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Perineal trauma and episiotomy

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https://www.readbyqxmd.com/read/29037175/a-ten-year-study-of-midwife-led-care-at-an-austrian-tertiary-care-center-a-retrospective-analysis-with-special-consideration-of-perineal-trauma
#1
Barbara Bodner-Adler, Oliver Kimberger, Julia Griebaum, Peter Husslein, Klaus Bodner
BACKGROUND: In contrast to other countries, Austria rarely offers alternative models to medical led-care. In an attempt to improve the facilities, a midwife-led care service was incorporated within the Department of Obstetrics and Fetomaternal Medicine. The aim of the present study was to analyze the maternal and neonatal outcomes of this approach. METHODS: Over a 10-years period, a total of 2123 low-risk women receiving midwife-led care were studied. Among these women, 148 required obstetric referral...
October 16, 2017: BMC Pregnancy and Childbirth
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
#2
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/28889193/are-obstetric-outcomes-affected-by-female-genital-mutilation
#3
Aswini A Balachandran, Swapna Duvalla, Abdul H Sultan, Ranee Thakar
INTRODUCTION AND HYPOTHESIS: Female genital mutilation (FGM) has been associated with adverse obstetric and neonatal outcomes, such as postpartum haemorrhage (PPH), perineal trauma, genital fistulae, obstructed labour and stillbirth. The prevalence of FGM has increased in the UK over the last decade. There are currently no studies available that have explored the obstetric impact of FGM in the UK. The aim of our study was to investigate the obstetric and neonatal outcomes of women with FGM when compared with the general population...
September 9, 2017: International Urogynecology Journal
https://www.readbyqxmd.com/read/28813712/management-of-the-perineum-during-delivery-with-the-kiwi-omnicup-effects-of-mediolateral-episiotomy-on-anal-sphincter-tears-in-nulliparous-women
#4
Barbara Bodner-Adler, Oliver Kimberger, Andreas Käfer, Peter Husslein, Klaus Bodner
AIM: The main objective of this study was to evaluate the association of mediolateral episiotomy with severe perineal trauma during Kiwi omnicup vacuum delivery. METHODS: This retrospective study analyzed all Kiwi omnicup vacuum deliveries between 2010 and 2015 in nulliparous women. Secondary outcomes of interest included frequency of genital tract trauma, outcome of Kiwi extraction and influence on neonatal parameters. RESULTS: A total of 572 nulliparous women who were delivered with the aid of vacuum were analyzed...
August 17, 2017: Gynecologic and Obstetric Investigation
https://www.readbyqxmd.com/read/28778037/comparison-of-midwife-led-care-and-obstetrician-led-care-on-maternal-and-neonatal-outcomes-in-singapore-a-retrospective-cohort-study
#5
Shi Tian Voon, Julie Tay Suan Lay, Wilson Tam Wai San, Shefaly Shorey, Serena Koh Siew Lin
OBJECTIVES: to examine the maternal and neonatal outcomes of low-risk women receiving midwife-led care and obstetrician-led care. DESIGN, SETTING,&PARTICIPANTS: a retrospective cohort study design was used. Data were collected from a large tertiary maternity hospital in Singapore. This involved a medical record review of 368 women who had singleton, normal to low-risk, term pregnancy, and received midwife-led care and obstetrician-led care between 2013 to 2014. MEASUREMENTS: a data extraction tool was used to solicit information on the outcome measures, including duration of labour, mode of delivery, episiotomy, and 5-minutes Apgar score (<7)...
October 2017: Midwifery
https://www.readbyqxmd.com/read/28753544/effect-of-female-genital-cutting-performed-by-health-care-professionals-on-labor-complications-in-egyptian-women-a-prospective-cohort-study
#6
Wael F Saleh, Haitham A Torky, Mohamed A Youssef, Wael S Ragab, Mohamed A Sayed Ahmed, Ashraf Eldaly
AIM: To examine the effect of the degree of female genital cutting (FGC) performed by health-care professionals on perineal scarring; delivery mode; duration of second stage of labor; incidence of perineal tears and episiotomy in a cohort of uncircumcised versus circumcised (types I and II) women. METHODS: A prospective cohort study included 450 primigravida women in active labor attending the Faculty of Medicine Cairo University Hospital between January 2013 and August 2014...
July 28, 2017: Journal of Perinatal Medicine
https://www.readbyqxmd.com/read/28637428/quality-of-care-provided-in-two-scottish-rural-community-maternity-units-a-retrospective-case-review
#7
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/28616828/perinatal-and-maternal-outcomes-at-term-in-low-risk-pregnancies-according-to-nice-criteria-comparison-between-a-tertiary-obstetrical-hospital-and-midwife-attended-units
#8
Tanja Ignatov, Holm Eggemann, Serban Dan Costa, Atanas Ignatov
PURPOSE: The aim of this study was to evaluate the perinatal and maternal outcomes at term at a single tertiary, university hospital in women with low-risk pregnancies. PATIENTS AND METHODS: We performed a retrospective cohort study of women with low-risk pregnancies, who delivered at University Women's Hospital Magdeburg between January 2010 and December 2014. Data were compared with data published by Brocklehurst et al. 2011. RESULTS: Of the 6052 women investigated, 2014 were classified as low risk according to the NICE criteria and were eligible for analysis...
August 2017: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/28608597/perineal-techniques-during-the-second-stage-of-labour-for-reducing-perineal-trauma
#9
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/28438209/selective-episiotomy-vs-implementation-of-a-non-episiotomy-protocol-a-randomized-clinical-trial
#10
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
#11
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...
October 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
#12
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
#13
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
https://www.readbyqxmd.com/read/28181214/aspirin-single-dose-for-perineal-pain-in-the-early-postpartum-period
#14
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
#15
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
#16
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
#17
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
#18
COMPARATIVE STUDY
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
#19
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
#20
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
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