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Episiotomy

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https://www.readbyqxmd.com/read/28725564/post-partum-streptococcal-toxic-shock-syndrome-associated-with-necrotizing-fasciitis
#1
Wei Chuan Chua, Mohd Zulfakar Mazlan, Saedah Ali, Sanihah Che Omar, Wan Mohd Nazaruddin Wan Hassan, S Praveena Seevaunnantum, Rhendra Hardy Mohd Zaini, Mohd Hasyizan Hassan, Alwi Muhd Besari, Zaidah Abd Rahman, Zeti Norfidiyati Salmuna Ayub, Sabrina Abd Ghani, Normalinda Yaacob, Wan Rosilawati Wan Rosli
We report a fatal case of post-partum streptococcal toxic shock syndrome in a patient who was previously healthy and had presented to the emergency department with an extensive blistering ecchymotic lesions over her right buttock and thigh associated with severe pain. The pregnancy had been uncomplicated, and the mode of delivery had been spontaneous vaginal delivery with an episiotomy. She was found to have septicemic shock requiring high inotropic support. Subsequently, she was treated for necrotizing fasciitis, complicated by septicemic shock and multiple organ failures...
2017: IDCases
https://www.readbyqxmd.com/read/28724657/prenatal-lipid-based-nutrient-supplements-do-not-affect-pregnancy-or-childbirth-complications-or-cesarean-delivery-in-bangladesh-a-cluster-randomized-controlled-effectiveness-trial
#2
Malay K Mridha, Susana L Matias, Rina Rani Paul, Sohrab Hussain, Mostofa Sarker, Mokbul Hossain, Janet M Peerson, Stephen A Vosti, Kathryn G Dewey
Background: Pregnancy and childbirth complications and cesarean delivery are common in Bangladesh.Objective: We evaluated the effect of lipid-based nutrient supplements for pregnant and lactating women (LNS-PL) on pregnancy and childbirth complications and cesarean delivery.Methods: We conducted the Rang-Din Nutrition Study, a cluster-randomized controlled effectiveness trial within a community health program in rural Bangladesh. We enrolled 4011 pregnant women in early pregnancy. Women in 48 clusters received iron and folic acid (IFA; 60 mg Fe + 400 μg folic acid/d) and women in 16 clusters received LNS-PL (20 g/d, 118 kcal) containing essential fatty acids and 22 vitamins and minerals...
July 19, 2017: Journal of Nutrition
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/28706102/a-method-to-assess-obstetric-outcomes-using-the-10-group-classification-system-a-quantitative-descriptive-study
#4
Janne Rossen, Miha Lucovnik, Torbjørn Moe Eggebø, Natasa Tul, Martina Murphy, Ingvild Vistad, Michael Robson
OBJECTIVES: Internationally, the 10-Group Classification System (TGCS) has been used to report caesarean section rates, but analysis of other outcomes is also recommended. We now aim to present the TGCS as a method to assess outcomes of labour and delivery using routine collection of perinatal information. DESIGN: This research is a methodological study to describe the use of the TGCS. SETTING: Stavanger University Hospital (SUH), Norway, National Maternity Hospital Dublin, Ireland and Slovenian National Perinatal Database (SLO), Slovenia...
July 12, 2017: BMJ Open
https://www.readbyqxmd.com/read/28699402/the-management-of-episiotomy-technique-and-its-effect-on-pelvic-floor-muscles-during-a-malposition-childbirth
#5
Dulce A Oliveira, Marco P L Parente, Begoña Calvo, Teresa Mascarenhas, Renato M Natal Jorge
Vaginal childbirth is the leading cause of pelvic floor muscles injury, which contributes to pelvic floor dysfunction, being enhanced by fetal malposition. Therefore, the aim of the present study is to verify the influence of mediolateral episiotomies in the mechanics of the pelvic floor with the fetus in occiput posterior position when compared to the occiput anterior position. Numerical simulations of vaginal deliveries, with and without episiotomy, are performed based on the Finite Element Method. The biomechanical model includes the pelvic floor muscles, a surface to delimit the anterior region of the birth canal and a fetus...
August 2017: Computer Methods in Biomechanics and Biomedical Engineering
https://www.readbyqxmd.com/read/28689647/effectiveness-of-a-physical-activity-programme-based-on-the-pilates-method-in-pregnancy-and-labour
#6
Luciano Rodríguez-Díaz, Carlos Ruiz-Frutos, Juana María Vázquez-Lara, Jesús Ramírez-Rodrigo, Carmen Villaverde-Gutiérrez, Gema Torres-Luque
OBJECTIVE: To assess the effectiveness and safety of a physical activity programme based on use of the Pilates method, over eight weeks in pregnant women, on functional parameters, such as weight, blood pressure, strength, flexibility and spinal curvature, and on labour parameters, such as, type of delivery, episiotomy, analgesia and newborn weight. METHOD: A randomized clinical trial was carried out on pregnant women, applying a programme of physical activity using the Pilates method, designed specifically for this population...
