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Episiotomy

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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
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

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

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

Mediolateral Episiotomy Reduces Obstetrical InjuryMediolateral Episiotomy Reduces Obstetrical Injury
The controversial approach during operative vaginal delivery significantly reduces the risk for injury, according to a large Dutch database study. Medscape Medical News (Source: Medscape Medical News Headlines)
Source: Medscape Medical News Headlines - July 28, 2014 Category: Consumer Health News Tags: Ob/Gyn & Women ' s Health News Source Type: news

Outcomes of the Evidence-Based Pitocin Administration Checklist at a Tertiary-Level Hospital
Pitocin, a synthetic form of the hormone oxytocin, is a high-alert medication that heightens patient harm when used incorrectly. This investigation examined the outcomes of an evidence-based Pitocin administration checklist used for labor augmentation at a tertiary-level hospital. Data came from patient records. Using the Perinatal Trigger Tool, N = 372 clinical records (n = 194 prior to and n = 178 following checklist implementation) were reviewed. Checklist implementation resulted in statistically significant reductions in the duration of hospitalization (1.72 vs. 2.02 days, p = .0005), presence of meconium (23.7% vs. 6....
Source: Western Journal of Nursing Research - July 28, 2014 Category: Nursing Authors: Wojnar, D. M., Cowgill, K., Hoffman, L., Carlson, H. Tags: Intervention Studies Source Type: research

Comparison between two incision angles of mediolateral episiotomy in primiparous women: A randomized controlled trial
ConclusionWhen compared to the 40°‐angled mediolateral episiotomies, 60°‐angled ones were associated with significantly higher short‐term‐related pain. Although they were also associated with lower rate of third/fourth‐degree perineal tears and higher rate of long‐term related pain and dyspareunia, these differences did not reach a statistically significant level. (Source: Journal of Obstetrics and Gynaecology Research)
Source: Journal of Obstetrics and Gynaecology Research - July 23, 2014 Category: OBGYN Authors: Adel S. S. El‐Din, Magdy M. Kamal, Malaka A. Amin Tags: Original Article Source Type: research

Mediolateral episiotomy significantly reduces the risk of obstetric-associated anal sphincter injury (OASIS) in women who deliver via vacuum extraction
Commentary on: Jangö H, Langhoff-Roos J, Rosthøj S, et al.. Modifiable risk factors of obstetric anal sphincter injury in primiparous women: a population-based cohort study. Am J Obstet Gynecol 2014;210:59.e1–6. Context Approximately 10% of women sustain obstetric-associated anal sphincter injury (OASIS) during vaginal delivery.1 Obstetric trauma is the most common cause of anal sphincter injury. Preventing OASIS is critical because between one-thirds and two-thirds of women with OASIS develop faecal incontinence (FI) with profound consequent physical and psychological effects. Primiparity, excess birth&n...
Source: Evidence-Based Medicine - July 18, 2014 Category: Internal Medicine Authors: Bharucha, A. E., Prichard, D. Tags: EBM Aetiology, Epidemiologic studies, Drugs: CNS (not psychiatric), Pain (neurology), Contraception, Drugs: obstetrics and gynaecology, Pregnancy, Pain (palliative care), Pain (anaesthesia) Source Type: research

Clinical evaluation of early postpartum pain and healing outcomes after mediolateral versus lateral episiotomy
To evaluate short-term perineal pain among primiparous women after mediolateral episiotomy (MLE) and lateral episiotomy (LE). (Source: International Journal of Gynaecology and Obstetrics)
Source: International Journal of Gynaecology and Obstetrics - July 17, 2014 Category: OBGYN Authors: Jaroslava Karbanova, Zdenek Rusavy, Lucie Betincova, Magdalena Jansova, Pavlina Necesalova, Vladimir Kalis Source Type: research

