Episiotomy use among vaginal deliveries and the association with anal sphincter injury: a population-based retrospective cohort study.

Episiotomy use among vaginal deliveries and the association with anal sphincter injury: a population-based retrospective cohort study. CMAJ. 2019 Oct 21;191(42):E1149-E1158 Authors: Muraca GM, Liu S, Sabr Y, Lisonkova S, Skoll A, Brant R, Cundiff GW, Stephansson O, Razaz N, Joseph KS Abstract BACKGROUND: The rate of obstetric anal sphincter injury has increased in recent years, particularly among operative vaginal deliveries. We sought to characterize temporal trends in episiotomy use and to quantify the association between episiotomy and obstetric anal sphincter injury. METHODS: Using a population-based retrospective cohort study design of hospital data from 2004 to 2017, we studied all vaginal deliveries of singleton infants at term gestation in Canada (excluding Quebec). Rates of obstetric anal sphincter injury were contrasted between women who had an episiotomy and those who did not. Log-binomial regression was used to estimate the association between episiotomy and obstetric anal sphincter injury among women with spontaneous and operative vaginal deliveries after controlling for confounders. RESULTS: The study population included 2 570 847 deliveries. Episiotomy use declined significantly among operative vaginal deliveries (53.1% in 2004 to 43.2% in 2017, p
Source: cmaj - Category: General Medicine Authors: Tags: CMAJ Source Type: research

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ConclusionsPFM function and UI prevalence at 6  weeks postpartum are not significantly affected by epidural analgesia.
Source: International Urogynecology Journal - Category: OBGYN Source Type: research
The objective of this study is the generation of descriptive data on the mode of delivery and on maternal and foetal complications in the case of foetal macrosomia. The causes and consequences of foetal macrosomia as well as the rate of shoulder dystocia are examined in relation to the severity of the macrosomia. Patients The study investigated all singleton births ≥ 37 + 0 weeks of pregnancy with a birth weight ≥ 4000 g at the Charité University Medicine Berlin (Campus Mitte 2001 - 2017, Campus Virchow Klinikum 2014 - 2017). Results 2277 consecutive newborns (birth w...
Source: Geburtshilfe und Frauenheilkunde - Category: OBGYN Tags: Geburtshilfe Frauenheilkd Source Type: research
Publication date: Available online 9 July 2019Source: European Journal of Obstetrics &Gynecology and Reproductive BiologyAuthor(s): A.H. Sultan, R. Thakar, K.M. Ismail, V. Kalis, K. Laine, S.H. Räisänen, J.W. de LeeuwAbstractThe role of episiotomy with regard to prevention of anal sphincter injuries (OASIS) is under discussion. The recently published guideline of the WHO “Intrapartum care for a positive childbirth experience” states that the role of episiotomy during operative vaginal deliveries remains to be established. This guideline is based on the evidence coming from randomised clinical tria...
Source: European Journal of Obstetrics and Gynecology and Reproductive Biology - Category: OBGYN Source Type: research
ConclusionsVBAC does not confer an increased risk of OASI after a first delivery by caesarean section when compared with nulliparous women. The rate of successful VBAC may be contributory and suggests that the risk conferred by VBAC may be unit-specific. Unit and national-level audit is necessary to investigate this risk further.
Source: International Urogynecology Journal - Category: OBGYN Source Type: research
ConclusionsImplementation of a restrictive MLE policy for operative delivery seems to be associated with an increase in OASI incidence with forceps, but not with vacuum.
Source: Archives of Gynecology and Obstetrics - Category: OBGYN Source Type: research
ConclusionDyspareunia is common among primiparous women, and these patients are more likely to suffer perineal tears and anxiety during delivery.
Source: European Journal of Obstetrics and Gynecology and Reproductive Biology - Category: OBGYN Source Type: research
CONCLUSION: In conclusion, results suggest that episiotomy should be used with caution, particularly among women with a previous vaginal delivery and in the setting of vacuum-assisted delivery. Episiotomy may protect against OASIS in forceps-assisted deliveries for women without a prior vaginal delivery. PMID: 31003947 [PubMed - as supplied by publisher]
Source: Journal of Obstetrics and Gynaecology Canada : JOGC - Category: OBGYN Tags: J Obstet Gynaecol Can Source Type: research
ConclusionDyspareunia is common among primiparous women, and these patients are more likely to suffer perineal tears and anxiety during delivery.
Source: European Journal of Obstetrics and Gynecology and Reproductive Biology - Category: OBGYN Source Type: research
ConclusionsQuality initiatives regarding OASI prevention and management may improve care. Our data suggest OASI training for midwives may improve delivery care in the US. Further studies of other obstetric providers are needed.
Source: International Urogynecology Journal - Category: OBGYN Source Type: research
Publication date: March 2019Source: European Journal of Obstetrics &Gynecology and Reproductive Biology, Volume 234Author(s): Stelios Myriknas, Papadakis Kostas
Source: European Journal of Obstetrics and Gynecology and Reproductive Biology - Category: OBGYN Source Type: research
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