scholarly journals OP24.01: A prolonged second stage of labor may be a predisposing factor for levator ani injury in women with 3rdand 4thdegree perineal tears

2008 ◽  
Vol 32 (3) ◽  
pp. 393-393
Author(s):  
V. H. Eisenberg ◽  
R. Achiron ◽  
I. Yodfat ◽  
M. Alcalay
Keyword(s):  
Levator Ani ◽  
Predisposing Factor ◽  
Second Stage Of Labor ◽  
Second Stage ◽  
Perineal Tears

scholarly journals Upright kneeling position during second stage of labor: a pilot study

2018 ◽  
Vol 7 (2) ◽  
pp. 401 ◽  
Author(s):  
Anjali Dabral ◽  
Pallavi Pawar ◽  
Rekha Bharti ◽  
Archana Kumari ◽  
Achla Batra ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Mode Of Delivery ◽  
Admission Rate ◽  
North India ◽  
Care Hospital ◽  
Apgar Scores ◽  
Second Stage Of Labor ◽  
Second Stage ◽  
Perineal Tears ◽  
Second Stage Of Labour

Background: Women delivering in upright position have shorter labour due to efficient and stronger contractions with faster descent of foetal head. The present study aimed to find out effect of upright kneeling position in the second stage of labour on maternal and foetal outcome and assess patients’ satisfaction.Methods: The study was carried out in a tertiary care hospital of North India from October 2012 to February 2014. Low risk women admitted in early labour were divided into two groups, women delivering in kneeling position and in supine position. The outcome measures studied were, duration of second stage of labour, mode of delivery, 2nd degree perineal tears, Apgar scores at 5 minutes, NICU admission rate and patient satisfaction.Results: The mean duration of second stage of labour in kneeling group was shorter by 14.901 minutes. The rate of vaginal delivery was comparable for both primigravidas and multigravida in kneeling and supine groups, RR: 2.275, 95% CI (0.7872-6.5831) and RR: 1.633, 95% CI (0.393-6.775). Primigravidas had more 2nd degree perineal tears in kneeling group as compared to supine, RR 4.191, 95% CI (1.54 to 11.41). No difference in Apgar scores >7 at 5 minutes was observed in both groups, however, significantly lesser babies in kneeling group were admitted in NICU, RR 0.246, 95% CI (0.079 to 0.761). There was no difference on comparing satisfaction scores of primigravidas and multigravida in both supine and kneeling position.Conclusions: Kneeling position reduces the duration of second stage of labour and NICU admissions.

scholarly journals P14.16: Prolonged second stage of labor and levator ani muscle injuries

2013 ◽  
Vol 42 (s1) ◽  
pp. 168-168
Author(s):  
V. Marsoosi ◽  
S. Aboutorabi ◽  
L. Eslamian ◽  
A. Jamal
Keyword(s):  
Levator Ani ◽  
Levator Ani Muscle ◽  
Muscle Injuries ◽  
Second Stage Of Labor ◽  
Second Stage

Prediction Index of Levator Ani Muscle Avulsion After Vaginal Delivery: An Evidence-Based Appraisal

2018 ◽  
Vol 24 (8) ◽  
pp. 6214-6217
Author(s):  
Budi Iman Santoso ◽  
Adly Nanda Al-Fattah ◽  
Raymond Surya ◽  
Surrahman Hakim
Keyword(s):  
Pelvic Floor ◽  
Vaginal Delivery ◽  
Pelvic Floor Dysfunction ◽  
Levator Ani ◽  
Influential Factors ◽  
Cochrane Library ◽  
Levator Ani Muscle ◽  
Second Stage Of Labor ◽  
Second Stage ◽  
Levator Ani Muscle Avulsion

Pelvic floor dysfunction (PFD) due to vaginal delivery is related to tear of levator ani muscle (LAM) that potentially lead to the impairment of quality of life among women. A number of attempts to predict LAM injury after vaginal delivery had been conducted. This study aims to appraise the accuracy of several prediction index determining LAM injury after vaginal delivery. We conducted a search in Cochrane Library®, Pubmed®, and Medline® with the keywords of “pelvic floor dysfunction” AND “vaginal delivery” AND “prediction.” Critical appraisal determining the validity, importance, and applicability (VIA) was conducted by 2 independent authors. After 6 weeks to 3 months’ duration of follow up, the incidence of LAM avulsion was varied from 15.4% to 35.6% from three studies. Multivariate analysis showed that forceps delivery, OASIS, and active second stage (OR 3.8; 3.1; 1.61; respectively) as the most influential factors for LAM incidence. Maternal age and time spent in active pushing were also contributed to LAM incidence. OASIS and second stage of labor could be used as the most influential components of prediction index for LAM incidence. Prediction indexes for LAM incidence are developed. OASIS and second stage of labor are acknowledged as two most influential variables among three appraised studies.

