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https://www.readbyqxmd.com/read/28267223/fundal-pressure-during-the-second-stage-of-labour
#1
REVIEW
G Justus Hofmeyr, Joshua P Vogel, Anna Cuthbert, Mandisa Singata
BACKGROUND: Fundal pressure during the second stage of labour (also known as the 'Kristeller manoeuvre') involves application of manual pressure to the uppermost part of the uterus directed towards the birth canal, in an attempt to assist spontaneous vaginal birth and avoid prolonged second stage or the need for operative birth. Fundal pressure has also been applied using an inflatable belt. Fundal pressure is widely used, however methods of its use vary widely. Despite strongly held opinions in favour of and against the use of fundal pressure, there is limited evidence regarding its maternal and neonatal benefits and harms...
March 7, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28252827/the-effect-of-rehabilitation-exercises-combined-with-direct-vagina-low-voltage-low-frequency-electric-stimulation-on-pelvic-nerve-electrophysiology-and-tissue-function-in-primiparous-women-a-randomised-controlled-trial
#2
Sumian Yang, Wenshu Sang, Jing Feng, Haifeng Zhao, Xian Li, Ping Li, Hongfang Fan, Zengjun Tang, Lina Gao
AIM AND OBJECTIVE: To evaluate the effect of rehabilitation exercises combined with Direct Vagina Low Voltage Low Frequency Electric Stimulation (DES) on pelvic nerve electrophysiology and tissue function after delivery. BACKGROUND: Whether and how DES effects pelvic floor dysfunction (PFD) are not known clearly. DESIGN: This was a randomised, controlled clinical trial. METHODS: The 189 primiparous women 20-35 years old and with an episiotomy or second degree episiotomy tear were divided into three groups: the control group (n=60) received routine postpartum guidance 2 hours postpartum, the training group (n=63) performed rehabilitation exercises (Kegel exercises and pelvic movements) from 2 days postpartum until 3 months postpartum, and the combination group (n=66) received DES 15 times (3 times a week for 30 min at a time) beginning at the sixth week postpartum in addition to performing rehabilitation exercises...
March 2, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28238246/clinical-presentation-and-value-of-echocardiography-in-the-diagnosis-of-freestyle-aortic-bioprosthesis-leaflet-tears-a-retrospective-study
#3
Philippe Rheault, Siamak Mohammadi, Kim O'Connor, François Dagenais, Pierre Voisine, Sébastien Bergeron, Mathieu Bernier, Christian Couture, Paul Poirier, Alexandre Cinq-Mars, Michelle Dubois, Mario Sénéchal
BACKGROUND: The unique design of the Freestyle stentless aortic bioprosthesis has led to different mechanisms of failure, particularly leaflet tearing. The aim of this retrospective study was to review the clinical presentation and echocardiographic data of symptomatic patients with leaflet tears and significant aortic regurgitation (AR) following implantation of the Freestyle bioprosthesis. METHODS: Between January 1993 and May 2011, a total of 430 consecutive patients was identified at the authors' institution who had undergone primary aortic valve replacement with a Freestyle stentless aortic bioprosthesis...
September 2016: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/28075154/survivorship-after-meniscal-allograft-transplantation-according-to-articular-cartilage-status
#4
Bum-Sik Lee, Seong-Il Bin, Jong-Min Kim, Won-Kyeong Kim, Jun Weon Choi
BACKGROUND: Clinical outcomes after meniscal allograft transplantation (MAT) in arthritic knees are unclear, and objective estimates of graft survival according to the articular cartilage status have not been performed. HYPOTHESIS: MAT should provide clinical benefits in knees with high-grade cartilage damage, but their graft survivorship should be inferior to that in knees with low-grade chondral degeneration after MAT. STUDY DESIGN: Cohort study; Level of evidence, 3...
