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Perineal trauma and episiotomy

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https://www.readbyqxmd.com/read/28438209/selective-episiotomy-vs-implementation-of-a-non-episiotomy-protocol-a-randomized-clinical-trial
#1
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/28412037/relationship-between-the-degree-of-perineal-trauma-at-vaginal-birth-and-change-in-haemoglobin-concentration
#2
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/28403314/implementation-of-care-practices-to-prevent-and-repair-perineal-trauma-in-childbirth
#3
Rafael Cleison Silva Dos Santos, Maria Luiza Gonzalez Riesco
Objective: To implement care practices for perineal trauma prevention and repairing in normal birth. Method: Quasi-experimental study conducted at Hospital da Mulher Mãe-Luzia, in Macapá, AP, Brazil. Seventy-four (74) nurses and obstetricians and 70 post-partum women were interviewed and the records of 555 patients were analyzed. The study was conducted in three stages: pre-audit and baseline audit (phase 1); educational intervention and implementation of best practices (phase 2); post-implementation audit (phase 3)...
April 6, 2017: Revista Gaúcha de Enfermagem
https://www.readbyqxmd.com/read/28391147/influence-of-a-pelvic-floor-training-programme-to-prevent-perineal-trauma-a-quasi-randomised-controlled-trial
#4
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...
March 27, 2017: Midwifery
https://www.readbyqxmd.com/read/28181214/aspirin-single-dose-for-perineal-pain-in-the-early-postpartum-period
#5
REVIEW
Sujana Molakatalla, Emily Shepherd, Rosalie M Grivell
BACKGROUND: Perineal trauma (due to spontaneous tears, surgical incision (episiotomy) or in association with operative vaginal birth) is common after vaginal birth, and is often associated with postpartum perineal pain. Birth over an intact perineum may also lead to perineal pain. There are adverse health consequences associated with perineal pain for the women and their babies in the short- and long-term, and the pain may interfere with newborn care and the establishment of breastfeeding...
February 9, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28176333/selective-versus-routine-use-of-episiotomy-for-vaginal-birth
#6
REVIEW
Hong Jiang, Xu Qian, Guillermo Carroli, Paul Garner
BACKGROUND: Some clinicians believe that routine episiotomy, a surgical cut of the vagina and perineum, will prevent serious tears during childbirth. On the other hand, an episiotomy guarantees perineal trauma and sutures. OBJECTIVES: To assess the effects on mother and baby of a policy of selective episiotomy ('only if needed') compared with a policy of routine episiotomy ('part of routine management') for vaginal births. SEARCH METHODS: We searched Cochrane Pregnancy and Childbirth's Trials Register (14 September 2016) and reference lists of retrieved studies...
February 8, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28027700/management-of-persistent-occiput-posterior-position-a-substantial-role-of-instrumental-rotation-in-the-setting-of-failed-manual-rotation
#7
Paul Guerby, Mickael Allouche, Caroline Simon-Toulza, Christophe Vayssiere, Olivier Parant, Fabien Vidal
INTRODUCTION: To compare the maternal and neonatal outcomes associated with Instrumental Rotation (IR) to operative vaginal delivery in occiput posterior (OP) position with Thierry's spatulas (TS), in the setting of failed manual rotation (MR). STUDY DESIGN: We led a prospective observational cohort study in a tertiary referral hospital in Toulouse, France. All women presenting in labor with persistent OP position at full cervical dilatation and who delivered vaginally after failed MR and with IR or OP assisted delivery were included from January 2014 to December 2015...
January 23, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/27889259/episiotomy-and-severe-perineal-trauma-among-eastern-african-immigrant-women-giving-birth-in-public-maternity-care-a-population-based-study-in-victoria-australia
#8
Fetene B Belihu, Rhonda Small, Mary-Ann Davey
BACKGROUND: Eastern African immigrants from countries affected by female genital mutilation have resettled in many developed countries, including Australia. Although possibly at risk of perineal trauma and episiotomy, research investigating their perineal status post-migration is sparse. AIM: To investigate variations in episiotomy use and incidence of severe perineal tear for women born in Eritrea, Ethiopia, Somalia and Sudan compared with Australian-born women...
