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https://www.readbyqxmd.com/read/29117015/racial-ethnic-differences-in-perineal-lacerations-in-a-diverse-urban-healthcare-system
#1
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/29043436/cervical-dilation-balloon-combined-with-intravenous-drip-of-oxytocin-for-induction-of-term-labor-a-multicenter-clinical-trial
#2
Xueqin Wu, Chunxiang Wang, Yufang Li, Chunmei Ouyang, Jiaying Liao, Weibin Cai, Yilei Zhong, Jianping Zhang, Hui Chen
OBJECTIVE: This study aimed to investigate the effectiveness and safety of a method combining double-balloon catheter for cervical ripening and intravenous drip of oxytocin on the induction of term labor, providing the reference for clinical safety. METHODS: A total of 120 pregnant women with a gestation between 37(+0) and  41(+6) weeks, indications of labor induction, singleton pregnancy with cephalic presentation were enrolled. The patients were divided into the research group receiving cervical dilation balloon combined with intravenous drip of oxytocin and the control group receiving an intravenous drip of oxytocin at a concentration of 0...
October 17, 2017: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/29037175/a-ten-year-study-of-midwife-led-care-at-an-austrian-tertiary-care-center-a-retrospective-analysis-with-special-consideration-of-perineal-trauma
#3
Barbara Bodner-Adler, Oliver Kimberger, Julia Griebaum, Peter Husslein, Klaus Bodner
BACKGROUND: In contrast to other countries, Austria rarely offers alternative models to medical led-care. In an attempt to improve the facilities, a midwife-led care service was incorporated within the Department of Obstetrics and Fetomaternal Medicine. The aim of the present study was to analyze the maternal and neonatal outcomes of this approach. METHODS: Over a 10-years period, a total of 2123 low-risk women receiving midwife-led care were studied. Among these women, 148 required obstetric referral...
October 16, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28969481/delivery-through-cervicovaginal-fistula-literature-review-and-case-report
#4
Rafał Watrowski, Burghardt Babbel, Gerald Gitsch
Less than 10 deliveries via cervicovaginal fistula (CVF) with closed cervical os were reported so far. In the majority of cases, the patients had a history of induced abortions. The CVF was usually recognized due to postpartum hemorrhage. The facilitating role of prostaglandins used for labor induction was supposed. In all cases, the babies remained unaffected by the delivery route. We report a new case of a 37-year-old gravida 2, para 0, with a history of a paracervical tear following a first trimester abortion 11 years ago...
October 23, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28941556/subgaleal-hematoma-at-the-contralateral-side-of-scalp-trauma-in-an-adult
#5
Ching-En Chen, Zen-Zhon Liao, Yen-Heng Lee, Cheng-Chieh Liu, Chi-Kao Tang, Yi-Rong Chen
BACKGROUND: Subgaleal hematoma (SGH), an abnormal accumulation of blood under the galeal aponeurosis of the scalp, is more commonly observed in newborns and children. According to previous cases, the etiology of SGH includes mild head trauma, vacuum-assisted vaginal delivery, contusion, and hair braiding or pulling. CASE REPORT: A 39-year-old healthy worker came to our emergency department (ED) due to scalp lacerations from an accident that caused severe twisting of his hair...
November 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28913129/evaluating-the-content-and-quality-of-intrapartum-care-in-vaginal-births-an-example-of-a-state-hospital
#6
Zekiye Karaçam, Döndü Arslan Kurnaz, Gizem Güneş
OBJECTIVE: The purpose of the research was to assess the content and quality of the intrapartum care offered in vaginal births in Turkey, based on the example of a state hospital. MATERIALS AND METHODS: This cross-sectional study was conducted between January 1(st), 2013 and December 31(st), 2014 at Aydın Maternity and Children's Hospital. The study sample consisted of 303 women giving vaginal birth, who were recruited into the study using the method of convenience sampling...
