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Perineal tear

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https://www.readbyqxmd.com/read/28698073/does-a-body-mass-index-greater-than-25kg-m-2-increase-maternal-and-neonatal-morbidity-a-french-historical-cohort-study
#1
P Deruelle, E Servan-Schreiber, O Riviere, C Garabedian, F Vendittelli
OBJECTIVES: To evaluate, in a French multicenter cohort, the risk of C-section based on a high pre-pregnancy body mass index (BMI). Secondary objectives were to assess the risk of elective C-section, severe post-partum hemorrhage (>1L), severe perineal tears (3rd and 4th degree) and neonatal complications according to pre-pregnancy BMI. STUDY DESIGN: This historical cohort study analyzed records from the French AUDIPOG perinatal database. Inclusion criteria were deliveries≥22 weeks (or with a birth weight≥500g)...
July 8, 2017: Journal of gynecology obstetrics and human reproduction
https://www.readbyqxmd.com/read/28682756/-can-the-rate-of-episiotomy-still-be-lowered-status-update-in-paca-region-south-of-france
#2
E Lesieur, J Blanc, A Loundou, M Dubuc, F Bretelle
OBJECTIVE: To evaluate professional practices relative to episiotomies in the Provence Alpes Côte d'Azur (PACA) region by analysing their incidence in maternity hospitals, by type and by sector of activity. Following this, to analyse maternal and obstetric characteristics associated with episiotomies and the occurrence of perineal tears in Marseille's university hospitals (CHU). METHODS: Data were extracted from the database for the period from 1st January 2012 to 31 December 2014...
March 2017: Gynecologie, Obstetrique, Fertilite & Senologie
https://www.readbyqxmd.com/read/28643664/intervention-of-the-obstetrician-during-childbirth-in-a-supposedly-low-risk-population-and-influence-of-parity
#3
J Huet, G Beucher, L Geoffroy, R Morello, G Benoist, M Dreyfus
OBJECTIVE: Compare obstetrician intervention and calling rates during labour and delivery between low-risk and high-risk women and study the influence of parity on these rates. MATERIAL AND METHODS: Descriptive retrospective study conducted on 227 patients in a university maternity unit (level 3 university hospital maternity unit) between 1st and 30th January 2014. The low- and high-risk populations were characterised according to the French National Authority for Health (HAS) and NICE guidelines...
April 2017: Journal of gynecology obstetrics and human reproduction
https://www.readbyqxmd.com/read/28639706/exercise-for-pregnant-women-with-gestational-diabetes-for-improving-maternal-and-fetal-outcomes
#4
REVIEW
Julie Brown, Gilles Ceysens, Michel Boulvain
BACKGROUND: Gestational diabetes mellitus (GDM) is associated with both short- and long-term complications for the mother and her baby. Exercise interventions may be useful in helping with glycaemic control and improve maternal and infant outcomes.The original review on Exercise for diabetic pregnant women has been split into two new review titles reflecting the role of exercise for pregnant women with gestational diabetes and for pregnant women with pre-existing diabetes. Exercise for pregnant women with gestational diabetes for improving maternal and fetal outcomes (this review) Exercise for pregnant women with pre-existing diabetes for improving maternal and fetal outcomes OBJECTIVES: To evaluate the effects of exercise interventions for improving maternal and fetal outcomes in women with GDM...
June 22, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28637428/quality-of-care-provided-in-two-scottish-rural-community-maternity-units-a-retrospective-case-review
#5
Sara Denham, Tracy Humphrey, Ruth Taylor
BACKGROUND: Women in Scotland with uncomplicated pregnancies are encouraged by professional bodies and national guidelines to access community based models of midwife-led care for their labour and birth. The evidence base for these guidelines relates to comparisons of predominantly urban birth settings in England. There appears to be little evidence available about the quality of the care during the antenatal, birth and post birth periods available for women within the Scottish Community Maternity Unit (CMU) model...