Analysis of hemorrhage at vaginal delivery by erythrocyte and hematocrit indices
Conclusion: The analysis of hemorrhage at vaginal delivery by using hemoglobin and hematocrit indices showed variation among the three types of vaginal delivery studied. There was greater hemorrhage with forceps delivery and less hemorrhage with spontaneous delivery. In women with forceps delivery, postpartum indices were lower than those at hospital admission. (Source: Acta Paulista de Enfermagem)
Source: Acta Paulista de Enfermagem - June 25, 2014 Category: Nursing Source Type: research

Curved versus straight scissors to avoid 3rd and 4th degree perineal tears: A randomised feasibility study.
The objective of this study was to compare the use of straight scissors for cutting an episiotomy with the use of curved scissors, which are designed to curve away from the anal sphincter. METHODS: We used a single-centre, randomised feasibility trial. The intervention was the use of curved scissors. Women were recruited during a prenatal visit and randomised in the delivery suite, when it became clear that an episiotomy was required. The feasibility outcomes were the proportion of women able to be recruited, randomised and followed up. We also calculated the incidence of obstetric anal sphincter injury when either str...
Source: Women Birth - June 24, 2014 Category: Midwifery Authors: Swift A, Webster J, Conroy AM, Hampton S, Kirby SJ, Minuzzo L, Kimble R Tags: Women Birth Source Type: research

A multifaceted intervention to increase prophylactic oxytocin use during the third stage of labor and to reduce routine episiotomies in Nicaragua
(Source: International Journal of Gynaecology and Obstetrics)
Source: International Journal of Gynaecology and Obstetrics - June 19, 2014 Category: OBGYN Authors: Ezequiel García-Elorrio, Alicia Aleman, Maria L. Cafferata, Mercedes Colomar, Giselle Tomasso, Yann Lacayo, Henry Espinoza, Shirley Villadiego, Susheela Engelbrecht, Fernando Althabe Source Type: research

Sexual violence and mode of delivery: a population-based cohort study.
CONCLUSIONS: Women with a history of rape had higher odds of elective caesarean section and induction and significantly fewer episiotomies. PMID: 24939396 [PubMed - as supplied by publisher] (Source: BJOG : An International Journal of Obstetrics and Gynaecology)
Source: BJOG : An International Journal of Obstetrics and Gynaecology - June 18, 2014 Category: OBGYN Authors: Henriksen L, Schei B, Vangen S, Lukasse M Tags: BJOG Source Type: research

Sexual violence and mode of delivery: a population‐based cohort study
ConclusionsWomen with a history of rape had higher odds of elective caesarean section and induction and significantly fewer episiotomies. (Source: BJOG: An International Journal of Obstetrics and Gynaecology)
Source: BJOG: An International Journal of Obstetrics and Gynaecology - June 18, 2014 Category: OBGYN Authors: L Henriksen, B Schei, S Vangen, M Lukasse Tags: Original Article Source Type: research

Maternal Morbidity of Women Receiving Birth Center Care in New South Wales: A Matched‐Pair Analysis Using Linked Health Data
ConclusionsBirth centers are a safe option for low‐risk women; however, further research is required for some rare maternal outcomes. (Source: Birth)
Source: Birth - June 17, 2014 Category: OBGYN Authors: Paula J. Laws, Fenglian Xu, Alec Welsh, Sally K. Tracy, Elizabeth A. Sullivan Tags: Original Article Source Type: research

Effect on anal pressure of percutaneous posterior tibial nerve stimulation for faecal incontinence
ConclusionPercutaneous PTNS was effective in over 70% of patients in the present study with improvements in urgency, anal pressures and Wexner score. (Source: Colorectal Disease)
Source: Colorectal Disease - June 12, 2014 Category: Gastroenterology Authors: A. López‐Delgado, A. Arroyo, J. Ruiz‐Tovar, M. J. Alcaide, M. Diez, P. Moya, J. Santos, R. Calpena Tags: Original Article Source Type: research

