The effect of maneuvers for shoulder delivery on perineal trauma: a randomized controlled trial

Aabakke, Anna J M; Willer, H.; Krebs, Lone

doi:10.1111/aogs.12914

Cited by 9 publications

(6 citation statements)

References 13 publications

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“…Because we performed almost all of our episiotomies on the right side, 29 % of lacerations in compartment C5 are due to those. The remaining 44 % of lacerations in C5 are mainly due to spontaneous perineal tears, which lies in the lower range of other studies [1,3,[5][6][7][8][9]22]. Furthermore, we had a rate of 1.4 % (2 cases) of third-or fourth-degree perineal tears, which is in accordance with or even less than the range in the studies mentioned above.…”

Section: Frequency and Distribution Of Birth Lacerationssupporting

confidence: 88%

“…In the literature, tears of any kind are described in 48.3-91.5 % of vaginal deliveries [1,[3][4][5][6][7][8][9][10]. Most of the studies mention solely perineal tears and fail to report other birth lacerations, such as vaginal, paraclitoral, paraurethral, and labial tears.…”

Section: Frequency and Distribution Of Birth Lacerationsmentioning

confidence: 99%

“…Millions of deliveries take place every year. Vaginal deliveries are accompanied by various types of birth lacerations in 48.3-91.5 % of cases, among them trauma to the perineum, the cervix, the vagina, and the vulva including labial, periclitoral, and periurethral lacerations [1][2][3][4][5][6][7][8][9][10]. Different maternal, fetal, and obstetric factors are associated with the occurrence of genital tract trauma, for example advanced maternal age, nulliparity, diabetes, obesity, fetal macrosomia, a prolonged second stage of labor, assisted vaginal deliveries, maternal birth position, and technique of perineal protection [1].…”

Section: Introductionmentioning

confidence: 99%

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Birth Lacerations in Different Genital Compartments and their Effect on Maternal Subjective Outcome: A Prospective Observational Study

Kimmich¹,

Grauwiler²,

Richter³

et al. 2019

Z Geburtshilfe Neonatol

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Introduction Lacerations are common in vaginal births, but little is known about tears other than perineal tears and their association with maternal impairment. This study aimed to evaluate the frequency and distribution of birth lacerations and their association with maternal discomfort. Methods From 2/2015 to 12/2016, we conducted a prospective observational study on 140 women with singletons in vertex presentation at term, who gave birth vaginally in our center and were affected by a laceration. The lacerations were assigned objectively and subjectively to eight genital tract compartments. The presence and effect of lacerations on maternal health were assessed by questionnaires for the time before birth (T1), 1–4 days (T2), and 6–8 weeks postpartum (T3). Results The number of affected compartments was 1.33 objectively and 2.99 at T2 and 1.27 at T3 subjectively. The most affected compartment was the right perineum (73%) followed by the right inner posterior (21%) and the right outer anterior (14%) compartment. Subjective and objective assessment concurred in 83% at T2 and 69% of cases at T3. Overall, impairment of women was low, reversible, and not directly associated with the location of lacerations, although women were psychologically affected. Conclusion Birth lacerations predominantly appear at the right perineum. Physical impairment from these lacerations is generally low, reversible, and not directly associated with the location of lacerations, although psychological impairment is not negligible.

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Section: Frequency and Distribution Of Birth Lacerationssupporting

confidence: 88%

Section: Frequency and Distribution Of Birth Lacerationsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Birth Lacerations in Different Genital Compartments and their Effect on Maternal Subjective Outcome: A Prospective Observational Study

Kimmich¹,

Grauwiler²,

Richter³

et al. 2019

Z Geburtshilfe Neonatol

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“…Vaginal births are accompanied by genital tears in 50-91.5% of cases, such as trauma on the perineum, the cervix, the vagina, and the vulva (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11). Some risk factors for such trauma are known, for example advanced maternal age, nulliparity, diabetes, adipositas, fetal macrosomia, a prolonged second stage of labor, operative-assisted vaginal births, maternal birth position, fetal occipito-posterior position and technique of perineal protection (1).…”

Section: Introductionmentioning

confidence: 99%

How do sustained birth tears after vaginal birth affect birth tear patterns in a subsequent birth?

