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https://www.readbyqxmd.com/read/28813712/management-of-the-perineum-during-delivery-with-the-kiwi-omnicup-effects-of-mediolateral-episiotomy-on-anal-sphincter-tears-in-nulliparous-women
#1
Barbara Bodner-Adler, Oliver Kimberger, Andreas Käfer, Peter Husslein, Klaus Bodner
AIM: The main objective of this study was to evaluate the association of mediolateral episiotomy with severe perineal trauma during Kiwi omnicup vacuum delivery. METHODS: This retrospective study analyzed all Kiwi omnicup vacuum deliveries between 2010 and 2015 in nulliparous women. Secondary outcomes of interest included frequency of genital tract trauma, outcome of Kiwi extraction and influence on neonatal parameters. RESULTS: A total of 572 nulliparous women who were delivered with the aid of vacuum were analyzed...
August 17, 2017: Gynecologic and Obstetric Investigation
https://www.readbyqxmd.com/read/28776641/the-great-divide-country-of-birth-as-a-risk-factor-for-obstetric-anal-sphincter-injuries
#2
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/28718248/outcome-of-0-2-glyceryltrinitrate-cream-versus-2-diltiazem-cream-in-the-treatment-of-chronic-anal-fissure
#3
Muhammad Siddique Khan, Ismail Akbar, Junaid Zeb, Salman Ahmad, Ajmal Khan
BACKGROUND: Anal fissure is a linear tear in the distal anal canal resulting from persistent hypertonia and spasm of the internal sphincter which results in mucosal ischemia. We have conducted a study in order to compare the outcome of 0.2% glyceryl trinitrate cream versus 2% diltiazem cream in the treatment of chronic anal fissure. METHODS: This randomized controlled trial (RCT) was carried out in the Department of Surgical "B" unit, at Ayub Teaching Hospital, Abbottabad, Pakistan from 15th June 2012 to 15th May 2015...
April 2017: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/28688109/root-causes-and-social-consequences-of-birth-injuries-in-western-uganda
#4
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
#5
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
#6
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/28655981/anal-self-massage-in-the-treatment-of-acute-anal-fissure-a-randomized-prospective-study
#7
Fabio Gaj, Ivano Biviano, Laura Candeloro, Jacopo Andreuccetti
BACKGROUND: An anal fissure (AF) is a tear in the epithelial lining of the anal canal. This is a very common condition, but the choice of treatment is unclear. The use of anal dilators is effective, economic, and safe. The aim of the study was to compare the efficacy of two conservative treatments, the use of anal dilators or a finger for anal dilatation, in reducing anal pressure and resolving anal fissures. METHODS: Fifty patients with a clinical diagnosis of AF were randomly assigned to one of the treatments, self-massage of the anal sphincter (group A, 25 patients) or passive dilatation using dilators (group B, 25 patients)...
2017: Annals of Gastroenterology: Quarterly Publication of the Hellenic Society of Gastroenterology
https://www.readbyqxmd.com/read/28477150/the-optimal-angle-of-the-mediolateral-episiotomy-at-crowning-of-the-head-during-labor
#8
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
#9
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/28461989/is-overactive-bladder-in-the-female-surgically-curable-by-ligament-repair
#10
Bernhard Liedl, Hiromi Inoue, Yuki Sekiguchi, Max Haverfield, Peter Richardson, Alexander Yassourides, Florian Wagenlehner
INTRODUCTION: Overactive bladder (OAB) symptoms (urge, frequency, nocturia) are not generally considered surgically curable by learning institutions. The Integral Theory hypothesizes that OAB is a prematurely activated, but normal micturition reflex caused by loose suspensory ligaments and potentially curable surgically by repairing such ligaments. To test this hypothesis by surgical repair of loose cardinal and uterosacral ligaments in patients with 2(nd) degree or greater uterine/apical prolapse...
2017: Central European Journal of Urology
https://www.readbyqxmd.com/read/28450789/body-after-baby-a-pilot-survey-of-genital-body-image-and-sexual-esteem-following-vaginal-birth
#11
Ruth Zielinski, Lisa Kane Low, Abigail R Smith, Janis M Miller
OBJECTIVE: The aim of this study was to determine acceptability of the Vaginal Changes Sexual and Body Esteem (VSBE) scale for women post childbirth and explore the association between childbirth events and sexual/body esteem. DESIGN: This is a cross-sectional study within the Evaluating Maternal Recovery from Labor and Delivery study. SETTING: This study was conducted in a community setting. POPULATION: The study was conducted in women post first vaginal birth with birth events that posed risk factors for levator ani muscle tears...
