scholarly journals Effect of episiotomy on perineal lacerations in spontaneous vertex deliveries

2016 ◽  
Vol 11 (4) ◽  
Author(s):  
Meherun Nisa
Keyword(s):  
Vaginal Delivery ◽  
Local Anaesthesia ◽  
Analytical Study ◽  
Study Groups ◽  
Perineal Laceration ◽  
Cross Sectional ◽  
Fourth Degree ◽  
Mediolateral Episiotomy ◽  
Perineal Tears ◽  
Perineal Lacerations

Objectives: To evaluate the effects of episiotomy on the frequency of perineal lacerations. Design: Cross-Sectional analytical study. Place & duration of study: Department of Gynae Obstetrics unit III. Lady willingdon Hospital Lahore. From April 1994 to March 1996. Patients & methods: 2918 women who delivered vaginally were included in the study. Only right mediolateral episiotomy incision was used in these cases. Local anaesthesia in the form of 2% Lignocain was used in all cases to infiltrate the area before episiotomy cut. The delivery was conducted in most cases by a resident. The rate of perineal lacerations with or without episiotomy in both primiparae and multiparae groups was noted. Results 2918 women of term singleton babies were entered into this study. Episiotomy was performed in 1419 (48.63%) of these women. There were 1095(37.53%) primiparae and 1823 (62.47%) multiparae in the study groups. The rate of episiotomy in primiparae and multiparae were 93.42% and 21.72% respectively. A total of 267 (9.2%) perineal tears were sustained by these women during vaginal delivery . Episiotomy was associated with 151 (10.6%) perineal tears compared to 116(7.7%) without episiotomy. The incidence of fourth degree perineal laceration was 0.4% without episiotomy but increased to 1% with the use of episiotomy. This difference is statistically significant. Conclusion: Episiotomy is not protective against severe perineal lacerations. A selective use of episiotomy is recommended for appropriate indications.

scholarly journals Use of 2D and multislice transperineal ultrasonography to describe the degree of perineal laceration following vaginal delivery

2018 ◽  
Vol 27 (2) ◽  
Author(s):  
Budi I. Santoso ◽  
Suskhan Djusad ◽  
Surahman Hakim ◽  
Fernandi Moegni ◽  
Alfa P. Meutia ◽  
...  
Keyword(s):  
Vaginal Delivery ◽  
Clinical Examination ◽  
Evaluation Method ◽  
Cross Sectional Study ◽  
Perineal Laceration ◽  
Perineal Tear ◽  
Cross Sectional ◽  
Measurement Variation ◽  
The Mean ◽  
Primiparous Women

Background: Perineal tear is the most common complication after vaginal delivery. Pill-rolling test is a widely used clinical evaluation method to determine the degree of perineal tear. However, the evaluation results of anal sphincter complex (ASC) differ between clinical examination and 2D/multislice transperineal ultrasonography (TPUS). This study aims to describe measurement variation between these modalities.Methods: This cross-sectional study was conducted at Cipto Mangunkusumo Hospital from November 2015 to May 2016. Subjects were primiparous women after vaginal delivery. Clinical examination using pill-rolling test was performed to determine the degree of perineal laceration. Suture was conducted accordingly. The subjects were subjected to 2D/multislice TPUS 72 hours after delivery to evaluate the integrity of internal and external anal sphincters. Data were collected and analyzed to determine compatibility between these examinations.Results: Among 70 prospective primiparous women, five were excluded due to unavailability to undergo 2D/multislice TPUS 72 hours after delivery. The mean duration to perform 2D/multislice TPUS was 4.5 minutes, and pain was tolerable during the examination. The compatibility values of clinical examination with 2D and multislice TPUS were 0.98 and 0.93, respectively, with Cohen’s kappa of 0.92 (95% CI 0.81–1.00) and 0.79 (95% CI 0.58–0.99), respectively.Conclusion: Clinical examination is compatible with 2D/multislice TPUS for determining the degree of perineal tear after vaginal delivery.

scholarly journals Management of Obstetric Perineal Tears: Do Obstetrics and Gynaecology Residents Receive Adequate Training? Results of an Anonymous Survey

