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Obstetric Anal Sphincter Injury and Anal Incontinence Following Vaginal Birth: A Systematic Review and Meta‐Analysis
DiscussionBoth episiotomy and third‐ or fourth‐degree perineal laceration are significantly associated with anal incontinence after vaginal birth. The evidence provided in this systematic review and meta‐analysis highlights the importance of reducing perineal trauma during vaginal births in order to ameliorate anal incontinence in parous women. (Source: Journal of Midwifery and Women's Health)
Source: Journal of Midwifery and Women's Health - February 24, 2015 Category: Midwifery Authors: Allison LaCross, Meredith Groff, Arlene Smaldone Tags: Original Review Source Type: research

Endometriosis node in Gynaecologic scars : A study of 17 patients and the diagnostic considerations in clinical experience in tertiary care center
Conclusions: A high level of suspicion is required to diagnose gynaecological scar endometriosis, which should be suspected in the differential diagnosis of scar masses in reproductive-aged women.Several theories have been proposed to explain the formation of endometriosis nodes in extrauterine localizations. The two of them that seem to be more plausible are the metaplasia and transport theories.Imaging with ultrasound, CT and MR facilitate the diagnosis. FNA could be used for preoperative diagnosis.Treatment must be by node resection with a security margin. In some cases, surgery could be combined with hormonal treatment...
Source: BMC Women's Health - February 18, 2015 Category: OBGYN Authors: Rocío Vellido-CoteloJose Muñoz-GonzálezMaria Oliver-PérezCristina de la Hera-LázaroCristina Almansa-GonzálezConcepción Pérez-SagasetaJesús Jiménez-López Source Type: research

Endometriosis node in Gynaecologic scars: A study of 17 patients and the diagnostic considerations in clinical experience in tertiary care center
Conclusions: A high level of suspicion is required to diagnose gynaecological scar endometriosis, which should be suspected in the differential diagnosis of scar masses in reproductive-aged women.Several theories have been proposed to explain the formation of endometriosis nodes in extrauterine localizations. The two of them that seem to be more plausible are the metaplasia and transport theories.Imaging with ultrasound, CT and MR facilitate the diagnosis. FNA could be used for preoperative diagnosis.Treatment must be by node resection with a security margin. In some cases, surgery could be combined with hormonal treatment...
Source: Epidemiologic Perspectives and Innovations - February 18, 2015 Category: Epidemiology Authors: Rocío Vellido-CoteloJose L Muñoz-GonzálezMaria R Oliver-PérezCristina de la Hera-LázaroCristina Almansa-GonzálezConcepción Pérez-SagasetaJesús S Jiménez-López Source Type: research

Periclitoral Endometriosis: the dilemma of a chronic disease invading a rare location
We present a unique case of periclitoral endometriosis, which to the best of our knowledge is the first in the literature. It is a 29 year old nulligravida female with a painful fluctuant right periclitoral mass that had been growing with no response to antibiotic therapy. (Source: The Journal of Minimally Invasive Gynecology)
Source: The Journal of Minimally Invasive Gynecology - February 10, 2015 Category: OBGYN Authors: Frances W. Grimstad, Erin Carey Source Type: research

Cutting an episiotomy at 60 degrees: how good are we?
Conclusions This original observational study shows that doctors and midwives were poor at cutting at the prompted episiotomy angle of 60°. This highlights the need to develop structured training programmes to improve the visual accuracy of estimating angles or the use of fixed angle devices to help improve the ability to estimate the desired angle. (Source: International Urogynecology Journal)
Source: International Urogynecology Journal - February 6, 2015 Category: OBGYN Source Type: research

Quality of intrapartum care by skilled birth attendants in a refugee clinic on the Thai-Myanmar border: a survey using WHO Safe Motherhood Needs Assessment
Conclusions: In the clinic of SMRU in Mae La refugee camp, SBAs were able to comply with evidence-based guidelines but support to improve quality of care in specific areas is required. The structure of the WHO Safe Motherhood Needs Assessment allowed significant insights into the quality of intrapartum care particularly through direct observation, identifying a clear pathway for quality improvement. (Source: BMC Pregnancy and Childbirth)
Source: BMC Pregnancy and Childbirth - February 5, 2015 Category: OBGYN Authors: Gabie HoogenboomMay ThwinKris VelinkMarijke BaaijensPrakaykaew CharrunwatthanaFrancois NostenRose McGready Source Type: research