scholarly journals Levator ani muscle coactivation at term is associated with longer second stage of labor in nulliparous women

2019 ◽  
Vol 53 (5) ◽  
pp. 686-692 ◽  
Author(s):  
A. Youssef ◽  
E. Montaguti ◽  
M. G. Dodaro ◽  
R. Kamel ◽  
N. Rizzo ◽  
...  
Keyword(s):  
Levator Ani ◽  
Levator Ani Muscle ◽  
Second Stage Of Labor ◽  
Second Stage ◽  
Nulliparous Women

scholarly journals Perineal Trauma in a Low-risk Maternity with High Prevalence of Upright Position during the Second Stage of Labor

2018 ◽  
Vol 40 (07) ◽  
pp. 379-383
Author(s):  
Mariana Peppe ◽  
Juliana Stefanello ◽  
Bruna Infante ◽  
Mauricio Kobayashi ◽  
Claudia Baraldi ◽  
...  
Keyword(s):  
Upright Position ◽  
Low Risk ◽  
Perineal Trauma ◽  
Fourth Degree ◽  
Second Stage Of Labor ◽  
Second Stage ◽  
Perineal Tears ◽  
Nulliparous Women ◽  
Risk Pregnancy ◽  
Severe Perineal Trauma

Objective Perineal trauma is a negative outcome during labor, and until now it is unclear if the maternal position during the second stage of labor may influence the risk of acquiring severe perineal trauma. We have aimed to determine the prevalence of perineal trauma and its risk factors in a low-risk maternity with a high incidence of upright position during the second stage of labor. Methods A retrospective cohort study of 264 singleton pregnancies during labor was performed at a low-risk pregnancy maternity during a 6-month period. Perineal trauma was classified according to the Royal College of Obstetricians and Gynecologists (RCOG), and perineal integrity was divided into three categories: no tears; first/second-degree tears + episiotomy; and third and fourth-degree tears. A multinomial analysis was performed to search for associated factors of perineal trauma. Results From a total of 264 women, there were 2 cases (0.75%) of severe perineal trauma, which occurred in nulliparous women younger than 25 years old. Approximately 46% (121) of the women had no tears, and 7.95% (21) performed mediolateral episiotomies. Perineal trauma was not associated with maternal position (p = 0.285), health professional (obstetricians or midwives; p = 0.231), newborns with 4 kilos or more (p = 0.672), and labor analgesia (p = 0.319). The multinomial analysis showed that white and nulliparous presented, respectively, 3.90 and 2.90 times more risk of presenting perineal tears. Conclusion The incidence of severe perineal trauma was low. The prevalence of upright position during the second stage of labor was 42%. White and nulliparous women were more prone to develop perineal tears.

scholarly journals Effectiveness of Perineal Massage in the Second Stage of Labor in Preventing Perineal Trauma

2020 ◽  
pp. 1
Author(s):  
Suleyman Cemil Oglak ◽  
Mehmet Obut
Keyword(s):  
Observational Study ◽  
Perineal Trauma ◽  
Control Group ◽  
Second Stage Of Labor ◽  
Second Stage ◽  
Mediolateral Episiotomy ◽  
Perineal Tears ◽  
Nulliparous Women ◽  
Massage Group ◽  
Perineal Massage

<p><strong>OBJECTIVE:</strong> This study was aimed to investigate the effect of perineal massage in the second stage of labor in prevention perineal traumas during childbirth.</p><p><strong>STUDY DESIGN:</strong> This observational study was conducted with 171 nulliparous women delivered by vaginally between January 2017 and May 2019. All the patients managed by the selective episiotomy principle. All the patients were divided into two groups: the perineal massage group and the control group. The perineal massage was performed during the second stage of labor until the baby's head was birth. The control group received routine labor care. In the case of threatening tears in any patient and at the preference of the midwife, mediolateral episiotomy was performed. Following childbirth, the perineum and vagina were examined for perineal tears and episiotomy by the midwives.</p><p><strong>RESULTS:</strong> The length of the second stage of labor was significantly lower in the massage group (36±19 minute) compared with the control group (46±25 minute, p=0.024). Twenty-five women (28.8%) in the massage group had intact perineum after vaginal birth, compared with five (6.0%) in the control group (p=0.003). The rate of first- and second-degree perineal tears are higher in the massage group [28 patients (32.2%) and 9 patients (10.3%), respectively] than in the control group [10 patients (11.9%) and 5 patients (6.0%), respectively, p&lt;0.001]. The incidence of episiotomy was significantly lower in the massage group (25 patients, 28.7%) than in the control group (64 patients, 76.1%, p&lt;0.001). </p><p><strong>CONCLUSION:</strong> Perineal massage should be considered a routine intervention to reduce the incidence of perineal trauma.</p>

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