Postpartum Traumatic Rectal Tear After Normal Vaginal Delivery with an Intact Anal Sphincter

2012 ◽  
Vol 28 (2) ◽  
pp. 176-178 ◽  
Author(s):  
Stavros Athanasiou ◽  
Athanasios Mousiolis ◽  
Themistoklis Grigoriadis ◽  
Aris Antsaklis
Keyword(s):  
Vaginal Delivery ◽  
Anal Sphincter ◽  
Normal Vaginal Delivery

scholarly journals OASIS: clinical audit in a tertiary care centre

2018 ◽  
Vol 7 (5) ◽  
pp. 1958
Author(s):  
Sruthy Soman ◽  
Sobha S. Nair ◽  
Janani J. N. ◽  
Radhamany K. ◽  
Ann John Kurien
Keyword(s):  
Epidural Analgesia ◽  
Vaginal Delivery ◽  
Anal Sphincter ◽  
Gestational Age ◽  
Rectal Mucosa ◽  
Shoulder Dystocia ◽  
Induction Of Labour ◽  
Normal Vaginal Delivery ◽  
Perineal Tear ◽  
Vertex Presentation

Background: Obstetric anal sphincter injury involves injury to the anal sphincter and rectal mucosa sustained at time of vaginal delivery and can result in significant long-term morbidity. These injuries have been defined as 3rd and 4th degree lacerations that involve disruption of the anal sphincter and rectal mucosa respectively. Objectives of this study were to find out the incidence of obstetrical anal sphincter injuries, to identify the risk factors for of OASIS and the outcome of primary repair in terms of anal incontinence and its associated complications.Methods: We did a descriptive study of OASIS by retrospective analysis of the labour case records. The study period was 1 year between August 2016 to July 2017. Inclusion criteria were singleton pregnancy, vertex presentation, instrumental and normal vaginal delivery. Exclusion criteria were multiple pregnancy, non-vertex presentation and caesarean section. Proforma was developed to capture the age, parity, gestational age in weeks, induction of labour, epidural analgesia, delivery duration, type of episiotomy, instrumentation, shoulder dystocia, occipito posterior position,manual support, weight of the baby, suturing method. Postnatal evaluation after 6 weeks and 6 months for perineal discomfort, pain, incontinence, wound infection, breakdown, fistula were noted. Results: The incidence of OASIS was 1.4%. 81.8% women had 3rd degree perineal and 18.1% had 4th degree perineal tear. The mean age of the patients were 27.9 years, gestational age of 39.45 weeks, 72.7% were primiparous. Induction of labour with prostaglandins was done in 36.36% and Pitocin augmentation for 81.81%. The duration of second 36.36% had 60-89 min and 27.27% had duration more than 90 min. 54.54% had epidural analgesia, 36.36% had shoulder dystocia, 36.36% had instrumental delivery. 72.72% babies had birth weight between 3-3.5 kg, 9% between 3.5-4 kg. Ano vaginal fistula developed in 9%.Conclusions: Appropriate training, anticipating and identifying major degrees of perineal tear helps in reducing the complications. Anovaginal fistula is distressing and disabling the patient and to her near ones.

scholarly journals On demand caesarean section: What’s women’s attitude?

1970 ◽  
Vol 2 (2) ◽  
pp. 12-15
Author(s):  
Nira S Shrestha ◽  
Sumita Pradhan
Keyword(s):  
Caesarean Section ◽  
Pregnant Women ◽  
Vaginal Delivery ◽  
Caesarean Delivery ◽  
Mode Of Delivery ◽  
University Teaching ◽  
Normal Vaginal Delivery ◽  
On Demand ◽  
Assisted Delivery ◽  
The Right