Bilateral Heel Numbness due to External Compression during Obstetric Epidural Analgesia
We describe the case of a 32-year-old woman who developed bilateral heel numbness after obstetric epidural analgesia. We diagnosed her with bilateral neuropathy of the medial calcaneal nerve, most likely due to longstanding pressure on both heels. Risk factors for the development of this neuropathy were prolonged labour with spinal analgesia and a continuation of analgesia during episiotomy. Padded footrests decrease pressure and can possibly prevent this neuropathy.Case Rep Neurol 2015;7:15-17 (Source: Case Reports in Neurology)
Source: Case Reports in Neurology - January 30, 2015 Category: Neurology Source Type: research

[Influence of a major decrease in the use of episiotomy applied to a high risk perineal situation: Occiput posterior presentation.]
CONCLUSION: A restrictive use of episiotomy in OP does not increase the risk of severe perineal tears and does not worsen perineal prognosis. PMID: 25639962 [PubMed - as supplied by publisher] (Source: Journal de Gynecologie, Obstetrique et Biologie de la Reproduction)
Source: Journal de Gynecologie, Obstetrique et Biologie de la Reproduction - January 29, 2015 Category: OBGYN Authors: Toubin C, Mottet N, Chehab M, Maurice M, Ramanah R, Riethmuller D Tags: J Gynecol Obstet Biol Reprod (Paris) Source Type: research

Association between perineal trauma and pain in primiparous women
Conclusion Primiparous women are subject to a high frequency of perineal trauma, with episiotomy being the most prominent. Perineal pain affects approximately one-third of primiparous women and is associated with the postpartum time and perineal traumas. Objetivo Identificar la asociación entre el trauma y el dolor perineal en 473 primíparas. Método Estudio transversal, en el que el dolor se midió por medio de la escala numérica del dolor (0 a 10; 0 = ningún dolor y 10 = dolor máximo...
Source: Revista da Escola de Enfermagem da USP - January 21, 2015 Category: Nursing Source Type: research

Episiotomies Are Becoming Less And Less Common, New Numbers Show
There was a time when episiotomy -- a surgical incision made in a woman's perineum -- was a routine part of childbirth in the United States, believed to help prevent the vaginal tears that can occur as babies emerge. But with the procedure leading to complications, including infection and even potential incontinence, doctors began stepping back from it in the 1990s. And promising new figures released this week suggest that rates have continued to fall after several major healthcare organizations in the mid 2000s spoke out against its routine use. In a short research letter published in the Journal of the American Medical...
Source: Healthy Living - The Huffington Post - January 16, 2015 Category: Consumer Health Advice Source Type: news

Episiotomies on The Decline for U.S. Births
But almost 12 percent of deliveries still involve the surgical procedure, study finds Source: HealthDay Related MedlinePlus Page: Childbirth (Source: MedlinePlus Health News)
Source: MedlinePlus Health News - January 13, 2015 Category: Consumer Health News Source Type: news

Episiotomy Rate Continues Steady Decline
(MedPage Today) -- White women still more likely to have procedure. (Source: MedPage Today OB/GYN)
Source: MedPage Today OB/GYN - January 13, 2015 Category: OBGYN Source Type: news

Variation in and Factors Associated With Use of Episiotomy
Episiotomy is a common obstetric procedure, estimated to be performed in 25% of vaginal deliveries in the United States in 2004. Restrictive use of episiotomy has been recommended given the risks of the procedure and unclear benefits of routine use. In 2006, the American Congress of Obstetricians and Gynecologists recommended against routine episiotomy, and, in 2008, the National Quality Forum recognized limiting routine episiotomy as an important measure of quality and patient safety, noting increased risks of pain, laceration, and anal incontinence with the procedure. (Source: JAMA)
Source: JAMA - January 13, 2015 Category: Journals (General) Source Type: research

Evaluation of perineal muscle strength in the first trimester of pregnancy.
CONCLUSION: pregnancy and childbirth can reduce the PFMS. PMID: 25591007 [PubMed - as supplied by publisher] (Source: Revista Latino-Americana de Enfermagem)
Source: Revista Latino-Americana de Enfermagem - January 9, 2015 Category: Nursing Authors: Caroci AS, Riesco ML, Rocha BM, Ventura LJ, Oliveira SG Tags: Rev Lat Am Enfermagem Source Type: research

