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Operative vaginal delivery

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 15, 2018: Techniques in Coloproctology
Tina Djernis Gundersen, Lone Krebs, Ellen Christine Leth Loekkegaard, Steen Christian Rasmussen, Julie Glavind, Tine Dalsgaard Clausen
OBJECTIVES: To examine the association between postpartum urinary tract infection and intended mode of delivery as well as actual mode of delivery. DESIGN: Retrospective cohort study. SETTING AND PARTICIPANTS: All live births in Denmark between 2004 and 2010 (n=450 856). Births were classified by intended caesarean delivery (n=45 053) or intended vaginal delivery (n=405 803), and by actual mode of delivery: spontaneous vaginal delivery, operative vaginal delivery, emergency or planned caesarean delivery in labour or prelabour...
March 14, 2018: BMJ Open
Mary McGunigal, Ariel Pollock, John T Doucette, Jerry Liu, Manjeet Chadha, Tamara Kalir, Vishal Gupta
OBJECTIVES: Randomized trials have shown a local control benefit with adjuvant radiotherapy (RT) in high-intermediate-risk endometrial cancer patients, although not all such patients receive RT. We reviewed the National Cancer Data Base to investigate which patient/tumor-related factors are associated with delivery of adjuvant RT. METHODS: The National Cancer Data Base was queried for patients diagnosed with International Federation of Gynecology and Obstetrics 2009 stage I endometrioid adenocarcinoma from 1998 to 2012 who underwent surgery +/- adjuvant RT...
March 14, 2018: International Journal of Gynecological Cancer
Marie-Louise Marschalek, Christof Worda, Lorenz Kuessel, Heinz Koelbl, Willi Oberaigner, Hermann Leitner, Julian Marschalek, Heinrich Husslein
BACKGROUND: In view of the reported increase in obstetric anal sphincter injuries, the objective of this study was to evaluate the incidence of such injuries over time and the associated risk and protective factors. METHODS: This was a retrospective cohort study from a national database of 168 137 primiparous women with term, singleton, cephalic, vaginal delivery between 2008 and 2014. The main outcome measure was obstetric anal sphincter injury. A multivariate regression model was used to identify risk and protective factors...
March 14, 2018: Birth
Hellen McKinnon Edwards
This thesis is comprised of three studies focusing on severe postpartum haemorrhage (PPH). PPH is a major cause of maternal morbidity and mortality worldwide. Risk factors include retained placenta, prolonged duration of the third stage of labour, previous caesarean section, and operative vaginal delivery. Occurrence and development of PPH are, however, unpredictable and can sometimes give rise to massive haemorrhage or even hysterectomy and maternal death. Severe haemorrhage can lead to coagulopathy causing further haemorrhage and requiring substitution with blood transfusions...
March 2018: Danish Medical Journal
M Lucovnik, I Blajic, I Verdenik, T Mirkovic, T Stopar Pintaric
BACKGROUND: The Ten Group Classification System (TGCS) allows critical analysis according to the obstetric characteristics of women in labor: singleton or multiple pregnancy, nulliparous, multiparous, or multiparous with a previous cesarean delivery, cephalic, breech presentation or other malpresentation, spontaneous or induced labor, and term or preterm births. Labor outcomes associated with epidural analgesia may be different among the different labor classification groups. The aim of this study was to explore associations between epidural analgesia and cesarean delivery, and epidural analgesia and assisted vaginal delivery, in women classified using the TGCS...
February 28, 2018: International Journal of Obstetric Anesthesia
Caterina Pizzicaroli, Carlotta Montagnoli, Ilaria Simonelli, Maria Grazia Frigo, Herbert Valensise, Mario Filippo Segatore, Giovanni Larciprete
PURPOSE: The aim of the study was to evaluate the progression and rotation of the fetal head during the second stage of labor using translabial ultrasound and to compare ultrasonographic data obtained in nulliparous women both receiving and not receiving neuraxial analgesia. METHODS: The 49 patients enrolled in the study were divided into two groups according to receiving or not receiving neuraxial analgesia. Every half hour from full dilation to delivery, the ultrasonographic translabial parameters of Angle of Progression, Head Symphysis Distance, and Midline Angle were obtained and recorded by a single operator...