June 21, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28608597/perineal-techniques-during-the-second-stage-of-labour-for-reducing-perineal-trauma
#6
REVIEW
Vigdis Aasheim, Anne Britt Vika Nilsen, Liv Merete Reinar, Mirjam Lukasse
BACKGROUND: Most vaginal births are associated with trauma to the genital tract. The morbidity associated with perineal trauma can be significant, especially when it comes to third- and fourth-degree tears. Different interventions including perineal massage, warm or cold compresses, and perineal management techniques have been used to prevent trauma. This is an update of a Cochrane review that was first published in 2011. OBJECTIVES: To assess the effect of perineal techniques during the second stage of labour on the incidence and morbidity associated with perineal trauma...
June 13, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28594775/perinatal-and-maternal-outcomes-after-training-residents-in-forceps-before-vacuum-instrumental-birth
#7
Sasha Skinner, Miranda Davies-Tuck, Euan Wallace, Ryan Hodges
OBJECTIVE: To compare the rates of attempted and successful instrumental births, intrapartum cesarean delivery, and subsequent perinatal and maternal morbidity before and after implementing a training intervention to arrest the decline in forceps competency among resident obstetricians. METHODS: This retrospective cohort study examined all attempted instrumental births at Monash Health from 2005 to 2014. We performed an interrupted time-series analysis to compare outcomes of attempted instrumental births in 2005-2009 with those in 2010-2014...
July 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28571213/the-effect-of-metoclopramide-addition-to-lidocaine-on-pain-of-patients-with-grades-ii-and-iii-post-episiotomy-repair
#8
Sheida Shabanian, Sara Kalbasi, Gholamreza Shabanian, Bahram Khoram, Forozan Ganji
INTRODUCTION: Episiotomy is the most common procedure used for dilatation of the vaginal opening for giving birth. Although episiotomy is associated with benefits for the mother, it may lead to short term and long term disabilities, including postpartum perineal pain that is secondary to perineal tearing. AIM: The aim of this study was to investigate the effect of subcutaneous lidocaine compared with lidocaine and metoclopramide on pain after episiotomy. MATERIALS AND METHODS: In this clinical trial study, the patients (83 for control group and 83 for case group) with episiotomy Grades II and III were enrolled and were asked to express their postpartum episiotomy pain as a number, from zero (no pain) to 10 (severest pain) Visual Analogue Scale (VAS score) at 0, 30 minute, 1 hour, 2 hour, 4 hour, 6 hour and 12 hour postpartum...
April 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28539008/position-in-the-second-stage-of-labour-for-women-without-epidural-anaesthesia
#9
REVIEW
Janesh K Gupta, Akanksha Sood, G Justus Hofmeyr, Joshua P Vogel
BACKGROUND: For centuries, there has been controversy around whether being upright (sitting, birthing stools, chairs, squatting, kneeling) or lying down (lateral (Sim's) position, semi-recumbent, lithotomy position, Trendelenburg's position) have advantages for women giving birth to their babies. This is an update of a review previously published in 2012, 2004 and 1999. OBJECTIVES: To determine the possible benefits and risks of the use of different birth positions during the second stage of labour without epidural anaesthesia, on maternal, fetal, neonatal and caregiver outcomes...
May 25, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28529661/slipped-capital-femoral-epiphysis-management-and-the-arthroscope
#10
F Accadbled, O May, C Thévenin-Lemoine, J Sales de Gauzy
BACKGROUND: In situ pinning of slipped capital femoral epiphysis (SCFE) results in various degrees of deformity of the femoral head-neck junction. Repetitive trauma from cam-type femoroacetabular impingement (FAI) can lead to labral tears and injury to the articular cartilage causing loss of function. Arthroscopic osteoplasty is an alternative to open procedure and to Southwick/Imhäuser-type osteotomies in symptomatic selected cases. SURGICAL TECHNIQUE: The amount of bone to be resected has to be carefully planned pre-operatively...