Use of intrapartum ultrasound in the prediction of complicated operative forceps delivery of fetuses in non‐occiput posterior position
ConclusionThe sonographic parameters AOP and HD can be used to predict complicated operative forceps delivery in fetuses in non‐occiput posterior position. Copyright © 2013 ISUOG. Published by John Wiley & Sons Ltd. (Source: Ultrasound in Obstetrics and Gynecology)
Source: Ultrasound in Obstetrics and Gynecology - June 3, 2014 Category: Radiology Authors: M. J. Cuerva, C. Bamberg, P. Tobias, M. M. Gil, M. De La Calle, J. L. Bartha Tags: Original Paper Source Type: research

New technique to prevent anal sphincter lesions due to episiotomy during child delivery
(Politecnico di Torino) An inexpensive disposable intra-anal probe carrying 16 circumferential electrodes identifies and displays, on a laptop or tablet, the innervation zones of the anal sphincter so that episiotomy, if deemed necessary at the moment of child delivery, can be avoided -- if too risky -- or properly planned, thereby reducing the likelihood of partial sphincter denervation and future incontinence. (Source: EurekAlert! - Medicine and Health)
Source: EurekAlert! - Medicine and Health - May 18, 2014 Category: Global & Universal Source Type: news

[Post-partum sexuality. Living in black African couple analysis.]
CONCLUSION: The delivery had a negative impact on the resumption of couple sexual activity. Also, we noted a strong influence of the cultural and religious faiths on the sexual practice of the post-partum in the absence of reliable information. A particular attention should be concerned by the medical profession on the question of sexuality in the post-partum. PMID: 24842644 [PubMed - as supplied by publisher] (Source: Reproductive Biology)
Source: Reproductive Biology - May 16, 2014 Category: Reproduction Medicine Authors: Kouakou KP, Doumbia Y, Djanhan LE, Menin MM, Djanhan Y Tags: J Gynecol Obstet Biol Reprod (Paris) Source Type: research

The effect on anal pressure of percutaneous posterior tibial nerve stimulation for faecal incontinence
ConclusionPercutaneous PTNS was effective in over 70% of patients in the present study with improvements in urgency, anal pressures and Wexner score.This article is protected by copyright. All rights reserved. (Source: Colorectal Disease)
Source: Colorectal Disease - March 28, 2014 Category: Gastroenterology Authors: A. López‐Delgado, A. Arroyo, J. Ruiz‐Tovar, M.J. Alcaide, M. Diez, P. Moya, J. Santos, R. Calpena Tags: Original Article Source Type: research

Low and high-frequency TENS in post-episiotomy pain relief: a randomized, double-blind clinical trial
Conclusions: LFT and HFT are an effective resource that may be included in the routine of maternity wards. (Source: Revista Brasileira de Fisioterapia)
Source: Revista Brasileira de Fisioterapia - March 26, 2014 Category: Physiotherapy Source Type: research

Outcome of deliveries among adolescent girls at the Yaoundé central hospital
Conclusions: Adolescent pregnancies in Cameroon compared to those in adults are associated with poorer outcomes. There is need for adolescent-specific services to prevent teenage pregnancies as well as interventions to prevent and manage the above mentioned predictors of in-facility maternal and perinatal mortality. (Source: BMC Pregnancy and Childbirth - Latest articles)
Source: BMC Pregnancy and Childbirth - Latest articles - March 17, 2014 Category: OBGYN Authors: Florent FouelifackTheodore TamehEta MbongPhilip NanaJeanne FouedjioJovanny FouogueRobinson Mbu Source Type: research

