Incidence and risk factors of severe lacerations during forceps delivery in a single teaching hospital where simulation training is held annually

Sano, Yasuko; Hirai, Chihiro; Makino, Shintaro; Li, Xianglan; Takeda, Jun; Itakura, Atsuo; Takeda, Satoru

doi:10.1111/jog.13558

Cited by 7 publications

(3 citation statements)

References 27 publications

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“…In our study, younger nulliparous women (adolescents <twenty years old and 20-29 years old) were associated with all perineal tears that were identified in previous reports. The comparative elasticity of the perineum in women who are nulliparous decreases after one or more deliveries compared to multiparous women, which result in tearing of perineum and need an episiotomy [22][23] .…”

Section: Discussionmentioning

confidence: 99%

The Risk Factors and Incidence of Perineal Tears among Pregnant Women

Mubashir¹,

Bano²,

Naeem³

et al. 2022

PJMHS

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Aim: To determine the risk factors and prevalence of perineal tear in low-risk pregnant females. Study Design: A retrospective cross-sectional study. Place and Duration: In the Obstetrics and Gynecology department of Khawaja Muhammad Safdar Medical College, Allama Iqbal Memorial Teaching Hospital Sialkot for one-year duration from January 2020 to December 2020. Methods: The females with perineal tear after birth included in this study. A total of 400 females were selected for this study. Results are articulated as adjusted odds ratio (OR) and <0.05 of P value is considered significant. Results: 400 total females had singleton vaginal delivery and perineal tears were noticed in 140 females. The episiotomy frequency for the total of 1st and 2nd degree, and 3rd and 4th degree (OASI) were 16.3%, 25%, and 1.5%, correspondingly. The perineal tear risk-factors are young mothers (teenagers OR = 5.6, 21-25 years OR = 4.3), primiparous women (OR = 12.6), gestational age less than 32 weeks OR = 0.175), received antenatal care (OR = 0.42), correspondingly. Primiparous females were 12.4 times more probable to have an episiotomy (OR = 12.4, 95% CI, 1.48-104.8, p = 0.02). A birth weight between 2.5-3.0 kgs and less than 2.5 kg (OR = 0.012 and 0.084, respectively) protects against Obstetric Anal Sphincter Injury. Conclusions: The perineal injuries risk factors are comparable to those formerly described in other researches. There is an urgent need to train the gynae staff and doctors in proper selection for episiotomy and better perineal care in order to improve obstetric services in the Gynecology department. Identifying those at danger can decrease obstetric perineal injuries. Keywords: Low risk pregnancy, episiotomy, low-risk pregnancy and Obstetric Anal Sphincter Injury.

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Section: Discussionmentioning

confidence: 99%

The Risk Factors and Incidence of Perineal Tears among Pregnant Women

Mubashir¹,

Bano²,

Naeem³

et al. 2022

PJMHS

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“…It is thought that the rate of rotational abnormalities and arrest of labor increase with neuraxial labor analgesia [14,15]. Furthermore, a high fetal head station (+ 2~+ 3) and malrotation were reported to be risk factors for severe lacerations during instrumental delivery [16].…”

Section: Discussionmentioning

confidence: 99%

Comparison of the labor curves with and without combined spinal-epidural analgesia in nulliparous women- a retrospective study

Ando

Makino

Takeda

et al. 2020

BMC Pregnancy Childbirth

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Background: Neuraxial labor analgesia is known to increase the rate of instrumental delivery and prolong the second stage of labor; however, there is no standard method to evaluate the progress of labor under analgesia. Friedman curve is considered the gold standard for evaluating the progress of labor. However, it included not only neuraxial labor analgesia but also labor without analgesia. Thus we compared the labor curves of primiparous women undergoing labor with and without neuraxial labor analgesia, to understand the progress of labor in both groups and to arrive at a standard curve to monitor the progress of labor under neuraxial analgesia. Methods: Primiparous women with cephalic singleton pregnancies who delivered at term from 2016 to 2017 were included. Two hundred patients who opted for combined spinal-epidural (CSE) labor analgesia were included in the CSE group and 200 patients who did not undergo CSE were included in the non-CSE group. In all, 400 cases were examined retrospectively. The evaluation parameters were cervical dilation and fetal station, and we calculated the average value per hour to plot the labor curves. Results: The labor curve of the non-CSE group was significantly different from the Friedman curve. In the CSE group, the time from 4 cm dilation of the cervix to full dilation was 15 h; in addition, the speed of cervical dilation was different from that in the non-CSE group. The progress of labor in the CSE group was faster than that in the non-CSE group during the latent phase; however, the progress in the CSE group was slower than that in the non-CSE group during the active phase. Conclusions: Neuraxial labor analgesia results in early cervical dilation and descent of the fetal head; thus, appropriate advance planning to manage the delivery may be essential.

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“…Similarly, Sano et al published the incidence and risk factors of severe lacerations during forceps delivery at another tertiary university hospital. 2) While these two reports focused on deliveries at tertiary hospitals, no study has yet reported on forceps delivery at obstetrics clinics in Japan. One reason is that only a few facilities in Japan perform forceps delivery, with most only performing vacuum-assisted delivery.…”

Section: Dear Editormentioning

confidence: 99%