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https://www.readbyqxmd.com/read/29785548/operative-vaginal-delivery-in-case-of-persistent-occiput-posterior-position-after-manual-rotation-failure-a-6-month-follow-up-on-pelvic-floor-function
#1
Paul Guerby, Olivier Parant, Elodie Chantalat, Christophe Vayssiere, Fabien Vidal
PURPOSE: To compare the short- and long-term perineal consequences (at 6 months postpartum) and short-term neonatal consequences of instrumental rotation (IR) to those induced by assisted delivery (AD) in the occiput posterior (OP) position, in case of manual rotation failure. METHODS: A prospective observational cohort study; tertiary referral hospital including all women presenting with persistent OP position who delivered vaginally after manual rotation failure with attempted IR or AD in OP position from September 2015 to October 2016...
May 21, 2018: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/29764255/knot-positioning-during-mcdonald-cervical-cerclage-does-it-make-a-difference-a-cohort-study
#2
Hytham Atia, Mohamed Ellaithy, Ahmed Altraigey, Heba Ibrahim
OBJECTIVE: To study the effect of McDonald cerclage knot position on the different maternal and neonatal outcomes. METHODS: This historical cohort study included women with singleton pregnancy who had a prophylactic McDonald cervical cerclage between 1 May 2010 and 31 September 2017. Maternal and neonatal outcome parameters were compared between the anterior and posterior knot cerclage procedures. The primary outcome measure was the rate of term birth. RESULTS: 550 Women had a prophylactic McDonald cervical cerclage, 306 with anterior knot (Group A) and 244 with posterior knot (Group B)...
May 15, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29730096/a-qualitative-exploration-of-techniques-used-by-expert-midwives-to-preserve-the-perineum-intact
#3
C Begley, K Guilliland, L Dixon, M Reilly, C Keegan, C McCann, V Smith
BACKGROUND: The perineum stretches during birth to allow passage of the baby, but 85% of women sustain some degree of perineal trauma during childbirth, which is painful post-partum. Episiotomy rates vary significantly, with some countries having rates of >60%. Recent Irish and New Zealand studies showed lower severe perineal trauma and episiotomy rates than other countries. AIM: To explore expert Irish and New Zealand midwives' views of the skills that they employ in preserving the perineum intact during spontaneous vaginal birth...
May 2, 2018: Women and Birth: Journal of the Australian College of Midwives
https://www.readbyqxmd.com/read/29664554/extensive-postpartum-urinary-retention-successfully-treated-with-clean-intermittent-catheterization
#4
Paweł Milart, Ewa Beata Wozniakowska, Piotr Czuczwar, Wojciech Wrona, Tomasz Paszkowski
We present a case of extensive urine retention after vaginal delivery. Postpartum urinary retention occurs in 0.7 to 0.9% of vaginal deliveries. In the literature, mediolateral episiotomy, epidural analgesia, perineal lacerations, macrosomic birth and prolonged 2nd stage of labor are suggested as risk factors for postpartum urine retention.
2018: Ginekologia Polska
https://www.readbyqxmd.com/read/29652745/severe-perineal-lacerations-after-vaginal-delivery-are-they-an-anesthesiologist-s-problem
#5
Feyce Peralta, Joseph Bradley Bavaro
PURPOSE OF REVIEW: Perineal tears or lacerations are common occurrences after vaginal delivery. Understanding the degree of severity of these tears and the immediate and long-term complications of severe perineal lacerations can assist anesthesiologists with the management of these patients in the immediate postpartum period. RECENT FINDINGS: Severe perineal lacerations have a high degree of association with postpartum depression. The presence of neuraxial labor analgesia decreases the odds of severe perineal lacerations...