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
A. Cornet ◽  
O. Porta ◽  
L. Piñeiro ◽  
E. Ferriols ◽  
I. Gich ◽  
...  
Keyword(s):  
Pelvic Floor ◽  
Vaginal Delivery ◽  
Specific Area ◽  
Cross Sectional Study ◽  
Teaching Hospitals ◽  
Sectional Study ◽  
Cross Sectional ◽  
Perineal Tears ◽  
Obstetrics And Gynaecology ◽  
Training And Supervision

Background/Aim. To evaluate the obstetrics and gynaecology residents' perspective of their training and experience in the management of perineal tears that occur during assisted vaginal delivery. We hypothesised that residents would perceive room for improvement in their knowledge of pelvic floor anatomy and the training received in tears repair.Design. Descriptive cross-sectional study.Population/Setting. Seventy-two major residents from all teaching hospitals in Catalonia.Methods. A questionnaire was designed to evaluate experience, perception of the training and supervision provided.Results. The questionnaire was sent to all residents (), receiving 46 responses (64%). The participants represented 15 out of the 16 teaching hospitals included in the study (94% of the hospitals represented). Approximately, 52% of residents were in their third year while 48% were in their fourth. The majority of them thought that their knowledge of pelvic floor anatomy was poor (62%), although 98% felt confident that they would know when an episiotomy was correctly indicated. The survey found that they lacked experience in the repair of major degree tears (70% had repaired fewer than ten), and most did not carry out followup procedures.Conclusion. The majority of them indicated that more training in this specific area is necessary (98%).

scholarly journals Relationship between Perineal Body Length and Degree of Perineal Tears in Primigravidas Undergoing Vaginal Delivery with Episiotomy

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Suskhan Djusad ◽  
Yuditiya Purwosunu ◽  
Fadil Hidayat
Keyword(s):  
Multivariate Analysis ◽  
Vaginal Delivery ◽  
Body Length ◽  
Head Circumference ◽  
Power Calculation ◽  
Perineal Body ◽  
Fourth Degree ◽  
Perineal Tears ◽  
Good Ability ◽  
Significant Difference

Background. Perineal tears are one of the most common complications of vaginal delivery. Severe perineal tears can cause various morbidities. There are many factors that affect the occurrence of perineal tears. One of the major factors related to the occurrence of perineal tears is the length of the perineal body. However, until now, no research in Indonesia has concluded that the length of perineal body can predict the perineal tears. Objective. To find the relationship between perineal body length and perineal tears, so it can provide a reference on the use of perineal body length to predict severe perineal tears in vaginal delivery with episiotomy. Methods. This nested case-control study was conducted at RSUD Tangerang and RSUD Karawang in Indonesia from February to September 2017. A total of 126 primigravida patients participated in the study consecutively. The length of the perineal body was then measured and followed until the start of the second stage of labor. Afterwards, the perineal length and degree of perineal tears were assessed using unpaired T-test for bivariate analysis, multivariate analysis, and scoring test to predict the occurrence of third- and fourth-degree of perineal tears with power calculation (β) 80% and Zβ 0.842. Results. There was a significant difference in mean length of the perineal body between the group with first- and second-degree perineal tears and the group with third- and fourth-degree perineal tears ( p < 0.001 ). From the multivariate analysis, adjusted OR was 5.26 (95% CI 1.52–18.17). Score test was performed to predict the occurrence of third- and fourth-grade perineal tears. Perineal body length and head circumference could be used as predicting factors of perineal tears. Perineum length ≤ 3.0 cm and head circumference ≥ 33.5 cm posed a risk of perineal tears of third and fourth degrees (70.52%). Conclusion. The length of the perineal body has a good ability to predict the occurrence of perineal tears.

scholarly journals PERBEDAAN DISFUNGSI SEKSUAL PADA WANITA PASCA PERSALINAN PERVAGINAM EPISIOTOMI MEDIOLATERAL DAN SEKSIO CAESARIA

