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Perineal tear

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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
#1
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 delivered at gestational age > 37 weeks with first or second degree perineal tears...
January 15, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29304391/incidence-and-risk-factors-of-third-and-fourth-degree-perineal-tears-in-a-single-italian-scenario
#2
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...
December 26, 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/29289503/midwifery-management-of-second-degree-perineal-tears-in-new-zealand-a-cross-sectional-survey-of-practice
#3
Robin S Cronin, Minglan Li, Kate Culliney, Robyn Maude, Katherine Nelson
BACKGROUND: Second-degree tears are the most common form of perineal trauma occurring after vaginal birth managed by New Zealand midwives, although little is known about midwives' perineal practice. AIM: The aim of this study was to identify how midwives managed the last second-degree perineal tear they treated and the level to which their practice reflects National Institute for Health and Care Excellence guidelines. METHODS: An (anonymous) online survey was conducted over a six-week period in 2013...
December 27, 2017: Women and Birth: Journal of the Australian College of Midwives
https://www.readbyqxmd.com/read/29288489/waterbirth-in-sweden-a-comparative-study
#4
Hanna Ulfsdottir, Sissel Saltvedt, Susanne Georgsson
INTRODUCTION: The literature describes advantages for mothers giving birth in water, but waterbirth is controversial in Sweden and has not been offered at hospitals until recently. This study aimed to describe and compare the characteristics and outcome of waterbirths with spontaneous vaginal births at the same clinics. MATERIAL AND METHODS: A retrospective cohort study was conducted on all waterbirths at two maternity units in Sweden from March 2014 to November 2015 (n=306), and a consecutively selected comparison group of 306 women having conventional spontaneous vaginal births...
December 29, 2017: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/29244523/hip-distraction-without-a-perineal-post-a-prospective-study-of-1000-hip-arthroscopy-cases
#5
Omer Mei-Dan, Matthew J Kraeutler, Tigran Garabekyan, Jesse A Goodrich, David A Young
BACKGROUND: Hip arthroscopy has traditionally been performed with a perineal post, resulting in various groin-related complications, including pudendal nerve neurapraxias, vaginal tears, and scrotal necrosis. PURPOSE: To assess the safety of a technique for hip distraction without the use of a perineal post. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: We prospectively analyzed a consecutive cohort of 1000 hips presenting to a dedicated hip preservation clinic; all patients had hip pain and were subsequently treated with hip arthroscopy...
December 1, 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/29241151/factors-that-influence-patient-preference-for-mode-of-delivery-following-an-obstetric-anal-sphincter-injury
#6
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...
December 8, 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/29205275/antenatal-maternal-education-for-improving-postnatal-perineal-healing-for-women-who-have-birthed-in-a-hospital-setting
#7
REVIEW
Sonia M O'Kelly, Zena Eh Moore
BACKGROUND: The female perineum becomes suffused and stretched during pregnancy, and further strain during vaginal childbirth contributes to approximately 85% of women experiencing some degree of trauma to the perineal region. Multiple factors play a role in the type and severity of trauma experienced, including parity, delivery method, and local practices. There is ongoing debate about best midwifery practice to reduce perineal trauma. Once perineal trauma has occurred, treatment also varies greatly, depending on its degree and severity, local practice and customs, and personal preference...
December 4, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29178349/effect-of-body-mass-index-on-the-incidence-of-perineal-trauma
#8
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
#9
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/29148634/labor-delivery-and-postpartum-complications-in-nulliparous-women-with-female-genital-mutilation-admitted-to-karamara-hospital
#10
Wondimu Gudu, Mutasim Abdulahi
Objectives: To assess labor, delivery and postpartum complications in nulliparous women with FGM/C and evaluate the attitude of mothers towards elimination of FGM. Methods: A prospective hospital based study using structured questionnaire was conducted between January to March 2015 at Karamara hospital, Jijiga, Ethiopia. All nulliparous women admitted for labor and delivery were included. Data were collected regarding circumcision status, events of labor, delivery; postpartum and neonatal outcomes as well as attitude of mothers towards elimination of FGM/C...
January 2017: Ethiopian Medical Journal
https://www.readbyqxmd.com/read/29103210/insulin-for-the-treatment-of-women-with-gestational-diabetes
#11
REVIEW
Julie Brown, Luke Grzeskowiak, Kathryn Williamson, Michelle R Downie, Caroline A Crowther
BACKGROUND: Gestational diabetes mellitus (GDM) is associated with short- and long-term complications for the mother and her infant. Women who are unable to maintain their blood glucose concentration within pre-specified treatment targets with diet and lifestyle interventions will require anti-diabetic pharmacological therapies. This review explores the safety and effectiveness of insulin compared with oral anti-diabetic pharmacological therapies, non-pharmacological interventions and insulin regimens...