January 1, 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/28027700/management-of-persistent-occiput-posterior-position-a-substantial-role-of-instrumental-rotation-in-the-setting-of-failed-manual-rotation
#5
Paul Guerby, Mickael Allouche, Caroline Simon-Toulza, Christophe Vayssiere, Olivier Parant, Fabien Vidal
INTRODUCTION: To compare the maternal and neonatal outcomes associated with Instrumental Rotation (IR) to operative vaginal delivery in occiput posterior (OP) position with Thierry's spatulas (TS), in the setting of failed manual rotation (MR). STUDY DESIGN: We led a prospective observational cohort study in a tertiary referral hospital in Toulouse, France. All women presenting in labor with persistent OP position at full cervical dilatation and who delivered vaginally after failed MR and with IR or OP assisted delivery were included from January 2014 to December 2015...
January 23, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28027607/third-or-fourth-degree-intrapartum-anal-sphincter-tears-are-associated-with-levator-ani-avulsion-in-primiparas
#6
Dan V Valsky, Sarah M Cohen, Michal Lipschuetz, Drorith Hochner-Celnikier, Hagit Daum, Itai Yagel, Simcha Yagel
OBJECTIVES: We evaluated primiparous women with clinically diagnosed third- and fourth-degree and anal sphincter tears, to evaluate the rate of levator ani muscle injury compared to primiparous women without sphincter tears. METHODS: Primiparous women delivering in our maternity ward with intrapartum diagnoses of third- or fourth-degree anal sphincter tears, repaired by the overlapping technique, were recruited to undergo 3-dimensional transperineal sonography of the pelvic floor anatomy, including the anterior and posterior compartments...
April 2016: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/27992558/pelvic-floor-disorders-6-months-after-attempted-operative-vaginal-delivery-according-to-the-fetal-head-station-a-prospective-cohort-study
#7
Guillaume Ducarme, Jean-François Hamel, Stéphanie Brun, Hugo Madar, Benjamin Merlot, Loïc Sentilhes
OBJECTIVE: To evaluate the effect of the fetal head station at attempted operative vaginal delivery (aOVD), and specifically midpelvic or low aOVD, on urinary incontinence (UI), anal incontinence (AI), and perineal pain at 6 months. DESIGN: Prospective cohort study. SETTING: 1941 women with singleton term fetuses in vertex presentation with midpelvic or low aOVD between 2008 and 2013 in a tertiary care university hospital. METHODS: Symptoms of urinary incontinence (UI) using the Bristol Female Lower Urinary Tract Symptoms questionnaire, and symptoms of anal incontinence (AI) severity using Fecal Incontinence Severity Index (FISI) were assessed 6 months after aOVD...
2016: PloS One
https://www.readbyqxmd.com/read/27987023/comparative-study-of-episiotomy-angles-achieved-by-cutting-with-straight-mayo-scissors-and-the-episcissors-60-in-a-birth-simulation-model
#8
Yves van Roon, Latha Vinayakarao, Louise Melson, Rebecca Percival, Sangeeta Pathak, Ashish Pradhan
INTRODUCTION AND HYPOTHESIS: We compared the clinician's ability to cut episiotomies at the recommended 60° angle with traditional straight Mayo scissors compared with patented fixed-angle episiotomy scissors EPISCISSORS-60® in a simulated setting using mounted incision pads. The hypothesis was that fixed-angle episiotomies would achieve a more accurate cutting angle of 60°. METHODS: Angles were cut on episiotomy incision pads in a mounted birth model simulating crowning: 110 midwives and doctors cut an 60° episiotomy with Mayo scissors and then EPISCISSORS-60...
December 16, 2016: International Urogynecology Journal
https://www.readbyqxmd.com/read/27986182/episiotomy-technique-and-management-of-anal-sphincter-tears-a-survey-of-clinical-practice-and-education
#9
Rebecca Menzies, Marian Leung, Nirmala Chandrasekaran, Andrea Lausman, Michael Geary
OBJECTIVE: To ascertain current techniques of episiotomy used by obstetrics and gynaecology faculty members and residents in an academic department and to determine the current management strategies for third and fourth degree tears. METHOD: A 14-question anonymous online survey was circulated to all faculty members and residents in the University of Toronto Department of Obstetrics and Gynaecology between October 2015 and March 2016. Results were analyzed descriptively or with Fisher exact test...
