INFLUENCE OF OBSTETRIC GEL ON THE PROCESS AND DURATION OF LABOR

The article discusses the problems of weak labor, obstetric injuries, an increase in the number of surgical interventions. A study of the efficacy and safety of Dianatal obstetric gel when used in childbirth has been carried out.

Possibilities for predicting perineal birth injury

Hypothesis/aims of study. To date, intranatal injuries of the genital tract and their adverse effects on the womans body remain one of the most important issues in obstetrics and gynecology. Despite the improved management of childbirth, the frequency of the birth canal tissue injuries has no tendency to decrease and amounts to 10.239.0%. The aim of this study was to assess the possibility for predicting intranatal perineal injuries. Study design, materials and methods. The study included a prospective analysis of 90 cases of labor through the natural birth canal based on data obtained from Ufa and Chita perinatal centers in the years 20172019. To determine the elasticity of perineal tissues, a perineoelastomer has been developed, which allows expressing the elasticity of the vulvar ring tissues by a special conditional coefficient. Data was processed using the IBM SPSS Statistics V25.0 software package. Results. Based on the assessment of the obtained data, a probability coefficient of perineal injuries was developed. Its calculation is based on a nonlinear regression analysis and is expressed by the formula: T = (100 ∙ CFH) / (PAA ∙ FBD ∙ ∙ ), where CFH is the circumference of the fetal head at the level of visual tubercles (mm), PAA is the pubic arch angle (degrees), FBD is the distance from the front to the back of the adhesion of the vulvar ring (cm), is the coefficient of elastic deformation of the perineum. When the coefficient T is more than 1, perineal rupture in labor is predicted. Conclusion. In the development of obstetric injuries of the perineum, a major role is played by the ratio of the circumference of the fetal head and the maximum perimeter of the extension of a vulvar ring, which, together with the value of the pubic arch angle and the coefficient of elastic deformation of the perineum, may be a criterion in favor of performing surgical protection of the perineum in case of a threatening rupture.

MODERN GOING NEAR PROPHYLAXIS OF OBSTETRIC TRAUMATISM AND ITS CONSEQUENCES

The article provides up-to-date data on the frequency, risk factors and causes of obstetric injuries of the soft tissues of the birth canal. The directions of preventive measures regarding the prevention of both the injuries themselves and their immediate and delayed complications are presented. As a preventative measure, the advantages of two-stage rehabilitation of the birth canal with the help of the selective probiotic «Vagilak» are presented, which allows you to quickly eliminate the clinical signs of vaginal inflammation and prevents relapse of the process. As an aid to the prevention of obstetric injuries and the treatment of its consequences, the possibilities and advantages of “Vagilak” moisturizing gel and soap for intimate hygiene are presented. The article defines the profile of patients who show the use of these drugs before childbirth, in childbirth and in the postpartum period.

Surgical Management of Fecal Incontinence

Fecal incontinence is a common yet socially stigmatized condition that results from a complex interplay of various etiologies. In commonly seen scenarios, obstetric injuries can result in fecal incontinence after assisted or uncomplicated vaginal births and can become symptomatic years after delivery. Postpartum women may initially present to their obstetrician-gynecologist or urogynecologist with fecal incontinence symptoms and require appropriate evaluation, initial management, and possible referral to further specialists. This chapter outlines the surgical assessment, work-up, and management of fecal incontinence. This review contains 21 figures, 1 tables, and 97 references. Keywords: Fecal incontinence, postpartum complications, pudendal nerve neuropathy, anal sphincter injury, operative management, preoperative workup, sacral nerve stimulation, MRI defecography, endanal ultrasound

Management of obstetrics tears

<p>Objective: Aim of the study is to analyse the literature about the management of obstetric</p><p>tears, in order to optimize clinicians work and women perineal care after</p><p>spontanous delivery.</p><p>Methodology: Review of literature</p><p>Results: After a correct definition of obstetric injuries (1,2,3,4, degree), we describe main risk</p><p>factors (birth weight, nulliparity, induction of labour, epidural analgesia), the role of</p><p>episiotomy (midline or mediolateral one), the correct clinical conduction of labour in</p><p>the care of perineum and the principles and techniques (over lapping or end-to-end</p><p>techinques, for sphinterial repair) of obstetric suturing. We define also the correct</p><p>clinical management of severe obstetric injuries repair (suture as soon as possible to</p><p>reduce bleeding and risk of infection, check equipment and count swabs before</p><p>starting the procedures, good lighting, ask for more experienced assistance if in doubt</p><p>regarding the extent of trauma or structures involved, use general anesthesia, ensure</p><p>good anatomical alignment of the wound, rectal examination after completing the</p><p>repair of III-IV degrees) and the corret management in postnatal period (follow up in</p><p>prevision of other pregnancies).</p><p>Conclusions: Improving surgical skills of clinicians could preserve perineal dysfunction.</p>

The causes and implications of obstetric malpractice

<p>Obstetrics and Gynaecology (O &amp; G) are among the specialties at high risk of malpractice claims. In particular, obstetric malpractice attracts high incidence of claims as birth injuries are usually serious and devastating. The resulting disabilities and malformation from the injuries tend to be life-long and victims are deprived of years of enjoyment in life, independence and productivity. As these injuries occur on the victims early in life, the costs of medical care are usually enormous. As this imposes stressful and heavy burden on the family members, they tend to resort to litigation as means of procuring monetary compensation. The highest numbers of medical negligence cases in Malaysia involve obstetric injuries and six to seven-figure court awards are now becoming the trend for compensating obstetric malpractice victims. However, proving obstetric malpractice is not an easy task with years of litigation, which eventually may not provide victims with monetary compensation if unsuccessful. Further, the increase in obstetric litigation has triggered higher premium for medical indemnity insurance causing many doctors to leave the subspecialty. Even though the doctor at the end may not be found guilty but the trauma of being sued caused them to suffer difficulties in returning to their work.</p>