Intervention or interference? The need for expectant care throughout normal labour
Conclusion Further research is needed into alternative methods of inducing labour, ways to preserve the perineum intact, and trials of expectant and active management of the third stage in low-risk women cared for by midwives skilled in using both methods. Clinicians need to develop their skills in these areas and reduce unnecessary reliance on these three medico-technical interventions, to provide the best possible care for women and babies. (Source: Sexual and Reproductive Healthcare)
Source: Sexual and Reproductive Healthcare - January 2, 2015 Category: Reproduction Medicine Source Type: research

Midwifery and Quality Care: Findings From a New Evidence-Informed Framework for Maternal and Newborn Care
ABSTRACT: Poor-quality maternal and newborn care is associated with maternal mortality, stillbirths, and infant deaths and contributes to acute and chronic clinical and psychological morbidity for women who survive. Midwifery care can make an essential contribution to high-quality maternal and newborn services. The participation of educated, trained, motivated, and respected licensed midwives, working effectively with medical and public health colleagues, is associated with a rapid and sustained decrease in maternal and newborn mortality and an improvement in quality of care. A multimethod approach was used to assess the k...
Source: Obstetrical and Gynecological Survey - January 1, 2015 Category: OBGYN Tags: Obstetrics: Ethics, Medicolegal Issues, and Public Policy Source Type: research

Obstetrics anal sphincter injury and repair technique: A review
Abstract The Urogynecology Committee of the Asia and Oceania Federation of Obstetrics and Gynaecology (AOFOG) has held seminars and workshops on various urogynecological problems in each country in the Asia–Oceania area in order to encourage young obstetricians and gynecologists. In 2013, we organized the operative seminar for obstetrical anal sphincter injuries (OASIS) in which we prepared porcine models to educate young physicians in a hands‐on workshop at the 23rd Asian and Oceanic Congress of Obstetrics and Gynaecology in Bangkok, Thailand. Laceration of the anal sphincter mostly occurs during vaginal delivery and ...
Source: Journal of Obstetrics and Gynaecology Research - December 29, 2014 Category: OBGYN Authors: Teerayut Temtanakitpaisan, Suvit Bunyacejchevin, Masayasu Koyama Tags: Invited Manuscript Source Type: research

Can inter‐professional simulation training influence the frequency of blood transfusions after birth?
ConclusionWe found a significant reduction in RBC transfusions after birth, which might be associated with mandatory simulation training. A causal link cannot be documented because of complex interactions of several variables.This article is protected by copyright. All rights reserved. (Source: Acta Obstetricia et Gynecologica Scandinavica)
Source: Acta Obstetricia et Gynecologica Scandinavica - December 24, 2014 Category: OBGYN Authors: Signe Egenberg, Pål Øian, Lars Edvin Bru, Michael Sautter, Gunn Kristoffersen, Torbjørn Moe Eggebø Tags: Main Research Article Source Type: research

Evidence‐Based Practice for Intrapartum Care: The Pearls of Midwifery
This article reviews the history of intrapartum practices that are now changing, the evidence that supports these changes, and the practical applications for the 13 Pearls of Midwifery. (Source: Journal of Midwifery and Womens Health)
Source: Journal of Midwifery and Womens Health - December 22, 2014 Category: Midwifery Authors: Tekoa L. King, Whitney Pinger Tags: Original Review Source Type: research

Association between perineal trauma and pain in primiparous women
Conclusion Primiparous women are subject to a high frequency of perineal trauma, with episiotomy being the most prominent. Perineal pain affects approximately one-third of primiparous women and is associated with the postpartum time and perineal traumas. Objetivo Identificar la asociación entre el trauma y el dolor perineal en 473 primíparas. Método Estudio transversal, en el que el dolor se midió por medio de la escala numérica del dolor (0 a 10; 0 = ningún dolor y 10 = dolor máximo). Resultados La prevalencia y el promedio de intensidad del dolor fueron 33,0% y 4,7 (Desviación Estándar = 2,0) puntos en la esca...
Source: Revista da Escola de Enfermagem da USP - December 19, 2014 Category: Nursing Source Type: research

166: Episiotomies: who does them and do they help?
To examine episiotomy rates in relation to obstetric provider characteristics and maternal and neonatal injury. (Source: American Journal of Obstetrics and Gynecology)
Source: American Journal of Obstetrics and Gynecology - December 19, 2014 Category: OBGYN Authors: Janet Burlingame, Chieko Kimata, Kelly Yamasato, Bruce Huegel, Marsha Durbin, Melinda Ashton Tags: Poster session I Source Type: research