July 6, 2017: Enfermería Clínica
https://www.readbyqxmd.com/read/28682756/-can-the-rate-of-episiotomy-still-be-lowered-status-update-in-paca-region-south-of-france
#7
E Lesieur, J Blanc, A Loundou, M Dubuc, F Bretelle
OBJECTIVE: To evaluate professional practices relative to episiotomies in the Provence Alpes Côte d'Azur (PACA) region by analysing their incidence in maternity hospitals, by type and by sector of activity. Following this, to analyse maternal and obstetric characteristics associated with episiotomies and the occurrence of perineal tears in Marseille's university hospitals (CHU). METHODS: Data were extracted from the database for the period from 1st January 2012 to 31 December 2014...
March 2017: Gynecologie, Obstetrique, Fertilite & Senologie
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/28672754/postpartum-infection-in-relation-to-maternal-characteristics-obstetric-interventions-and-complications
#9
Daniel Axelsson, Jan Brynhildsen, Marie Blomberg
The purpose was to evaluate the association between maternal characteristics, obstetrical interventions/complications and postpartum wound infections (WI), urinary tract infection (UTI) and endometritis. Furthermore, this study aimed to determine the time from delivery to onset of infections after discharge from the hospital. Three large Swedish Medical Health Registers were scrutinized for the period 2005-2012. A total of 582,576 women had 795,072 deliveries. Women with diagnosis codes for WIs, UTIs or endometritis, from delivery to 8 weeks postpartum, were compared to non-infected women...
June 26, 2017: Journal of Perinatal Medicine
https://www.readbyqxmd.com/read/28663610/lignocaine-versus-ropivacaine-infiltration-for-postpartum-perineal-pain
#10
Jyoti P Deshpande, Girish Y Saundattikar
BACKGROUND: Millions of women worldwide undergo postpartum perineal repair under local infiltration. Inadequate postpartum pain management can negatively impact a mother's physical and psychological recovery. AIMS: To study and compare the analgesic effect and maternal satisfaction with lignocaine versus ropivacaine infiltration for postpartum perineal pain relief. MATERIALS AND METHODS: After clearance from the Institutional Ethics Committee, a double-blind prospective randomized study carried out on 100 parturients of aged 18-40 years who had spontaneous vaginal delivery, comparing 1% lignocaine and 0...
April 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28659122/effects-of-combined-spinal-epidural-labor-analgesia-on-episiotomy-a-retrospective-cohort-study
#11
Dandan Zhou, Hui Gong, Shan He, Wei Gao, Qiang Wang
BACKGROUND: According to some published studies, neuraxial analgesia may be associated with prolonged labor and an increased risk for instrumental vaginal delivery. However, its effects on episiotomy are unknown. This study aimed to examine the incidence of episiotomy with and without combined spinal-epidural analgesia (CSEA) during labor. METHODS: This was a retrospective cohort study, in which the computerized medical records of nulliparous women with singleton, cephalic and live births were reviewed and women with and without CSEA were matched based on their propensity scores...
June 28, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28658851/risk-factors-and-incidence-of-puerperal-genital-haematomas
#12
Shikha Rani, Meesha Verma, Dilpreet Kaur Pandher, Navneet Takkar, Anju Huria
INTRODUCTION: Puerperal genital haematomas although an uncommon entity but is elusive. This painful condition is not only distressing and dangerous to patient but is embarrassing to the obstetrician who has conducted the delivery. AIM: This study has been planned to evaluate the incidence and risk factors for puerperal genital haematomas. MATERIALS AND METHODS: A case control study was done from August 2005 to August 2015, of all puerperal genital haematomas...
May 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28637428/quality-of-care-provided-in-two-scottish-rural-community-maternity-units-a-retrospective-case-review
#13
Sara Denham, Tracy Humphrey, Ruth Taylor
BACKGROUND: Women in Scotland with uncomplicated pregnancies are encouraged by professional bodies and national guidelines to access community based models of midwife-led care for their labour and birth. The evidence base for these guidelines relates to comparisons of predominantly urban birth settings in England. There appears to be little evidence available about the quality of the care during the antenatal, birth and post birth periods available for women within the Scottish Community Maternity Unit (CMU) model...
June 21, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28631876/incidence-of-episiotomy-in-slovenia-the-story-behind-the-numbers
#14
Anita Jug Došler, Ana Polona Mivšek, Ivan Verdenik, Teja Škodič Zakšek, Tina Levec, Petra Petročnik
Episiotomy is a surgical cut of the perineum performed in the second stage of labor in order to widen the vaginal opening and thus facilitate the birth of an infant. Despite current recommendations against the routine use of episiotomy, it is one of the most commonly performed surgical interventions during childbirth. This retrospective study explores the number of episiotomies performed in Slovenian maternity hospitals and the differences in episiotomy rates in relation to parity. Data were obtained from the Slovenian National Perinatal Information System and pooled for 2013...