March 2017: Turk J Obstet Gynecol
https://www.readbyqxmd.com/read/28885403/postpartum-management-after-obstetric-anal-sphincter-injuries
#7
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/28838864/pelvic-abscess-secondary-to-mycoplasma-hominis-following-vaginal-laceration
#8
Vini Vijayan, Gail L Woods, Dale R Donnell, José R Romero
BACKGROUND: Mycoplasma hominis frequently colonizes the urogenital and respiratory tracts of healthy individuals. It has also been associated with genitourinary tract and extra-genital syndromes. CASE: We present a 14-year-old girl who developed a pelvic abscess secondary to M. hominis following a vaginal laceration during sexual intercourse. Despite drainage and broad spectrum antimicrobial therapy, the patient remained symptomatic until M. hominis was identified and specific therapy instituted...
August 21, 2017: Journal of Pediatric and Adolescent Gynecology
https://www.readbyqxmd.com/read/28833082/use-of-bulldog-vascular-clamps-to-reduce-intraoperative-bleeding-during-cesarean-hysterectomy-for-placenta-percreta
#9
Polat Dursun
Postpartum hemorrhage causes 25% of all maternal deaths worldwide and is the leading cause of maternal morbidity and mortality following vaginal or caesarean delivery. Every year, postpartum hemorrhage is estimated to cause approximately 125 000 maternal deaths and is associated with morbidity among 20 million women. It is caused by several obstetric conditions, including uterine atony and placental problems such as placenta accreta spectrum disorders, trauma, and lacerations. Several techniques are known to prevent postpartum hemorrhage, including uterine cavity tamponade, uterine artery ligation, uterine artery embolization, pre-cesarean prophylactic balloon catheterization, uterine compression sutures, hypogastric artery ligation, and hysterectomy...
August 21, 2017: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/28806489/characteristics-of-spontaneous-births-attended-by-midwives-and-physicians-in-us-hospitals-in-2014
#10
Patrick Thornton
INTRODUCTION: This study compares characteristics and birth outcomes of women attended by certified nurse-midwives/certified midwives (midwives) and physicians in US hospitals in 2014. METHODS: Data reported in 2014 on the 2003 version of the US birth certificate were examined. Spontaneous vaginal births attributed to midwives and physicians and occurring in hospitals were included. Demographic and risk profiles and adjusted odds ratios for maternal and newborn outcomes were compared by provider type...
August 14, 2017: Journal of Midwifery & Women's Health
https://www.readbyqxmd.com/read/28800671/-outcomes-of-planned-out-of-hospital-and-low-risk-hospital-births-in-lower-saxony
#11
Antje Petersen, Lea-Marie Köhler, Christiane Schwarz, Bernhard Vaske, Mechthild M Gross
Introduction Internationally, there is debate on the safety of different birth settings inside and outside of hospitals. Low-risk women in Germany can choose where they give birth, and out-of-hospital births are especially necessary in regions lacking infrastructure. To date, national studies are required. Materials and Methods We investigated planned out-of-hospital (OH) and hospital births in Lower Saxony, Germany, in 2005. Women with a singleton fetus in the vertex position were included once they reached 34+0 gestational weeks...
August 2017: Zeitschrift Für Geburtshilfe und Neonatologie
https://www.readbyqxmd.com/read/28757410/massive-vaginal-hematoma-a-complication-of-in%C3%A2-vitro-fertilization
#12
Marta Wais, Crystal Chan
BACKGROUND: The rates of serious complications from IVF with transvaginal oocyte retrieval are low. However, as the usage of IVF continues to increase, more complications are presenting to acute care and physicians should be aware of management issues. CASE: A 36-year-old, gravida 4, para 1 woman presented to the emergency department with significant vaginal hemorrhage and severe abdominal pain after undergoing a routine transvaginal oocyte retrieval. She was taken to the operating room and found to have extensive lacerations of the posterior vaginal mucosa and a large vaginal hematoma tracking to the retroperitoneal space...
July 28, 2017: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
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
#13
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
#14
J H Lee, F M Peralta, A Palatnik, C L Gaupp, R 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...
November 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28649718/anal-sphincters-evaluation-by-endoanal-ultrasound-in-obstructed-defecation
#15
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
#16
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
#17
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
#18
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)...
July 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
#19
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
#20
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
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