June 2018: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29629963/health-care-seeking-characteristics-of-women-with-pelvic-floor-disorders-after-obstetric-anal-sphincter-injury
#6
Jon F Pennycuff, Deborah R Karp, Julia Shinnick, Catherine O Hudson, Gina M Northington
OBJECTIVES: Obstetric anal sphincter injury (OASIS) is a potentially serious complication of vaginal delivery and can lead to both short-term and long-term sequelae. This study sought to identify health care seeking patterns of women who developed pelvic floor symptoms including pelvic pain after OASIS. It also identified demographic and clinical factors associated with seeking subspecialty care from a pelvic floor specialist and demographic and clinical factors associated with seeking care for pelvic pain after OASIS...
April 6, 2018: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/29628615/pelvic-artery-embolization-for-treatment-of-postpartum-hemorrhage
#7
REVIEW
Jonathan D Lindquist, Robert L Vogelzang
Postpartum hemorrhage (PPH) is the leading cause of maternal perinatal morbidity and mortality worldwide. Defined as greater than 500 mL blood loss after vaginal delivery, and greater than 1,000 mL blood loss after cesarean delivery, PPH has many causes, including uterine atony, lower genital tract lacerations, coagulopathy, and placental anomalies. Correction of coagulopathy and identification of the cause of bleeding are mainstays of treatment. Medical therapies such as uterotonics, balloon tamponade, pelvic artery embolization, and uterine-sparing surgical options are available...
March 2018: Seminars in Interventional Radiology
https://www.readbyqxmd.com/read/29577777/factors-associated-with-spontaneous-perineal-lacerations-in-deliveries-without-episiotomy-in-a-university-maternity-hospital-in-the-city-of-recife-brazil-a-cohort-study
#8
Vanessa Maria Laranjeiras Lins, Fernanda Barros Lima Vasconcelos, Leila Katz, Isabela Coutinho, Melania Amorim
OBJECTIVES: To determine factors associated with spontaneous perineal laceration in low-risk pregnant women who delivered vaginally without episiotomy in a university maternity hospital in Recife, Pernambuco, Brazil. METHODS: A prospective cohort study was conducted with 222 low-risk, full-term pregnant women admitted in labor with a single fetus in cephalic presentation. Women with malformed fetuses were excluded from the study. The variables analyzed were: the frequency and severity of lacerations, the women's biological, sociodemographic, clinical and obstetrical characteristics, neonatal characteristics and data on their deliveries and procedures...
March 25, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29575180/sonographic-assessment-of-the-anal-sphincter-after-obstetric-anal-sphincter-injury-oasi-using-transperineal-ultrasound-tpus
#9
EDITORIAL
Vered H Eisenberg, Dan V Valsky, Simcha Yagel
Obstetric anal sphincter injury (OASI) is the most common cause of anal incontinence and ano-rectal symptoms in women1 . Reported rates of anal incontinence following primary repair of OASI range between 15-61%, with a mean of 39%2, 3 . Other possible complications of OASI include perineal pain, dyspareunia, and less commonly, abscess formation, wound breakdown, and rectovaginal fistulae. Symptom onset may occur immediately, several years postpartum, or only late in life when aging of tissues adds to the delivery insult...
March 24, 2018: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/29559867/opiate-prescribing-practices-in-the-postpartum-unit
#10
Angela Nakahara, Nicole D Ulrich, Rajiv Gala
Background: Louisiana is significantly impacted by the opioid epidemic. In preparation for a quality improvement project aimed at decreasing postpartum narcotics prescriptions, we evaluated routine prescribing practices on a postpartum unit and the number of patient-initiated encounters for postpartum pain. Methods: We conducted a retrospective medical record review of all vaginal deliveries occurring at Ochsner Baptist Medical Center in New Orleans, LA in December 2016 and January 2017...
