Obesity May Be Protective against Severe Perineal Lacerations

Garretto, Diana; Lin, Brian B.; Syn, Helen L.; Judge, Nancy E.; Beckerman, Karen; Atallah, Fouad; Friedman, Arnold J.; Brodman, Michael; Bernstein, Peter S.

doi:10.1155/2016/9376592

Cited by 26 publications

(26 citation statements)

References 16 publications

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“…Nevertheless, obese patients have a higher risk of conceiving macrosomic newborns, a well-known risk factor for OASIS [ 30 ]. Two studies on large populations also showed that obesity was protective against OASIS [ 31 , 32 ]. This could be explained by the fact that obese patients have a larger anus-to-vulva distance because of their fat tissue.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Suzor forceps training by studying obstetric anal sphincter injuries: a retrospective study

Mazeau

Boukeffa

Boileau

et al. 2020

BMC Pregnancy Childbirth

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Background Instrumental deliveries are an unavoidable part of obstetric practice. Dedicated training is needed for each instrument. To identify when a trainee resident can be entrusted with instrumental deliveries by Suzor forceps by studying obstetric anal sphincter injuries. Methods A French retrospective observational study of obstetric anal sphincter injuries due to Suzor forceps deliveries performed by trainee residents was conducted from November 2008 to November 2016 at Limoges University Hospital. Perineal lesion risk factors were studied. Sequential use of a vacuum extractor and then forceps was also analyzed. Results Twenty-one residents performed 1530 instrumental deliveries, which included 1164 (76.1%) using forceps and 89 (5.8%) with sequential use of a vacuum extractor and then forceps. Third and fourth degree perineal tears were diagnosed in 82 patients (6.5%). Residents caused fewer obstetric anal sphincter injuries after 23.82 (+/− 0.8) deliveries by forceps (p = 0.0041), or after 2.36 (+/− 0.7) semesters of obstetrical experience (p = 0.0007). No obese patient (body mass index> 30) presented obstetric anal sphincter injuries (p = 0.0013). There were significantly fewer obstetric anal sphincter injuries after performance of episiotomy (p < 0.0001), and more lesions in the case of the occipito-sacral position (p = 0.028). Analysis of sequential instrumentation did not find any additional associated risk. Conclusion Training in the use of Suzor forceps requires extended mentoring in order to reduce obstetric anal sphincter injuries. A stable level of competence was found after the execution of at least 24 forceps deliveries or after 3 semesters (18 months) of obstetrical experience.

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Section: Discussionmentioning

confidence: 99%

Evaluation of Suzor forceps training by studying obstetric anal sphincter injuries: a retrospective study

Mazeau

Boukeffa

Boileau

et al. 2020

BMC Pregnancy Childbirth

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“…23 Obesity may be protective against third-and fourth-degree perineal lacerations, independent of parity, race, birth weight and mode of delivery. 24 In the current study, the obese cohort had a significantly lower episiotomy rate, with a non-significant increase in 3 In the current study, only one obese woman with a history of previous LSCS deliveries suffered a wound haematoma and none of the women experienced deep vein thrombosis. Such reduced morbidity rates may be due to the fact that the study was conducted in a tertiary care centre with strict intrapartum monitoring protocols and a greater availability of senior obstetricians.…”

Section: Discussionmentioning

confidence: 46%

Implications of Early Pregnancy Obesity on Maternal, Fetal and Neonatal Health: Retrospective cohort study from Oman

Zutshi

Santhosh

Sheikh

et al. 2018

Sultan Qaboos Univ Med J

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abstract:Objectives: This study aimed to determine the prevalence of early pregnancy obesity among Omani women and to review maternal antenatal complications, intrapartum and postpartum events and neonatal complications among such women in comparison to women of normal weight. Methods: This retrospective cohort study included 2,652 pregnant Omani women who delivered at the Royal Hospital, Muscat, Oman, between November 2011 and April 2012. The patients' electronic medical records were reviewed for antenatal, intrapartum and postpartum data. Body mass index was measured during the first trimester (≤12 gestational weeks) and classified according to the World Health Organization categories. Maternal and neonatal complications were compared between obese women and those of normal weight. Obstetric outcomes in uncomplicated pregnancies were also compared. Results: In the study cohort, there were 901 (34%) obese women and 912 (34.4%) women of normal weight; of these, 440 (48.8%) and 672 (73.7%) had uncomplicated pregnancies, respectively. Obese women had a significantly increased incidence of gestational diabetes (relative risk [RR]: 2.23; 95% confidence interval [CI]: 1.70-2.92; P <0.01), gestational hypertension (RR: 3.04; 95% CI: 1.63-5.65; P <0.01), Caesarean delivery (RR: 1.48; 95% CI: 1.08-2.03; P <0.01), postpartum haemorrhage (RR: 2.10; 95% CI: 1.11-4.10; P = 0.01) and fetal macrosomia (RR: 2.71; 95% CI: 1.21-6.09; P <0.01). Conclusion: Approximately one-third of the studied Omani women were obese. These women had a significantly increased risk of various maternal antenatal complications, intrapartum and postpartum events and neonatal complications. Keywords

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“…From previous research result also found out that woman with obesity (BMI ≥ 30 kg/m 2 ) has perineum laceration degree 3 and 4 (OR = 0.75; 95% CI 0.58-0.98). Small sample size also consider affecting the result and the subjects were not selected randomly, thus the result can be biased and can't be generalized for other population (Araújo and Oliveira, 2008, Fahami et al, 2012, Albers et al, 2005, Garretto et al, 2016…”

Section: Resultsmentioning

confidence: 99%

Effectiveness of Virgin Coconut Oil and Virgin Olive Oil on Perineal Laceration

Asiyah¹,

Risnawati²,

Khoirunnisa³

2018

Kemas

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Perineal massage is one of the way to reduce maternal morbidity and reduce the risk of bleeding caused by laceration of the perineum. Not only Virgin Olive Oil, but also Virgin Coconut Oil becomes the alternative thing that easily absorbed by the skin. This study aims to examine the effect of Virgin Coconut Oil and Virgin Olive Oil on perineal massage on the degree of perineal laceration. This research was Quasi experimental designs, with the subjects were pregnant women with gestational age ≥34-35 weeks. The data used the Mann-Whitney test and tested 2 proportions to assess the effectiveness of the essential oils used. The result showed that there was influence of perineal massage with perineal laceration (p <0,05). Therefore, there is influence of VCO and VOO on perineal massage against the perineal laceration event. Further research is needed to assess the determinants of perineal laceration with different variables or interventions.

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Obesity May Be Protective against Severe Perineal Lacerations

Cited by 26 publications

References 16 publications

Evaluation of Suzor forceps training by studying obstetric anal sphincter injuries: a retrospective study

Evaluation of Suzor forceps training by studying obstetric anal sphincter injuries: a retrospective study

Implications of Early Pregnancy Obesity on Maternal, Fetal and Neonatal Health: Retrospective cohort study from Oman

Effectiveness of Virgin Coconut Oil and Virgin Olive Oil on Perineal Laceration

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