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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
#1
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/29575180/sonographic-assessment-of-the-anal-sphincter-after-obstetric-anal-sphincter-injury-oasi-using-transperineal-ultrasound-tpus
#2
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
#3
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
https://www.readbyqxmd.com/read/29516128/is-increased-peripheral-ligamentous-laxity-in-term-pregnant-women-associated-with-obstetric-anal-sphincter-injury
#4
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
#5
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...
February 21, 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
#6
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...
February 14, 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
#7
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
#8
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
#9
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
#10
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
#11
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/29155474/visual-biofeedback-using-trans-perineal-ultrasound-during-the-second-stage-of-labor
#12
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
#13
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
#14
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
#15
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
#16
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
https://www.readbyqxmd.com/read/28923011/nurse-midwives-ability-to-diagnose-acute-third-and-fourth-degree-obstetric-lacerations-in-western-kenya
#17
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/28914706/long-term-sexual-function-after-obstetric-anal-sphincter-injuries
#18
Michele S OʼShea, Christina Lewicky-Gaupp, Dana R Gossett
OBJECTIVES: Obstetric anal sphincter injuries (OASIS) are associated with severe short and long-term morbidities, although little is known about the long-term sexual function or satisfaction of women and partners of women with history of OASIS. The objective of this study was to describe the long-term sexual function and satisfaction of women who previously sustained OASIS and to assess sexual satisfaction among their male partners. METHODS: This was a follow-up study of participants enrolled in the For Optimal Recovery: Care After Severe Tears (FORCAST) prospective cohort study of women with a history of OASIS after delivery of a full-term singleton infant between 2011 and 2013...
September 13, 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/28889406/intrapartum-transperineal-ultrasound-used-to-predict-cases-of-complicated-operative-vacuum-and-forceps-deliveries-in-nulliparous-women
#19
José A Sainz, José A García-Mejido, Adriana Aquise, María J Bonomi, Carlota Borrero, Paloma De La Fuente, Ana Fernández-Palacín
INTRODUCTION: The objective of this study was to investigate the predictive value of intrapartum transperineal ultrasound in the identification of complicated operative (vacuum or forceps) deliveries in nulliparous women. MATERIAL AND METHODS: Prospective observational study of nulliparous women with an indication for operative delivery who underwent intrapartum transperineal ultrasound before fetal extraction. Managing obstetricians were blinded to the ultrasound data...
December 2017: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/28864269/uses-of-chitosan-for-treating-different-forms-of-serious-obstetrics-hemorrhages
#20
G Carles, C Dabiri, A Mchirgui, E O Saoudi, N Hcini, K Pouget, B Seve, B de Matteis
Postpartum hemorrhage is a major cause of maternal death worldwide. Many therapeutic strategies have been developed to reduce maternal morbidity and mortality like oxytocin, prostaglandin, and uterine balloons. A new member of the therapeutic arsenal has recently emerged, the chitosan (Celox® ), used since several years by military doctors to stop bleeding of combat wounds. In 2012, a first study was reported with the successful use of chitosan-coated gauze to treat severe postpartum hemorrhage. We report here four cases of the use of chitosan to treat life-threatening obstetric bleeding...
November 2017: Journal of Gynecology Obstetrics and Human Reproduction
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