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https://www.readbyqxmd.com/read/29785549/once-episiotomy-always-episiotomy
#1
Ayala Zilberman, Eyal Sheiner, Orit Barrett, Batel Hamou, Tali Silberstein
OBJECTIVE: To investigate the association between episiotomy and perineal damage in the subsequent delivery. STUDY DESIGN: A retrospective cohort study was conducted, comparing outcome of subsequent singleton deliveries of women with and without episiotomy in their first (index) delivery. Deliveries occurred between the years 1991-2015 in a tertiary medical center. Traumatic vaginal tears, multiple pregnancies, and cesarean deliveries (CD) in the index pregnancy were excluded from the analysis...
May 21, 2018: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/29785548/operative-vaginal-delivery-in-case-of-persistent-occiput-posterior-position-after-manual-rotation-failure-a-6-month-follow-up-on-pelvic-floor-function
#2
Paul Guerby, Olivier Parant, Elodie Chantalat, Christophe Vayssiere, Fabien Vidal
PURPOSE: To compare the short- and long-term perineal consequences (at 6 months postpartum) and short-term neonatal consequences of instrumental rotation (IR) to those induced by assisted delivery (AD) in the occiput posterior (OP) position, in case of manual rotation failure. METHODS: A prospective observational cohort study; tertiary referral hospital including all women presenting with persistent OP position who delivered vaginally after manual rotation failure with attempted IR or AD in OP position from September 2015 to October 2016...
May 21, 2018: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/29768662/immersion-in-water-during-labour-and-birth
#3
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/29757716/us-assessment-of-sports-related-hip-injuries
#4
Eugen Lungu, Johan Michaud, Nathalie J Bureau
Traumatic and overuse hip injuries occur frequently in amateur and professional athletes. After clinical assessment, imaging plays an important role in diagnosis and in defining care management of these injuries. Ultrasonography (US) is being increasingly used in assessment of hip injuries because of the wide availability of US machines, the lower cost, and the unique real-time imaging capability, which allows both static and dynamic evaluation as well as guidance of point-of-care interventions such as fluid aspiration and steroid injection...
May 2018: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/29730096/a-qualitative-exploration-of-techniques-used-by-expert-midwives-to-preserve-the-perineum-intact
#5
C Begley, K Guilliland, L Dixon, M Reilly, C Keegan, C McCann, V Smith
BACKGROUND: The perineum stretches during birth to allow passage of the baby, but 85% of women sustain some degree of perineal trauma during childbirth, which is painful post-partum. Episiotomy rates vary significantly, with some countries having rates of >60%. Recent Irish and New Zealand studies showed lower severe perineal trauma and episiotomy rates than other countries. AIM: To explore expert Irish and New Zealand midwives' views of the skills that they employ in preserving the perineum intact during spontaneous vaginal birth...
May 2, 2018: Women and Birth: Journal of the Australian College of Midwives
https://www.readbyqxmd.com/read/29716537/accuracy-of-immediate-antepartum-ultrasound-estimated-fetal-weight-and-its-impact-on-mode-of-delivery-and-outcome-a-cohort-analysis
#6
Johannes Stubert, Adam Peschel, Michael Bolz, Änne Glass, Bernd Gerber
BACKGROUND: The aim of the study was to investigate the accuracy of ultrasound-derived estimated fetal weight (EFW) and to determine its impact on management and outcome of delivery. METHODS: In this single-center cohort analysis, women with a singleton term pregnancy in the beginning stages of labor were included. Women with immediately antepartum EFW (N = 492) were compared to women without ultrasound (N = 515). RESULTS: EFW was correct (deviation from birth weight ≤ 10%) in 72...
May 2, 2018: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29680718/are-we-performing-episiotomies-correctly-a-study-to-evaluate-french-technique-in-a-high-risk-maternity-unit
#7
Fanny Béchard, Julia Geronimi, Pierre Vieille, Vincent Letouzey, Renaud de Tayrac
INTRODUCTION: The aim of this study was to evaluate episiotomy technique, in particular suture angles, and any correlation between suture angle and severe perineal tears. MATERIAL AND METHODS: An observational questionnaire-based study was conducted between 01 August 2015 and 30 April 2016 among accoucheurs performing episiotomies in a French maternity unit with facilities for high-risk pregnancies. For each patient included, accoucheurs were asked to measure the episiotomy suture angle, and to record the angle at which they thought they had cut, the length of the episiotomy, its distance from the anus, and whether the woman sustained a sphincter injury...