Kimmich

Te-ying

Zimmermann

et al. 2020

Journal of Perinatal Medicine

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BackgroundTears are common after vaginal birth, and different impact factors are known. However, the impact of tears from a previous birth to the tears of a subsequent birth is unknown. Therefore, we aimed to evaluate the distribution of birth tear patterns according to the sustained tears in a previous birth, in addition to other impact factors.MethodsIn a retrospective cohort study, we evaluated all women up to parity 4 with subsequent vaginal, singleton births of vertex presentation at ≥37 + 0 gestational weeks between 1/2005 and 12/2016. Their tears were grouped into tear patterns and were analyzed by parity. Tear patterns in the subsequent births were analyzed in association to the patterns of the previous births and impact factors were evaluated.ResultsWe counted 4017 births in 1855 women [P1: 1368 (34.1%), P2: 1730 (43.1%), P3: 741 (18.4%), P4: 178 (4.4%)]. The frequency of tears and episiotomies decreased with higher parity, whereas the frequency of intact perineum increased. Twenty-eight different unique tear patterns were found. We could show that birth tear patterns changed with increasing parity and were associated with sustained tears in a previous birth. In addition, some impact factors on tear patterns could be identified.ConclusionThe distribution of the single tear types is in accordance with the current literature. However, it is new that distinct tear patterns are associated to sustained tear patterns of previous births. Furthermore, we demonstrated some weak associations of tear patterns to certain impact factors, such as more episiotomies, low-grade perineal or vaginal tears isolated or in combination with other tears with increasing fetal weight and head circumference in the higher parities, and with a longer duration of the second stage and the pushing phase in lower parities.

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“…Vaginale Geburten werden in 50-91,5 % der Fälle von irgendeiner Form der Geburtsverletzung begleitet, wie z. B. Verletzungen des Dammes, der Zervix, der Vagina, der Vulva inklusive der Labien sowie paraklitorale und paraurethrale Verletzungen [1][2][3][4][5][6][7][8][9]. Verschiedene maternale, fetale und geburtshilfliche Faktoren sind mit dem Auftreten genitaler Verletzungen während einer Geburt vergesellschaftet, z.…”

Section: Introductionunclassified

Assoziation zwischen Geburtsverletzungen und der Einführung geburtshilflicher Observationsmaßnahmen: eine retrospektive Kohortenstudie

Birri¹,

Kreft²,

Zimmermann³

et al. 2018

Z Geburtshilfe Neonatol

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The overall incidence of birth lacerations is high, with lacerations predominantly appearing as first- and second-degree perineal tears but also vaginal and labial lacerations. The initiation of different obstetrical monitoring tools is associated with a change in the incidence of birth traumas and a shift from an external to an internal distribution, probably due to more careful management by the obstetrical staff. The implementation of such tools might help to improve obstetrical management and laboring women might benefit. However, it is important to realize the effect of monitoring and observation itself on the course of observational studies.

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The effect of maneuvers for shoulder delivery on perineal trauma: a randomized controlled trial

Abstract: There was no difference in the degree of perineal trauma after primary delivery of either the anterior or posterior shoulder. Consequently both maneuvers for shoulder delivery can be used at vaginal delivery, but further trials are warranted before certain methods can be recommended.

Cited by 9 publications

References 13 publications

Birth Lacerations in Different Genital Compartments and their Effect on Maternal Subjective Outcome: A Prospective Observational Study

Birth Lacerations in Different Genital Compartments and their Effect on Maternal Subjective Outcome: A Prospective Observational Study

How do sustained birth tears after vaginal birth affect birth tear patterns in a subsequent birth?

Assoziation zwischen Geburtsverletzungen und der Einführung geburtshilflicher Observationsmaßnahmen: eine retrospektive Kohortenstudie

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