December 2016: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/27924373/female-sexual-function-following-different-degrees-of-perineal-tears
#10
Waleed Ali Sayed Ahmed, Eman Ahmed Kishk, Rasha Imam Farhan, Rasha Elsayed Khamees
INTRODUCTION AND HYPOTHESIS: Perineal tears may have a negative impact on female sexual function (FSF). The aim of the study was to assess the effect of different degrees of perineal tears sustained during delivery on subsequent FSF. METHODS: This prospective cohort study assessed women with third- or fourth-degree perineal tears following vaginal delivery (study group) and compared them with women who underwent episiotomy or had minor lacerations (control group)...
December 6, 2016: International Urogynecology Journal
https://www.readbyqxmd.com/read/27923280/obstetric-and-neonatal-characteristics-of-pregnancy-and-delivery-for-infant-birthweight-%C3%A2-5-0%C3%A2-kg
#11
David A Crosby, Sahar Ahmed, Aminah Razley, John J Morrison
AIM: Infant birthweight ≥5.0 kg represents a significant risk factor for mother and neonate. The objective of this study was to examine the obstetric and neonatal outcome measures in a large cohort of such deliveries. METHODS: The data used for this study were prospectively entered into an obstetric computerized database during the period 1989-2013. All pregnancies where the delivery resulted in an infant weighing ≥5.0 kg were identified. The results were retrospectively analyzed separately for parity, and a separate analysis was performed comparing the outcome measures observed in the earlier years of the study with those of the later years...
January 4, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/27852647/plantar-plate-repair-for-lesser-metatarsophalangeal-joint-instability
#12
Wesley W Flint, David M Macias, James R Jastifer, Jesse F Doty, Christopher B Hirose, Michael J Coughlin
BACKGROUND: Lesser metatarsophalangeal (MTP) joint instability is a common cause of forefoot pain. Advances in operative technique and instrumentation have made it possible to anatomically treat plantar plate tears through a dorsal approach. Our goal was to evaluate the subjective, functional, and radiographic outcomes of plantar plate repair (PPR) from a dorsal approach. METHODS: A prospective case series was performed evaluating the results of PPR in 97 feet with 138 plantar plate tears...
March 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/27788533/24-7-presence-of-medical-staff-in-the-labor-ward-no-day-night-differences-in-perinatal-and-maternal-outcomes
#13
Sara Tavares, João Cavaco-Gomes, Marina Moucho, Milton Severo, Mário Mateus, Carla Ramalho, Gerard H A Visser, Nuno Montenegro
Objective The objective of this study was to assess possible day-night differences in perinatal and maternal labor outcomes in a hospital setting with no day-night differences in the presence of experienced medical staff. Design This was a retrospective study conducted over 5 years between 2008 and 2012. Setting This study was set at the obstetric delivery unit in a tertiary hospital. Population A total of 9,143 singleton deliveries were assessed after 34 weeks of gestation and after exclusion of major congenital malformations, inductions of labor, and elective cesarean sections...
October 27, 2016: American Journal of Perinatology
https://www.readbyqxmd.com/read/27761586/reducing-obstetric-anal-sphincter-injuries-using-perineal-support-our-preliminary-experience
#14
Madhu Naidu, Abdul H Sultan, Ranee Thakar
INTRODUCTION AND HYPOTHESIS: Obstetric anal sphincter injuries (OASIs) are associated with significant short-term and long-term morbidity. Over the past decade, there has been a steady rise in the rate of OASIs. There is therefore a compelling need to identify strategies to minimize OASIs. The objective of this study was to determine if perineal support at the time of vaginal delivery can reduce the incidence and severity of OASIs. METHODS: All labour ward staff including midwives and doctors were invited to train in the technique of perineal support during vaginal delivery...