February 28, 2018: Journal of Ultrasound
Novera G Chughtai, Raheela Mohsin Rizvi
The management of puerperal hematomas after normal delivery has always been challenging for obstetricians. Vulvar, vulvovaginal, or paravaginal hematomas are common. On the other hand, retroperitoneal hematomas are uncommon and can be life-threatening. The diagnosis of vascular injury is rarely made preoperatively as atonic or traumatic postpartum hemorrhage (PPH), uterine rupture and amniotic fluid embolism are more common differential diagnoses. Injury to internal pudendal and uterine vessels is extremely rare in cases of vaginal delivery and, therefore, the literature on this topic is very scarce...
March 2018: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
D Alastair Taylor, Steven L Merten, Gavin D Sandercoe, Dilip Gahankari, Scott B Ingram, Nicholas J Moncrieff, Kevin Ho, Graham D Sellars, Mark R Magnusson
BACKGROUND: The authors studied the incidence of low back pain and urinary incontinence in the postpartum population presenting for abdominoplasty, and the extent of improvement following the operation. METHODS: This multicenter prospective study used validated questionnaires: the Oswestry Disability Index for back pain and the International Consultation on Incontinence Questionnaire-Urinary Incontinence-Short Form for urinary incontinence. Questionnaires were administered preoperatively and at 6 weeks and 6 months postoperatively...
March 2018: Plastic and Reconstructive Surgery
Pina Amin, Summia Zaher, Richard Penketh, Sobha Cherian, Rachel E Collis, Julia Sanders, Kiron Bhal
OBJECTIVE: To evaluate caesarean section (CS) rates and moderate to severe hypoxaemic ischaemic encephalopathy (HIE) rates with other core intra-partum outcomes following reconfiguration of maternity services in Cardiff, South Wales, UK. DESIGN: Cohort study of births from 2006 to 2015. SETTINGS: A University tertiary referral centre for foetal and maternal medicine with 6000 births/year, University Hospital of Wales, United Kingdom. METHOD: Data relating to births from 1 January 2006 to 31 December 2015 were extracted from the computerized maternity database on a yearly basis...
February 19, 2018: Journal of Maternal-fetal & Neonatal Medicine
Megan S Bradley, Amy L Askew, Monique H Vaughan, Amie Kawasaki, Anthony G Visco
BACKGROUND: Currently, the decision to perform a concurrent posterior repair/perineoplasty at the time of robotic-assisted sacrocolpopexy is not standardized. OBJECTIVE: To compare anatomic failure after robotic-assisted sacrocolpopexy among three groups of patients categorized by their pre- and post-operative genital hiatus size. STUDY DESIGN: We performed a retrospective cohort study of women who underwent robotic-assisted sacrocolpopexy, from 1/2013 to 9/2016...
February 6, 2018: American Journal of Obstetrics and Gynecology
Maria V Fraga, Pablo Laje, William H Peranteau, Holly L Hedrick, Nahla Khalek, Juliana S Gebb, Julie S Moldenhauer, Mark P Johnson, Alan W Flake, N Scott Adzick
AIM OF THE STUDY: To evaluate if gestational age (GA), mode of delivery and abdominal wall closure method influence outcomes in uncomplicated gastroschisis (GTC). METHODS: Retrospective review of NICU admissions for gastroschisis, August 2008-July 2016. Primary outcomes were: time to start enteral feeds (on-EF), time to discontinue parenteral nutrition (off-PN), and length of stay (LOS). MAIN RESULTS: A total of 200 patients with GTC were admitted to our NICU...
February 7, 2018: Pediatric Surgery International
Nicole S Carlson, Elizabeth J Corwin, Teri L Hernandez, Elizabeth Holt, Nancy K Lowe, K Joseph Hurt
BACKGROUND: Term nulliparous women have the greatest variation across hospitals and providers in cesarean rates and therefore present an opportunity to improve quality through optimal care. We evaluated associations between provider type and mode of birth, including examination of intrapartum management in healthy, laboring nulliparous women. METHODS: Retrospective cohort study using prospectively collected perinatal data from a United States academic medical center (2005-2012)...