313: Maternal and neonatal outcomes following implementation of a policy of restricted use of episiotomy
Restricted use of episiotomy was recommended by ACOG in 2006 despite limited data detailing the impact of such a change on maternal and neonatal outcomes. We sought to determine the impact of a policy of restricted use of episiotomy in a large tertiary care hospital. (Source: American Journal of Obstetrics and Gynecology)
Source: American Journal of Obstetrics and Gynecology - December 19, 2014 Category: OBGYN Authors: Erin Habecker, Matthew Hoffman Tags: Poster session II Source Type: research

Anal incontinence, urinary incontinence and sexual problems in primiparous women ¿ a comparison between women with episiotomy only and women with episiotomy and obstetric anal sphincter injury
Conclusion: Women with OASIS had more AI and sexual problems than those without OASIS. Episiotomy characteristics varied greatly between the women. Episiotomy with protective characteristics was not associated with increased dysfunctions. OASIS should be avoided, and correct episiotomy used if indicated. (Source: BMC Women's Health)
Source: BMC Women's Health - December 16, 2014 Category: OBGYN Authors: Mona StedenfeldtJouko PirhonenEllen BlixTom WilsgaardBarthold VonenPål Øian Source Type: research

Maternal Asian ethnicity and the risk of anal sphincter injury
ConclusionThere are ethnic differences in the rates of anal sphincter injury not fully explained by known risk factors for such trauma. This may have implications for care provision.This article is protected by copyright. All rights reserved. (Source: Acta Obstetricia et Gynecologica Scandinavica)
Source: Acta Obstetricia et Gynecologica Scandinavica - December 12, 2014 Category: OBGYN Authors: Miranda Davies‐Tuck, Mary‐Anne Biro, Joanne Mockler, Lynne Stewart, Euan M Wallace, Christine East Tags: Main Research Article Source Type: research

Board #306 - Technology Innovation Modifications to the SimMan3G Advanced Patient Simulator for a High-fidelity Postpartum Hemorrhage Team-based Scenario (Submission #8851).
Conclusion: The postpartum hemorrhage model was constructed over a period of one week and tested for required functionality. The completed model was successfully deployed and tested with the simulation scenario for a postpartum/labor and delivery multi-department in-situ training session. The model worked as intended. Initial anecdotal reviews had favorable responses. The participants did not require additional familiarization with the model. Future research will include assessing if the participants in the postpartum hemorrhage simulation scenario improved competency and ultimately if this reflects in an improvement in cl...
Source: Simulation in Healthcare: The Journal of the Society for Simulation in Healthcare - December 1, 2014 Category: Medical Equipment Tags: Abstracts: 1st PLACE AWARD WINNER: PDF Only Source Type: research

Risk factors for severe perineal trauma during vaginal childbirth: A Western Australian retrospective cohort study.
CONCLUSION: Parity differences in risk factors such as episiotomy, infant weight, OP delivery, gestational diabetes and prolonged second stage warrant investigation into clinical management. Although rates differ internationally, and replication evidence has confirmed consistency for certain demographic and obstetric factors, the development of internationally endorsed clinical guidelines and further research around interventions to protect the perineum are recommended. PMID: 25476878 [PubMed - as supplied by publisher] (Source: Women Birth)
Source: Women Birth - December 1, 2014 Category: Midwifery Authors: Hauck YL, Lewis L, Nathan EA, White C, Doherty DA Tags: Women Birth Source Type: research

Evaluation of In Vivo Properties of Velosorb™ Fast Versus Vicryl™ Rapide in a Functional Rabbit Model of Intradermic Suture and Episiotomy.
Conclusions: Velosorb™ Fast seems to be as efficient as Vicryl™ Rapide for use in perineal and skin closure. PMID: 25437773 [PubMed - as supplied by publisher] (Source: Hand Surgery)
Source: Hand Surgery - December 1, 2014 Category: Surgery Authors: Vieille P, Huberlant S, Bastide S, Bayon Y, de Tayrac R Tags: J Invest Surg Source Type: research