April 19, 2018: Journal of Gynecology Obstetrics and Human Reproduction
https://www.readbyqxmd.com/read/29652745/severe-perineal-lacerations-after-vaginal-delivery-are-they-an-anesthesiologist-s-problem
#8
Feyce Peralta, Joseph Bradley Bavaro
PURPOSE OF REVIEW: Perineal tears or lacerations are common occurrences after vaginal delivery. Understanding the degree of severity of these tears and the immediate and long-term complications of severe perineal lacerations can assist anesthesiologists with the management of these patients in the immediate postpartum period. RECENT FINDINGS: Severe perineal lacerations have a high degree of association with postpartum depression. The presence of neuraxial labor analgesia decreases the odds of severe perineal lacerations...
June 2018: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29648935/episiotomy-and-perineal-tear-risk-factors-in-a-group-of-4493-women
#9
Grażyna Gebuza, Marzena Kaźmierczak, Alicja Gdaniec, Estera Mieczkowska, Małgorzata Gierszewska, Agnieszka Dombrowska-Pali, Mariola Banaszkiewicz, Marek Maleńczyk
Episiotomy belongs to the most frequent procedures carried out during delivery. Performing episiotomy should be reduced as there is scientific evidence indicating that it can cause pain, sexual problems, and serious, long-term health consequences. The aim of the researchers is to identify factors associated with episiotomy and the perineal tear. Analyses were performed using a model of a logistic regression. The study involved 4493 women. The episiotomy risk was related to: a birth weight exceeding 3500 grams, an instrumental delivery by means of forceps or vacuum extraction...
April 12, 2018: Health Care for Women International
https://www.readbyqxmd.com/read/29624952/an-audit-of-perineal-trauma-and-vertical-transmisson-of-hiv
#10
Amaka N Ocheke, Ephraim Samuels, Isaac E Ocheke, Patricia A Agaba, Clement Ekere, James Bitrus, Emmanuel I Agaba, Atiene S Sagay
Restrictive episiotomy is recommended for the prevention of vertical transmission of HIV. The study compared the frequency of episiotomy use and the occurrence of perineal tears; and related factors in HIV positive and HIV negative women and to assess their effect on Mother-to-child transmission (MTCT) of HIV. A total of 110 HIV positive and 134 HIV negative parturients were enrolled in the study. The incidence of episiotomy was more in the HIV negative group (p=0.0000) while that of perineal tear was not affected by HIV status (p=0...
December 2017: African Journal of Reproductive Health
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
#11
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
#12
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/29526165/odon-device-for-instrumental-vaginal-deliveries-results-of-a-medical-device-pilot-clinical-study
#13
Javier A Schvartzman, Hugo Krupitzki, Mario Merialdi, Ana Pilar Betrán, Jennifer Requejo, My Huong Nguyen, Effy Vayena, Angel E Fiorillo, Enrique C Gadow, Francisco M Vizcaino, Felicitas von Petery, Victoria Marroquin, María Luisa Cafferata, Agustina Mazzoni, Valerie Vannevel, Robert C Pattinson, A Metin Gülmezoglu, Fernando Althabe, Mercedes Bonet
BACKGROUND: A prolonged and complicated second stage of labour is associated with serious perinatal complications. The Odon device is an innovation intended to perform instrumental vaginal delivery presently under development. We present an evaluation of the feasibility and safety of delivery with early prototypes of this device from an early terminated clinical study. METHODS: Hospital-based, multi-phased, open-label, pilot clinical study with no control group in tertiary hospitals in Argentina and South Africa...
