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https://www.readbyqxmd.com/read/29785549/once-episiotomy-always-episiotomy
#1
Ayala Zilberman, Eyal Sheiner, Orit Barrett, Batel Hamou, Tali Silberstein
OBJECTIVE: To investigate the association between episiotomy and perineal damage in the subsequent delivery. STUDY DESIGN: A retrospective cohort study was conducted, comparing outcome of subsequent singleton deliveries of women with and without episiotomy in their first (index) delivery. Deliveries occurred between the years 1991-2015 in a tertiary medical center. Traumatic vaginal tears, multiple pregnancies, and cesarean deliveries (CD) in the index pregnancy were excluded from the analysis...
May 21, 2018: Archives of Gynecology and Obstetrics
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
#2
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/29768662/immersion-in-water-during-labour-and-birth
#3
REVIEW
Elizabeth R Cluett, Ethel Burns, Anna Cuthbert
BACKGROUND: Water immersion during labour and birth is increasingly popular and is becoming widely accepted across many countries, and particularly in midwifery-led care settings. However, there are concerns around neonatal water inhalation, increased requirement for admission to neonatal intensive care unit (NICU), maternal and/or neonatal infection, and obstetric anal sphincter injuries (OASIS). This is an update of a review last published in 2011. OBJECTIVES: To assess the effects of water immersion during labour and/or birth (first, second and third stage of labour) on women and their infants...
May 16, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29680718/are-we-performing-episiotomies-correctly-a-study-to-evaluate-french-technique-in-a-high-risk-maternity-unit
#4
Fanny Béchard, Julia Geronimi, Pierre Vieille, Vincent Letouzey, Renaud de Tayrac
INTRODUCTION: The aim of this study was to evaluate episiotomy technique, in particular suture angles, and any correlation between suture angle and severe perineal tears. MATERIAL AND METHODS: An observational questionnaire-based study was conducted between 01 August 2015 and 30 April 2016 among accoucheurs performing episiotomies in a French maternity unit with facilities for high-risk pregnancies. For each patient included, accoucheurs were asked to measure the episiotomy suture angle, and to record the angle at which they thought they had cut, the length of the episiotomy, its distance from the anus, and whether the woman sustained a sphincter injury...
April 19, 2018: Journal of Gynecology Obstetrics and Human Reproduction
https://www.readbyqxmd.com/read/29648935/episiotomy-and-perineal-tear-risk-factors-in-a-group-of-4493-women
#5
Grażyna Gebuza, Marzena Kaźmierczak, Alicja Gdaniec, Estera Mieczkowska, Małgorzata Gierszewska, Agnieszka Dombrowska-Pali, Mariola Banaszkiewicz, Marek Maleńczyk
Episiotomy belongs to the most frequent procedures carried out during delivery. Performing episiotomy should be reduced as there is scientific evidence indicating that it can cause pain, sexual problems, and serious, long-term health consequences. The aim of the researchers is to identify factors associated with episiotomy and the perineal tear. Analyses were performed using a model of a logistic regression. The study involved 4493 women. The episiotomy risk was related to: a birth weight exceeding 3500 grams, an instrumental delivery by means of forceps or vacuum extraction...
April 12, 2018: Health Care for Women International
https://www.readbyqxmd.com/read/29602451/-autologous-serum-tears-long-term-treatment-in-dry-eye-syndrome
#6
M Beylerian, M Lazaro, J Magalon, J Veran, A Darque, F Grimaud, N Stolowy, H Beylerian, F Sabatier, L Hoffart
INTRODUCTION: Dry eye disease is a multifactorial pathology of the ocular surface. The high incidence of this pathology, as well as its significant impact on quality of life and vision and its financial cost, makes it a real public health problem. While the treatment of mild cases is generally simple and effective, treatment of severe forms is often disappointing. The use of autologous serum tears (AST) represents a therapeutic alternative for the most severe cases. The purpose of our study is to evaluate the efficacy of long-term AST treatment in patients with severe dry eye disease refractory to conventional treatment or secondary to systemic diseases such as Sjögren's syndrome or Graft versus Host disease (GVH), or ocular pathologies such as neurotrophic keratitis, chemical burns and ocular cicatricial pemphigoid...
