Occipitoposterior

BACKGROUND: Fetal distress indicated as the cause for cesarean delivery based on cardiotocography findings most often does not reflect in the newborn assessment. Cardiotocography findings are just the decision indicators for cesarean delivery, in the background of labor abnormalities owing to deflexed head or occipitoposterior position. OBJECTIVE: This study aimed to investigate the association between cardiotocography findings and the attitude of fetal head and occiput position...

AIMS AND OBJECTIVES: To evaluate and quantify the best available evidence regarding risk factors for severe perineal lacerations. BACKGROUND: Many studies have evaluated the risk factors for severe perineal lacerations. However, the results of those studies are inconsistent, and meta-analysis which thoroughly evaluates the risk factors for severe perineal lacerations is still lacking. DESIGN: Systematic review and meta-analysis of cohort studies based on the PRISMA guideline...

This randomised controlled trial aimed to compare the effect of early and delayed pushing during the second stage of labour in women with occipitoposterior (OP) malposition. It included 184 nulliparous women with OP position randomised to early pushing in which women were allowed to push within one hour after full cervical dilatation or delayed pushing in which women were asked not to push for maximum of three hours or start pushing when the vertex was visible. The primary outcome was successful vaginal delivery...

Postpartum peripheral nerve disorders are an uncommon obstetrical complication, with most cases resulting from intrinsic obstetric palsies. We present the case of a full-term nulliparous pregnant 33-year-old woman with a vacuum-assisted vaginal delivery due to a prolonged second stage of labour and occipitoposterior position of the fetal head. For analgesia, a combined spinal-epidural technique was used. Four hours after delivery, the patient experienced a painless asymmetric motor deficit and hypoesthesia in the lower limbs, followed by sphincter disturbance...

OBJECTIVES: To evaluate the rates of third- and fourth-degree tears and related predisposing factors for the tears in singleton vaginal deliveries. Methods: This was a retrospective study of third- and fourth-degree perineal tears in all women who underwent vaginal delivery in a tertiary hospital in Assir region between January 2014 and December 2019. There are approximately 5000 deliveries per year at the Abha Maternity and Children Hospital. The total number of deliveries during the study period was 31,788, of which 19,374 were delivered vaginally...

BACKGROUND: Vaginal delivery is the ideal mode of delivery for the termination of a pregnancy. However, the cesarean section rate in China is much higher than the published by the World Health Organization in the Lancet in 2010. AIM: To retrospectively analyze the factors related to failed trial of labor and the clinical indications for cesarean section conversion, explore how to promote the trial of labor success rate, and determine the feasibility of reducing the rate of conversion to cesarean section...

OBJECTIVE:  To evaluate the ability of the pubic arch angle (PAA) as measured by transperineal ultrasonography during labor to predict the delivery type and cephalic pole disengagement mode. METHODS:  The present prospective cross-sectional study included 221 women in singleton-gestational labor ≥ 37 weeks with cephalic fetuses who underwent PAA measurement using transperineal ultrasonography. These measurements were correlated with the delivery type, cephalic pole disengagement mode, and fetal and maternal characteristics...

OBJETIVE: Operative vaginal delivery (OVD) is the most important risk fact for obstetric anal sphincter injury (OASI). Knowledge of possible risk factors for their occurrence may therefore reduce the likelihood of faecal incontinence. The aim is to analyse the effect of mediolateral episitomy and perineum characteristics on the occurrence of OASI in OVD. STUDY DESIGN: Case-control study, which included 958 OVD that were reviewed in Pelvic Floor and Puerperium Clinic...

OBJECTIVES: Obstetric anal sphincter injury (OASIS) includes the third and fourth degree of perineal injury. The risk for OASIS is about 1% of all vaginal deliveries. If not recognised and treated properly, obstetric anal sphincter injury can have serious consequences for reproductive age woman. MATERIAL AND METHODS: We have retrospectively gathered and analysed data on obstetric anal sphincter injury in a four-year period at our department. The control group in this study included vaginal deliveries in 2012...

This chapter reviews clinical and scientific approaches to optic ataxia. This double historic track allows us to address important issues such as the link between Bálint syndrome and optic ataxia, the alleged double dissociation between optic ataxia and visual agnosia, and the use of optic ataxia to argue for a specific vision-for-action occipitoposterior parietal stream. Clinical cases are described and reveal that perceptual deficits have been long shown to accompany ataxia. Importantly, the term ataxia appears to be misleading as patients exhibit a combination of visual and nonvisual perceptual, attentional, and visuomotor guidance deficits, which are confirmed by experimental approaches...