January 31, 2018: Birth
Zhang Wangping, Wu Hanbing
RATIONALE: Postpartum hemorrhage is a common complication and difficult problem in obstetrics. Radiofrequency-induced endometrial ablation (RFIEA) widely used in abnormal uterine bleeding and achieved good effects. This article will investigate the effect of RFIEA for treatment of postpartum hemorrhage. PATIENTS CONCERNS: A 26-year-old healthy full-term parturient woman presented with postpartum hemorrhage after vaginal delivery for 11 hours, who was ready to emergency surgery (hysterectomy) 7 hours after inserting an intrauterine balloon into uterine cavity...
December 2017: Medicine (Baltimore)
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
Emmanuel Amabebe, David R Chapman, Victoria L Stern, Graham Stafford, Dilly O C Anumba
OBJECTIVES: Perturbation of the choriodecidual space before the onset of spontaneous preterm birth (sPTB) could lead to a concomitant rise in both cervicovaginal fluid (CVF) cytokine and fetal fibronectin (FFN), and assessing the concentrations of both markers could improve the prediction of sPTB (delivery before 37 completed weeks of gestation). Therefore, we prospectively determined mid-trimester changes in CVF cytokine and FFN concentrations, and their predictive capacity for sPTB in asymptomatic pregnant women...
January 10, 2018: Journal of Reproductive Immunology
Suzan Gunduz, Semra Kara, Ayşe Aktas, Abdulkadir Eren, Vedat Bakan
Macrosomia is a risk factor for birth injuries and is associated with neonatal morbidity and mortality. Cephalohematoma and clavicular fracture are the most frequent birth injuries. Intraabdominal injuries are uncommon birth injuries. Rectus sheath hematoma (RSH) is an accumulation of blood in the sheath of rectus abdominis muscle. It is associated with trauma, operations and anticoagulant therapy, especially in adults and elders. We present a macrosomic male neonate with difficult vaginal delivery, who had in the physical examination periumblical ecchymose of 1x1 cm and a parietal cephalohametoma of 1x1 cm...
February 1, 2018: Archivos Argentinos de Pediatría
Liam Dunn, Christopher Flatley, Sailesh Kumar
Placental growth factor (PlGF) has important angiogenic function that is critical to placental development. Lower levels of PlGF are associated with fetal growth restriction, pre-eclampsia and intrapartum fetal compromise. The aim of this study was to investigate the effect of labour on maternal PlGF levels. METHOD: This was a prospective observational cohort study. Normotensive women with a singleton, normally grown, non-anomalous, fetus between 37 + 0 and 42 + 0 weeks gestation were eligible for inclusion...
January 2018: Placenta
Ziad Hilal, Jennifer Mrkvicka, Günther A Rezniczek, Askin Dogan, Clemens B Tempfer
Fetal blood gas analysis (FBGA) using scalp blood is commonly used to identify serious fetal distress. However, there is a lack of data regarding its accuracy and reliability. The aim of this study was to determine the positive predictive value (PPV) and negative predictive value (NPV) of FBGA for predicting postpartum acidosis in case of nonreassuring fetal heart rate tracings (NRFHRT). To this end, we conducted a retrospective cohort study of singleton term deliveries with NRFHRT according to Fédération Internationale de Gynécologie et d'Obstétrique and Fisher cardiotocography scores undergoing FBGA in a university hospital...
December 2017: Medicine (Baltimore)
Shintaro Makino, Chihiro Hirai, Jun Takeda, Atsuo Itakura, Satoru Takeda
OBJECTIVE: To predict acidosis in fetus showing deceleration associated with non-reassuring fetal status during delivery, we examined the relationship between duration of the deceleration and umbilical arterial pH. MATERIALS AND METHODS: A total of 19,907 deliveries in eight facilities of the Juntendo Perinatal Care Group, 895 cases of vaginal deliveries with level 3 decelerations were selected for the subjects of this study. The cut-off point of time when the umbilical arterial pH fell below 7...
December 2017: Taiwanese Journal of Obstetrics & Gynecology
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