2018: Ochsner Journal
https://www.readbyqxmd.com/read/29500215/temporal-trends-in-severe-maternal-and-neonatal-trauma-during-childbirth-a-population-based-observational-study
#11
Qi Wen, Giulia M Muraca, Joseph Ting, Sarah Coad, Kenneth I Lim, Sarka Lisonkova
OBJECTIVE: Instrumental vaginal delivery is associated with birth trauma to infant and obstetric trauma to mother. As caesarean delivery rates increased during the past decades, the rate of instrumental vaginal delivery declined. We examined concomitant temporal changes in the rates of severe birth trauma and maternal obstetric trauma. DESIGN: A retrospective observational study. SETTINGS AND PARTICIPANTS: All hospital singleton live births in Washington State, USA, 2004-2013, excluding breech delivery...
March 2, 2018: BMJ Open
https://www.readbyqxmd.com/read/29474285/incidence-of-obstetric-anal-sphincter-injuries-after-training-to-protect-the-perineum
#12
Jennifer Yeung, Anna Stecher, Catrina C Crisp, Donna Mazloomdoost, Benjamin Smith, Steven D Kleeman, Rachel N Pauls
OBJECTIVES: Obstetric anal sphincter injuries (OASISs) are a devastating postpartum complication; reducing rates is paramount to improving quality of care. In Norway, implementation of a perineal protection program decreased the incidence of OASIS by 48%. We sought to assess impact on OASIS rates following a similar program. METHODS: This institutional review board-approved, retrospective cohort study was performed in an academic hospital system. The periods of analysis were November 2014 through October 2015 for the preintervention arm and November 2015 through October 2016 for the postintervention arm...
March 2018: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/29453728/single-site-port-robotic-assisted-hysterectomy-an-update
#13
REVIEW
Christos Iavazzo, Evelyn Eleni Minis, Ioannis D Gkegkes
Single-incision approach in robotic gynecology is a relatively new concept. The role of single-port systems in robotic hysterectomy, their advantages and disadvantages, as well as the technical challenges, are still under investigation. A systematic review was performed by searching in PubMed and Scopus databases. In 810 out of 1225 patients, hysterectomy was performed for non-neoplastic disease. Single-Site® was the most common port system. Duration of the procedure and relative blood loss ranged from 60 to 311 min and 7 to 750 ml, respectively...
February 16, 2018: Journal of Robotic Surgery
https://www.readbyqxmd.com/read/29411072/prospective-evaluation-of-the-safety-and-feasibility-of-a-pelvic-floor-dilator-during-active-labor
#14
Francisco J Orejuela, Rajshi Gandhi, Lauren Mack, Wesley Lee, Haleh Sangi-Haghpeykar, Hans P Dietz, Susan M Ramin
INTRODUCTION AND HYPOTHESIS: The objective was to assess the safety and feasibility of using a pelvic floor dilator during active labor to prevent injuries to the levator ani muscle (LAM) and perineum. METHODS: In a prospective pilot study, a pelvic floor dilator using soft pads was introduced into the vaginal canal to gradually expand the vagina, in 30 nulliparous women and in 10 controls. The primary outcomes were adverse events related to the device. Secondary outcomes were perineal lacerations after delivery, sonographically defined levator ani injury, hiatal area dimensions, and anal sphincter disruption, all at 12-20 weeks postpartum, and maximum pelvic floor dilation, time to achieve maximum dilation, and device retention rate...
February 6, 2018: International Urogynecology Journal
https://www.readbyqxmd.com/read/29383415/autologous-fibroblast-seeded-amnion-for-reconstruction-of-neo-vagina-in-male-to-female-reassignment-surgery
#15
Kamal Seyed-Forootan, Hamid Karimi, Nazilla-Sadat Seyed-Forootan
BACKGROUND: Plastic surgeons have used several methods for the construction of neo-vaginas, including the utilization of penile skin, free skin grafts, small bowel or recto-sigmoid grafts, an amnion graft, and cultured cells. PURPOSE: The aim of this study is to compare the results of amnion grafts with amnion seeded with autograft fibroblasts. MATERIALS AND METHODS: Over 8 years, we compared the results of 24 male-to-female transsexual patients retrospectively based on their complications and levels of satisfaction...