2017: International Journal of Women's Health
https://www.readbyqxmd.com/read/28403956/severe-perineal-morbidity-of-instrumental-deliveries-using-thierry-s-spatulas-and-vacuum-extraction-a-prospective-observational-cohort-study
#12
S Hamouda, J Mancini, F Marchand, F Bretelle, L Boubli, C D'Ercole, X Carcopino
OBJECTIVES: To evaluate the risk of severe perineal tear following instrumental vaginal delivery (IVD) performed with spatulas and vacuum extraction. Secondary objectives were to estimate the impact of episiotomy on this risk. METHODS: From December 2008 to October 2012, women who underwent spatulas or vacuum were prospectively included. Each spontaneous vaginal delivery (SVD) following each included IVD were included as control cases (1-1 ratio). Careful perineal examination was systematically performed...
January 2017: Journal of gynecology obstetrics and human reproduction
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
#13
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/28239456/chronic-anal-fissures-open-lateral-internal-sphincterotomy-result-a-case-series-study
#14
Abdulwahid M Salih
INTRODUCTION: Anal fissure are defined as a tear in the skin of the anal canal distal to dentate line. Although still there are controversies about the exact management, lateral sphincterotomy is promising. The aim of this series is to present the outcome of lateral sphincterotomy for internal anal sphincter in term of patient satisfaction and complication. PATIENT AND METHODS: A prospective single cohort study, 190 patients, who were undergone lateral sphincterotomy for internal anal sphincter from 2010 to 2014, were analyzed...
March 2017: Annals of Medicine and Surgery
https://www.readbyqxmd.com/read/28207499/laparoscopic-heller-myotomy-is-not-superior-to-pneumatic-dilation-in-the-management-of-primary-achalasia-conclusions-of-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#15
REVIEW
Ji-Wei Cheng, Yin Li, Wen-Qun Xing, Hong-Wei Lv, Hao-Ran Wang
BACKGROUND: Achalasia is an esophageal motility disorder, of unknown cause, which results in increased lower esophageal sphincter tone and symptoms of difficulty swallowing. Current major therapeutic options include laparoscopic Heller myotomy (LHM) and pneumatic dilation (PD). We undertake a systematic review comparing the efficacy and safety of these 2 treatments in the treatment of esophageal achalasia. METHODS: PubMed, Embase, and Cochrane Central Register of Controlled Trials were searched for randomized controlled trial investigating LHM versus PD in the treatment of primary achalasia...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28159134/routine-interventions-in-childbirth-before-and-after-initiation-of-an-action-research-project
#16
Viola Nyman, Leyla Roshani, Marie Berg, Terese Bondas, Soo Downe, Anna Dencker
BACKGROUND: Unnecessary routine interventions in uncomplicated labour and birth, like cardiotocography (CTG), amniotomy, use of scalp electrode and oxytocin treatment, are associated with further interventions that could harm the woman and the infant. A four year Action Research (AR) project was done on a labour ward to enhance the capacity of local midwives in the promotion of physiological labour and birth. AIM: To describe the use of interventions during labour and birth in healthy women at term with spontaneous onset of labour, before and after initiation of an Action Research project...
March 2017: Sexual & Reproductive Healthcare: Official Journal of the Swedish Association of Midwives
https://www.readbyqxmd.com/read/28117880/intrapartum-predictors-of-maternal-levator-ani-injury
#17
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/28027700/management-of-persistent-occiput-posterior-position-a-substantial-role-of-instrumental-rotation-in-the-setting-of-failed-manual-rotation
#18
Paul Guerby, Mickael Allouche, Caroline Simon-Toulza, Christophe Vayssiere, Olivier Parant, Fabien Vidal
INTRODUCTION: To compare the maternal and neonatal outcomes associated with Instrumental Rotation (IR) to operative vaginal delivery in occiput posterior (OP) position with Thierry's spatulas (TS), in the setting of failed manual rotation (MR). STUDY DESIGN: We led a prospective observational cohort study in a tertiary referral hospital in Toulouse, France. All women presenting in labor with persistent OP position at full cervical dilatation and who delivered vaginally after failed MR and with IR or OP assisted delivery were included from January 2014 to December 2015...
January 23, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28027607/third-or-fourth-degree-intrapartum-anal-sphincter-tears-are-associated-with-levator-ani-avulsion-in-primiparas
#19
Dan V Valsky, Sarah M Cohen, Michal Lipschuetz, Drorith Hochner-Celnikier, Hagit Daum, Itai Yagel, Simcha Yagel
OBJECTIVES: We evaluated primiparous women with clinically diagnosed third- and fourth-degree and anal sphincter tears, to evaluate the rate of levator ani muscle injury compared to primiparous women without sphincter tears. METHODS: Primiparous women delivering in our maternity ward with intrapartum diagnoses of third- or fourth-degree anal sphincter tears, repaired by the overlapping technique, were recruited to undergo 3-dimensional transperineal sonography of the pelvic floor anatomy, including the anterior and posterior compartments...
April 2016: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
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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