June 20, 2017: Nursing & Health Sciences
https://www.readbyqxmd.com/read/28626856/delivery-parameters-neonatal-parameters-and-incidence-of-urinary-incontinence-6-months-postpartum-a-cohort-study
#15
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 incidence of urinary incontinence six months postpartum and single obstetric risk factors as well as combinations of risk factors. MATERIAL AND METHOD: This study was based on the Norwegian Mother and Child Cohort Study, conducted by the Norwegian Institute of Public Health during 1998-2008. This substudy was based on 7561 primiparous women who were continent before and during pregnancy...
June 19, 2017: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/28616828/perinatal-and-maternal-outcomes-at-term-in-low-risk-pregnancies-according-to-nice-criteria-comparison-between-a-tertiary-obstetrical-hospital-and-midwife-attended-units
#16
Tanja Ignatov, Holm Eggemann, Serban Dan Costa, Atanas Ignatov
PURPOSE: The aim of this study was to evaluate the perinatal and maternal outcomes at term at a single tertiary, university hospital in women with low-risk pregnancies. PATIENTS AND METHODS: We performed a retrospective cohort study of women with low-risk pregnancies, who delivered at University Women's Hospital Magdeburg between January 2010 and December 2014. Data were compared with data published by Brocklehurst et al. 2011. RESULTS: Of the 6052 women investigated, 2014 were classified as low risk according to the NICE criteria and were eligible for analysis...
August 2017: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/28608597/perineal-techniques-during-the-second-stage-of-labour-for-reducing-perineal-trauma
#17
REVIEW
Vigdis Aasheim, Anne Britt Vika Nilsen, Liv Merete Reinar, Mirjam Lukasse
BACKGROUND: Most vaginal births are associated with trauma to the genital tract. The morbidity associated with perineal trauma can be significant, especially when it comes to third- and fourth-degree tears. Different interventions including perineal massage, warm or cold compresses, and perineal management techniques have been used to prevent trauma. This is an update of a Cochrane review that was first published in 2011. OBJECTIVES: To assess the effect of perineal techniques during the second stage of labour on the incidence and morbidity associated with perineal trauma...
June 13, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28598517/impact-of-episiotomy-on-the-urogenital-hiatus-using-transperineal-ultrasound
#18
Jordi Cassadó Garriga, Ana Carmona Ruiz, Antoni Pessarrodona Isern, Monica Rodríguez Carballeira, Esther Esteve Serena, Pablo García Manau, Marta Valls Esteve, Eva Huguet Galofré
AIMS: To analyze whether episiotomy affects the urogenital hiatal area and the difference in the hiatus at rest and during contraction, as an indirect measurement of the contractile capacity of the levator ani muscle. METHODS: We performed an observational, comparative, retrospective study of primiparous women who had normal vaginal deliveries. The urogenital hiatal area was compared in women with and without episiotomy. All women underwent transperineal ultrasound scanning after delivery, and all the images were analyzed offline by the principal investigator who was blinded to all clinical data...
June 9, 2017: Neurourology and Urodynamics
https://www.readbyqxmd.com/read/28594775/perinatal-and-maternal-outcomes-after-training-residents-in-forceps-before-vacuum-instrumental-birth
#19
Sasha Skinner, Miranda Davies-Tuck, Euan Wallace, Ryan Hodges
OBJECTIVE: To compare the rates of attempted and successful instrumental births, intrapartum cesarean delivery, and subsequent perinatal and maternal morbidity before and after implementing a training intervention to arrest the decline in forceps competency among resident obstetricians. METHODS: This retrospective cohort study examined all attempted instrumental births at Monash Health from 2005 to 2014. We performed an interrupted time-series analysis to compare outcomes of attempted instrumental births in 2005-2009 with those in 2010-2014...
July 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28594760/an-initiative-to-reduce-the-episiotomy-rate-association-of-feedback-and-the-hawthorne-effect-with-leapfrog-goals
#20
Kathy Zhang-Rutledge, Steven L Clark, Stacie Denning, Audra Timmins, Gary A Dildy, Manisha Gandhi
OBJECTIVE: To assess the association of education, performance feedback, and the Hawthorne effect with a reduction in the episiotomy rate in a large academic institution. METHODS: We describe a prospective observational study of a project conducted between March 2012 and February 2017 to assist clinicians in meeting the Leapfrog Group (www.leapfroggroup.org) target rates for episiotomy. Phases of this project included preintervention (phase 1, March 2012 to April 2014), education and provision of collective department episiotomy rates (phase 2, May 2014 to December 2014), ongoing education with emphasis on a revised Leapfrog target rate (phase 3, January 2015 to February 2016), and provision of individual episiotomy rates to practitioners on a monthly basis (phase 4, March 2016 to February 2017)...
June 6, 2017: Obstetrics and Gynecology
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