OBJECTIVE: To evaluate the ability of intrapartum ultrasound to differentiate occipitoposterior (OP) rotation with normal flexion of the head from deflexion, to compare the accuracy of ultrasound with the digital examination, and to assess the outcome of labor according to the type of presentation. PATIENTS AND METHODS: A retrospective study of patients with abnormal labor because of either prolongation and/or abnormal cardiotocography and OP rotation who underwent intrapartum sonography...

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INTRODUCTION AND HYPOTHESIS: To establish the contribution of maternal, fetal and intrapartum factors to the risk of incidence of obstetric anal sphincter injuries (OASIS) and assess the feasibility of an OASIS risk prediction model based on variables available to clinicians prior to birth. METHODS: This was a population-based, retrospective cohort study using single-site data from the birth database of Aarhus University Hospital, Denmark. The participants were all women who had a singleton vaginal birth during the period 1989 to 2006...

INTRODUCTION: Pregnancy- and delivery-related factors affect postpartum anal incontinence. We aimed to explore changes in continence status among primiparas from late pregnancy through the first year postpartum. MATERIAL AND METHODS: In this prospective cohort study set in two Norwegian hospitals, 862 healthy primiparas completed questionnaires about the main outcome measure anal incontinence, including flatus incontinence and urgency, at three time points; late pregnancy, 6 and 12 months postpartum...

OBJECTIVES: There is an ongoing debate regarding the routine versus restrictive use of episiotomy The study aim was to investigate if episiotomy during vaginal deliveries can reduce both, the number and severity of genital lacerations. MATERIAL AND METHODS: The study included all women who gave vaginal birth at AOU. "G. Martino" Messina (n=382) and the Clinic for Ob/Gyn Clinical Center of Serbia, Belgrade (n=4227) during 2011. Lacerations during birth were recorded and divided according to location and severity Women with lacerations were subdivided into two groups: with or without mediolateral episiotomy We assessed potential risk factors for laceration: maternal age, parity use of labor stimulants and epidural analgesia, participation in antenatal classes, fetal presentation, neonatal birth weight, and duration of the second stage of labor...

INTRODUCTION: The objective of this study was to develop a model for predicting perineal lacerations in women attempting forceps-assisted delivery. METHODS: We identified all forceps-assisted deliveries at our institution from January 1, 2002 to June 30, 2012. Multiple gestations were excluded. The laceration group included third and fourth degree was compared with a control group including a random sample of women who had a forceps-assisted delivery without lacerations...

It is common practice for epidural analgesia to be offered to women in labour with a suspected occipito-posterior (OP) position. Therefore, this article will challenge whether this practice ensures informed choice and optimal outcomes. Based on a case study, I will explore how midwives can promote normality in an OP labour through autonomous practice. My intuition was that Jane (a pseudonym) may not have consented to an epidural had she known the risks, and as a result, she might have achieved a spontaneous vaginal birth...

OBJECTIVE: To review and describe the impact of varied recruitment processes in two intrapartum studies. DESIGN: Retrospective review of one prospective cohort study and one pilot randomized controlled trial. SETTING: Australian tertiary referral hospital. POPULATION: Women with term, cephalic singleton pregnancies. METHODS: Recruitment processes in one observational and one interventional study examining the management of occipitoposterior position in labor were reviewed...

INTRODUCTION AND HYPOTHESIS: Risk factors related to obstetric anal sphincter injuries (OASIS) are known for singleton deliveries. No study to date has described the rate and risk factors involved in twin deliveries. METHODS: We conducted a retrospective cohort study (1985-2010) of all vaginal twin and singleton deliveries in a single tertiary center. The adjusted odds ratio (OR) for OASIS at delivery was estimated using the logistic regression model. RESULTS: The study comprised 1,538 and 91,312 patients with vaginal twin and singleton delivery, respectively...

OBJECTIVE: To examine how well ultrasound-assessed occipitoposterior (OP) position or high sagittal (HS) position in primiparous women with a prolonged first stage of labor predicts a vaginal delivery and the duration of labor. DESIGN: Prospective observational study. SETTING: Stavanger University Hospital, a secondary referral center in Norway. POPULATION: 105 primiparous women with prolonged first stage of labor. METHODS: Ultrasound assessment of fetal head position...