November 5, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29037545/perineal-length-among-vietnamese-women
#12
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/29036756/acupuncture-or-acupressure-for-induction-of-labour
#13
REVIEW
Caroline A Smith, Mike Armour, Hannah G Dahlen
BACKGROUND: This is one of a series of reviews of methods of cervical ripening and labour induction. The use of complementary therapies is increasing. Women may look to complementary therapies during pregnancy and childbirth to be used alongside conventional medical practice. Acupuncture involves the insertion of very fine needles into specific points of the body. Acupressure is using the thumbs or fingers to apply pressure to specific points. The limited observational studies to date suggest acupuncture for induction of labour has no known adverse effects to the fetus, and may be effective...
October 17, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28981973/resumption-of-intercourse-self-reported-decline-in-sexual-intercourse-and-dyspareunia-in-women-by-mode-of-birth-a-prospective-follow-up-study
#14
José-Matías Triviño-Juárez, Dulce Romero-Ayuso, Beatriz Nieto-Pereda, Maria João Forjaz, Cristina Oliver-Barrecheguren, Sonia Mellizo-Díaz, Beatriz Avilés-Gámez, Begoña Arruti-Sevilla, Juan-José Criado-Álvarez, Consuelo Soto-Lucía, Rosa Plá-Mestre
AIM: To evaluate the association between mode of birth and the resumption of sexual intercourse, self-reported decline in sexual intercourse and dyspareunia in women at the 6(th) week and 6(th) month postpartum. BACKGROUND: Interest in the relationship between mode of birth and postpartum sexual functioning is increasing. However, previous findings are contradictory. DESIGN: Prospective, longitudinal, observational study. METHOD: The participants comprised 552 healthy primiparous women aged 18-45 years who gave birth at a hospital between February 2013 - April 2014...
October 5, 2017: Journal of Advanced Nursing
https://www.readbyqxmd.com/read/28968521/irish-and-new-zealand-midwives-expertise-at-preserving-the-perineum-intact-the-meppi-study-perspectives-on-preparations-for-birth
#15
Valerie Smith, Karen Guilliland, Lesley Dixon, Mary Reilly, Caroline Keegan, Colette McCann, Cecily Begley
OBJECTIVES: perineal trauma during birth can result in short or long term morbidity for women. Internationally, rates of episiotomy and severe perineal tears vary considerably. In New Zealand, in 2011, and in a trial of midwife-led care in Ireland, episiotomy rates were found to be considerably lower than those in many other countries. A qualitative exploratory study was undertaken to ascertain how midwives achieve these low rates, in these countries and settings. DESIGN AND PARTICIPANTS: a qualitative exploratory study was conducted...
September 20, 2017: Midwifery
https://www.readbyqxmd.com/read/28962649/adolescent-deliveries-in-rural-cameroon-an-8-year-trend-prevalence-and-adverse-maternofoetal-outcomes
#16
Valirie Ndip Agbor, Clarence Mvalo Mbanga, Tsi Njim
BACKGROUND: Adolescent deliveries remain a global public health concern especially in low- and middle-income countries where 95% of these deliveries occur. In Cameroon, adolescent pregnancies have a high disease burden due to their association with adverse pregnancy outcomes. We sought to evaluate the prevalence, trend and adverse maternofoetal outcomes of adolescent deliveries in a rural community in Cameroon. METHOD: We carried out a retrospective register analysis of 1803 singleton deliveries in two health facilities located in the Oku sub-division over an 8-year period (2009 to 2016)...
September 29, 2017: Reproductive Health
https://www.readbyqxmd.com/read/28932882/no-episiotomy-versus-selective-lateral-mediolateral-episiotomy-epitrial-an-interim-analysis
#17
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...
September 20, 2017: International Urogynecology Journal
https://www.readbyqxmd.com/read/28923011/nurse-midwives-ability-to-diagnose-acute-third-and-fourth-degree-obstetric-lacerations-in-western-kenya
#18
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/28889406/intrapartum-transperineal-ultrasound-used-to-predict-cases-of-complicated-operative-vacuum-and-forceps-deliveries-in-nulliparous-women
#19
José Antonio Sainz, José Antonio García-Mejido, Adriana Aquise, María José 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...
September 10, 2017: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/28885779/the-global-challenge-to-improve-the-sexual-and-reproductive-health-of-women-affected-by-fgm-c
#20
Mary McCauley
Against a background of an increasing demand for surgical intervention for the treatment of FGM/C related complications, Berg et al<comment> Note for typesetter: Please update reference when assigned to an issue.</comment> have conducted a systematic review of 62 studies involving 5829 women, to assess the effectiveness of defibulation, excision of cysts and clitoral reconstructive surgery. Berg et al report that defibulation showed a lower risk of Caesarean section and perineal tears; excision of cysts commonly resulted in resolution of symptoms; and clitoral reconstruction resulted in most women self-reporting improvements in their sexual health...
September 8, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
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