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https://www.readbyqxmd.com/read/29921684/enhancing-recognition-of-obstetric-anal-sphincter-injuries-in-six-maternity-units-in-palestine-an-interventional-quality-improvement-study
#1
Hadil Ali-Masri, Sahar Hassan, Khaled Ismail, Kaled Zimmo, Mohammed Zimmo, Erik Fosse, Åse Vikanes, Katariina Laine
OBJECTIVE: To explore the impact of a training intervention on obstetric anal sphincter injuries' (OASIS) detection rate. DESIGN: Prospective quality improvement interventional study. SETTING: Six secondary and tertiary maternity units in Palestine. POPULATION: Women having singleton vaginal births ≥23 weeks' gestation or babies weighing ≥500 g (n=22 922). Caesarean births (n=5431), multiple gestations (n=443) and vaginal births of unregistered perineum status (n=800) were excluded...
June 19, 2018: BMJ Open
https://www.readbyqxmd.com/read/29907972/resumption-of-sex-after-a-second-birth-an-australian-prospective-cohort
#2
Ellie A McDonald, Deirdre Gartland, Hannah Woolhouse, Stephanie J Brown
BACKGROUND: Few longitudinal studies have examined women's experiences of sex after childbirth. Much of the advice given to couples about what to expect in relation to sex after childbirth is based on cross-sectional studies. OBJECTIVE: To investigate timing of resumption of sex after a second birth and assess associations with obstetric factors (method of birth and perineal trauma) and time interval between first and second births. METHOD: Prospective cohort of 1507 nulliparous women recruited before 25 weeks' gestation in Melbourne, Australia followed up at 3, 6, 9, and 12 months after first births, and 6 and 12 months after second births...
June 15, 2018: Birth
https://www.readbyqxmd.com/read/29877601/blood-group-o-a-novel-risk-factor-for-increased-postpartum-blood-loss
#3
M K Kahr, D Franke, R Brun, J Wisser, R Zimmermann, C Haslinger
INTRODUCTION: Blood group O is known to be associated with lower levels of von Willebrand factor (VWF) and with increased bleeding complications. The influence of blood group O on postpartum blood loss was assessed by a few studies, however, without adjustment for important obstetric risk factors for postpartum blood loss. AIM: Aim of this study was to investigate whether women with blood group O exhibit increased blood loss after delivery in consideration of established risk factors for postpartum bleeding...
June 7, 2018: Haemophilia: the Official Journal of the World Federation of Hemophilia
https://www.readbyqxmd.com/read/29768662/immersion-in-water-during-labour-and-birth
#4
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/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
#5
Vanessa Maria Laranjeiras Lins, Leila Katz, Fernanda Barros Lima Vasconcelos, Isabela Coutinho, Melania Maria Amorim
OBJECTIVES: The objective of this study is 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...
April 18, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29575180/sonographic-assessment-of-the-anal-sphincter-after-obstetric-anal-sphincter-injury-oasi-using-transperineal-ultrasound-tpus
#6
EDITORIAL
Vered H Eisenberg, Dan V Valsky, Simcha Yagel
Obstetric anal sphincter injury (OASI) is the most common cause of anal incontinence and ano-rectal symptoms in women1 . Reported rates of anal incontinence following primary repair of OASI range between 15-61%, with a mean of 39%2, 3 . Other possible complications of OASI include perineal pain, dyspareunia, and less commonly, abscess formation, wound breakdown, and rectovaginal fistulae. Symptom onset may occur immediately, several years postpartum, or only late in life when aging of tissues adds to the delivery insult...
March 24, 2018: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/29546469/outcomes-of-primary-anal-sphincter-repair-after-obstetric-injury-and-evaluation-of-a-novel-three-choice-assessment
#7
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/29516128/is-increased-peripheral-ligamentous-laxity-in-term-pregnant-women-associated-with-obstetric-anal-sphincter-injury
#8
Bertrand Gachon, Marion Desgranges, Laetitia Fradet, Arnaud Decatoire, Florian Poireault, Fabrice Pierre, Xavier Fritel, David Desseauve
INTRODUCTION AND HYPOTHESIS: Increased ligamentous laxity is associated with pelvic floor distension in pregnant women. This considered, it may also be related to the risk of obstetric anal sphincter injury (OASI). Our objective was to assess the association among increased ligamentous laxity, perineal tear severity, and OASI occurrence. METHODS: This is a prospective study. We assessed ligamentous laxity between the 36th week of pregnancy and the onset of labor, by measuring the passive extension of the nondominant index finger for a 0...
March 7, 2018: International Urogynecology Journal
https://www.readbyqxmd.com/read/29482056/interventional-program-to-reduce-both-the-incidence-of-anal-sphincter-tears-and-rate-of-caesarean-sections
#9
Jouko Pirhonen, Ellen Samuelsson, Tiina Pirhonen, Anders Odeback, Mika Gissler
OBJECTIVE: To estimate the ability of an intensive interventional program to decrease the number of obstetric anal sphincter injuries (OASIS), while simultaneously decreasing the rate of Caesarean sections (CS). STUDY DESIGN: The intervention, which aimed at decreasing the number of OASIS, started with a compulsory tutorial for all the midwives and physicians. At the same time, the clinic initiated a program to decrease the number of CS. We compared the outcomes before and after the intervention by calculating the risk ratios with 95% confidence intervals...