November 23, 2016: Women and Birth: Journal of the Australian College of Midwives
https://www.readbyqxmd.com/read/27870738/persistent-pain-after-cesarean-delivery-and-vaginal-delivery-a-prospective-cohort-study
#9
J Petter Kainu, Erja Halmesmäki, Kari T Korttila, P Johanna Sarvela
BACKGROUND: Persistent pain after cesarean delivery and vaginal delivery has been the subject of only a few research articles. The primary outcome of our prospective study was the incidence of persistent pain and its association to mode of delivery. We also studied the nature and intensity of pain after delivery. METHODS: A questionnaire was distributed on postpartum day 2 to 1052 women who had given birth vaginally and to 502 who had undergone cesarean delivery in a tertiary maternity hospital in Helsinki, Finland, in 2010...
December 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27859542/midwives-management-during-the-second-stage-of-labor-in-relation-to-second-degree-tears-an-experimental-study
#10
Malin Edqvist, Ingegerd Hildingsson, Margareta Mollberg, Ingela Lundgren, Helena Lindgren
INTRODUCTION: Most women who give birth for the first time experience some form of perineal trauma. Second-degree tears contribute to long-term consequences for women and are a risk factor for occult anal sphincter injuries. The objective of this study was to evaluate a multifaceted midwifery intervention designed to reduce second-degree tears among primiparous women. METHODS: An experimental cohort study where a multifaceted intervention consisting of 1) spontaneous pushing, 2) all birth positions with flexibility in the sacro-iliac joints, and 3) a two-step head-to-body delivery was compared with standard care...
March 2017: Birth
https://www.readbyqxmd.com/read/27797099/the-effect-of-perineal-lacerations-on-pelvic-floor-function-and-anatomy-at-6-months-postpartum-in-a-prospective-cohort-of-nulliparous-women
#11
Lawrence Leeman, Rebecca Rogers, Noelle Borders, Dusty Teaf, Clifford Qualls
OBJECTIVE: To determine the effect of perineal lacerations on pelvic floor outcomes, including urinary and anal incontinence, sexual function, and perineal pain in a nulliparous cohort with low incidence of episiotomy. METHODS: Nulliparous women were prospectively recruited from a midwifery practice. Pelvic floor symptoms were assessed with validated questionnaires, physical examination, and objective measures in pregnancy and 6 months postpartum. Two trauma groups were compared, those with an intact perineum or only 1st degree lacerations and those with second-, third-, or fourth-degree lacerations...
December 2016: Birth
https://www.readbyqxmd.com/read/27793119/obstetric-outcomes-for-women-with-female-genital-mutilation-at-an-australian-hospital-2006-2012-a-descriptive-study
#12
Nesrin Varol, Angela Dawson, Sabera Turkmani, John J Hall, Susie Nanayakkara, Greg Jenkins, Caroline S E Homer, Kevin McGeechan
BACKGROUND: Women, who have been subjected to female genital mutilation (FGM), can suffer serious and irreversible physical, psychological and psychosexual complications. They have more adverse obstetric outcomes as compared to women without FGM. Exploratory studies suggest radical change to abandonment of FGM by communities after migration to countries where FGM is not prevalent. Women who had been subjected to FGM as a child in their countries of origin, require specialised healthcare to reduce complications and further suffering...
October 28, 2016: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/27473380/perineal-injuries-and-birth-positions-among-2992-women-with-a-low-risk-pregnancy-who-opted-for-a-homebirth
#13
Malin Edqvist, Ellen Blix, Hanne K Hegaard, Olöf Ásta Ólafsdottir, Ingegerd Hildingsson, Karen Ingversen, Margareta Mollberg, Helena Lindgren
BACKGROUND: Whether certain birth positions are associated with perineal injuries and severe perineal trauma (SPT) is still unclear. The objective of this study was to describe the prevalence of perineal injuries of different severity in a low-risk population of women who planned to give birth at home and to compare the prevalence of perineal injuries, SPT and episiotomy in different birth positions in four Nordic countries. METHODS: A population-based prospective cohort study of planned home births in four Nordic countries...
July 29, 2016: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/27426042/effect-of-low-level-laser-therapy-on-pain-and-perineal-healing-after-episiotomy-a-triple-blind-randomized-controlled-trial
#14
Marina B Alvarenga, Sonia Maria Junqueira Vasconcellos de Oliveira, Adriana A Francisco, Flora Maria B da Silva, Marcelo Sousa, Moacyr Roberto Nobre
BACKGROUND AND OBJECTIVE: Episiotomy is associated with perineal pain and healing complications. The low-level laser therapy (LLLT) reduces pain and inflammation and stimulates the healing process. This study aimed to assess the effect of LLLT on pain and perineal healing after an episiotomy. DESIGN/MATERIALS AND METHODS: A randomized, triple-blind, parallel clinical trial with 54 postpartum women who had a spontaneous birth with a right mediolateral episiotomy...
