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forceps delivery

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
Molly R Altman, Karen Colorafi, Kenn B Daratha
BACKGROUND:  Hospital electronic health record (EHR) data are increasingly being called upon for research purposes, yet only recently has it been tested to examine its reliability. Studies that have examined reliability of EHR data for research purposes have varied widely in methods used and field of inquiry, with little reporting of the reliability of perinatal and obstetric variables in the current literature. OBJECTIVE:  To assess the reliability of data extracted from a commercially available inpatient EHR as compared with manually abstracted data for common attributes used in obstetrical research...
January 2018: Applied Clinical Informatics
M A Almeida, E Araujo Júnior, L Camano, A B Peixoto, W P Martins, R Mattar
OBJECTIVE: To evaluate the incidence of, indications of, and maternal and neonatal morbidity and mortality rates in cesarean sections in a private health service in Brazil. DESIGN: Retrospective and observational study. SETTING: Private health service in Vitória, Espírito Santo, Brazil. METHODS: The patients were interviewed using a structured questionnaire to determine maternal age, gestational age at the time of delivery, number of previous deliveries, type of delivery performed, duration of labor, indications for cesarean delivery, point at which cesarean section was performed, physician responsible for delivery, and maternal morbidity, fetal morbidity, and fetal mortality rates...
2018: Ceská Gynekologie
Qi Wen, Giulia M Muraca, Joseph Ting, Sarah Coad, Kenneth I Lim, Sarka Lisonkova
OBJECTIVE: Instrumental vaginal delivery is associated with birth trauma to infant and obstetric trauma to mother. As caesarean delivery rates increased during the past decades, the rate of instrumental vaginal delivery declined. We examined concomitant temporal changes in the rates of severe birth trauma and maternal obstetric trauma. DESIGN: A retrospective observational study. SETTINGS AND PARTICIPANTS: All hospital singleton live births in Washington State, USA, 2004-2013, excluding breech delivery...
March 2, 2018: BMJ Open
Srinivas Goli, Anu Rammohan, Moradhvaj
BACKGROUND AND OBJECTIVE: The studies measured Out-of-Pocket Expenditure (OOPE) for hospital births previously suffer from serious data limitations. To overcome such limitations, we designed a hospital-based study for measuring the levels and factors of OOPE on maternity care for hospital births by its detailed components. METHODS: Data were collected from women for non-complicated deliveries 24-h before the survey and complicated deliveries 48-h prior to the survey at the hospital settings in Uttar Pradesh, India during 2014...
February 27, 2018: Health Economics Review
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
Jennifer Yeung, Anna Stecher, Catrina C Crisp, Donna Mazloomdoost, Benjamin Smith, Steven D Kleeman, Rachel N Pauls
OBJECTIVES: Obstetric anal sphincter injuries (OASISs) are a devastating postpartum complication; reducing rates is paramount to improving quality of care. In Norway, implementation of a perineal protection program decreased the incidence of OASIS by 48%. We sought to assess impact on OASIS rates following a similar program. METHODS: This institutional review board-approved, retrospective cohort study was performed in an academic hospital system. The periods of analysis were November 2014 through October 2015 for the preintervention arm and November 2015 through October 2016 for the postintervention arm...
March 2018: Female Pelvic Medicine & Reconstructive Surgery
Maria TR Borges
In the United States, women are routinely forced to undergo cesarean sections, episiotomies, and the use of forceps, despite their desire to attempt natural vaginal delivery. Yet, the current American legal system does little to provide redress for women coerced to undergo certain medical procedures during childbirth. Courts and physicians alike are prepared to override a woman's choice of childbirth procedure if they believe this choice poses risks to the fetus, and both give little value to the woman's right to bodily autonomy...
January 2018: Duke Law Journal
Maria-Jesus Pueyo, Ramon Escuriet, M Pérez-Botella, I de Molina, D Ruíz-Berdun, S Albert, S Díaz, P Torres-Capcha, V Ortún
AIM: To explore the effect of hospital's characteristics in the proportion of obstetric interventions (OI) performed in singleton fullterm births (SFTB) in Catalonia (2010-2014), while incentives were employed to reduce C-sections. METHODS: Data about SFTB assisted at 42 public hospitals were extracted from the dataset of hospital discharges. Hospitals were classified according to the level of complexity, the volume of births attended, and the adoption of a non-medicalized delivery (NMD) strategy...
February 10, 2018: Health Policy
Sanjay Sinha, Daniel Levi, Alejandro Peirone, Carlos Pedra
BACKGROUND: Nit-Occlud ® (atrial septal defect) ASD-R and (patent ductus arteriosus) PDA-R devices are used outside the United States for percutaneous closure of the patent ductus arteriosus and atrial septal defects. When embolization occurs, these devices have been difficult to retrieve. METHODS: Bench simulations of retrieval of PDA-R and ASD-R devices were performed in a vascular model. Retrieval of each device was attempted using snare techniques or with bioptome forceps with a range of devices...
February 5, 2018: Catheterization and Cardiovascular Interventions
Jessica Caudwell-Hall, Ixora Kamisan Atan, Chris Brown, Rodrigo Guzman Rojas, Susanna Langer, Ka Lai Shek, Hans Peter Dietz
INTRODUCTION: Levator trauma is a risk factor for development of pelvic organ prolapse. We aimed to identify antenatal predictors for significant damage to the levator ani muscle during first vaginal delivery. MATERIALS AND METHODS: A retrospective observational study utilising data from two studies with identical inclusion criteria and assessment protocols between 2005 and 2014. 1148 primiparae with an uncomplicated singleton pregnancy were recruited and assessed with translabial ultrasound at 36 weeks antepartum and 871 (76%) returned for reassessment 3-6 months postpartum...
