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vaginal laceration

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https://www.readbyqxmd.com/read/28721929/obstetric-hemorrhages-at-the-chu-yalgado-ou%C3%A3-draogo-of-ouagadougou%C3%A2-etiological-therapeutic-and-prognostic-aspects
#1
D P Kain, R D Ajavon, H Zamané, S Kiemtore, Y A Sawadogo, I Ouédraogo
To evaluate the maternal and perinatal prognosis of obstetric hemorrhages in the maternity department of the Yalgado Ouédraogo University Hospital of Ouagadougou. This descriptive cross-sectional study conducted in the four-month period from April through July 2015 included all women consulting on an emergency basis for vaginal bleeding during pregnancy at or after 28 weeks of gestation, or during labor, delivery, or the postpartum period. Obstetric hemorrhages accounted for 6% of admissions. The women's mean age was 27...
July 19, 2017: Médecine et Santé Tropicales
https://www.readbyqxmd.com/read/28705534/neuraxial-labor-analgesia-is-not-an-independent-predictor-of-perineal-lacerations-after-vaginal-delivery-of-patients-with-intrauterine-fetal-demise
#2
Ji H Lee, Feyce M Peralta, Anna Palatnik, Christina Lewicky Gaupp, Robert J McCarthy
INTRODUCTION: The role of neuraxial labor analgesia in perineal trauma following live births is controversial, and no studies have assessed the association in women delivering an intrauterine fetal demise. We evaluated the relationship between neuraxial labor analgesia and perineal laceration in these patients. METHODS: This was a retrospective case-control study of women with a diagnosis of fetal death after 20weeks of gestation, a vaginal delivery, and an Apgar score of 0 at delivery, during the period from January 2007 through December 2015...
June 1, 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28649718/anal-sphincters-evaluation-by-endoanal-ultrasound-in-obstructed-defecation
#3
Andreia Albuquerque, Guilherme Macedo
OBJECTIVES: To evaluate anal sphincter abnormalities detected by endoanal ultrasound in obstructed defecation due to rectocele and rectal intussusception. METHODS: The retrospective analysis includes 45 patients with obstructed defecation syndrome due to rectocele and/or rectal intussusception with or without fecal incontinence, and submitted to endoanal ultrasound. RESULTS: Ninety-three percent (n = 42) were women (mean age of 63 ± 12 years), and 47% (n = 21) of the patients had fecal incontinence...
June 26, 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/28624920/interobserver-agreement-in-perineal-ultrasound-measurement-of-the-anovaginal-distance-a-methodological-study
#4
Sofia Pihl, Eva Uustal, Linda Hjertberg, Marie Blomberg
INTRODUCTION AND HYPOTHESIS: Objective outcome measures of the extent of laceration at delivery are needed. In this study we evaluated and describe here a method for learning perineal ultrasound measurement of the anovaginal distance (AVD). The learning period needed for examiners proficient in vaginal ultrasound examination and the interobserver agreement after reaching proficiency in AVD measurement were determined. The hypothesis was that the method is feasible to learn and reproducible for use in further research...
June 17, 2017: International Urogynecology Journal
https://www.readbyqxmd.com/read/28606903/estimating-the-incidence-and-the-economic-burden-of-third-and-fourth-degree-obstetric-tears-in-the-english-nhs-an-observational-study-using-propensity-score-matching
#5
Martina Orlovic, Alexander William Carter, Joachim Marti, Elias Mossialos
OBJECTIVE: Obstetric care is a high-risk area in healthcare delivery, so it is essential to have up-to-date quantitative evidence in this area to inform policy decisions regarding these services. In light of this, the objective of this study is to investigate the incidence and economic burden of third and fourth-degree lacerations in the English National Health Service (NHS) using recent national data. METHODS: We used coded inpatient data from Hospital Episode Statistics (HES) for the financial years from 2010/2011 to 2013/2014 for all females that gave birth during that period in the English NHS...
June 12, 2017: BMJ Open
https://www.readbyqxmd.com/read/28594760/an-initiative-to-reduce-the-episiotomy-rate-association-of-feedback-and-the-hawthorne-effect-with-leapfrog-goals
#6
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
https://www.readbyqxmd.com/read/28422365/successful-vaginal-delivery-at-term-after-vaginal-reconstruction-with-labium-minus-flaps-in-a-patient-with-vaginal-atresia-a-rare-case-report
#7
Yu Liu, Yi-Feng Wang
We report a case of successful vaginal delivery after vaginal reconstruction with labium minus flaps in a 23-year-old patient with congenital vaginal atresia. The patient primarily presented with amenorrhea and cyclic abdominal pain; transabdominal ultrasonography revealed an enlarged uterus due to hematometra and absence of the lower segment of the vagina. Eight years ago, she had undergone an unsuccessful attempt at canalization at a local hospital. Upon referral to our hospital, she underwent vaginal reconstruction with labium minus flaps...