July 18, 2016: Lasers in Surgery and Medicine
https://www.readbyqxmd.com/read/27412362/oral-non-steroidal-anti-inflammatory-drugs-single-dose-for-perineal-pain-in-the-early-postpartum-period
#15
REVIEW
Francesca Wuytack, Valerie Smith, Brian J Cleary
BACKGROUND: Many women experience perineal pain after childbirth, especially after having sustained perineal trauma. Perineal pain-management strategies are thus an important part of postnatal care. Non-steroidal anti-inflammatory drugs (NSAIDs) are a commonly used type of medication in the management of postpartum pain and their effectiveness and safety should be assessed. OBJECTIVES: To determine the effectiveness of a single dose of an oral NSAID for relief of acute perineal pain in the early postpartum period...
2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27406639/complementary-therapies-for-labour-and-birth-study-a-randomised-controlled-trial-of-antenatal-integrative-medicine-for-pain-management-in-labour
#16
Kate M Levett, C A Smith, A Bensoussan, H G Dahlen
OBJECTIVE: To evaluate the effect of an antenatal integrative medicine education programme in addition to usual care for nulliparous women on intrapartum epidural use. DESIGN: Open-label, assessor blind, randomised controlled trial. SETTING: 2 public hospitals in Sydney, Australia. POPULATION: 176 nulliparous women with low-risk pregnancies, attending hospital-based antenatal clinics. METHODS AND INTERVENTION: The Complementary Therapies for Labour and Birth protocol, based on the She Births and acupressure for labour and birth courses, incorporated 6 evidence-based complementary medicine techniques: acupressure, visualisation and relaxation, breathing, massage, yoga techniques, and facilitated partner support...
July 12, 2016: BMJ Open
https://www.readbyqxmd.com/read/27377504/pattern-of-episiotomy-use-its-immediate-complications-among-vaginal-deliveries-in-18-tertiary-care-hospitals-in-india
#17
Shalini Singh, Tushita Thakur, Nomita Chandhiok, Balwan Singh Dhillon
BACKGROUND & OBJECTIVES: In developed countries, efforts have been made to restrict episiotomy practice. However, in developing countries the episiotomy rates continue to be high. This study was conducted to evaluate the pattern of episiotomy use and its immediate complications among women delivering at tertiary level public hospitals in India. METHODS: Prospective data of all women undergoing vaginal delivery including instrumental delivery were collected daily from the labour room registers of the 18 tertiary care hospitals on a structured proforma...
April 2016: Indian Journal of Medical Research
https://www.readbyqxmd.com/read/27333357/practice-bulletin-no-165-prevention-and-management-of-obstetric-lacerations-at-vaginal-delivery
#18
(no author information available yet)
Lacerations are common after vaginal birth. Trauma can occur on the cervix, vagina, and vulva, including the labial, periclitoral, and periurethral regions, and the perineum. Most of these lacerations do not result in adverse functional outcomes. Severe perineal lacerations, extending into or through the anal sphincter complex, although less frequent, are more commonly associated with increased risk of pelvic floor injury, fecal and urinary incontinence, pain, and sexual dysfunction with symptoms that may persist or be present many years after giving birth...
July 2016: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27333355/practice-bulletin-no-165-summary-prevention-and-management-of-obstetric-lacerations-at-vaginal-delivery
#19
(no author information available yet)
Lacerations are common after vaginal birth. Trauma can occur on the cervix, vagina, and vulva, including the labial, periclitoral, and periurethral regions, and the perineum. Most of these lacerations do not result in adverse functional outcomes. Severe perineal lacerations, extending into or through the anal sphincter complex, although less frequent, are more commonly associated with increased risk of pelvic floor injury, fecal and urinary incontinence, pain, and sexual dysfunction with symptoms that may persist or be present many years after giving birth...
July 2016: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27237831/mothers-and-midwives-perceptions-of-birthing-position-and-perineal-trauma-an-exploratory-study
#20
Faith C Diorgu, Mary P Steen, June J Keeling, Elizabeth Mason-Whitehead
BACKGROUND: Studies have associated lithotomy position during childbirth with negative consequences and increased risk of perineal injuries. AIMS: To identify prevalence rates of different birthing position and episiotomy and to explore the differences in perspectives of mothers and midwives about birthing positions and perineal trauma. METHODS: A survey involving 110 mothers and 110 midwives at two hospitals. Participants were mothers who had a vaginal birth/perineal injury and midwives who attended births that resulted in perineal injuries...
December 2016: Women and Birth: Journal of the Australian College of Midwives
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