Attitude of Maternity Staff Regarding Episiotomies in an African Rural Hospital with High HIV Prevalence: A Descriptive Qualitative Study.
Abstract In a typical sub-Saharan African rural hospital, maternity staff seems to avoid episiotomies. The aim of this research is to develop a deeper understanding in the attitude of maternity staff regarding episiotomies. We used a descriptive qualitative approach: interviews, written questionnaires, and a group discussion. All methods showed strong reservations toward episiotomies among staff members. Most staff members have been trained to be very restrictive concerning episiotomies to prevent the transmission of human immunodeficiency virus (HIV). As a result of training and hence changing attitudes, the use o...
Source: The American Journal of Tropical Medicine and Hygiene - March 17, 2014 Category: Tropical Medicine Authors: Héman LM, van der Linden PJ, Stigter RH Tags: Am J Trop Med Hyg Source Type: research

Outcome of deliveries among adolescent girls at the Yaounde central hospital
Conclusions: Adolescent pregnancies in Cameroon compared to those in adults are associated with poorer outcomes. There is need for adolescent-specific services to prevent teenage pregnancies as well as interventions to prevent and manage the above mentioned predictors of in-facility maternal and perinatal mortality. (Source: BMC Pregnancy and Childbirth - Latest articles)
Source: BMC Pregnancy and Childbirth - Latest articles - March 17, 2014 Category: OBGYN Authors: Florent FouelifackTheodore TamehEta MbongPhilip NanaJeanne FouedjioJovanny FouogueRobinson Mbu Source Type: research

Purse-string morphology of external anal sphincter revealed by novel imaging techniques
The external anal sphincter (EAS) may be injured in 25–35% of women during the first and subsequent vaginal childbirths and is likely the most common cause of anal incontinence. Since its first description almost 300 years ago, the EAS was believed to be a circular or a "donut-shaped" structure. Using three-dimensional transperineal ultrasound imaging, MRI, diffusion tensor imaging, and muscle fiber tracking, we delineated various components of the EAS and their muscle fiber directions. These novel imaging techniques suggest "purse-string" morphology, with "EAS muscles" crossing contralaterally in the perineal body t...
Source: AJP: Gastrointestinal and Liver Physiology - March 15, 2014 Category: Gastroenterology Authors: Mittal, R. K., Bhargava, V., Sheean, G., Ledgerwood, M., Sinha, S. Tags: NEUROREGULATION AND MOTILITY Source Type: research

Born in another country: Women's experience of labour and birth in Queensland, Australia.
CONCLUSION: In comparing the labour and birth experiences of women born outside the country who spoke another language with native-born English speaking women, the present study presents a largely positive picture. However, there were some marked differences in both clinical and interpersonal aspects of care. PMID: 24613218 [PubMed - as supplied by publisher] (Source: Women Birth)
Source: Women Birth - March 5, 2014 Category: Midwifery Authors: Hennegan J, Redshaw M, Miller Y Tags: Women Birth Source Type: research

Female genital mutilation and efforts to achieve Millennium Development Goals 3, 4, and 5 in southeast Nigeria
Conclusion: FGM is still a common practice in southeast Nigeria, where its association with adverse reproductive outcomes militates against efforts to achieve MDGs 3, 4, and 5. (Source: International Journal of Gynaecology and Obstetrics)
Source: International Journal of Gynaecology and Obstetrics - March 5, 2014 Category: OBGYN Authors: Lucky O. Lawani, Azubuike K. Onyebuchi, Chukwuemeka A. Iyoke, Nwabunike E. Okeke Tags: Clinical Articles Source Type: research

Risk factors for severe perineal lacerations during childbirth
Conclusions: Various factors contribute to the occurrence of perineal lacerations. Future studies should consistently evaluate all examined parameters to determine their possible interrelation. (Source: International Journal of Gynaecology and Obstetrics)
Source: International Journal of Gynaecology and Obstetrics - February 18, 2014 Category: OBGYN Authors: Vasileios Pergialiotis, Dimitrios Vlachos, Athanasios Protopapas, Kaliopi Pappa, Georgios Vlachos Tags: Review Articles Source Type: research