A Comparison of the “Hands-Off” and “Hands-On” Methods to Reduce Perineal Lacerations: A Randomised Clinical Trial
Conclusion Application of the “Hands-off” method for vaginal delivery has a positive effect on the mother’s health because of the reduction of Episiotomy and third degree tearing. Therefore, we conclude that the “Hands-off” method offers a safer alternative for perineal control during labor. (Source: The Journal of Obstetrics and Gynecology of India)
Source: The Journal of Obstetrics and Gynecology of India - December 1, 2014 Category: OBGYN Source Type: research

OASI: a preventable Injury?
Conclusions Most risk factors related to OASI are non-modifiable however gestational age and episiotomy are modifiable risk factors. (Source: European Journal of Obstetrics and Gynecology and Reproductive Biology)
Source: European Journal of Obstetrics and Gynecology and Reproductive Biology - November 27, 2014 Category: OBGYN Source Type: research

Provider contribution to an episiotomy risk model
Journal of Maternal-Fetal and Neonatal Medicine, Ahead of Print. (Source: Journal of Maternal-Fetal and Neonatal Medicine)
Source: Journal of Maternal-Fetal and Neonatal Medicine - November 25, 2014 Category: Perinatology & Neonatology Tags: article Source Type: research

National survey of perineal trauma and its subsequent management in the United Kingdom
Conclusions This study provides comprehensive data regarding the incidence and management of perineal trauma across the UK. Clinicians and policy-makers, both local and at the RCOG, can devise up-to-date realistic guidelines on the anticipated rate of OASIS and help to assess the compliancy of units with guidelines on the appropriate management of perineal trauma. (Source: International Urogynecology Journal)
Source: International Urogynecology Journal - November 18, 2014 Category: OBGYN Source Type: research

Effect of different episiotomy techniques on perineal pain and sexual activity 3 months after delivery
Conclusions No difference was found in perineal pain perception 3 months postpartum between different episiotomy techniques or when comparing midline and lateral incision points. Dyspareunia was not associated with any particular episiotomy technique or incision point. (Source: International Urogynecology Journal)
Source: International Urogynecology Journal - November 18, 2014 Category: OBGYN Source Type: research

NIH state-of-the-science conference statement on prevention of fecal and urinary incontinence in adults.
CONCLUSIONS: (1) Fecal incontinence and urinary incontinence will affect more than one fourth of all U.S. adults during their lives. The natural history of fecal incontinence is unknown, and the natural history of urinary incontinence over several years is not well described. (2) Fecal incontinence and urinary incontinence often have serious effects on the lives of the many individuals who suffer physical discomfort, embarrassment, stigma, and social isolation, and on family members, caregivers, and society. Financial costs are substantial and may be underestimated because of underreporting. (3) Routine episiotomy is the m...
Source: NIH Consensus and State of the Science Statements - November 16, 2014 Category: American Health Tags: NIH Consens State Sci Statements Source Type: research

Routine perineal shaving on admission in labour.
CONCLUSIONS: There is insufficient evidence to recommend perineal shaving for women on admission in labour. PMID: 25398160 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - November 14, 2014 Category: Journals (General) Authors: Basevi V, Lavender T Tags: Cochrane Database Syst Rev Source Type: research

Clinical evaluation of early postpartum pain and healing outcomes after mediolateral versus lateral episiotomy
Conclusion Incidence and extent of pain in the first 10days after LE correspond to those after adequately performed MLE. (Source: International Journal of Gynecology and Obstetrics)
Source: International Journal of Gynecology and Obstetrics - November 12, 2014 Category: OBGYN Source Type: research

Hands-poised technique: The future technique for perineal management of second stage of labour? A modified systematic literature review.
CONCLUSION: as the five studies selected for this review have widely differing variables, comparisons that have been drawn must be viewed with caution. Evidence would suggest that the hands-poised technique is a safe and recommended technique for perineal management and discussions of such a technique should be included in all midwifery education and training programmes. The challenge for midwives is how to support women in making informed choices about perineal management during childbirth. Until there is conclusive evidence, the choice of the hands-on or hands-poised technique will ultimately be determined by the clinica...
Source: Midwifery - November 5, 2014 Category: Midwifery Authors: Petrocnik P, Marshall JE Tags: Midwifery Source Type: research

Effects of cinnamon on perineal pain and healing of episiotomy: a randomized placebo-controlled trial
Conclusion Cinnamon can be used for reducing perineal pain and improving healing of episiotomy incision. (Source: Journal of Integrative Medicine)
Source: Journal of Integrative Medicine - November 3, 2014 Category: Complementary Medicine Source Type: research