February 2, 2018: Acta Obstetricia et Gynecologica Scandinavica
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
Ulrich Schaudig, Matthias Keserü
BACKGROUND: Presentation of a congenital abnormality that is rare, but follows a distinct course and can be diagnosed and cured promptly if the pathognomonic presentation is recognized. A congenital tarsal kink leads to a malposition of the upper eyelid margin that must not be missed, as it will lead to ulcerative keratitis if it is not treated. CASE PRESENTATION: An otherwise healthy newborn was presented after delivery with forceps with marked unilateral purulent secretion and blepharospasm...
January 2018: Klinische Monatsblätter Für Augenheilkunde
José L Gálvez, Carlos L Errando, Silvia Serrano, Marga Martín-Ayuso, José M Valverde-Mantecón
Type I neurofibromatosis is characterised by altered skin pigmentation and the growth of benign tumours, particularly along the peripheral nerves and central nervous system. We report a 36-year-old primigravida woman in labour who was admitted to the obstetric suite of the Hospital Sant Joan de Déu, Barcelona, Spain, in 2007 with hypothyroidism, type I neurofibromatosis and a factor V Leiden mutation. Due to a lack of cranial and spinal imaging data, an epidural was not indicated; instead, continuous intravenous remifentanil analgaesia was administered...
November 2017: Sultan Qaboos University Medical Journal
Pedro A Maldonado, Donald Mcintire, Marlene M Corton
OBJECTIVE: The aim of this study was to report subjective, long-term outcomes and describe patient demographics, presenting symptoms, perioperative management, and complications after overlapping sphincteroplasty repair for chronic fourth-degree lacerations (cloacal-like deformities). METHODS: In this retrospective study, hospital records were reviewed for women who underwent overlapping anal sphincteroplasty for a cloacal-like deformity of the perineum at a single institution from 1996 to 2013...
January 10, 2018: Female Pelvic Medicine & Reconstructive Surgery
Yasuko Sano, Chihiro Hirai, Shintaro Makino, Xianglan Li, Jun Takeda, Atsuo Itakura, Satoru Takeda
AIM: This study was conducted to evaluate the incidence of severe lacerations during forceps delivery and the risk factors associated with such delivery in a hospital where simulation training is held annually. METHODS: The medical records of 857 women who underwent forceps delivery at term with singleton cephalic presentation from 2010 to 2015 were reviewed. The relationship between clinical characteristics and birth canal trauma was analyzed. Birth canal trauma included third and fourth degree perineal lacerations...
January 5, 2018: Journal of Obstetrics and Gynaecology Research
Victoria L Handa, Joan L Blomquist, Jennifer Roem, Alvaro Muňoz
BACKGROUND: Pelvic organ prolapse is more common among parous (versus nulliparous) women and also more common after vaginal (versus cesarean) birth. However, very little is known about how childbirth affects the course and progression of pelvic organ prolapse across a woman's lifespan. OBJECTIVE: To investigate longitudinal, quantitative changes in pelvic organ support after childbirth, focusing on the impact of vaginal versus cesarean delivery. STUDY DESIGN: This was a prospective longitudinal cohort study in which parous women were recruited 5-10 years from first delivery and followed annually...
December 22, 2017: American Journal of Obstetrics and Gynecology
Sanghee Lee, Alonso Carrasco, Randall B Meacham, Anna P Malykhina
Transurethral instillation can be used to deliver different solutions with active ingredients (e.g., drugs, chemicals, bacteria, and viruses) locally into the urinary bladder to either induce animal models of bladder pathologies or evaluate the effectiveness of intravesical treatments. Most rodent models of lower urinary tract (LUT) pathologies are induced in female mice due to ease of intravesical instillation of the substances via the female urethra. However, due to anatomical differences between the female and male LUT, transurethral instillation in a male mouse has been deemed a very challenging procedure, and it has not been previously described...
November 2, 2017: Journal of Visualized Experiments: JoVE
Sallie Oliphant, Timothy Canavan, Stacy Palcsey, Leslie Meyn, Pamela Moalli
BACKGROUND: Parity is the greatest risk factor for the development of pelvic organ prolapse. The normally supported vagina is pulled up and back over the levator ani. Loss of vaginal angulation has been associated with prolapse and may represent injury to the vaginal supportive tissues. OBJECTIVE: We proposed and examined the following hypotheses: (1) pregnancy and delivery impact vaginal support, leading to loss of vaginal angle; (2) vaginal angulation is restored postpartum; and (3) uncomplicated vaginal delivery (VD) is associated with accelerated remodeling of the vaginal fibrillar matrix...
February 2018: American Journal of Obstetrics and Gynecology
L Ni, A Elsaharty, I McConachie
BACKGROUND: Cesarean birth is known as both cesarean section (CS) or cesarean delivery (CD). The International Journal of Obstetric Anesthesia (IJOA) is the leading obstetric anesthesia journal, and a barometer of attitudes within the profession. The journal recently published the hundredth issue, spanning 25 years (to December 2016). It is an opportune time to examine the evolution of surgical birth terminology (CS versus CD) during that period. METHODS: We examined 1583 articles in IJOA, subdividing them into editorials, papers, review articles, debates and case reports...
September 28, 2017: International Journal of Obstetric Anesthesia
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