March 2018: Journal Français D'ophtalmologie
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
#7
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/29546469/outcomes-of-primary-anal-sphincter-repair-after-obstetric-injury-and-evaluation-of-a-novel-three-choice-assessment
#8
K Kuismanen, K Nieminen, K Karjalainen, K Lehto, J Uotila
BACKGROUND: The aim of the present study was to evaluate the subjective outcome of primary repair of obstetric anal sphincter injury (OASIS) at 6 months, the factors associated with the symptoms of anal incontinence (AI), and the role of a simple survey consisting in one question with three answer choices, combined with the Wexner incontinence score for the assessment of this patient population. METHODS: A retrospective cohort study was conducted on patients with third- or fourth-degree OASIS operated on between January 2007 and December 2013 inclusive at Tampere University Hospital, Finland...
March 2018: Techniques in Coloproctology
https://www.readbyqxmd.com/read/29526165/odon-device-for-instrumental-vaginal-deliveries-results-of-a-medical-device-pilot-clinical-study
#9
Javier A Schvartzman, Hugo Krupitzki, Mario Merialdi, Ana Pilar Betrán, Jennifer Requejo, My Huong Nguyen, Effy Vayena, Angel E Fiorillo, Enrique C Gadow, Francisco M Vizcaino, Felicitas von Petery, Victoria Marroquin, María Luisa Cafferata, Agustina Mazzoni, Valerie Vannevel, Robert C Pattinson, A Metin Gülmezoglu, Fernando Althabe, Mercedes Bonet
BACKGROUND: A prolonged and complicated second stage of labour is associated with serious perinatal complications. The Odon device is an innovation intended to perform instrumental vaginal delivery presently under development. We present an evaluation of the feasibility and safety of delivery with early prototypes of this device from an early terminated clinical study. METHODS: Hospital-based, multi-phased, open-label, pilot clinical study with no control group in tertiary hospitals in Argentina and South Africa...
March 12, 2018: Reproductive Health
https://www.readbyqxmd.com/read/29455000/the-impact-of-increased-number-of-low-risk-deliveries-on-maternal-and-neonatal-outcomes-a-retrospective-cohort-study-in-finland-in-2011-2015
#10
Elina Karalis, Anna-Maija Tapper, Mika Gissler, Veli-Matti Ulander
OBJECTIVES: Our aim was to demonstrate the influence of increased number of low-risk deliveries on obstetric and neonatal outcome. STUDY DESIGN: The study hospital was Kätilöopisto Maternity Hospital in Helsinki. Simultaneously, we studied all three delivery units in the Helsinki region in the population-based analysis. The study population was singleton hospital deliveries occurring between 2011 and 2012, and 2014-2015. The study hospital included 11 237 and 15 637 births and the population-based group included 28 950 and 27 979 births...
April 2018: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/29366610/-occiput-posterior-presentation-at-delivery-materno-foetal-outcomes-and-predictive-factors-of-rotation
#11
V Othenin-Girard, M Boulvain, M-J Guittier
OBJECTIVES: To describe the maternal and foetal outcomes of an occiput posterior foetal position at delivery; to evaluate predictive factors of anterior rotation during labour. METHODS: Descriptive retrospective analysis of a cohort of 439 women with foetuses in occiput posterior position during labour. Logistic regression analysis to quantify the effect of factors that may favour anterior rotation. RESULTS: Most of foetuses (64%) do an anterior rotation during labour and 13% during the expulsive phase...
February 2018: Gynecologie, Obstetrique, Fertilite & Senologie
https://www.readbyqxmd.com/read/29304391/incidence-and-risk-factors-of-third-and-fourth-degree-perineal-tears-in-a-single-italian-scenario
#12
Matteo Frigerio, Stefano Manodoro, Davide P Bernasconi, Debora Verri, Rodolfo Milani, Patrizia Vergani
OBJECTIVE: This study aimed to evaluate III and IV degree tears rates and related risk factors in a single Italian centre. The secondary goal was to build a predictive model based on identified risk factors. STUDY DESIGN: This was a retrospective cohort study. All vaginal deliveries from 2011 to 2015 in a single Italian University Hospital were analysed. Univariate analysis was applied to evaluate the overall association between each factor and severe tear. Multivariate logistic regression was used to build a predictive model for the absolute risk of severe tear...
February 2018: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/29178349/effect-of-body-mass-index-on-the-incidence-of-perineal-trauma
#13
Constantin M Durnea, Ali E Jaffery, Nivedita Gauthaman, Stergios K Doumouchtsis
OBJECTIVE: To investigate the association between perineal trauma at childbirth and maternal body mass index (BMI), and estimate the risk of perineal trauma among different BMI groups. METHODS: Data were retrospectively assessed from all vaginal deliveries in a UK tertiary maternity unit between 1999 and 2014. Associations between BMI at booking and first- and second-degree tears (minor perineal trauma), third- and fourth-degree tears (obstetric anal sphincter injuries [OASIS]), and frequency of instrumental deliveries were assessed...