April 19, 2017: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/28405063/perineal-body-length-and-perineal-lacerations-during-delivery-in-primigravid-patients
#8
T Lance Lane, Christopher P Chung, Paul M Yandell, Thomas J Kuehl, Wilma I Larsen
This study assessed the relation between perineal body length and the risk of perineal laceration extending into the anal sphincter during vaginal delivery in primigravid patients at an institution with a low utilization of episiotomy. This was a prospective study of primigravid patients in active labor. Primigravid women with singleton pregnancies who were in the first stage of labor at 37 weeks gestation or greater were recruited, and the admitting physician measured the length of the perineal body. The degree of perineal laceration and other delivery characteristics were recorded...
April 2017: Proceedings of the Baylor University Medical Center
https://www.readbyqxmd.com/read/28371359/maternal-and-neonatal-outcomes-in-birth-centers-versus-hospitals-among-women-with-low-risk-pregnancies-in-japan-a-retrospective-cohort-study
#9
Yaeko Kataoka, Yuko Masuzawa, Chiho Kato, Hiromi Eto
AIM: In order for low-risk pregnant women to base birth decisions on the risks and benefits, they need evidence of birth outcomes from birth centers. The purpose of this study was to describe and compare the maternal and neonatal outcomes of low-risk women who gave birth in birth centers and hospitals in Japan. METHODS: The participants were 9588 women who had a singleton vaginal birth at 19 birth centers and two hospitals in Tokyo. The data were collected from their medical records, including their age, parity, mode of delivery, maternal position at delivery, duration of labor, intrapartum blood loss, perineal trauma, gestational weeks at birth, birth weight, Apgar score, and stillbirths...
March 29, 2017: Japan Journal of Nursing Science: JJNS
https://www.readbyqxmd.com/read/28357560/maternal-and-neonatal-outcomes-after-induction-of-labor-a-population-based-study
#10
Christoph Zenzmaier, Hermann Leitner, Christoph Brezinka, Willi Oberaigner, Martina König-Bachmann
PURPOSE: To evaluate maternal and neonatal outcomes at and beyond term associated with induction of labor compared to spontaneous onset of labor stratified by week of gestational age. METHODS: In this retrospective cohort study, data form 402,960 singleton pregnancies from the Austria Perinatal Registry were used to estimate odds ratios of secondary cesarean delivery, operative vaginal delivery, epidural analgesia, fetal scalp blood testing, episiotomy, 3rd/4th-degree lacerations, retained placenta, 5-min APGAR <7, umbilical artery pH <7...
March 29, 2017: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/28349526/pushing-bearing-down-methods-for-the-second-stage-of-labour
#11
REVIEW
Andrea Lemos, Melania Mr Amorim, Armele Dornelas de Andrade, Ariani I de Souza, José Eulálio Cabral Filho, Jailson B Correia
BACKGROUND: Maternal pushing during the second stage of labour is an important and indispensable contributor to the involuntary expulsive force developed by uterine contraction. There is no consensus on an ideal strategy to facilitate these expulsive efforts and there are contradictory results about the influence on the mother and fetus. OBJECTIVES: To evaluate the benefits and possible disadvantages of different kinds of techniques regarding maternal pushing/breathing during the expulsive stage of labour on maternal and fetal outcomes...
March 26, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28282772/does-meperidine-analgesia-affect-the-incidence-of-obstetric-lacerations-at-vaginal-delivery
#12
Yossi Mizrachi, Sophia Leytes, Michal Levy, Shimon Ginath, Jacob Bar, Tiberiu Ezri, Michal Kovo
PURPOSE: To study whether meperidine analgesia affects the incidence of obstetric lacerations at normal vaginal deliveries. MATERIALS AND METHODS: A retrospective cohort study of all women with term vertex singleton pregnancies, who underwent normal vaginal deliveries, in a single tertiary hospital, between 2011 and 2015, was performed. The incidence of various obstetric lacerations was compared between deliveries with meperidine analgesia and deliveries with no analgesia...
February 28, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28262236/disseminated-intravascular-coagulation-in-pregnancy-clinical-phenotypes-and-diagnostic-scores
#13
Offer Erez
During a women's life cycle, pregnancy is a period in which she is at risk for hemorrhagic events and obstetrical syndromes that may develop into disseminated intravascular coagulation (DIC). This life-threatening condition is a complication of obstetrical and non-obstetrical causes including: (1) acute peripartum hemorrhage (uterine atony, cervical and vaginal lacerations, and uterine rupture); (2) placental abruption; (3) Pre-eclampsia/HELLP syndrome; (4) retained stillbirth; (5) sepsis; (6) amniotic fluid embolism; and (7) acute fatty liver of pregnancy...
March 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28222704/duration-of-second-stage-of-labor-and-instrumental-delivery-as-risk-factors-for-severe-perineal-lacerations-population-based-study
#14
Marija Simic, Sven Cnattingius, Gunnar Petersson, Anna Sandström, Olof Stephansson
BACKGROUND: We sought to investigate the impact of the duration of second stage of labor on risk of severe perineal lacerations (third and fourth degree). METHODS: This population based cohort study was conducted in the Stockholm/Gotland region, Sweden, 2008-2014. Study population included 52 211 primiparous women undergoing vaginal delivery with cephalic presentation at term. Unconditional logistic regression analysis was used to calculate crude and adjusted odds ratios (OR), using 95% confidence intervals (CI)...