Birth control: to what extent do women report being informed and involved in decisions about pregnancy and birth procedures?
Conclusions: There is an urgent need for interventions that facilitate information provision and consumer involvement in decision-making about several perinatal procedures, especially those performed within the time-limited intrapartum care episode. (Source: BMC Pregnancy and Childbirth - Latest articles)
Source: BMC Pregnancy and Childbirth - Latest articles - February 7, 2014 Category: OBGYN Authors: Rachel ThompsonYvette Miller Source Type: research

Hyaluronidase for reducing perineal trauma.
CONCLUSIONS: Perineal HAase injection during second stage of labour had a lower incidence of perineal trauma compared with control or no intervention, but there was no clear evidence of benefit compared with placebo injection. The difference in incidence of perineal trauma may probably be due to bias and confounding in the non-placebo controlled comparison, this result should be interpreted cautiously. The potential use of perineal HAase injection as a method to reduce perineal trauma were yet to be determined as there was no appropriate established dose for HAase, no evidence of follow up, and the number of high-quality t...
Source: Cochrane Database of Systematic Reviews - February 5, 2014 Category: Journals (General) Authors: Zhou F, Wang XD, Li J, Huang GQ, Gao BX Tags: Cochrane Database Syst Rev Source Type: research

Levator hematoma at the attachment zone as an early marker for levator ani muscle avulsion
ConclusionHematomas at the site of LAM attachment to the pubic bone always result in avulsion diagnosed 3 months postpartum. However, one third of avulsions are not preceded by a hematoma at the site of LAM attachment to the pubic bone. Copyright © 2013 ISUOG. Published by John Wiley & Sons Ltd. (Source: Ultrasound in Obstetrics and Gynecology)
Source: Ultrasound in Obstetrics and Gynecology - February 4, 2014 Category: Radiology Authors: K. van Delft, R. Thakar, S. Abbas Shobeiri, A. H. Sultan Tags: Original Paper Source Type: research

Birth Volume and the Quality of Obstetric Care in Rural Hospitals
ConclusionsObstetric quality and safety outcomes vary significantly across rural hospitals by birth volume. Better performance is not consistently associated with either lower or higher volume facilities. (Source: The Journal of Rural Health)
Source: The Journal of Rural Health - February 1, 2014 Category: Rural Health Authors: Katy B. Kozhimannil, Peiyin Hung, Shailendra Prasad, Michelle Casey, Maeve McClellan, Ira S. Moscovice Tags: ORIGINAL ARTICLE Source Type: research

The Purse String Morphology of External Anal Sphincter Revealed by Novel Imaging Techniques.
Abstract External anal sphincter may be injured in 25 - 35 % of women during the first and subsequent vaginal child births and is likely the most common cause of anal incontinence. Since its first description, almost 300 years ago, EAS is believed to be a circular or a "donut-shaped" structure. We performed 3D-transperineal ultrasound imaging, magnetic resonance imaging, diffusion tensor imaging and muscle fiber tracking to delineate various components of EAS and their muscle fiber directions. These novel imaging techniques suggest "purse-string" morphology, with "external anal sphincter" muscles crossing contra-la...
Source: Am J Physiol Gastroi... - January 23, 2014 Category: Gastroenterology Authors: Mittal RK, Bhargava V, Sheean G, Ledgerwood M, Sinha S Tags: Am J Physiol Gastrointest Liver Physiol Source Type: research

Labouring women who used a birthing pool in obsteric units in Italy: prospective observational study
Conclusions: Birthing pool use was associated with spontaneous vaginal birth. The increase in second degree tears was balanced by fewer episiotomies. Undue umbilical cord traction should be avoided during waterbirth. (Source: BMC Pregnancy and Childbirth - Latest articles)
Source: BMC Pregnancy and Childbirth - Latest articles - January 14, 2014 Category: OBGYN Authors: Jane HendersonEthel BurnsAnna RegaliaGiovanna CasaricoMary BoultonLesley Smith Source Type: research