March 12, 2018: Reproductive Health
https://www.readbyqxmd.com/read/29516128/is-increased-peripheral-ligamentous-laxity-in-term-pregnant-women-associated-with-obstetric-anal-sphincter-injury
#14
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/29514531/measurement-of-the-fetal-occiput-spine-angle-during-the-first-stage-of-labor-as-predictor-of-the-progress-and-outcome-of-labor
#15
Ahmed M Maged, Ehab M Soliman, Ali A Abdellatif, Mohamed Nabil, Omar I Said, Mohamed N Mohesen, Ayman N Raslan, Sahar M Y Elbaradie
BACKGROUND: Fetal head attitude has a substantial impact on labor progress and outcome. Fetal head deflexion is basically diagnosed by digital vaginal examination during labor. OBJECTIVES: To assess the effect of the fetal occiput-spine angle (OSA) measured through transabdominal ultrasound during the first stage of labor on the progress and outcome of labor. MATERIAL AND METHODS: A prospective cohort study conducted on 400 women with term uncomplicated singleton pregnancy with occipitoanterior position during active labor...
March 7, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29459612/review-of-uterine-sling-after-five-years-of-operation-in-a-40-years-lady
#16
R A Khanam, A Rubaiat, A S Azam
Uterine sling is a operation, done with own rectus sleeve to correct the uterine descend. If necessary correction of cystocele and/or rectocele and or perineal tear done on the same sitting. After 5 years of such operation abdomen of Mrs. X was opened due to ovarian cyst in Nirapad Hospital, Shantinagar, Dhaka, Bangladesh on August 2016. Uterus was found in normal position and size. Rectus sleeves were found attached with the uterus where it was anchored. Omentum was attached over the rectus sleeves and sealed the weak points at both lateral ends of the rectus sleeves through which the sleeves were taken to the abdominal cavity...
January 2018: Mymensingh Medical Journal: MMJ
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
#17
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/29429318/perineal-tears-a-review
#18
Ryan Goh, Daryl Goh, Hasthika Ellepola
BACKGROUND: The female perineum is the diamond-shaped inferior outlet of the pelvis. This structure is at risk of trauma during labour because of spontaneous perineal tears of varying degrees or iatrogenic episiotomies. These injuries can result in disabling immediate and long-term complications in the woman. OBJECTIVE: The aim of this article is to provide general practitioners (GPs) with a good understanding of perineal tears by discussing the different classifications, immediate and long-term management, and recommendations for future deliveries...
January 2018: Australian journal of general practice
https://www.readbyqxmd.com/read/29366610/-occiput-posterior-presentation-at-delivery-materno-foetal-outcomes-and-predictive-factors-of-rotation
#19
V Othenin-Girard, M Boulvain, M-J Guittier
OBJECTIVES: To describe the maternal and foetal outcomes of an occiput posterior foetal position at delivery; to evaluate predictive factors of anterior rotation during labour. METHODS: Descriptive retrospective analysis of a cohort of 439 women with foetuses in occiput posterior position during labour. Logistic regression analysis to quantify the effect of factors that may favour anterior rotation. RESULTS: Most of foetuses (64%) do an anterior rotation during labour and 13% during the expulsive phase...
February 2018: Gynecologie, Obstetrique, Fertilite & Senologie
https://www.readbyqxmd.com/read/29334290/topical-lidocaine-prilocaine-cream-versus-lidocaine-infiltration-for-pain-relief-during-repair-of-perineal-tears-after-vaginal-delivery-randomized-clinical-trial
#20
Ahmed M Abbas, Hamida A Abdel Hafiz, Aya M Abdelhafez, Armia Michael, Alaa M Ismail
OBJECTIVE: The current study aims to compare the analgesic effect of lidocaine-prilocaine (LP) cream with lidocaine infiltration during repair of perineal tears after vaginal delivery. MATERIALS AND METHODS: A single center open-labeled randomized clinical trial was carried out in a tertiary University Hospital between October 2016 and May 2017 (Clinical Trials.Gov: NCT02883179). We included parous women, who delivered at gestational age >37 weeks with first- or second-degree perineal tears...
January 31, 2018: Journal of Maternal-fetal & Neonatal Medicine
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