Prise en charge des périnées complets (déchirure périnéale stade 3 et 4) : revue de la littérature

Villot, Anne; Deffieux, X.; Demoulin, G.; Rivain, A L; Trichot, C.; Thubert, Thibault

doi:10.1016/j.jgyn.2015.06.005

Cited by 16 publications

(4 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The present study should be considered with limitations. The important increase in OASIS rate highlighted in the present study might be attributed not only to the increase of instrumental procedures but also to the new classification of perineal injury used 7 or to the new imaging methods, including endo-anal sonography, which identifies injuries that were previously occult. 25 A better identification of lesions in connection with better awareness and training of caregivers may also be a hypothesis that could explain the increased prevalence of OASIS.…”

Section: Discussionmentioning

confidence: 80%

“…Third‐degree rupture of the perineum is divided into three grades: 3a when the external anal sphincter is involved up to 50%; 3b when the external sphincter is involved over 50%; 3c corresponding to a complete injury of external and internal anal sphincters. Fourth‐degree tear represents an injury of both anal sphincter and rectum 7 . The prevalence of OASIS is estimated to be from 0.1% to 5% 8,9 .…”

Section: Introductionmentioning

confidence: 99%

“…Fourth-degree tear represents an injury of both anal sphincter and rectum. 7 The prevalence of OASIS is estimated to be from 0.1% to 5%. 8,9 In this context, the purpose of episiotomy is either to expedite delivery in the case of fetal distress by facilitating instrumental deliveries or managing shoulder dystocia, or to minimize the occurrence of OASIS.…”

mentioning

confidence: 99%

See 2 more Smart Citations

Is there still an indication for episiotomy? Results from a French national database analysis

Levaillant

Loury

Venara

et al. 2022

Intl J Gynecology & Obste

View full text Add to dashboard Cite

Objective To assess the link between mediolateral episiotomy and the occurrence of obstetrical anal sphincter injury (OASIS). Methods Data were collected from the national database (PMSI; Programme de Médicalisation des Systèmes d'Information). Women between 18 and 50 years old, undergoing a vaginal delivery in France in 2018 were included. The main outcome was factors associated with a higher adjusted OASIS rate after a vaginal delivery. Results Of 623 003 women with a vaginal delivery, 239 949 were primiparous (38.5%), 62 310 experienced mediolateral episiotomy (10.0%) and 7077 had a third‐ or fourth‐degree perineal tear (1.14%). Risk factors for OASIS were primiparity (adjusted odds ratio [OR] 2.97), shoulder dystocia (aOR 2.57), instrumental delivery (aOR 2.81), gestational diabetes (aOR 1.20), and post‐term delivery (aOR 1.53). Mediolateral episiotomy increased the occurrence of OASIS for women without an instrumental delivery, either for parous (OR 1.32, 95% confidence interval [CI] 1.07–1.62) or primiparous (OR 1.26, 95% CI 1.13–1.39) women. In contrast, episiotomy among primiparous women with episiotomy and a vacuum or forceps delivery significantly decreased the risk for OASIS (OR 0.62, 95% CI 0.56–0.67). Conclusions The practice of routine episiotomy should be discouraged. Selective mediolateral episiotomy should be considered with extreme caution and mainly for primiparous women during instrumental vaginal delivery. Further randomized trial may confirm such results.

show abstract

Section: Discussionmentioning

confidence: 80%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Is there still an indication for episiotomy? Results from a French national database analysis

Levaillant

Loury

Venara

et al. 2022

Intl J Gynecology & Obste

View full text Add to dashboard Cite

show abstract

“…It is very important to recognize the injury of birth canal. There are reports on many unrecognized perineal injuries, especially third degree perineal tear ( 3 , 8 , 40 , 41 ). Long-lasting repercussions can occur even in cases of first and second degree injuries.…”

Section: Discussionmentioning

confidence: 99%

Increased Oasis Incidence – Indicator of the Quality of Obstetric Care?

Košec

Djaković

Čukelj

et al. 2019

ACC

View full text Add to dashboard Cite

SUMMARYIn the era of new molecular, epigenetic and proteomic discoveries, birth canal injuries seem like outdated discussion. A vast increase in the incidence of obstetric anal sphincter injuries (OASIS) has been recorded in the last two decades despite advantages in modern medicine and new obstetric methods. This increase might be attributed to the new classification of perineal injury but also to the new imaging methods, including endoanal sonography, which earlier identifies injuries that previously were considered to be occult and actually underwent unrecognized, and which should have been recognized immediately postpartum. OASIS are third and fourth degree perineal injuries that occur during delivery. The reported incidence of OASIS varies from 0.1% to 10.9%. It is well known that third and fourth degree perineal injuries occur more often in primiparae, and in cases of macrosomic newborn, dorsoposterior position of fetal head and shoulder dystocia. The protective role of episiotomy is controversial. Birth canal injury during delivery can happen to any parturient woman. It is important for obstetricians to have this in mind at every delivery. Repercussions of OASIS are serious and can persist for life. They include emotional, psychological, social, physical and sexual disturbances. Therefore, it is very important to recognize the risk factors, diagnose the injury on time and treat it properly by a multidisciplinary team. Accordingly, it can be concluded that the increased incidence of OASIS is a result of better recognition of the risk factors, reduced rates of unrecognized sphincter injuries, adoption of the new classification and better postpartum imagining methods for detection of occult injuries.

show abstract

The frequency of maternal morbidity: A systematic review of systematic reviews

Gon

Leite

Calvert

et al. 2018

Int J Gynecol Obstet

View full text Add to dashboard Cite

BackgroundEstimates of the burden of maternal morbidity are patchy.ObjectiveTo conduct a systematic review of systematic reviews of maternal conditions to: (1) make available the most up‐to‐date frequency estimates; (2) identify which conditions do not have reliable estimates; and (3) scrutinize the quality of the available reviews.Search strategyWe searched Embase, MEDLINE, and CINAHL, combining terms for pregnancy, frequency (e.g. prevalence, incidence), publication type, and specific terms for each of 121 conditions.Selection criteriaWe included peer‐reviewed systematic reviews aiming to estimate the frequency of at least one of the conditions in WHO's list of maternal morbidities, with estimates from at least two countries.Data collection and analysisWe present the frequency estimates with their uncertainty bounds by condition, region, and pregnancy/postpartum period. We also assess and present information on the quality of the systematic reviews.Main resultsOut of 11 930 found, 48 reviews were selected and one more was added. From 49 reviews we extracted 34 direct and 60 indirect frequency estimates covering 35 conditions. No review was available for 71% of the conditions on the WHO list. The extracted estimates show substantial maternal morbidity, spanning the time before and beyond childbirth. There were several gaps in the quality of the reviews. Notably, one‐third of the estimates were based only on facility‐based studies.ConclusionsGood‐quality systematic reviews are needed for several conditions, as a research priority.

show abstract

Prise en charge des périnées complets (déchirure périnéale stade 3 et 4) : revue de la littérature

Cited by 16 publications

References 29 publications

Is there still an indication for episiotomy? Results from a French national database analysis

Is there still an indication for episiotomy? Results from a French national database analysis

Increased Oasis Incidence – Indicator of the Quality of Obstetric Care?

The frequency of maternal morbidity: A systematic review of systematic reviews

Contact Info

Product

Resources

About