Effect of vaginal delivery on the external anal sphincter muscle innervation pattern evaluated by multichannel surface EMG: results of the multicentre study TASI-2
Conclusions Right episiotomy reduces the number of IZs on the right-ventral side of the EAS. The fast and reliable test proposed indicates the sphincter innervation pattern before delivery and helps obstetricians to evaluate the risks and to choose the preferred side of the episiotomy, if deemed necessary at the time of delivery. (Source: International Urogynecology Journal)
Source: International Urogynecology Journal - October 9, 2014 Category: OBGYN Source Type: research

The implantation of cervical neoplasia at postpartum episiotomy scar: the clinical evidence
Conclusion Clinicians should be aware about the importance of carefully examining not only the cervix at the time of labor, but also the episiotomy scar in women following a pregnancy complicated by cervical cancer. (Source: Irish Journal of Medical Science)
Source: Irish Journal of Medical Science - October 7, 2014 Category: Journals (General) Source Type: research

Antibiotic prophylaxis for third- and fourth-degree perineal tear during vaginal birth.
CONCLUSIONS: Although the data suggest that prophylactic antibiotics help to prevent perineal wound complications following third- or fourth-degree perineal tear, loss to follow-up was very high. The results should be interpreted with caution as they are based on one small trial. PMID: 25289960 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - October 7, 2014 Category: Journals (General) Authors: Buppasiri P, Lumbiganon P, Thinkhamrop J, Thinkhamrop B Tags: Cochrane Database Syst Rev Source Type: research

Chronic non-healing sinus manifesting in episiotomy scar: hidden fistula-in-ano
We report one such woman. There were no underlying risk factors like third- or fourth-degree tear or inflammatory bowel disease. In spite of previous attempted exploration the problem had persisted. Examination of the case under anaesthesia revealed it to be a low fistula-in-ano. The methodical evaluation and management of the case is detailed. Fistulectomy completely cured the patient. Most of these patients present to obstetricians and gynaecologists. Awareness and a high index of suspicion of communication with the anorectal canal are important. A team approach with the colorectal surgeon would help in better preoperati...
Source: International Urogynecology Journal - September 25, 2014 Category: OBGYN Source Type: research

Interventions for treating postpartum constipation.
CONCLUSIONS: We could not make explicit conclusions on interventions for treating postpartum constipation because we found no studies for inclusion in this review. Rigorous and well-conducted large randomised controlled trials aimed at treating postpartum women diagnosed with constipation would be beneficial. These trials should also address the criteria for administering the intervention (time and stage of a diagnosis of postpartum constipation), and the safety and effectiveness of such interventions. PMID: 25246307 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - September 23, 2014 Category: Journals (General) Authors: Turawa EB, Musekiwa A, Rohwer AC Tags: Cochrane Database Syst Rev Source Type: research

Evaluation of accuracy of mediolateral episiotomy incisions using a training model.
Abstract BACKGROUND: Episiotomy is one of the most commonly performed surgical procedures worldwide. In the UK the use of episiotomy is selective, rather than routine, and a right mediolateral episiotomy (RMLE) is considered standard practice. According to The National Institute of Health and Care Excellence (NICE, 2007) guideline for intrapartum care such an episiotomy should be cut at an angle between 45° and 60° to the vertical axis. Recent evidence suggests that the angle of incision of mediolateral episiotomy (MLE) is associated with risk of obstetric anal sphincter injury (OASIS). OBJECTIVE: to assess t...
Source: Midwifery - September 2, 2014 Category: Midwifery Authors: Silf K, Woodhead N, Kelly J, Fryer A, Kettle C, Ismail KM Tags: Midwifery Source Type: research

Widespread non-adherence to evidence-based maternity care guidelines: a population-based cluster randomised household survey.
CONCLUSION: Present practices fall short of evidence-based guidelines, with relative overuse of interventions in private hospitals and deficiency of patient-centred practices such as labour support in public hospitals. PMID: 25145674 [PubMed - as supplied by publisher] (Source: BJOG : An International Journal of Obstetrics and Gynaecology)
Source: BJOG : An International Journal of Obstetrics and Gynaecology - August 22, 2014 Category: OBGYN Authors: Nagpal J, Sachdeva A, Sengupta Dhar R, Bhargava V, Bhartia A Tags: BJOG Source Type: research

