-
Pediatrics and Neonatology Mar 2022
Topics: Anal Canal; Humans; Infant, Newborn; Infant, Newborn, Diseases; Perineum
PubMed: 34674971
DOI: 10.1016/j.pedneo.2021.09.002 -
Ultrasound in Obstetrics & Gynecology :... Mar 2022
Topics: Female; Humans; Lipoma; Perineum; Pregnancy; Prenatal Diagnosis
PubMed: 34254705
DOI: 10.1002/uog.23735 -
The Journal of Maternal-fetal &... Jan 2022To investigate the effect of unique skill of perineum protection in forceps delivery on the maternal and neonatal morbidity.
OBJECTIVE
To investigate the effect of unique skill of perineum protection in forceps delivery on the maternal and neonatal morbidity.
METHODS
A case-control study was conducted. Singleton pregnancies with forceps-assisted and normal vaginal deliveries were recruited. The maternal and neonatal complications were compared between forceps and normal deliveries.
RESULTS
Five hundred forty participants were included. The prevalence of maternal anal sphincter injury, postpartum hemorrhage, vaginal hematoma, cervical laceration, perineal wound infection, perineal wound dehiscence, dyspareunia, urinary incontinence, and anal incontinence were not significantly different between forceps and normal deliveries ( > .05). However, the rate of neonatal facial injury was higher in the forceps group (2.9% versus 0, = .004).
CONCLUSIONS
Cooperation according to the tension of perineum and labor process between obstetrician and midwife is important for perineum protection. Forceps-assisted delivery concentrating on perineum protection is an effective alternative in decreasing maternal morbidity.
Topics: Case-Control Studies; Delivery, Obstetric; Female; Humans; Infant, Newborn; Lacerations; Obstetrical Forceps; Perineum; Pregnancy; Retrospective Studies
PubMed: 31928263
DOI: 10.1080/14767058.2020.1712699 -
Revista Brasileira de Ginecologia E... Jun 2016Introduction Episiotomy is a controversial procedure, especially because the discussion that surrounds it has gone beyond the field of scientific debate, being adopted... (Review)
Review
Introduction Episiotomy is a controversial procedure, especially because the discussion that surrounds it has gone beyond the field of scientific debate, being adopted as an indicator of the "humanization of childbirth". The scientific literature indicates that episiotomy should not be performed routinely, but selectively. Objectives To review the literature in order to assess whether the implementation of selective episiotomy protects against severe perineal lacerations, the indications for the procedure, and the best technique to perform it. Methods A literature search was performed in PubMed using the terms episiotomy or perineal lacerations, and the filter clinical trial. The articles concerning the risk of severe perineal lacerations with or without episiotomy, perineal protection, or episiotomy techniques were selected. Results A total of 141 articles were identified, and 24 of them were included in the review. Out of the 13 studies that evaluated the risk of severe lacerations with and without episiotomy, 5 demonstrated a protective role of selective episiotomy, and 4 showed no significant differences between the groups. Three small studies confirmed the finding that episiotomy should be performed selectively and not routinely, and one study showed that midline episiotomy increased the risk of severe lacerations. The most cited indications were primiparity, fetal weight greater than 4 kg, prolonged second stage, operative delivery, and shoulder dystocia. As for the surgical technique, episiotomies performed with wider angles (> 40°) and earlier in the second stage (before "crowning ") appeared to be more protective. Conclusions Selective episiotomy decreases the risk of severe lacerations when compared with the non-performance or the performance of routine episiotomy. The use of a proper surgical technique is fundamental to obtain better results, especially in relation to the angle of incision, the distance from the vaginal introitus, and the correct timing for performing the procedure. Not performing the episiotomy when indicated or not applying the correct technique may increase the risk of severe perineal lacerations.
Topics: Episiotomy; Female; Humans; Injury Severity Score; Lacerations; Perineum; Pregnancy
PubMed: 27399925
DOI: 10.1055/s-0036-1584942 -
The Journal of Maternal-fetal &... Jul 2021To evaluate the relevance of the angle of progression (AOP) and head-perineum distance (HPD) for predicting the type of delivery and duration of the second stage of...
OBJECTIVE
To evaluate the relevance of the angle of progression (AOP) and head-perineum distance (HPD) for predicting the type of delivery and duration of the second stage of labor using intrapartum ultrasonography.
METHODS
In total, 221 women in labor with a single gestational sac at ≥37 weeks of gestation and fetuses in cephalic presentation underwent two-dimensional ultrasonography by transperineal route for measurements of AOP and HPD. Correlations between the type of delivery (vaginal or surgical (cesarean section and forceps)), duration of the second stage of labor, and fetal and maternal characteristics were assessed. AOP and HPD variables were separately studied in the first and second stages of labor. Multivariate logistic regression was followed in stages to identify the predictors for the surgical delivery outcome - stepwise forward method.
RESULTS
In total, 153 (69.2%) women underwent vaginal deliveries, 7 (3.2%) underwent forceps deliveries, and 61 (27.6%) underwent cesarean deliveries. AOP was a statistically significant parameter in first and second stages of labor (107.8 ± 12.1° versus 100.8 ± 13.7°; = .017), with an inverse correlation with the occurrence of vaginal delivery. HPD was a statistically significant parameter in the second stage of labor (3.42 ± 0.84 cm versus 4.17 ± 0.54 cm; < .003), with a direct correlation with the occurrence of surgical delivery. The value of AOP that optimized the curve was 129.9° with 85% specificity and 63% sensitivity for the vaginal delivery endpoint. The value of HPD that optimized the curve was 4.3 cm with 69% specificity and 89% sensitivity for the surgical delivery endpoint. In the first phase, the variables defining the type of delivery were the following: height, body mass index, and AOP. In the second phase, the variables defining were the following: height, labor analgesia, HPD, and position of the fetal occiput.