April 2017: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/28525825/what-is-to-blame-for-postnatal-pelvic-floor-dysfunction-in-primiparous-women-pre-pregnancy-or-intrapartum-risk-factors
#11
Constantin M Durnea, Ali S Khashan, Louise C Kenny, Uliana A Durnea, James C Dornan, Suzanne M O'Sullivan, Barry A O'Reilly
BACKGROUND: The aetiology of pelvic floor dysfunction (PFD) is still poorly understood. However childbearing is recognized as a major risk factor. OBJECTIVES: To elucidate the natural history of PFD by investigating the impact of the mode of delivery on postnatal pelvic floor dysfunction in primiparas, when PFD existing before the first pregnancy is taken into consideration. STUDY DESIGN: 4P-study (Prevalence and Predictors of Pelvic floor dysfunction in Primips) is a prospective cohort study, nested within the Screening for Pregnancy Endpoints (SCOPE) study set in a tertiary referral teaching hospital with 9000 deliveries annually...
July 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28499362/active-delivery-of-the-anterior-arm-and-incidence-of-second-degree-perineal-tears-a-clinical-practice-evaluation
#12
Nicolas Mottet, Marine Bonneaud, Astrid Eckman-Lacroix, Rajeev Ramanah, Didier Riethmuller
BACKGROUND: Evaluate the feasibility of active delivery of the anterior arm during spontaneous delivery. This maneuver could decrease incidence of second-degree perineal tears because it reduces fetal biacromial diameter. METHODS: An observational comparative prospective study was conducted at our teaching maternity from July 2012 to March 2013. The study included 199 nulliparous women ≥18 years, who met the following criteria: singleton pregnancy, vaginal delivery with occiput anterior presentation, on epidural analgesia, from 37 weeks of gestation onward...
May 12, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28477150/the-optimal-angle-of-the-mediolateral-episiotomy-at-crowning-of-the-head-during-labor
#13
Shimon Ginath, Osnat Elyashiv, Eran Weiner, Ron Sagiv, Jacob Bar, Joseph Menczer, Michal Kovo, Alexander Condrea
INTRODUCTION AND HYPOTHESIS: The aim of the mediolateral episiotomy incision is to increase the diameter of the soft tissue of the vaginal outlet to facilitate birth and to prevent vaginal tears. Episiotomy angles that are too narrow and close to the midline increase the risk of obstetric anal sphincter injuries. In order to determine the optimal angle of the episiotomy, we assessed the changes in the angles of episiotomy lines marked during the first stage of labor and measured at the time of crowning of the head...
May 5, 2017: International Urogynecology Journal
https://www.readbyqxmd.com/read/28472859/lifestyle-interventions-for-the-treatment-of-women-with-gestational-diabetes
#14
REVIEW
Julie Brown, Nisreen A Alwan, Jane West, Stephen Brown, Christopher Jd McKinlay, Diane Farrar, Caroline A Crowther
BACKGROUND: Gestational diabetes (GDM) is glucose intolerance, first recognised in pregnancy and usually resolving after birth. GDM is associated with both short- and long-term adverse effects for the mother and her infant. Lifestyle interventions are the primary therapeutic strategy for many women with GDM. OBJECTIVES: To evaluate the effects of combined lifestyle interventions with or without pharmacotherapy in treating women with gestational diabetes. SEARCH METHODS: We searched the Pregnancy and Childbirth Group's Trials Register (14 May 2016), ClinicalTrials...
May 4, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28467760/obstetric-anal-sphincter-injuries-oasis-in-israel-a-review-of-the-incidence-and-risk-factors
#15
REVIEW
Shimon Ginath, Yossi Mizrachi, Jacob Bar, Alexander Condrea, Michal Kovo
Obstetric anal sphincter injuries (OASIs) following vaginal deliveries are the main reason for subsequent development of anal incontinence in women. The diagnosis of such tears is crucial for treating and preventing such a grave sequela. The reported rate of OASIs in Israel was between 0.1% and 0.6%, out of all vaginal births, which is 10-fold lower than that reported in Europe and the United States. Structured hands-on training in repair of OASIs in seven medical centers in Israel significantly increased the detection rate of third-degree perineal tears...