Widespread non‐adherence to evidence‐based maternity care guidelines: a population‐based cluster randomised household survey
ConclusionPresent practices fall short of evidence‐based guidelines, with relative overuse of interventions in private hospitals and deficiency of patient‐centred practices such as labour support in public hospitals. (Source: BJOG: An International Journal of Obstetrics and Gynaecology)
Source: BJOG: An International Journal of Obstetrics and Gynaecology - August 22, 2014 Category: OBGYN Authors: J Nagpal, A Sachdeva, R Sengupta Dhar, VL Bhargava, A Bhartia Tags: Original article Source Type: research

Prevalence and Predictors of Genito‐Pelvic Pain in Pregnancy and Postpartum: The Prospective Impact of Fear Avoidance
ConclusionsResults suggest that about half of women may develop genito‐pelvic pain during pregnancy, which will persist for about a third, and a subset will develop this pain after childbirth. Prior recurrent nongenito‐pelvic pain may enhance the risk of developing genito‐pelvic pain postpartum, while greater pain‐related anxiety in pregnancy may increase the risk for greater intensity of postpartum genito‐pelvic pain. Glowacka M, Rosen N, Chorney J, Snelgrove−Clarke E, and George RB. Prevalence and predictors of genito‐pelvic pain in pregnancy and postpartum: The prospective impact of fear avoidance. J Sex M...
Source: The Journal of Sexual Medicine - August 15, 2014 Category: Sexual Medicine Authors: Maria Glowacka, Natalie Rosen, Jill Chorney, Erna Snelgrove−Clarke, Ronald B. George Tags: Original Research Source Type: research

Selective episiotomy vs. implementation of a non episiotomy protocol: a randomized clinical trial
Background: World Health Organization (WHO) recommends that the episiotomy rate should be around 10%, which is already a reality in many European countries. Currently the use of episiotomy should be restricted and physicians are encouraged to use their clinical judgment to decide when the procedure is necessary. There is no clinical evidence corroborating any indication of episiotomy, so until the present moment it is not yet known whether episiotomy is indeed necessary in any context of obstetric practice.Objectives: To compare maternal and perinatal outcomes in women undergoing a protocol of not performing episiotomy ver...
Source: Reproductive Health - August 14, 2014 Category: OBGYN Authors: Inês MeloLeila KatzIsabela CoutinhoMelania Amorim Source Type: research

Perineal outcome and the risk of pelvic floor dysfunction: A cohort study of primiparous women
ConclusionsThis study shows a relationship between perineal outcome and PFD and suggests that an episiotomy is associated with the least morbidity due to symptoms of urinary incontinence. Additional large‐scale prospective research is required to further investigate and delineate the impact of childbirth on PFD. (Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology)
Source: The Australian and New Zealand Journal of Obstetrics and Gynaecology - August 13, 2014 Category: OBGYN Authors: Joan Rikard‐Bell, Jay Iyer, Ajay Rane Tags: Original Article Source Type: research

Adherence to evidence based care practices for childbirth before and after a quality improvement intervention in health facilities of Rajasthan, India
Conclusions: An intervention based on repeated facility visits combined with actions at the level of decision makers can lead to substantial improvements in quality of childbirth practices at health facilities. (Source: BMC Pregnancy and Childbirth - Latest articles)
Source: BMC Pregnancy and Childbirth - Latest articles - August 13, 2014 Category: OBGYN Authors: Kirti IyengarMotilal JainSunil ThomasKalpana DashoraWilliam LiuParamsukh SainiRajesh DattatreyaIndrani ParkerSharad Iyengar Source Type: research

Obstetric interventions during labor and childbirth in Brazilian low-risk womenEscola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz.
This study evaluated the use of best practices (eating, movement, use of nonpharmacological methods for pain relief and partograph) and obstetric interventions in labor and delivery among low-risk women. Data from the hospital-based survey Birth in Brazil conducted between 2011 and 2012 was used. Best practices during labor occurred in less than 50% of women and prevalence of the use of these practices was lower in the North, Northeast and Central West Regions. The rate of use of oxytocin drips and amniotomy was 40%, and was higher among women admitted to public hospitals and in women with a low level of education. The ute...
Source: Cadernos de Saude Publica - August 1, 2014 Category: Global & Universal Authors: Leal MD, Pereira AP, Domingues RM, Filha MM, Dias MA, Nakamura-Pereira M, Bastos MH, Gama SG Tags: Cad Saude Publica Source Type: research