Obstetric Perineal Tears in Pregnant Adolescents and the Influencing Factors

Karaca, Suna Yıldırım; Adıyeke, Mehmet; İleri, Alper; Vural, Tayfun; Şenkaya, Ayşe Rabia; İleri, Hande; Özeren, Mehmet

doi:10.1016/j.jpag.2021.10.017

Cited by 5 publications

(5 citation statements)

References 33 publications

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“…The high prevalence of perineal tears in post-rape minors in our study should be noted. Suna Yıldırım in Turkey found a low rate of perineal tears among adolescents [30] while In Lubumbashi, a study [29] reported no statistically significant difference between adolescent girls and adults in the prevalence of soft tissue tears, with a rate of 10% among adolescent girls. In fact, another study conducted in France reported that the rate of vaginal tears was statistically higher in adolescents than in adults (14.7% vs. 3.9%).…”

Section: Discussionmentioning

confidence: 96%

Characteristics and Obstetrical Outcomes of Post-Rape Pregnancies among Adolescent Girls in Post Conflict Context in Eastern DR Congo

Madoli¹,

Ilunga-Mbaya²,

Maroyi³

et al. 2023

OJOG

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Introduction: In conflicts such as the Democratic Republic of the Congo, sexual violence is systematically perpetrated against children and adolescent girls. Unwanted pregnancy is one of the complications with a myriad of consequences for the victim, the newborn, and society. This study aims to draw up characteristics and obstetrical outcomes of post-rape pregnancies of victims under 18 years old treated at Panzi General Referral Hospital (PGRH) in Eastern DR Congo. Methods: A single-centre prospective descriptive study was conducted at PGRH over two years (June 2020 to June 2022). This study included 140 adolescent girls who became pregnant post sexual assault. They were followed from confirmation of pregnancy to delivery. Sociodemographic, psycho-affective and clinical parameters were recorded and analyzed using XLSTAT 2014 software. Results: 76.4% came from rural areas, with a median age of 16 [13][14][15][16][17]. Pregnancy was continued in 50.7% and terminated in 20%. The victims were casual acquaintances of the perpetrators in 33.6% and unknown in 26.4%. 57.9% attended regular antenatal consultations. 74.3% had an individual birth plan/preparation for labor, with the primary route of delivery being vaginal (69.3%). The frequency of caesarean sections was 30.7%. Some psychological symptoms were identified during labor in 52.9% like agitation (10.7%) and hypersensitivity (8.6%). Conclusion: Pregnancy post rape is a public health problem affecting adolescents between 13 and 17 years of age. These pregnancies require closer follow-up with multi-disciplinary shared care, including psychology, obstetrics, and community input, to improve mother and newborn antenatal, intrapartum, and postpartum outcomes. In addition, long-term psychological sequelae of these pregnancies can be mitigated through supportive care in this high-risk period.

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Section: Discussionmentioning

confidence: 96%

Characteristics and Obstetrical Outcomes of Post-Rape Pregnancies among Adolescent Girls in Post Conflict Context in Eastern DR Congo

Madoli¹,

Ilunga-Mbaya²,

Maroyi³

et al. 2023

OJOG

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“…Nulliparity, operative delivery, birthweight over 3500 g, labor induction, and lengthier second-stage labor are some of the risk factors for perineal laceration [ 52 , 57 ]. This aspect is also marked by conflict in the literature.…”

Section: Discussionmentioning

confidence: 99%

Mirroring Perinatal Outcomes in a Romanian Adolescent Cohort of Pregnant Women from 2015 to 2021

