The mediating effect of the prolonged second stage of labor on delivery mode and urinary incontinence among postpartum women: evidence from Shandong, China

Objective: The objective of this study was to investigate prevalence of urinary incontinence at 3 months postpartum andto study how continence status during pregnancy and different factors influence urinary incontinence at 3 months postpartum inprimiparous women. Setting: Pregnant women attending routine antenatal clinic at Ziauddin hospital and Kharader general hospitalKarachi were recruited to this study. Methods: Urinary incontinence before and during pregnancy was assessed at study enrolment earlyin the third trimester. Incontinence was re-assessed three months postpartum. Logistic regression analysis was used to assess the role ofmaternal and obstetric factors in causing postpartum urinary incontinence. Results: Urinary incontinence was reported in 15 women(10.6% ) out of 141 women, mode of delivery, onset of labor weight of the baby, episiotomy, and the length of the second stage of labor,were not predictive of urinary incontinence after delivery. Adjusted RR for incontinence after spontaneous vaginal delivery compared withelective caesarean section was 2.200(95% CI .6-7.28) among women who were continent during pregnancy. Conclusions: Urinaryincontinence was prevalent 3 months postpartum. The association between incontinence postpartum mode of delivery, onset of labor,perineal trauma and weight of baby was not statistically significant.

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Intrapartum ultrasound use in clinical practice as a predictor of delivery mode during prolonged second stage of labor

10.21203/rs.3.rs-596945/v1 ◽

2021 ◽

Author(s):

tamar katzir ◽

Yoav Brezinov ◽

Ella Kharish ◽

Shira Hadad ◽

Edi Vaisbuch ◽

...

Keyword(s):

Clinical Practice ◽

Real Life ◽

Vacuum Extraction ◽

Delivery Mode ◽

Fetal Head ◽

Second Stage Of Labor ◽

Second Stage ◽

Nulliparous Women ◽

The Mean ◽

Time To Delivery

Abstract Purpose To determine the validity of Intrapartum ultrasound (IPUS), and particularly the angle of progression (AOP), in predicting delivery mode when measured in real-life clinical practice among women with protracted second stages of labor. Methods Using electronic medical records, nulliparous women with a second stage of labor of ≥ 3hours ("prolonged") and a documented AOP measurement during the second stage were identified. The ability of a single AOP measurement in "prolonged" second stage to predict a vaginal delivery (VD) was assessed. Fetal head descend, measured by AOP change/hour (calculated from serial measurements) was compared between women who delivered vaginally and those who had a cesarean delivery (CD) for arrest of descent. Results Of the 191 women who met the inclusion criteria, 62 (32.5%) delivered spontaneously, 96 (50.2%) had a vacuum extraction (VE) and 33 (17.3%) had a CD. The mean AOP was wider among women who had VD (spontaneous or VE) compared to those who had CD (153º±19 vs. 133º±17, p < 0.001). Wider AOPs were associated with higher rates of VD and an AOP ≥ 127º was associated with a VD rate of 88.6% (148/167). Among the 87 women who had more than one AOP measurement, the mean AOP change per hour was higher in the VD group than in the CD group (15.1º±11.4º vs. 6.2º±6.3º, p < 0.001). Conclusion Ultrasound assessed fetal head station in nulliparous women with a protracted second stage of labor can be an accurate and objective additive tool in predicting mode and interval time to delivery in real-life clinical practice.

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Effect of female genital cutting performed by health care professionals on labor complications in Egyptian women: a prospective cohort study

Journal of Perinatal Medicine ◽

10.1515/jpm-2016-0429 ◽

2018 ◽

Vol 46 (4) ◽

pp. 419-424

Author(s):

Wael F. Saleh ◽

Haitham A. Torky ◽

Mohamed A. Youssef ◽

Wael S. Ragab ◽

Mohamed A. Sayed Ahmed ◽

...

Keyword(s):

Health Care Professionals ◽

Female Genital Cutting ◽

Delivery Mode ◽

Type Ii ◽

Second Stage Of Labor ◽

Second Stage ◽

Perineal Tears ◽

Labor Complications ◽

Genital Cutting ◽

Female Genital

Abstract Aim: To examine the effect of the degree of female genital cutting (FGC) performed by health-care professionals on perineal scarring; delivery mode; duration of second stage of labor; incidence of perineal tears and episiotomy in a cohort of uncircumcised versus circumcised (types I and II) women. Methods: A prospective cohort study included 450 primigravida women in active labor attending the Faculty of Medicine Cairo University Hospital between January 2013 and August 2014. Women were divided into three groups based on medical examination upon admission. Group I (Control) included 150 uncut women, Group II included 150 women with type I FGC and Group III included 150 women with type II FGC. A structured questionnaire elicited the information on women’s socio-demographic characteristics including age, residence, occupation, educational level, age of marriage and FGC circumstances. Association between FGC and labor complications was examined. Main outcomes: risk of perineal scarring; delivery mode; duration of second stage of labor; incidence of perineal tears and episiotomy. Results: Family history of genitally cut mother/sister was the most significant socio-demographic factor associated with FGC. FGC especially type II was associated with significantly higher incidence of vulvar scar (P<0.0002), perineal tears (P<0.0001) and increased likelihood of additional vaginal and perineal trauma [odds ratio (OR): 1.85, 95% CI: 0.60–5.65. P≤0.001]. There was insignificant difference in risks of cesarean section (CS), instrumental delivery, episiotomy and short-term neonatal outcomes. Conclusion: The study strengthens the evidence that FGC increases the risk of tears in spite of medicalization of the practice.

