Objective: To assess the classification, repair, and follow up of extensive obstetric perineal injuries in the Czech and Slovak Republics.
Methods: A survey conducted in 2009 using questionnaires distributed to obstetric departments regarding classification and management of obstetric perineal injuries.
Results: Although 15 centers in the Czech Republic and 2 in the Slovak Republic indicated use of a 4-degree classification system, none of these centers reported using the classification accepted by the Royal College of Obstetricians and Gynaecologists. Use of a 3-degree classification system in accordance with definitions in Czech textbooks was reported by 14 Czech and 3 Slovak maternity hospitals. There was significant heterogeneity in clinical practice regarding techniques to repair extensive obstetric perineal injuries, antibiotic prophylaxis, early postpartum care, and follow up.
Conclusions: There is great inconsistency in the classification and management of extensive obstetric perineal injuries. Uniform recommendations should be created and accepted, not only in the Czech and Slovak Republics, but worldwide.
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http://dx.doi.org/10.1016/j.ijgo.2010.03.035 | DOI Listing |
Geburtshilfe Frauenheilkd
January 2025
Department of Obstetrics and Gynaecology, Erlangen University Hospital, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany.
Introduction: Preconception obesity is a risk factor for pregnancy and delivery, which is why giving birth in a perinatal center (care levels I and II) is recommended. There are currently no studies which have investigated the birth outcomes of obese patients based on the care level of the maternity hospital. This study aims to assess the effect of a higher body mass index prior to conception on maternal and fetal outcomes in a maternity hospital (care level IV).
View Article and Find Full Text PDFBMC Public Health
January 2025
Department of Women's and Children's Health, Karolinska Institutet, Tomtebodavägen 18A, Stockholm, Solna, 171 77, Sweden.
Background: Globally, the quality of maternal and newborn care remains inadequate, as seen through indicators like perineal injuries and low Apgar scores. While midwifery practices have the potential to improve care quality and health outcomes, there is a lack of evidence on how midwife-led initiatives, particularly those aimed at improving the use of dynamic birth positions, intrapartum support, and perineal protection, affect these outcomes.
Objective: To explore how the use of dynamic birth positions, intrapartum support, and perineal protection impact the incidence of perineal injuries and the 5-min Apgar score within the context of a midwife-led quality improvement intervention.
Int J Gynaecol Obstet
December 2024
Third Medical Faculty, Charles University, Prague, Czech Republic.
This review describes our experience with native tissue repair of the visceral pelvic fascia, the perineum, and anal sphincters in women. We propose that complex repair of the pelvic floor should consider vaginal support in all three anatomical Delancey's levels, together with more caudal structures-the external and internal anal sphincters. Original illustrations were created to facilitate the understanding of the complex anatomy of common multi-level defects.
View Article and Find Full Text PDFAm J Obstet Gynecol
December 2024
Department of Medicine and Surgery, Obstetrics and Gynecology Unit, University of Parma, Parma, Italy. Electronic address:
Background: Occiput-posterior (OP) position is associated with labor arrest, need of operative delivery and failed instrumental vaginal delivery with resulting adverse peripartum outcomes. Vacuum extraction (VE) is the most commonly performed type of instrumental delivery worldwide. This study aimed to investigate the outcome of VE in fetuses with sonographically confirmed OP position prior to the procedure.
View Article and Find Full Text PDFInt J Surg Case Rep
December 2024
Department of Obstetrics and Gynecology, College of Medicine, King Khalid University, Saudi Arabia. Electronic address:
Introduction And Importance: Female circumcision, also known as female genital mutilation/cutting (FGM/C), is a common practice in many Arab countries, including Egypt. One potential complication of FGM/C is the development of a clitoral epidermal inclusion cyst, which occurs when keratinized epithelial cells and sebaceous glands become incorporated into the circumcision scar line in the clitoral or labial area. The objective of this study is to present a rare case of a large clitoral epidermal inclusion cyst following FGM/C and to review the current practice of FGM/C in the Arab world, including Egypt, Sudan, and Saudi Arabia.
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