2019 ◽  
Vol 7 (2) ◽  
pp. 54
Author(s):  
Roni - Subrata ◽  
Retno Rahayu
Keyword(s):  
Sexual Dysfunction ◽  
Cesarean Section ◽  
Sexual Function ◽  
Vaginal Delivery ◽  
Female Sexual Dysfunction ◽  
Sampling Technique ◽  
Perineal Pain ◽  
Cross Sectional ◽  
Mediolateral Episiotomy ◽  
Incision Wound

Postpartum women will experience some changes related to the labor process experienced. Changes that occur are the presence of physical and psychological discomfort. These changes can affect the sexual needs of women and their partners. Causes of Postpartum Female Sexual Dysfunction are dyspareunia, perineal pain, incision wound discomfort including surgery, reduced libido, lack of lubrication in the vagina, changes in body image to negative and anorgasms associated with pain and trauma. The purpose of this study was to determine the differences in sexual dysfunction of women after vaginal delivery with a mediolateral episiotomy with cesarean section at Bangil Pasuruan Hospital. This research using a cross sectional method. The study subjects consisted of vaginal delivery women with mediolateral episiotomy and post cesarean section. Each group consists of 30 people. The sampling technique used was consecutive sampling. After three months postpartum, sexual function is assessed using an FSFI score (Femal Sexual Function Index. Data in the form of a questionnaire then tested by analysis of the T-test. The results of this study a difference between postpartum female sexual dysfunction and mediolateral episiotomy with cesarean section, seen from the desirability of 4,787> 1.67, stimulation 8.723> 1.67 lubrication namely 9,102>1.67 orgasm namely 7,381>1.67 satisfaction is 11,040> 1,67 and pain 9,981> 1,67.

scholarly journals PERINEAL TEARS

2018 ◽  
Vol 25 (10) ◽  
pp. 1532-1536
Author(s):  
Rashida Parveen ◽  
Quratulain Sadiq ◽  
Syeda Ali
Keyword(s):  
Vaginal Delivery ◽  
Study Design ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Perineal Tear ◽  
Cross Sectional ◽  
Perineal Tears ◽  
Second Degree

Objectives: To arbitrate the frequency and severity of perineal tears amongthe patients of Vaginal delivery. Study Design: A Cross-sectional study. Place and Durationof Study: Nishtar Hospital Multan from 29 December 2014 to 28 June 2015. Methodology:The study was conducted after obtaining the approval of ethical committee for collecting datafrom patients. The patients aged 20-40 years were included in the study, both multipara andprimipara. An examination was performed on the perineum, vulva, vagina, and cervix at thethird stage of labor in order to discover any tears or injuries. All the informations were collectedon per designed Performa. Collected data was entered and analyzed by using SPSS software.Results: The incidence of perineal tears was calculated to be 79.89%. The most commonlyobserved injury was the first-degree perineal tear. it accounted for 101(68.70%) cases. whilethe second-degree perineal tear was found to be 39(26.53%) cases. third and fourth degreeperineal tear remained the least in observed frequency as in 2.72% and 2.04% of casesrespectively. Conclusion: The observations of our study concluded that majority of patientsdelivered vaginally experienced perineal tear, among those first degree perineal tear was moreprevalent.

scholarly journals Association and Outcome of the Primary Repair of Obstetric Perineal Injuries

2010 ◽  
Vol 14 (3) ◽  
Author(s):  
Naseem Saba ◽  
Anwar Sultana ◽  
Mehnaz Afridi
Keyword(s):  
Key Words ◽  
Primary Repair ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Study Methods ◽  
Fourth Degree ◽  
Factors Associated ◽  
Mediolateral Episiotomy ◽  
Perineal Injuries

Objectives: To study the association and outcome of the primary repair obstetric perineal injures. Design:  Cross sectional study. Methods:  Patients presenting with third and fourth degree tears were included, factors associated with injures were studied. Primary repair was performed and outcome was looked after three months of repair. Results:  Sixty Four (64) patients were studied in 18 months 59% were having their first pregnancy. Instrumental deliveries an macrosomia are strong associations. Primary repair with end to end approximation was done which was successful. Conclusion:  Prevention is important Mediolateral episiotomy and skill of instrumental deliveries can minimize the risk of obstetrics perineal injures. Key Words:  erineal tears, feacal incontinence, instrumental deliveries, mediolateral episiotomy.

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