Perineal Trauma and Postpartum Perineal Morbidity in Asian and Non-Asian Primiparous Women Giving Birth in Australia

Objective To identify the association between perineal trauma and pain in 473 primiparous women. Method Cross-sectional study in which pain was measured by the numerical pain scale (0 to 10 - 0 being no pain and 10 maximal pain). Results The prevalence and mean intensity of pain were 33.0% and 4.7 points (standard deviation = 2.0) in the numeric scale, respectively. Episiotomy represented the most frequent trauma (46.7%). The occurrence and intensity of the pain were associated with perineal trauma and postpartum time. Having perineal trauma tripled the chance of pain. Each hour elapsed following the birth reduced the chance of pain by 4.8%. Conclusion Primiparous women are subject to a high frequency of perineal trauma, with episiotomy being the most prominent. Perineal pain affects approximately one-third of primiparous women and is associated with the postpartum time and perineal traumas.

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Perineal Trauma in Primiparous Women with Spontaneous Vaginal Delivery: Episiotomy or Second Degree Perineal Tear?

International Journal of Women s Health and Reproduction Sciences ◽

10.15296/ijwhr.2015.16 ◽

2015 ◽

Vol 3 (2) ◽

pp. 84-88 ◽

Cited By ~ 4

Author(s):

Irene Mora-Hervás ◽

Emília Sánchez ◽

Francisco Carmona ◽

Montserrat Espuña-Pons

Keyword(s):

Vaginal Delivery ◽

Perineal Trauma ◽

Perineal Tear ◽

Spontaneous Vaginal Delivery ◽

Primiparous Women ◽

Second Degree

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Is Selective Mediolateral Episiotomy Protective Against Spontaneous Perineal Trauma and OASIS in Malaysian Tertiary hospitals? A Cross Sectional Study from the National Obstetrics Registry.

10.21203/rs.3.rs-32207/v1 ◽

2020 ◽

Author(s):

Shamala Devi Karalasingam ◽

Ravichandran Jeganathan ◽

Ravindran Jegasothy ◽

Sharul Aiman Soelar ◽

Daniel Reidpath

Keyword(s):

Medical Officer ◽

Peninsular Malaysia ◽

Primary Objective ◽

Perineal Trauma ◽

Contributing Factors ◽

Cross Sectional ◽

Vaginal Deliveries ◽

Multiparous Women ◽

Tertiary Hospitals ◽

Primiparous Women

Abstract Introduction: Perineal trauma has short- and long-term debilitating effects on women. This study aimed to determine if selective episiotomy is protective against spontaneous perineal trauma and Obstetric anal sphincter injury following singleton vaginal birth in Malaysian tertiary hospitals and to identify the contributing factors.Methods: This study used data from the Malaysian National Obstetrics Registry (NOR)which collects data from 11 tertiary hospitals in Peninsular Malaysia, 1 hospital in the Federal Territory Kuala Lumpur and in 2 from East Malaysia from 2010 to 2017. A total of 1,109,856 deliveries were analyzed of which 731,475 singleton vaginal deliveries with complete variables were included in this study. The primary objective were to identify contributing factors to spontaneous perineal trauma and Obstetric anal splinter injury (OASIS) and if selective episiotomy was effective in reducing perineal trauma.Results: Prevalence of spontaneous perineal trauma in primiparous women was 23% while in multiparous women was 49.7%. First and second-degree perineal tears were the commonest perineal injury followed by vaginal wall tears and labial tears. Less than 0.5% of the subjects had OASIS. Average episiotomy rate was 33.3%. In both primiparous (OR = 0.06; 95% CI; 0.06) and multiparous women (OR 0.08; 95% CI: 0.03), selective episiotomy significantly reduces the risk spontaneous perineal trauma. The risk of OASIS, is reduced by episiotomy in primiparous women (OR 0.06; 95% CI: 0.05–0.07) and in multiparous women (OR 0.19; 95% CI: 0.14–0.26).Conclusion: Women have a higher risk of spontaneous perineal trauma when the accoucheur is a medical officer with less than 6 months’ experience. In primiparous women spontaneous vaginal delivery is a risk for vaginal trauma and selective episiotomy appears to reduce the risk. All women with instrumental delivery are at risk of OASIS and selective episiotomy appears to reduce risk.

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A Prospective Study of Haemostatic Tests at 28 Weeks Gestation as Predictors of Pre-Eclampsia and Growth Retardation

Thrombosis and Haemostasis ◽

10.1055/s-0038-1646567 ◽

1989 ◽

Vol 61 (02) ◽

pp. 243-245 ◽

Cited By ~ 4

Author(s):

J G Thornton ◽

B J Molloy ◽

P S Vinall ◽

P R Philips ◽

R Hughes ◽

...

Keyword(s):

Discriminant Analysis ◽

Prospective Study ◽

Fetal Growth ◽

Growth Retardation ◽

Degradation Products ◽

Fetal Growth Retardation ◽

Fibrin Degradation Products ◽

A Prospective Study ◽

Primiparous Women ◽

Significant Model

SummaryA panel of haemostatic tests was perfomed on 400 primiparous women at 28 weeks to test whether one or more could predict the development of pregnancy complications. Fifteen women subsequently developed pre-eclampsia with significant proteinuria and 13 delivered growth retarded infants. There were no significant differences between mothers in the pre-eclampsia group and 22 randomly selected controls. A stepwise logistic discriminant analysis of the data did not produce a significant model. In the growth retarded group only beta thromboglobulin levels were significantly lower than in the controls (p <0.05), although in the logistic discriminant analysis the inclusion of both beta thromboglobulin and fibrin degradation products led to a borderline significant improvement in fit of the model. We conclude that the haemostatic variables studied are not significantly changed at 28 weeks nor clinically useful predictors of either pre-eclampsia or fetal growth retardation.

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The Effect of Reflexology on Labor Pain and Length Among Primiparous Women: A Randomized Controlled Trial

International Electronic Journal of Medicine ◽

10.31661/iejm805 ◽

2018 ◽

Vol 7 ◽

Author(s):

Azita Kamjoo

Keyword(s):

Controlled Trial ◽

Intervention Group ◽

Active Phase ◽

Labor Pain ◽

Control Group ◽

Singleton Pregnancy ◽

Group Data ◽

Significant Difference ◽

Labor Length ◽

Primiparous Women

Background: Pain control is considered as the key issue in modern midwifery. Along with medical painkillers, reflexology is viewed as a non-medical and noninvasive method. Hence, we aimed to investigate the effect of reflexology on the intensity of pain and length of labor. Materials and Methods: In this clinical trial, participants included 240 Iranian primiparous women with term and singleton pregnancy. Having a 3-4 cm cervical dilatation once they visited the hospital. Through a convenient sampling method, they were selected and then randomly divided into two groups. In the intervention group, reflexology was performed, and the intensity of pain during the active phase of labor along with the length of labor in the active phase was measured by visual analog scale (VAS) and compared with the control group. Data were analyzed using descriptive statistics, t-test, and Mann-Whitney U-test. Result: Data analysis showed a statistically significant difference between the intensity of pain in the 5-7 and 8-10 cm dilatation in the two groups (P=0.01). Moreover, the labor length in the active phase was found to be significantly shorter in the intervention group (P<0.001). Conclusion: It appears that reflexology can lead to a reduction in the pain and length of labor. Therefore, through instructing this technique, a goal of midwifery, which is reducing labor pain and its length can be achieved. Keywords: Reflexology, Labor Pain, Labor Length, Primiparous Women

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