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Perineal trauma and episiotomy

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...
2016: BMC Pregnancy and Childbirth
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
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
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...
2016: BMJ Open
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
(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
(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
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...
May 26, 2016: Women and Birth: Journal of the Australian College of Midwives
Kathrine Fodstad, Anne Cathrine Staff, Katariina Laine
INTRODUCTION AND HYPOTHESIS: Knowledge on sexual complaints and time to sexual resumption after obstetric anal sphincter injury (OASI) is scarce. The aim of the study was to investigate self-reported sexual activity and coital problems 1 year postpartum in relation to perineal trauma, in addition to delivery mode. METHODS: Among 2,846 women recruited during pregnancy, all women who delivered with OASI (n = 42, all third-degree perineal tears), in addition to 20 randomly selected controls per OASI case, a total of 882 women, were sent a self-administered questionnaire addressing time to coital resumption after delivery and potential coital difficulty 1 year postpartum...
October 2016: International Urogynecology Journal
Tilemachos Kavvadias, Irene Hoesli
Aims. The aim of this review is to provide a comprehensive overview of the available literature on preventing perineal trauma with the EpiNo. Methods. We perfomed a literature research in the MedLine and EMBASE databases for studies referring to EpiNo published between 1990 and 2014, without restrictions for language and study type. Results. Five published studies were identified, regarding the effect of EpiNo on the rate of episiotomy and perineal tears, pelvic floor muscle function, and fetal outcome. The device seems to reduce episiotomy and perineal tears' rate, as well as the risk for levator ani microtrauma and avulsion, though not always statistically significant...
2016: Obstetrics and Gynecology International
Jo-Anne Hammond
OBJECTIVE: To compare patient outcomes and complications before and after involvement of family medicine residents in intrapartum care. DESIGN: Secondary data analysis. SETTING: London, Ont. PARTICIPANTS: Obstetric patients of a family physician with a special interest in obstetrics. MAIN OUTCOME MEASURES: Total number of births attended and births missed, as well as rates of inductions, augmentations for dystocia, augmentations for prelabour ruptured membranes, types of births (ie, normal vaginal, vacuum-assisted, low and outlet forceps deliveries; cesarean sections; and obstetrician-assisted vaginal births), and perineal outcomes (ie, intact; first-, second-, third-, or fourth-degree tears; episiotomies; and episiotomies with third-or fourth-degree extensions)...
November 2015: Canadian Family Physician Médecin de Famille Canadien
Giussy Barbara, Paola Pifarotti, Federica Facchin, Ivan Cortinovis, Dhohua Dridi, Camilla Ronchetti, Luca Calzolari, Paolo Vercellini
INTRODUCTION: Several studies have explored the association between modes of delivery and postpartum female sexual functioning, although with inconsistent findings. AIM: To investigate the impact of mode of delivery on female postpartum sexual functioning by comparing spontaneous vaginal delivery, operative vaginal delivery, and cesarean section. METHODS: One hundred thirty-two primiparous women who had a spontaneous vaginal delivery, 45 who had an operative vaginal delivery, and 92 who underwent a cesarean section were included in the study (N = 269)...
March 2016: Journal of Sexual Medicine
Marzieh Akbarzadeh, Faride Vaziri, Mahnaz Farahmand, Zahra Masoudi, Sedigheh Amooee, Najaf Zare
BACKGROUND: Genital trauma during vaginal delivery may result from episiotomy, spontaneous perineal tears (perineum, vagina), or both. In 2012, this study aimed to investigate the effect of warm compress bistage intervention on the rate of episiotomy, perineal trauma, and postpartum pain intensity in the primiparous woman with delayed Valsalva maneuver. METHODS: In this randomized clinical trial, which was performed in hospitals in Shiraz, Iran, in 2012-2013, 150 women were randomly divided into 2 groups: 1 intervention and 1 control...
February 2016: Advances in Skin & Wound Care
Rakhshanda Aslam, Shazia Amir Khan, Zain ul Amir, Fouzia Amir
BACKGROUND: Performing an episiotomy is generally reserved for complicated childbirths, in cases of foetal distress, or when tearing of tissues with serious consequences are foreseen. In addition to the extent of the trauma, the surgical skill, repair after childbirth can have an important effect on the magnitude and degree of morbidity experienced by women after repair. The best technique for this repair would be that which produces less pain in the short and long term. The study was done with an objective to compare the frequency and severity of pain (slight/severe) by using interrupted and continuous methods for repair of episiotomy or second degree perineal tears...
