scholarly journals EP19.12: Sonographic demonstration of a third degree perineal tear after delivery

2017 ◽  
Vol 50 ◽  
pp. 350-350
Author(s):  
F. Bellussi ◽  
G. Pilu ◽  
A. Youssef
2003 ◽  
Vol 42 (145) ◽  
pp. 54-58
Author(s):  
D S Malla

ABSTRACTThe professional literatures on the development of widely practiced procedure, episiotomy through theyears from the first publication in 1742 are reviewed. It reveals the change in number of publication as wellas the contributors to the development of perception about episiotomy. So it consisted expression of opinionof doctors initially then the co-workers like nurses and researchers and clients or consumers themselvestoo. It concludes that episiotomies prevent anterior perineal tear but fails to accomplish other benefitstraditionally ascribed to pelvic floor damage and relaxation including its sequel and also protection ofnewboin from intracranial haemorrhage and intrapartum asphyxia. Episiotomy substantially increasematernal blood loss during delivery and risk of anal sphincter damage with their long term morbidity.There is an urgent need to restrict the use of episiotomy in vaginal delivery.Key Words: Episiotomy, Perineal tear, anal sphincter damage.


1993 ◽  
Vol 160 (5) ◽  
pp. 1151-1151 ◽  
Author(s):  
R Arkun ◽  
A Memis ◽  
E Sevinc ◽  
E E Ustun

2020 ◽  
Vol 48 (6) ◽  
pp. 575-581
Author(s):  
Martina Kreft ◽  
Roland Zimmermann ◽  
Nina Kimmich

AbstractObjectivesBirth tears are a common complication of vaginal childbirth. We aimed to evaluate the outcomes of birth tears first by comparing the mode of vaginal birth (VB) and then comparing different vacuum cups in instrumental VBs in order to better advise childbearing women and obstetrical professionals.MethodsIn a retrospective cohort study, we analyzed nulliparous and multiparous women with a singleton pregnancy in vertex presentation at ≥37 + 0 gestational weeks who gave birth vaginally at our tertiary care center between 06/2012 and 12/2016. We compared the distribution of tear types in spontaneous births (SBs) vs. vacuum-assisted VBs. We then compared the tear distribution in the vacuum group when using the Kiwi Omnicup or Bird’s anterior metal cup. Outcome parameters were the incidence and distribution of the different tear types dependent on the mode of delivery and type of vacuum cup.ResultsA total of 4549 SBs and 907 VBs were analyzed. Birth tear distribution differed significantly between the birth modes. In 15.2% of women with an SB an episiotomy was performed vs. 58.5% in women with a VB. Any kind of perineal tear was seen in 45.7% after SB and in 32.7% after VB. High-grade obstetric anal sphincter injuries (OASIS) appeared in 1.1% after SB and in 3.1% after VB. No significant changes in tear distribution were found between the two different VB modes.ConclusionsThere were more episiotomies, vaginal tears and OASIS after VB than after SB. In contrast, there were more low-grade perineal and labial tears after SB. No significant differences were found between different vacuum cup systems, just a slight trend toward different tear patterns.


2021 ◽  
Vol 2 (3) ◽  
pp. 34-39
Author(s):  
Z. Nusee ◽  
M. N. Ainy ◽  
P. Hafizah

Background: Female sexual dysfunction (FSD) following childbirth imposes significant burden to the marital institution around the world. The perineal injury may potentially be one of the main risk factors contributing to postpartum female sexual dysfunction (PPFSD). The study aimed to determine the effect of perineal injury and patients’ characteristics on PPFSD. Methodology: This cross-sectional questionnaire study was conducted in six different health clinics in the district of Kuantan from April 2019 to October 2019. Eligible women who came to the family health clinics at 6 months postpartum were recruited as study population. The participants completed their biodata and socio-demographic form and the Malay-validated Female Sexual Function Index (MVFSFI) questionnaire given. A cut-off point of 26.55 and below on MVFSFI scoring system was used as a measure of the primary outcome of sexual dysfunction. Results: Out of 240 women who delivered vaginally, 34 (14%) had intact perineum, 107 (44.6%) sustained 1st degree perineal tear, 96 (40%) 2nd degree tear and three (1.25%) 3rd degree tear. Among the respondents, 60.9% of the sexually active respondents who had vaginal delivery, reported to have PPFSD. The timing of sexual resumption does not correlate with the severity of perineal tear. The severity of perineal tear is significantly associated with age (p=0.018), duration of marriage (p=0.008), body mass index (BMI) (p=0.019) and instrumental delivery (p=0.025). The level of personnel skill whom performed the repair were also found to have a significant relationship to PPFSD (p= 0.001). The relationship of participants’ mean age (p=0.271), marriage duration (p=0.903), race (p=0.928), religion (p=0.852), education level (p=0.549), employment status (p=0.102), family income (p=0.460) and BMI(p=0.159) with presence of PPFSD were all found to be statistically not significant. Conclusion: Occurrence of PPFSD is high among sexually active women who had vaginal delivery complicated by perineal tear, especially among those requiring instrumentation. The severity of perineal tear is associated with age, duration of marriage, BMI and mode of delivery. However, PPFSD does not significantly relate to the severity of perineal tear. None of the socio-demographic factors show a significant difference to sexual dysfunction.