February 21, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28195378/to-cut-or-not-to-cut-that-is-the-question-a-review-of-the-anatomy-the-technique-risks-and-benefits-of-an-episiotomy
#15
REVIEW
Mitchel Alan Muhleman, Islam Aly, Andrew Walters, Nitsa Topale, R Shane Tubbs, Marios Loukas
Childbirth can be a traumatic experience on the female body. Some techniques may be implemented to make the process smoother and decrease the potential lacerations that can occur. Episiotomies have been used by obstetricians and midwives to help make the fetal decent down the vaginal canal less turbulent. A physician must use his best judgment on when it is necessary to make this incision and what form of incision to make. Before making an incision one must understand the female external and internal anatomy and thoroughly comprehend the stages of birth to understand how and what complications can occur...
April 2017: Clinical Anatomy
https://www.readbyqxmd.com/read/28178050/filled-prescriptions-for-opioids-after-vaginal-delivery
#16
Marian Jarlenski, Lisa M Bodnar, Joo Yeon Kim, Julie Donohue, Elizabeth E Krans, Debra L Bogen
OBJECTIVE: To estimate the prevalence of filled opioid prescriptions after vaginal delivery. METHODS: We conducted a retrospective cohort study of 164,720 Medicaid-enrolled women in Pennsylvania who delivered a liveborn neonate vaginally from 2008 to 2013, excluding women who used opioids during pregnancy or who had an opioid use disorder. We assessed overall filled prescriptions as well as filled prescriptions in the presence or absence of the following pain-inducing conditions: bilateral tubal ligation, perineal laceration, or episiotomy...
March 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28164296/deinfibulation-for-preventing-or-treating-complications-in-women-living-with-type-iii-female-genital-mutilation-a%C3%A2-systematic-review-and-meta-analysis
#17
REVIEW
Babasola O Okusanya, Olabisi Oduwole, Nuria Nwachuku, Martin M Meremikwu
BACKGROUND: Deinfibulation is a surgical procedure carried out to re-open the vaginal introitus of women living with type III female genital mutilation (FGM). OBJECTIVES: To assess the impact of deinfibulation on gynecologic or obstetric outcomes by comparing women who were deinfibulated with women with type III FGM or women without FGM. SEARCH STRATEGY: Major databases including CENTRAL, MEDLINE, and Scopus were searched until August 2015...
February 2017: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/28099786/labor-intervention-and-outcomes-in-women-who-are-nulliparous-and-obese-comparison-of-nurse-midwife-to-obstetrician-intrapartum-care
#18
COMPARATIVE STUDY
Nicole S Carlson, Elizabeth J Corwin, Nancy K Lowe
BACKGROUND: Women who are obese have slower labors than women of normal weight, and show reduced response to interventions designed to speed labor progress like oxytocin augmentation and artificial rupture of membranes. The optimal labor management for these women has not been described. METHODS: This retrospective cohort study compared 2 propensity score-matched groups of women (N = 360) who were healthy, nulliparous, spontaneously laboring, and obese (body mass index ≥ 30 kg/m(2) )...
January 2017: Journal of Midwifery & Women's Health
https://www.readbyqxmd.com/read/28099742/does-breech-delivery-in-an-upright-position-instead-of-on-the-back-improve-outcomes-and-avoid-cesareans
#19
COMPARATIVE STUDY
Frank Louwen, Betty-Anne Daviss, Kenneth C Johnson, Anke Reitter
OBJECTIVE: To compare breech outcomes when mothers delivering vaginally are upright, on their back, or planning cesareans. METHODS: A retrospective cohort study was undertaken of all women who presented for singleton breech delivery at a center in Frankfurt, Germany, between January 2004 and June 2011. RESULTS: Of 750 women with term breech delivery, 315 (42.0%) planned and received a cesarean. Of 269 successful vaginal deliveries of neonates, 229 in the upright position were compared with 40 in the dorsal position...
February 2017: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/28079778/association-of-intended-route-of-delivery-and-maternal-morbidity-in-twin-pregnancy
#20
Sarah Rae Easter, Julian N Robinson, Ellice Lieberman, Daniela Carusi
OBJECTIVE: To evaluate maternal morbidity in twin pregnancies according to intended mode of delivery. METHODS: We assembled a 7-year retrospective cohort (2007-2014) of women delivering viable, vertex-presenting twins at or beyond 32 weeks of gestation without contraindication to labor or uterine scar. We classified women as undergoing a trial of labor to attempt vaginal birth or choosing an elective cesarean delivery. Our primary outcome was a measure of composite maternal morbidity including death, postpartum hemorrhage, infection, major procedure, readmission for infection or reoperation, need for dilation and evacuation for hemorrhage or infection, venous thromboembolism, small bowel obstruction or ileus, or intensive care unit admission...
February 2017: Obstetrics and Gynecology
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