et al. 2023

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Although the rates of adolescent pregnancies appear to have dropped according to the World Health Organization (WHO), the decrease in the age of the first menarche and better nutrition seems to contribute to the otherwise high rate of adolescent pregnancy worldwide, despite the efforts of different organizations to improve upon this trend. We conducted a population-based retrospective cohort study from January 2015 to December 2021 using our hospitals’ database. We totaled 2.954 adolescent and 6.802 adult pregnancies. First, we compared younger adolescents’ outcomes with those of older adolescents, as well as with adolescents aged between 18 and 19 years old; secondly, we compared adolescent pregnancies with adult ones. We detected higher percentages of cephalo-pelvic disproportion (43.2%), cervical dystocia (20.7%), and twin pregnancy (2.7%) in underage adolescents compared with 32%, 14.1%, and 1% in older underage adolescents, respectively, and 15.3%, 3.1%, and 0.6% in older ones. As teens became older, the likelihood of malpresentations and previous C-sections rose, whereas the likelihood of vaginal lacerations declined. When comparing adolescents with adult women, we found more cases that required episiotomy (48.1% compared with 34.6%), instrumental delivery (2.1% compared with 1%), and cervical laceration (10.7% compared with 8.4%) in the adolescent group, but the rates of malpresentation (11.4% compared with 13.5%), previous C-section (13.9% compared with 17.7%), and placenta and vasa praevia (4.5.6% compared with 14%) were higher in the adult women group. Adolescent pregnancy is prone to being associated with higher risks and complications and continues to represent a challenge for our medical system.

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“…Another relevant aspect in the results of the study is the relationship that may exist between the decrease in thickness of the pubovisceral muscle and the performance of labor induction. In fact, labour induction has been studied as one of the important risk factors for pelvic floor tears [ 45 , 46 , 47 , 48 ]. In our study, patients who had a thickness of the pubovisceral fasciculus less than the average, have a higher probability of labour induction (OR = 3.34; CI 95% 0.94–11.85; p = 0.06).…”

Section: Discussionmentioning

confidence: 99%

3D Ultrasound in Pelvic Floor: Is It Useful as a Prognostic Tool in Type of Labor Development and Subsequent Pelvic Floor Diseases?

Barca

Bravo

Tizón

et al. 2022

IJERPH

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The objective of our study is to determine the thickness of the pubovisceral fasciculus of the levator ani muscle and the area of the genital hiatus by means of three-dimensional perineal ultrasound, in pregnant women in the 2nd trimester, and to analyze the related maternal, perinatal and postpartum clinical variables. Furthermore, to compare the results of our study with two similar series previously published. An observational, prospective study of pelvic floor ultrasound was carried out, performed at week 20, whose delivery was attended in the obstetrics service of the Hospital General Universitario Gregorio Marañón de Madrid (HGUGM), during the period of August from 2021 to June 2022. Maternal, ultrasound, perinatal and postpartum clinical variables were collected from each participant. During the study period, a total of 54 patients were included in it. The mean gestational age at which the ultrasound was performed was 19.81 ± 0.91 weeks. In relation to the ultrasound variables, the mean thickness of the pubovisceral muscle was 0.87 ± 0.13 cm (95% CI, 0.64–1.38 cm), while, in the plane of minimum dimension of the genital hiatus, the hiatal area at rest was 13.41 ± 3.22 (95% CI, 4.60–18.78) cm2. There is a significant correlation between the age of pregnant women (over 35 years of age) and the increase in the area of the genital hiatus (r = 0.295, p = 0.031). 3D ultrasound of the pelvic floor performed at week 20 of gestation can to be an effective, non-invasive, reproducible and cheap tool in the prognosis of the development of labor and of possible subsequent perineal dysfunctions.

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Obstetric Perineal Tears in Pregnant Adolescents and the Influencing Factors

Cited by 5 publications

References 33 publications

Characteristics and Obstetrical Outcomes of Post-Rape Pregnancies among Adolescent Girls in Post Conflict Context in Eastern DR Congo

Characteristics and Obstetrical Outcomes of Post-Rape Pregnancies among Adolescent Girls in Post Conflict Context in Eastern DR Congo

Mirroring Perinatal Outcomes in a Romanian Adolescent Cohort of Pregnant Women from 2015 to 2021

3D Ultrasound in Pelvic Floor: Is It Useful as a Prognostic Tool in Type of Labor Development and Subsequent Pelvic Floor Diseases?

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