Objectives: To evaluate the knowledge and attitude of Nepalese women towards mode of delivery and caesarean on demand. Study design: Hospital based cross sectional descriptive study where 200 pregnant women after 37 completed weeks of gestation were recruited randomly and interviewed, and their answers were analyzed. Results: Of the 200 interviewed pregnant women, all of them knew about normal vaginal delivery and caesarean delivery, but only 30% knew about instrumentally assisted delivery and 9% had heard about painless labour. Vaginal delivery was the preferred mode in 93% and 7% preferred caesarean delivery. Only 35% of the interviewed women believed that women should have the right to demand a caesarean section Conclusion: Knowledge assessment of two hundred women regarding the mode of delivery clearly indicates the need for strengthening counseling aspect of antenatal care and awareness program regarding mode of delivery. In Nepal on demand caesarean section is not provided in the University Teaching Hospital. However one third of women still felt that women should have the right to choose caesarean section on demand. Key words: Attitude, mode of delivery, Caesarean on demand. doi:10.3126/njog.v2i2.1448 N. J. Obstet. Gynaecol 2007 Nov-Dec; 2 (2): 12 - 15

scholarly journals Risk Factors for Obstetric Anal Sphincter Injuries among Women Delivering at a Tertiary Hospital in Southwestern Uganda

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Mahad Ali ◽  
Richard Migisha ◽  
Joseph Ngonzi ◽  
Joy Muhumuza ◽  
Ronald Mayanja ◽  
...  
Keyword(s):  
Risk Factors ◽  
Vaginal Delivery ◽  
Anal Sphincter ◽  
Tertiary Hospital ◽  
Monthly Income ◽  
Obstetric Anal Sphincter Injuries ◽  
Perineal Tear ◽  
Fourth Degree ◽  
Anal Sphincter Injury ◽  
Second Stage Of Labour

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.

scholarly journals A comparison of women’s expectations of labour and birth with the experiences in primiparas and multiparas with normal vaginal delivery

2016 ◽  
Vol 4 (1) ◽  
pp. 16-25 ◽  
Author(s):  
Manijeh Pirdil ◽  
Leila Pirdel
Keyword(s):  
Health Care ◽  
Vaginal Delivery ◽  
Health Care Providers ◽  
Normal Vaginal Delivery ◽  
Care Providers ◽  
Medical College ◽  
Childbirth Experience ◽  
Significant Difference ◽  
Negative Expectations

Background: Maternal childbirth expectations play an important role in determining a woman’s response to her childbirth experience. Women need to be helped to develop realistic and positive expectations and identify the factors that influence these expectations.Objective: The aim of this study was to compare woman’s expectations and experiences of childbirth.Methods: This descriptive-comparative study was carried out in Tabriz Alzahra Hospital from 2006 to 2007. For this purpose, a total of 600 primiparas and multiparas women who were candidates for vaginal delivery, were randomly selected and interviewed. The data were collected by questionnaire.Results: Comparison of the means of mothers expectation and experience of labor and birth between the two groups demonstrated a statistically significant difference (p<0.05). The findings indicated a number of differences exist between primiparas and multiparas women in relation to expectations and experiences of birth when compare two groups. The majority of women had negative expectations and experiences of childbirth.Conclusion: The evaluation and understanding of birth expectations and experiences as positive and negative is priority of maternity system. Antenatal educators need to ensure that pregnant women are appropriately prepared for what might actually happen to limit this expectation-experience gap. Health-care providers should improve the quality of antenatal care which can change negative childbirth expectations and experiences of womenJournal of Kathmandu Medical College, Vol. 4(1) 2015, 16-25

scholarly journals Recurrent fetal postpartum stress induced cardiomyopathy after normal vaginal delivery

2017 ◽  
Vol 32 (2) ◽  
pp. 244
Author(s):  
Yong-Sun Noh ◽  
Sung-Ho Her ◽  
Jong Bum Kwon ◽  
Chan Joon Kim ◽  
Tae-Seok Kim
Keyword(s):  
Vaginal Delivery ◽  
Normal Vaginal Delivery ◽  
Postpartum Stress

Pubovisceral muscle and anal sphincter defects in women with fecal or urinary incontinence after vaginal delivery

2018 ◽  
Vol 23 (2) ◽  
pp. 117-128 ◽  
Author(s):  
S. M. Murad-Regadas ◽  
F. S. P. Regadas ◽  
F. S. P. R. Filho ◽  
L. B. Borges ◽  
A. da Silva Vilarinho ◽  
...  
Keyword(s):  
Urinary Incontinence ◽  
Vaginal Delivery ◽  
Anal Sphincter ◽  
Sphincter Defects ◽  
Anal Sphincter Defects
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