November 27, 2017: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/29155037/long-term-anal-incontinence-after-obstetric-anal-sphincter-injury-does-grade-of-tear-matter
#14
Hanna Jangö, Jens Langhoff-Roos, Susanne Rosthøj, Abelone Saske
BACKGROUND: Anal incontinence is a major concern following delivery with obstetric anal sphincter injury (OASIS), and has been related to the degree of sphincter tear. OBJECTIVE: The aims of this study were (1) to evaluate whether women with a fourth-degree OASIS in the first delivery have an increased risk of long-term anal and fecal incontinence after a second delivery, and (2) to assess the impact of mode of second delivery on anal incontinence and related symptoms in these patients...
February 2018: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29107784/incidence-of-postpartum-anaemia-and-risk-factors-associated-with-vaginal-birth
#15
Ana Rubio-Álvarez, Milagros Molina-Alarcón, Antonio Hernández-Martínez
BACKGROUND: Postpartum anaemia is a frequent and potentially preventable complication that has serious repercussions on health and maternal well-being. AIM: Determine the incidence and perinatal risk factors associated with postpartum anaemia in women who gave birth vaginally. METHODS: An observational and analytical retrospective cohort study conducted at the Mancha-Centro Hospital during the 2010-2014 period. Data were collected from 2990 women who gave birth vaginally...
October 26, 2017: Women and Birth: Journal of the Australian College of Midwives
https://www.readbyqxmd.com/read/28923011/nurse-midwives-ability-to-diagnose-acute-third-and-fourth-degree-obstetric-lacerations-in-western-kenya
#16
Leeya F Pinder, Kelsey H Natsuhara, Thomas F Burke, Svjetlana Lozo, Monica Oguttu, Leah Miller, Brett D Nelson, Melody J Eckardt
BACKGROUND: Obstetric fistula devastates the lives of women and is found most commonly among the poor in resource-limited settings. Unrepaired third- and fourth-degree perineal lacerations have been shown to be the source of approximately one-third of the fistula burden in fistula camps in Kenya. In this study, we assessed potential barriers to accurate identification by Kenyan nurse-midwives of these complex perineal lacerations in postpartum women. METHODS: Nurse-midwife trainers from each of the seven sub-counties of Siaya County, Kenya were assessed in their ability to accurately identify obstetric lacerations and anatomical structures of the perineum, using a pictorial assessment tool...
September 18, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28818007/kiwi-omnicup-handheld-vs-mityvac-m-style-conventional-vacuum-system-a-retrospective-observational-study
#17
Tal Weissbach, Nasreen Hag-Yahia, Michal Ovadia, Keren Tzadikevitch Geffen, Omer Weitzner, Tal Biron-Shental
INTRODUCTION: To improve choice of vacuum-assisted delivery (VAD) system, we compared outcomes of Kiwi handheld system and Mityvac M-style conventional system (both use disposable plastic cups). MATERIALS AND METHODS: Retrospective observational study with data collection from electronic medical records. The study was conducted at a tertiary medical center, with approximately 7000 deliveries annually. Categorical and continuous variables were analyzed using chi-square test and t-test, respectively...
August 17, 2017: Journal of Maternal-fetal & Neonatal Medicine
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
#18
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/28793827/kiwi-omnicup-handheld-versus-mityvac-m-style-conventional-vacuum-system-a-retrospective-observational-study
#19
Tal Weissbach, Nasreen Hag-Yahia, Michal Ovadia, Keren Tzadikevitch Geffen, Omer Weitzner, Tal Biron-Shental
INTRODUCTION: To improve the choice of vacuum-assisted delivery (VAD) system, we compared the outcomes of Kiwi handheld system and Mityvac M-style conventional system (both use disposable plastic cups). MATERIALS AND METHODS: Retrospective observational study with data collection from electronic medical records. The study was conducted at a tertiary medical center, with approximately 7000 deliveries annually. Categorical and continuous variables were analyzed using chi-square test and t-test, respectively...
August 24, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28776641/the-great-divide-country-of-birth-as-a-risk-factor-for-obstetric-anal-sphincter-injuries
#20
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...
February 2018: Australian & New Zealand Journal of Obstetrics & Gynaecology
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