2020 ◽  
pp. 78-84
Author(s):  
Giang Truong Thi Linh ◽  
Quang Mai Van

Background: Fetal macrosomia has a major influence on maternal, neonatal and pregnancy outcomes.Objective: To describe the clinical and subclinical features and the management of fetal macrosomia on pregnancy outcomes. Subjects and methods: Study subjects including pregnant women and babies born ≥ 3500 g with nulliparous and over 4000 grams with primiparous or multiparous at Departement of Obstetrics and Gynecology in Hue University of Medicine and Pharmacy Hospital. The time of choosing subjects to enter the research group is that after birth, the weight is above 3500/4000 grams, then follow up the pregnancy result and retrospect the clinical and subclinical characteristics. Results: From May 2019 to April 2020, there were 223 pregnant women with the birth weight ≥ 3500 g in this study. The mean neonatal weight for macrosomia was 3869.96 ± 315.72 (g). The birth weight ≥ 4000 g, the rate of cesarean section was 91.5%, vaginal birth was 8.5%. The birth weight 3500 - under 4000 g, the rate of cesarean section was 76%, vaginal birth was 24%. 1.1% maternal complications was perineal tear. Conclusion:Factors related to fetal macrosomia: Maternal age, gender of fetus, parity, a history of fetal macrosomia, maternal height, pregnancy weight gain. Caesarean section is the majority. Key words: Fetal macrosomia, gestational diabetes mellitus, normal labor, caesarean section.


2021 ◽  
Vol 8 (2) ◽  
pp. 53-57
Author(s):  
Dr. Asmita Misal ◽  
Dr. Urmila Gavali ◽  
Dr. Gautam S. Aher

Background: Pregnancy beyond term is associated with adverse maternal and perinatal outcome. The aim of the study the maternal and perinatal outcome in pregnancies at and beyond 41 week of gestation. Methods: This is a prospective study of 140 patients with pregnancy beyond 41 weeks fulfilling the eligibility criteria and admitted and delivered in department of obstetrics and gynaecology at a tertiary care hospital. We examined its association with following outcomes: age, parity, genetic factors, bishop’s score at admission, mode of delivery, induction rate, meconium stained amniotic fluid, oligohydramnios, Perinatal and neonatal morbidity, Perineal tear, postpartum haemorrhage, maternal morbidity and mortality etc. Results: Out of 140 patients, majority in the age group of 21-25 years, 68 (48.6%) patients were primigravida while 72 (51.4%) patients were multigravida. Maximum patients 65% were not in labour whereas 35% were in labour. In 51 (36.4%) patients mode of delivery was caesarean section, in which most common indication being foetal distress in 25.5% followed by meconium stained amniotic fluid in 17.6%. In present study perinatal morbidity like stillbirth, RDS were 2.86% & 25.8% respectively. Maternal morbidity like PPH, tear and wound infection were 4.31%, 6.4%, 0.7%respectively. Conclusions: With Regular antenatal check-up, incidence of post term pregnancy can be decreased and Labour induction should be considered at 41weeks to prevent lot of maternal and perinatal complications.


2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Mahad Ali ◽  
Richard Migisha ◽  
Joseph Ngonzi ◽  
Joy Muhumuza ◽  
Ronald Mayanja ◽  
...  

Background. Obstetric anal sphincter injuries (OASIS) arise from perineal trauma during vaginal delivery and are associated with poor maternal health outcomes. Most OASIS occur in unattended deliveries in resource-limited settings. However, even in facilities where deliveries are attended by skilled personnel, a number of women still get OASIS. Objectives. To determine the incidence and risk factors for obstetric anal sphincter injuries among women delivering at Mbarara Regional Referral Hospital (MRRH). Methods. We conducted an unmatched hospital-based case control study, with the ratio of cases to controls of 1 : 2 (80 cases and 160 controls). We defined a case as a mother who got a third- or fourth-degree perineal tear after vaginal delivery while the controls recruited were the next two mothers who delivered vaginally without a third- or fourth-degree perineal tear. A questionnaire and participants’ medical records review were used to obtain sociodemographic and clinical data. We estimated the incidence of OASIS and performed univariable and multivariable logistic regression to identify the associated risk factors. Results. The cumulative incidence for OASIS during the study period was 6.6%. The risk factors for OASIS were 2nd stage of labour ≥1 hour (aOR 6.07, 95%CI 1.86–19.82, p=0.003), having episiotomy performed during labour (aOR 2.57, 95%CI 1.07–6.17, p=0.035), perineum support during delivery (aOR 0.03, 95%CI 0.01–0.12, p<0.001), and monthly income of >50,000 shillings (aOR 0.09, 95%CI 0.03–0.28, p<0.001). Conclusions and Recommendations. The risk factors for obstetric anal sphincter injury were prolonged second stage of labour and performing episiotomies during deliveries while higher monthly income and perineum support during delivery were protective. We recommend routine support to the perineum during delivery. Care should be taken in mothers with episiotomies, as they can extend and cause OASIS.


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