April 2018: European Journal of Obstetrics, Gynecology, and Reproductive Biology
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/29305115/the-waterbirth-project-s%C3%A3-o-bernardo-hospital-experience
#11
Joyce C S Camargo, Vitor Varela, Fernanda M Ferreira, Lucila Pougy, Angela M Ochiai, Maria Elisabete Santos, Maria Catarina L R Grande
INTRODUCTION: The following quantitative observational study aimed to analyse the maternal and neonatal outcomes of 90 low-risk pregnant women who gave birth in water at São Bernardo Hospital. METHODS: A form containing information on the obstetric history of the parturient, the type of immersion, and the labour and birth follow-up was used by midwives to collect the data. BACKGROUND: The Apgar score (at 1min after birth) used in this study, called Aqua Apgar, was adapted by Cornelia Enning...
January 2, 2018: Women and Birth: Journal of the Australian College of Midwives
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/29241928/uses-of-floseal-%C3%A2-in-obstetric-hemorrhage-case-series-and-literature-review
#13
Jacqueline Pui-Wah Chung, Tak-Yeung Leung
OBJECTIVE: FloSeal© has been shown to be an alternative and effective method of hemostasis. The current study examines the various uses of FloSeal© in obstetric hemorrhage and gives an overview of the literature. CASE REPORTS: In this retrospective case review, a total of 11 cases with obstetric hemorrhage were reviewed throughout a period of one year. All but one case was successful in using FloSeal© in arresting the bleeding with hysterectomy avoided. FloSeal© can be considered when bleeding occurs locally at the placental bed, bladder base, adhesiolysis site, vaginal tears or at suture holes...
December 2017: Taiwanese Journal of Obstetrics & Gynecology
https://www.readbyqxmd.com/read/29241151/factors-that-influence-patient-preference-for-mode-of-delivery-following-an-obstetric-anal-sphincter-injury
#14
Emma Long, Swati Jha
PURPOSE: A common indication for elective caesarean is previous obstetric anal sphincter injury (OASI). This study aims to identify factors that influence womens' preferences regarding mode of delivery (MoD) in a subsequent pregnancy following an OASI. METHODS: 100 consecutive women who sustained an OASI completed a questionnaire when attending postnatal follow up at a perineal trauma clinic. They also completed ePAQ-PF to assess pelvic floor symptoms. Data was collated and percentages generated for each response...
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
#15
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...
May 2018: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/29155474/visual-biofeedback-using-trans-perineal-ultrasound-during-the-second-stage-of-labor
#16
Yinon Gilboa, Tahl I Frenkel, Yael Schlesinger, Sofie Rousseau, Daniel Hamiel, Reuven Achiron, Sharon Perlman
OBJECTIVES: to assess the obstetrical and psychological effect of visual biofeedback using trans-perineal ultrasound (TPU) during the second stage of labor. METHODS: Visual biofeedback using TPU was performed prospectively during the second stage of labor in twenty-six low risk nulliparous women. Pushing efficacy was assessed by the angle of progression at rest and during pushing efforts before and after observing the ultrasound screen. Obstetrical outcomes included level of perineal tearing, mode of delivery and length of the second stage...
November 20, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/29155037/long-term-anal-incontinence-after-obstetric-anal-sphincter-injury-does-grade-of-tear-matter
#17
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/29037545/perineal-length-among-vietnamese-women
#18
Anh T Trinh, Tanya A Nippita, Trang N Dien, Jonathan M Morris, Christine L Roberts
OBJECTIVE: Vietnamese clinicians routinely perform episiotomies in the belief that 3rd-4th degree tears may be prevented, based partly on the view that Vietnamese women have a short perineal length that puts them at increased risk of tears. However, there is no evidence to suggest Vietnamese women have a short perineum compared with other populations. We aimed to determine the mean perineal length among Vietnamese women in early labor and in the second stage, and to compare this to findings from similar studies in other populations...
October 2017: Taiwanese Journal of Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28969481/delivery-through-cervicovaginal-fistula-literature-review-and-case-report
#19
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/28932882/no-episiotomy-versus-selective-lateral-mediolateral-episiotomy-epitrial-an-interim-analysis
#20
Lena Sagi-Dain, Rabia Bahous, Orna Caspin, Inna Kreinin-Bleicher, Ron Gonen, Shlomi Sagi
INTRODUCTION AND HYPOTHESIS: The objective of this trial was to evaluate whether avoiding episiotomy can decrease the risk of advanced perineal tears. MATERIAL AND METHODS: In this randomized (1:1) parallel-group superiority trial, primiparous women underwent randomization into standard care (155 cases) vs. no episiotomy (154 cases) groups. The primary endpoint was the incidence of advanced (3rd- and 4th-degree) perineal tears. Secondary outcomes included perineal integrity, suturing characteristics, second-stage duration, incidence of postpartum hemorrhage, neonatal variables, and various postpartum symptoms 2 days and 2 months after delivery...
March 2018: International Urogynecology Journal
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