vaginal delivery. She asks you, "What can be done to optimize my recovery?"
October 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28818731/association-between-severities-of-striae-gravidarum-and-obstetric-anal-sphincter-injuries-oasis
#11
Ofra Halperin, Anita Noble, Shosh Balachsan, Ester Klug, Michal Liebergall-Wischnitzer
OBJECTIVES: to examine the association between the severities of Striae Gravidarum (SG) and Obstetric Anal Sphincter Injuries (OASIS) and to measure the symptoms regarding urinary incontinence, fecal/flatus incontinence, and dyspareunia, at 6 and 12 months postpartum. DESIGN: this is a cohort study. SETTING: four university teaching medical centers in Israel, two in the north and two in the center of the country. PARTICIPANTS: women with OASIS were interviewed and assessed for SG...
November 2017: Midwifery
https://www.readbyqxmd.com/read/28782264/anal-sphincter-defects-and-faecal-incontinence-15-24-years-after-first-delivery-a-cross-sectional-study
#12
Rodrigo A Guzmán Rojas, Kjell Å Salvesen, Ingrid Volløyhaug
OBJECTIVES: To establish the prevalence of external (EAS) and internal anal sphincter (IAS) defects 15-24 years after childbirth in association to mode of delivery and faecal incontinence (FI), and compare the proportion of obstetric anal sphincter injuries (OASIS) reported at delivery with defects on ultrasound. METHODS: This was a cross-sectional study including 563 women, who delivered their first child from 1990-97. Women responded to a validated questionnaire (PFDI) in 2013-14...
August 6, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28776641/the-great-divide-country-of-birth-as-a-risk-factor-for-obstetric-anal-sphincter-injuries
#13
James Brown, Supuni Kapurubandara, Emma Gibbs, Jennifer King
BACKGROUND: Obstetric anal sphincter injuries (OASIS) can complicate up to 6% of births and are a major contributor to preventable maternal morbidity. Asian women have a risk of third and fourth degree perineal tears up to four times greater than women of other ethnicities in the same community, but the lack of differentiation of Asian women into regional groups has limited insight into the reasons behind their increased risk. AIMS: To investigate risk of OASIS associated with country of birth...
August 4, 2017: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/28727899/sacral-neuromodulation-for-combined-faecal-and-urinary-incontinence-following-obstetric-anal-sphincter-injury
#14
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
#15
COMPARATIVE STUDY
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
#16
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
#17
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
#18
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
#19
Jennifer N Angell, Priscilla Busingye, Gabriel Y-K Ganyaglo, Cheryl A Moyer
No abstract text is available yet for this article.
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
#20
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
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