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Perineal tears royal

G Thiagamoorthy, A Johnson, R Thakar, A H Sultan
INTRODUCTION AND HYPOTHESIS: Perineal trauma affects approximately 350,000 women per annum in the United Kingdom (UK) and is associated with considerable morbidity. Symptoms are most severe following obstetric anal sphincter injuries (OASIS) compared with other grades of perineal trauma. The Royal College of Obstetricians and Gynaecologists (RCOG) guidelines indicate that the rate of OASIS is 1 % of vaginal deliveries. In 2011, the RCOG implemented the "Maternity Dashboard" so that units could benchmark their performance against national standards of which OASIS is a component...
December 2014: International Urogynecology Journal
Debra E Bick, Khaled M Ismail, Sue Macdonald, Peter Thomas, Sue Tohill, Christine Kettle
BACKGROUND: The accurate assessment and appropriate repair of birth related perineal trauma require high levels of skill and competency, with evidence based guideline recommendations available to inform UK midwifery practice. Implementation of guideline recommendations could reduce maternal morbidity associated with perineal trauma, which is commonly reported and persistent, with potential to deter women from a future vaginal birth. Despite evidence, limited attention is paid to this important aspect of midwifery practice...
2012: BMC Pregnancy and Childbirth
Camille Le Ray, François Audibert, Dominique Cabrol, François Goffinet
OBJECTIVE: To study how differences in birth management can influence the frequency and types of perineal lesions. MATERIAL AND METHODS: We compared outcomes and obstetric practices during labour and birth in low-risk primiparous women in two maternity units: one Canadian (maternitA Sainte-Justine, Montreal, Quebec), one French (maternité Cochin-Port-Royal, Paris). We compared the occurrence of perineal lesions--episiotomy and severe perineal tear--in these two maternity units according to delivery method...
November 2009: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
R Panigrahy, J Welsh, F MacKenzie, P Owen
We present a complete audit cycle of the management of third/fourth degree perineal tears in the three Glasgow maternity hospitals measured against the recommendations of the Royal College of Obstetricians and Gynaecologists (RCOG) Guideline No. 29 ( Following an initial 6-month data collection period, shortcomings in the practice were identified, circulated and an operative proforma was designed and introduced. A re-audit demonstrated improved compliance with the RCOG guidelines. We recommend the introduction of an operative proforma to aid management and documentation of third/fourth degree tear repairs...
April 2008: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
Yoram Abramov, Beni Feiner, Thalma Rosen, Motti Bardichev, Eli Gutterman, Arie Lissak, Ron Auslander
Advanced obstetric anal sphincter tears are often associated with a high incidence of fecal and flatus incontinence. We aimed to assess the clinical outcome of these repairs when done by the overlapping sphincteroplasty technique with reconstruction of the internal anal sphincter and perineum. Between August 2005 and December 2006, all grades 3 and 4 obstetric anal sphincter tears in our department were repaired by a reconstructive pelvic surgeon, primarily using the overlapping sphincteroplasty technique with reconstruction of the internal anal sphincter and perineum...
August 2008: International Urogynecology Journal and Pelvic Floor Dysfunction
Vasanth Andrews, Ranee Thakar, Abdul H Sultan, Peter W Jones
OBJECTIVE: Postpartum perineal pain and dyspareunia have been reported to affect 42% of women within the first 2 weeks after their first vaginal delivery. We aimed to determine the prevalence of dyspareunia and perineal pain using validated pain scores following accurate classification of perineal trauma according to the guidelines of the Royal College of Obstetricians and Gynaecologists. STUDY DESIGN: Prospective study of women having their first vaginal delivery...
April 2008: European Journal of Obstetrics, Gynecology, and Reproductive Biology
Hannah G Dahlen, Maureen Ryan, Caroline S E Homer, Margaret Cooke
OBJECTIVE: to determine risk factors for the occurrence of severe perineal trauma (third and fourth degree tears) during childbirth. DESIGN: a prospective cohort study was conducted using the hospital's computerised obstetric information system. Additional data were gathered on women who sustained severe perineal trauma. Descriptive statistics and logistic regression were used to assess risk factors for severe perineal trauma. Midwives were asked to comment on possible reasons for severe perineal trauma...
June 2007: Midwifery
N Mackenzie, L Parry, M Tasker, M R Gowland, H R Michie, J H Hobbiss
OBJECTIVE: To assess the anal function of women who have suffered a third degree perineal tear during parturition. PATIENTS: Fifty-three consecutive women who sustained a third degree tear, between January 1998 and March 2000, at the Princess Anne Maternity Unit, Royal Bolton Hospital were assessed. METHODS: Women were assessed at 3 months post partum using the Cleveland Clinic Incontinence Score, digital assessment of anal sphincter and endo-anal ultrasound scan...
March 2004: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
B O Ononeze, Noreen Gleeson, M J Turner
This study evaluates the management of third/fourth-degree obstetric tears and choice of mode of delivery in subsequent pregnancies amongst obstetricians practising in Ireland. Of the 185 obstetricians who were sent questionnaires 133 replied, giving a response rate of 72%. The consultant obstetricians were significantly more likely to suture third-degree tears in the labour ward than the non-consultant counterpart, P=0.04. There was no statistically significant difference between the two groups on the repair technique, P=0...
February 2004: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
R Campbell, A Macfarlane, V Hempsall, K Hatchard
OBJECTIVE: To compare the outcome of care given to women 'booking' for delivery in a midwife-led maternity unit with that for comparable women 'booking' for care in a consultant obstetric unit. DESIGN AND METHOD: Prospective cohort study with a quasi-experimental design and data extracted from case notes. SETTING: East Dorset, midwife-led maternity unit at Royal Bournemouth Hospital and consultant-led maternity unit at Poole General Hospital...
September 1999: Midwifery
C East, J Webster
OBJECTIVE: to determine whether the incidence of perineal outcomes, including episiotomy, at the Royal Women's Hospital (RWH) Brisbane reflected trends reported in the literature. DESIGN: retrospective record review. SETTING: RWH Brisbane. PARTICIPANTS: 953 women who delivered vaginally at the RWH in 1986 and 1992. MEASUREMENTS AND FINDINGS: there was a decline in the episiotomy rate from 65% in 1986 to 36% in 1992...
December 1995: Midwifery
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