March 2017: International Urogynecology Journal
https://www.readbyqxmd.com/read/27720515/-assessment-of-restrictive-episiotomy-use-and-impact-on-perineal-tears-in-the-burgundy-s-perinatal-network
#15
P Ginod, B Khallouk, E Benzenine, T Desplanches, T Dub, E Schmutz, S Douvier, P Sagot
OBJECTIVES: To analyse episiotomy and perineal tears rates in Burgundy after French National College of Obstetricians and Gynecologists (CNGOF) guidelines in 2005. MATERIALS AND METHOD: Multicenter retrospective study, between 2003-2005 (period 1) et 2012-2014 (period 2), conducted on singletons vaginal deliveries, in cephalic presentation from 37 weeks. We compared the episiotomy rate (ER), and perineal lesions in normal deliveries (ND) and instrumental deliveries (ID) between the two periods...
November 2016: Journal de Gynécologie, Obstétrique et Biologie de la Reproduction
https://www.readbyqxmd.com/read/27677194/the-effect-of-prostaglandin-induced-labor-and-selected-factors-on-the-occurrence-and-extent-of-birth-canal-injuries
#16
A Kacvinska, M Drab, A Totka, K Holoman, M Gabor
OBJECTIVES: To determine the effect of labor induction using prostaglandin, gestation period and delivery type on the cause and extent of birth-canal injuries. METHODS: A retrospective study based on the records of II. GPK UNB Ružinov. The total set (n = 1377) consisted of patients who went into labor in second half of the year 2014 at this clinic. The research used categorical data divided into groups of factors (induction, week of delivery, type of delivery) and birth injuries...
2016: Bratislavské Lekárske Listy
https://www.readbyqxmd.com/read/27548421/committee-opinion-no-647-limitations-of-perineal-lacerations-as-an-obstetric-quality-measure
#17
(no author information available yet)
Perineal lacerations are a common occurrence with vaginal delivery. Although perineal lacerations are tracked easily from coding data, there are a variety of problems with using rates of such tears as a quality measure. The rate of severe perineal lacerations should not be used as a measure of obstetric quality for the following three reasons: 1) third-degree and fourth-degree perineal lacerations may not be defined uniformly; 2) severe perineal lacerations are associated strongly with nonmodifiable risk factors; and 3) diminishing the use of operative vaginal delivery, in an effort to decrease severe perineal lacerations, likely would result in an increased rate of cesarean delivery...
May 2016: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27548419/committee-opinion-no-647-summary-limitations-of-perineal-lacerations-as-an-obstetric-quality-measure
#18
(no author information available yet)
Perineal lacerations are a common occurrence with vaginal delivery. Although perineal lacerations are tracked easily from coding data, there are a variety of problems with using rates of such tears as a quality measure. The rate of severe perineal lacerations should not be used as a measure of obstetric quality for the following three reasons: 1) third-degree and fourth-degree perineal lacerations may not be defined uniformly; 2) severe perineal lacerations are associated strongly with nonmodifiable risk factors; and 3) diminishing the use of operative vaginal delivery, in an effort to decrease severe perineal lacerations, likely would result in an increased rate of cesarean delivery...
May 2016: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27532307/non-surgical-intrapartum-practices-for-the-prevention-of-severe-perineal-trauma-a-systematic-review-protocol
#19
Sophie van Limbeek, Deborah Davis, Marian Currie, Nola Wong
The objective of this review is to determine the effectiveness of non-surgical intrapartum practices in reducing the incidence of severe perineal trauma (third and fourth degree tears) during childbirth.
April 2016: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/27406639/complementary-therapies-for-labour-and-birth-study-a-randomised-controlled-trial-of-antenatal-integrative-medicine-for-pain-management-in-labour
#20
Kate M Levett, C A Smith, A Bensoussan, H G Dahlen
OBJECTIVE: To evaluate the effect of an antenatal integrative medicine education programme in addition to usual care for nulliparous women on intrapartum epidural use. DESIGN: Open-label, assessor blind, randomised controlled trial. SETTING: 2 public hospitals in Sydney, Australia. POPULATION: 176 nulliparous women with low-risk pregnancies, attending hospital-based antenatal clinics. METHODS AND INTERVENTION: The Complementary Therapies for Labour and Birth protocol, based on the She Births and acupressure for labour and birth courses, incorporated 6 evidence-based complementary medicine techniques: acupressure, visualisation and relaxation, breathing, massage, yoga techniques, and facilitated partner support...
July 12, 2016: BMJ Open
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