July 2015: Journal of Ayub Medical College, Abbottabad: JAMC
Amanda J Ampt, Jane B Ford
OBJECTIVES: Population data are often used to monitor severe perineal trauma trends and investigate risk factors. Within New South Wales (NSW), two different datasets can be used, the Perinatal Data Collection ('birth' data) or a linked dataset combining birth data with the Admitted Patient Data Collection ('hospital' data). Severe perineal trauma can be ascertained by birth data alone, or by hospital International Classification of Diseases Australian Modification (ICD-10-AM) diagnosis and procedure coding in the linked dataset...
September 2015: Public Health Research & Practice
E Gonzalez-Díaz, C Fernández Fernández, A Fernández Corona
OBJECTIVES: The objective of our study was to compare the theoretical concept of the accoucheur in our institution with regard to the characteristics of the mediolateral episiotomy (MLE), with a crowning head and after a delivery. METHODS: We devised two simple pictorial questionnaires (one with a crowning head and the other in rest after a delivery) in order to explore possible differences in clinical practice between the accoucheurs of our institution with respect to the MLE characteristics...
2016: Journal of Maternal-fetal & Neonatal Medicine
Clémence Schantz, Kruy Leang Sim, Ek Meng Ly, Hubert Barennes, So Sudaroth, Sophie Goyet
First documented in 1741, the practice of episiotomy substantially increased worldwide during the 20th century. However, research shows that episiotomy is not effective in reducing severe perineal trauma and may be harmful. Using a mixed-methods approach, we conducted a study in 2013-14 on why obstetricians and midwives in a large maternity hospital in Phnom Penh, Cambodia, still do routine episiotomies. The study included the extent of the practice, based on medical records; a retrospective analysis of the delivery notes of a random sample of 365 patients; and 22 in-depth interviews with obstetricians, midwives and recently delivered women...
May 2015: Reproductive Health Matters
Lin Zhu, Jing Yang, Jing Wang, Zhi Li, Junmei Shi, Liye Zhu, Yunping Zhang, Xiaoyan Zhang
OBJECTIVE: To explore the restrictive use of episiotomy for low forceps delivery. METHODS: A total of 311 low forceps delivery women at ≥37 weeks of gestation with live singleton cephalic pregnancies were recruited from June 2013 to December 2013 at our hospital. Among whom, 117 women underwent no episiotomy another 194 had mediolateral episiotomy. The maternal and neonatal outcomes of two types of episiotomy were compared. RESULTS: The amount of intra and post-partum hemorrhage, I-II perineal tearing, time of perineal suturing, perineal pain severity of post-partum 24 h significantly decreased than control group (P<0...
May 5, 2015: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Erbil Karaman, Numan Çim, Zülküf Akdemir, Erkan Elçi, Hüseyin Akdeniz
Introduction. Vulvar cyst in adolescent girls is very uncommon. Epidermoid cyst can be seen in many sites including face, trunk, and extremities but its occurrence in vulva is uncommon. This is the first case of epidermoid cyst of vulva reported in an adolescent girl. Case. A 17-year-old, adolescent girl admitted to our gynecology outpatient clinic with a complaint of painful and palpable mass in her vulva. On examination, a giant mass located in left vulva and labia majora with 11 cm in diameter was seen...
2015: Case Reports in Obstetrics and Gynecology
Ramón Escuriet, María J Pueyo, Mercedes Perez-Botella, Xavi Espada, Isabel Salgado, Analía Gómez, Herminia Biescas, Isabel Espiga, Joanna White, Rosa Fernandez, Josep Fusté, Vicente Ortún
BACKGROUND: In Spain, the Strategy for Assistance in Normal Childbirth (SANC) promoted a model of care, which respects the physiological birth process and discards unnecessary routine interventions, such as episiotomies. We evaluated the rate of episiotomy use and perineal trauma as indicators of how selective introduction of the SANC initiative has impacted childbirth outcomes in hospitals of Catalonia. METHODS: Cross-sectional study of all singleton vaginal term deliveries without instrument registered in the Minimum Basic Data Set (MBDS) of Catalonia in 2007, 2010 and 2012...
2015: BMC Health Services Research
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