April 28, 2017: Rambam Maimonides Medical Journal
https://www.readbyqxmd.com/read/28438209/selective-episiotomy-vs-implementation-of-a-non-episiotomy-protocol-a-randomized-clinical-trial
#16
M M Amorim, Isabela Cristina Coutinho, Inês Melo, Leila Katz
BACKGROUND: Despite all the evidence corroborating the selective use of episiotomy and although routine use of the procedure is contraindicated, there are no evidences corroborating if episiotomy is necessary in any circumstance. The present clinical randomized trial was performed to compare maternal and perinatal outcomes in women submitted to a non-episiotomy protocol versus one of selective episiotomy. METHODS: An open-labelled, randomized clinical trial was carried out in a tertiary teaching hospital in Recife, Northeastern Brazil...
April 24, 2017: Reproductive Health
https://www.readbyqxmd.com/read/28426452/defining-the-most-appropriate-delivery-mode-in-women-with-inflammatory-bowel-disease-a-systematic-review
#17
Arthur Foulon, Jean-Louis Dupas, Charles Sabbagh, Julien Chevreau, Lionel Rebibo, Franck Brazier, Guillaume Bouguen, Jean Gondry, Mathurin Fumery
INTRODUCTION: High cesarean section (CS) rates are observed in patients with inflammatory bowel disease (IBD), but limited data are available to support this decision. We conducted a comprehensive review to evaluate the most appropriate mode of delivery in women with IBD according to disease phenotype and activity, as well as surgical history. MATERIALS AND METHODS: We searched MEDLINE (source PubMed) and international conference abstracts, and included all studies that evaluated digestive outcome after delivery in patients with IBD...
May 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28412037/relationship-between-the-degree-of-perineal-trauma-at-vaginal-birth-and-change-in-haemoglobin-concentration
#18
Ana Rubio-Álvarez, Milagros Molina-Alarcón, Antonio Hernández-Martínez
BACKGROUND: Postpartum anaemia is a problem with high prevalence that significantly affects maternal recovery. Among the causal factors is perineal trauma. However, it is still not known what degree of perineal trauma produces a greater reduction of haemoglobin. AIM: To assess the relationship between the degree of perineal trauma and change in haemoglobin concentration at vaginal birth. METHODS: An observational, analytical retrospective cohort study was performed at the Mancha-Centro Hospital (Spain) during the period 2010-2014...
April 12, 2017: Women and Birth: Journal of the Australian College of Midwives
https://www.readbyqxmd.com/read/28403956/severe-perineal-morbidity-of-instrumental-deliveries-using-thierry-s-spatulas-and-vacuum-extraction-a-prospective-observational-cohort-study
#19
S Hamouda, J Mancini, F Marchand, F Bretelle, L Boubli, C D'Ercole, X Carcopino
OBJECTIVES: To evaluate the risk of severe perineal tear following instrumental vaginal delivery (IVD) performed with spatulas and vacuum extraction. Secondary objectives were to estimate the impact of episiotomy on this risk. METHODS: From December 2008 to October 2012, women who underwent spatulas or vacuum were prospectively included. Each spontaneous vaginal delivery (SVD) following each included IVD were included as control cases (1-1 ratio). Careful perineal examination was systematically performed...
January 2017: Journal of gynecology obstetrics and human reproduction
https://www.readbyqxmd.com/read/28391147/influence-of-a-pelvic-floor-training-programme-to-prevent-perineal-trauma-a-quasi-randomised-controlled-trial
#20
Fatima Leon-Larios, Isabel Corrales-Gutierrez, Rosa Casado-Mejía, Carmen Suarez-Serrano
BACKGROUND: perineal injury is common after birth and may be caused by tears or episiotomy or both. Perineal massage has been shown to prevent episiotomies in primiparous women. On the other hand, pelvic floor exercises might have an influence by shortening the first and second stages of labour in the primigravida. AIM: the aim of this study was to investigate the effects of a pelvic floor training following a birth programme on perineal trauma. DESIGN: a single-blind quasi-randomized controlled trial with two groups: standard care and intervention...
July 2017: Midwifery
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