CONCLUSION
AOP and HPD determined by intrapartum ultrasonography were associated with duration of labor, which may aid in predicting the type of delivery in association with clinical parameters.
Topics: Cesarean Section; Delivery, Obstetric; Female; Humans; Labor Presentation; Perineum; Pregnancy; Prospective Studies; Ultrasonography; Ultrasonography, Prenatal
PubMed: 31505974
DOI: 10.1080/14767058.2019.1666818 -
Can pelvic floor muscle training prevent perineal laceration? A systematic review and meta-analysis.International Journal of Gynaecology... May 2022Pelvic floor muscle training (PFMT) is reportedly able to reduce risk factors for perineal trauma. However, the effects of these exercises on perineal injuries are... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Pelvic floor muscle training (PFMT) is reportedly able to reduce risk factors for perineal trauma. However, the effects of these exercises on perineal injuries are unclear.
OBJECTIVE
To investigate the effectiveness of PFMT in the prevention of perineal laceration.
SEARCH STRATEGY
Searches were conducted in PubMed/Medline, LILACS, Scopus, Cochrane Library, Web of Science, and CINAHL. For search strategies, we combined the terms PFMT, tear, laceration, perineum, and delivery.
SELECTION CRITERIA
We included randomized controlled trials that evaluated the effectiveness of PFMT for the prevention of perineal laceration during vaginal delivery. There were no period or language limitations.
DATA COLLECTION AND ANALYSIS
We conducted data extraction and synthesis. We performed a quality appraisal, a qualitative synthesis, and for meta-analysis we used the Software R.
MAIN RESULTS
Nine studies were included. In most studies, PFMT was performed daily, with a wide range of the number of contractions and sustainability. Prevalence of perineal laceration had a wide range and information on laceration degree was limited. Meta-analysis showed that PFMT was not effective to prevent perineal laceration.
CONCLUSION
Pelvic floor muscle training does not prevent perineal laceration. Further studies are needed to investigate different protocols and interventions.
Topics: Delivery, Obstetric; Exercise Therapy; Female; Humans; Lacerations; Pelvic Floor; Perineum; Pregnancy
PubMed: 34270799
DOI: 10.1002/ijgo.13826 -
Journal of Pediatric Hematology/oncology Jul 2021
Topics: Biopsy; Female; Humans; Infant; Perineum; Rhabdomyosarcoma, Embryonal; Subcutaneous Tissue
PubMed: 34001786
DOI: 10.1097/MPH.0000000000002194 -
BMJ Case Reports Apr 2017A 45-year-old woman with a history of total hysterectomy with adnexal preservation for uterine leiomyomas presented to our hospital with a right gluteal palpable mass,...
A 45-year-old woman with a history of total hysterectomy with adnexal preservation for uterine leiomyomas presented to our hospital with a right gluteal palpable mass, which she first noticed 6 months before and had progressively enlarged since then.Radiological studies revealed a 14 cm lesion with translevator growth that displaced rather than invaded adjacent structures, with a peculiar whorled pattern on T2-weighted MRI, which enhanced following gadolinium administration. CT-guided biopsy was performed, and in conjunction with imaging features the diagnosis of an aggressive angiomyxoma was assumed and confirmed following surgical excision.
Topics: Biopsy; Female; Humans; Magnetic Resonance Angiography; Middle Aged; Myxoma; Perineum; Tomography, X-Ray Computed; Treatment Outcome
PubMed: 28400400
DOI: 10.1136/bcr-2016-217705 -
JPMA. the Journal of the Pakistan... Jul 2020Aggressive Angiomyxoma (AA) is a soft tissue tumour that principally affects women of the reproductive age, primarily involving the pelvis and the perineum. Despite...
Aggressive Angiomyxoma (AA) is a soft tissue tumour that principally affects women of the reproductive age, primarily involving the pelvis and the perineum. Despite being slow growing, it is classified as aggressive due to its locally infiltrative nature and high recurrence. It is rare, often asymptomatic and is misdiagnosed. However, it has characteristic features on radiographic imaging. Complete surgical resection is the ideal approach to treat AA. We report a case of an aggressive angiomyxoma in a 17 year old female, located in the ischiorectal fossa and diagnosed incidentally on a magnetic resonance imaging (MRI). The lesion was excised without complication.
Topics: Adolescent; Female; Humans; Magnetic Resonance Imaging; Myxoma; Neoplasm Recurrence, Local; Perineum; Rectum
PubMed: 32799303
DOI: 10.5455/JPMA.30242 -
Tidsskrift For Den Norske Laegeforening... Oct 2021Surgical procedures in the perineum can cause major soft-tissue defects that require reconstruction with plastic surgery. In this article we present plastic surgery...
Surgical procedures in the perineum can cause major soft-tissue defects that require reconstruction with plastic surgery. In this article we present plastic surgery principles for the reconstruction of wound defects and common methods used to reconstruct wound defects in the perineum.
Topics: Humans; Perineum; Plastic Surgery Procedures; Surgery, Plastic
PubMed: 34726052
DOI: 10.4045/tidsskr.21.0161