April 2018: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/29368789/techniques-for-repair-of-obstetric-anal-sphincter-injuries
#16
Melanie R Meister, Joshua I Rosenbloom, Jerry L Lowder, Alison G Cahill
Importance: Obstetric anal sphincter injuries (OASISs) complicate up to 11% of vaginal deliveries; obstetricians must be able to recognize and manage these technically challenging injuries. Objective: The aim of this study was to share our approach for management of these challenging complications of childbirth based on a multidisciplinary collaboration between general obstetrician-gynecologists, maternal fetal medicine specialists, and female pelvic medicine and reconstructive surgeons established at our institution...
January 2018: Obstetrical & Gynecological Survey
https://www.readbyqxmd.com/read/29343918/pediatric-pelvic-fracture-urethral-distraction-defect-causing-complete-urethrovaginal-avulsion
#17
Ritesh Kumar Singh, Devashish Kaushal, Nikhil Khattar, Rishi Nayyar, T Manasa, Rajeev Sood
Pelvic fracture with urethral injury in girls is an uncommon entity that is usually associated with concomitant vaginal lacerations. Management options vary from immediate exploration and urethral anastomosis to delayed urethroplasty. We report our experience of managing a 10-year old girl presenting 6 months after a pelvic fracture with urethrovaginal injury and a completely obliterated urethral meatus managed successfully with a single-stage bladder tube repair.
January 2018: Indian Journal of Urology: IJU: Journal of the Urological Society of India
https://www.readbyqxmd.com/read/29324610/risk-factors-for-the-development-of-obstetric-anal-sphincter-injuries-in-modern-obstetric-practice
#18
Olga Ramm, Victoria G Woo, Yun-Yi Hung, Hsuan-Chih Chen, Miranda L Ritterman Weintraub
OBJECTIVE: To characterize the rate of obstetric anal sphincter injuries and identify key risk factors of obstetric anal sphincter injuries, including duration of the second stage of labor. METHODS: This retrospective cohort study included all singleton, term, cephalic vaginal deliveries within Kaiser Permanente Northern California between January 2013 and December 2014 (N=22,741). Incidence of obstetric anal sphincter injuries, defined as third- or fourth-degree perineal lacerations, was the primary outcome...
February 2018: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29324570/long-term-outcomes-after-overlapping-sphincteroplasty-for-cloacal-like-deformities
#19
Pedro A Maldonado, Donald Mcintire, Marlene M Corton
OBJECTIVE: The aim of this study was to report subjective, long-term outcomes and describe patient demographics, presenting symptoms, perioperative management, and complications after overlapping sphincteroplasty repair for chronic fourth-degree lacerations (cloacal-like deformities). METHODS: In this retrospective study, hospital records were reviewed for women who underwent overlapping anal sphincteroplasty for a cloacal-like deformity of the perineum at a single institution from 1996 to 2013...
January 10, 2018: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/29305940/complications-and-outcomes-of-pregnancy-and-cesarean-delivery-in-women-with-neuropathic-bladder-and-lower-urinary-tract-reconstruction
#20
Joshua D Roth, Jessica T Casey, Benjamin M Whittam, Konrad M Szymanski, Martin Kaefer, Richard C Rink, Frank P Schubert, Mark P Cain, Rosalia Misseri
OBJECTIVE: To determine the outcomes of pregnancy and cesarean delivery (CD) in women with neuropathic bladder (NB) and pediatric lower urinary tract reconstruction (LUTR) as these women often have normal fertility and may become pregnant. METHODS: We reviewed consecutive patients with NB due to spinal dysraphism who underwent LUTR, became pregnant, and had a CD at our institution from July 2001 to June 2016. We collected data on demographics, hydronephrosis, symptomatic urinary tract infection, continence, and catheterization during pregnancy...
January 3, 2018: Urology
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