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Inkontinensia Urin Pascapersalinan dan Faktor-Faktor Risiko yang Memengaruhinya

Jurnal Ilmu Kedokteran ◽

10.26891/jik.v10i2.2016.98-105 ◽

2017 ◽

Vol 10 (2) ◽

pp. 98

Author(s):

Edy Fakhrizal ◽

Sri Wahyu Maryuni

Keyword(s):

Risk Factors ◽

Body Weight ◽

Urinary Incontinence ◽

Data Analysis ◽

Maternal Morbidity ◽

Delivery Mode ◽

Second Stage ◽

Cough Test

Postpartum urinary incontinence is an important and often overlooked form of maternal morbidity. The aim of thisstudy is to obtain prevalence of postpartum urinary incontinence and its influential risk factors. This is an observationalstudy. The subjects were all primipara stayed in Obstetric & Gynecology of Arifin Achmad Pekanbaru – Riau hospital,between July 1st and December 31st 2014. The data of risk factors (demographic and obstetric) was obtained frommedical records and cough test was done too. The data was analyzed with computerized statistic data analysis 12 (Stata 12 ). The distribution of data were analyzed with descriptive univariate and presented in (n) and (%). Bivariateanalysis was done to see any influential risk factors to postpartum urinary incontinence event. The prevalence ofurinary incontinence in this study was 30% and the influential risk factors were BMI, body weight changing duringpregnancy, delivery mode, birthweight and length of second stage.

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A Simulation Analysis of Maternal Pelvic Floor Muscle

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph182010821 ◽

2021 ◽

Vol 18 (20) ◽

pp. 10821

Author(s):

Rongrong Xuan ◽

Mingshuwen Yang ◽

Yajie Gao ◽

Shuaijun Ren ◽

Jialin Li ◽

...

Keyword(s):

Pelvic Floor ◽

Pelvic Floor Muscle ◽

Levator Ani ◽

Stress And Strain ◽

Delivery Mode ◽

Levator Ani Muscle ◽

Pelvic Mri ◽

Second Stage Of Labor ◽

Attachment Point ◽

Second Stage

Pelvic floor disorder (PFD) is a common disease affecting the quality of life of middle-aged and elderly women. Pelvic floor muscle (PFM) damage is related to delivery mode, fetal size, and parity. Spontaneous vaginal delivery causes especially great damage to PFM. The purpose of this study was to summarize the characteristics of PFM action during the second stage of labor by collecting female pelvic MRI (magnetic resonance imaging) data and, further, to try to investigate the potential pathogenetic mechanism of PFD. A three-dimensional model was established to study the influence factors and characteristics of PFM strength. In the second stage of labor, the mechanical responses, possible damage, and the key parts of postpartum lesions of PFM due to the different fetal biparietal diameter (BPD) sizes were analyzed by finite element simulations. The research results showed that the peak stress and strain of PFM appeared at one-half of the delivery period and at the attachment point of the pubococcygeus to the skeleton. In addition, during the simulation process, the pubococcygeus was stretched by about 1.2 times and the levator ani muscle was stretched by more than two-fold. There was also greater stress and strain in the middle area of the levator ani muscle and pubococcygeus. According to the statistics, either being too young or in old maternal age will increase the probability of postpartum PFM injury. During delivery, the entire PFM underwent the huge deformation, in which the levator ani muscle and the pubococcygeus were seriously stretched and the attachment point between the pubococcygeus and the skeleton were the places with the highest probability of postpartum lesions.

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Intrapartum ultrasound prior to Kristeller maneuver: an observational study

Journal of Perinatal Medicine ◽

10.1515/jpm-2014-0079 ◽

2015 ◽

Vol 43 (2) ◽

Cited By ~ 4

Author(s):

Marcos Javier Cuerva ◽

Pablo Tobias ◽

Jose Angel Espinosa ◽

Jose Luis Bartha

Keyword(s):

Observational Study ◽

Apgar Score ◽

Umbilical Artery ◽

Ph Value ◽

Delivery Mode ◽

Second Stage Of Labor ◽

Second Stage ◽

Perineal Tears ◽

Digital Palpation ◽

Angle Of Progression

AbstractTo evaluate the accuracy of criteria followed by obstetricians when performing a Kristeller maneuver in cases of prolonged second stage of labor.In this prospective observational study, the station of the fetal head was measured using the angle of progression (intrapartum ultrasound) just prior to the intervention of the managing obstetrician in 52 women with prolonged second stage of labor. The managing obstetricians were blinded to the sonographic results. The decision of performing a Kristeller maneuver was taken by the obstetricians based on digital palpation and their experience. Delivery mode, Apgar score, umbilical artery pH value, episiotomy, perineal tears, bleeding, and time to delivery were recorded.Kristeller maneuver was performed in 36/52 (69.2%) cases. There were no significant differences between the Kristeller and the non-Kristeller group regarding the angle of progression. There were no significant differences between both groups with respect to delivery mode, perineal tears, episiotomy, bleeding, Apgar score, and umbilical artery pH value.Our study failed to define any criteria followed by obstetricians when performing a Kristeller maneuver in cases of prolonged second stage of labor. There was no relation between the angle of progression and the decision to perform a Kristeller maneuver.

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