Private health care coverage and increased risk of obstetric intervention
Obstetric interventions in Ireland are more frequent in patients in private obstetric care, irrespective of risk factors, largely due to more elective caesarian sections and episiotomies. (Source: BMC Pregnancy and Childbirth - Latest articles)
Source: BMC Pregnancy and Childbirth - Latest articles - January 13, 2014 Category: OBGYN Authors: Jennifer LutomskiMichael MurphyDeclan DevaneSarah MeaneyRichard Greene Source Type: research

The Use of Episiotomy in a Low‐Risk Population in The Netherlands: A Secondary Analysis
ConclusionsThe incidence of episiotomy is high compared with some low‐risk settings in other Western countries. Episiotomy was associated with higher rates of adverse maternal outcomes. Restricted use of episiotomy is likely to be beneficial for women. (Source: Birth)
Source: Birth - December 17, 2013 Category: OBGYN Authors: A. E. Seijmonsbergen‐Schermers, C. C. Geerts, M Prins, M. T. Diem, T. Klomp, A. L. M. Lagro‐Janssen, A. Jonge Tags: Original Article Source Type: research

Risk of Episiotomy and Perineal Lacerations Recurring After First Delivery
ConclusionThe risk of undergoing a spontaneous perineal tear or an episiotomy in the second delivery is increased by the practice of episiotomy in the first one. (Source: Birth)
Source: Birth - December 17, 2013 Category: OBGYN Authors: Sebastian Manzanares, Davinia Cobo, Maria Dolores Moreno‐Martínez, Mar Sánchez‐Gila, Alicia Pineda Tags: Original Article Source Type: research

Care in a birth center according to the recommendations of the World Health Organization
Birth centers are maternal care models that use appropriate technology when providing care to birthing women. This descriptive study aimed to characterize intrapartum care in a freestanding birth center, in light of the practices recommended by the World Health Organization (WHO), with 1,079 assisted births from 2006 to 2009 in the Sapopemba Birth Center, São Paulo, Brazil. Results included the use of intermittent auscultation (mean=7 controls); maternal positions during delivery: semi-sitting (82.3%), side-lying (16.0%), other positions (1.7%), oral intake (95.6%); companionship (93.3%); exposure to up to three vaginal e...
Source: Revista da Escola de Enfermagem da USP - December 13, 2013 Category: Nursing Source Type: research

Pregnancy and vaginal delivery in epidural analgesia in woman with cerebrospinal fluid shunt.
We present a case of labor in the 32-year old woman, with congenital hydrocephalus and a preexisting ventriculoperitoneal (VP) shunt. After thorough review of current literature, we came to conclusion that without absolute neurosurgical indication or acute development of listed symptoms (headaches, irritability, light sensitivity, hyperesthesia nausea, vomiting, vertigo, migraines, seizures, weakness in the arms or legs, strabismus and double vision) the best way to finish the pregnancy of woman with VP shunt is spontaneous vaginal delivery with the use of epidural analgesia, mediolateral episiotomy and vacuum extraction. ...
Source: Collegium Antropologicum - December 1, 2013 Category: Epidemiology Authors: Bursac D, Kulas T, Persec J, Persec Z, Duić Z, Partl JZ, Glavić Z, Hrgović Z, Bojanić K Tags: Coll Antropol Source Type: research

Intrapartum ultrasound, a predictive method for complicated operative forceps delivery in non-occiput posterior deliveries.
CONCLUSIONS: In non-occiput posterior forceps deliveries, the sonographic parameters of AOP and head direction can be used to predict complicated deliveries. PMID: 24265172 [PubMed - as supplied by publisher] (Source: The Ultrasound Review of Obstetrics and Gynecology)
Source: The Ultrasound Review of Obstetrics and Gynecology - November 21, 2013 Category: Radiology Authors: Cuerva MJ, Bamberg C, Tobias P, Gil MD, De La Calle M, Bartha JL Tags: Ultrasound Obstet Gynecol Source Type: research