Perineal injury sustained during childbirth is a major aetiological factor in the development of perineal pain, sexual dysfunction, prolapse and disturbance in bowel and bladder function. Preferential use of the vacuum extractor, restricting the use of episiotomy, repair of anal sphincter rupture by a trained doctor and selective caesarean section in these women can be beneficial in preventing ...

BACKGROUND: Evidence-based obstetric care is widely promoted in developing countries, but the success of implementation is not known. Using selected childbirth care procedures in four hospitals in Shanghai, we compared practice against evidence-based information, and explored user and provider views about each procedure. METHODS: Observational study. Using the Cochrane Library, we identified si...

This study evaluated the use of best practices (eating, movement, use of nonpharmacological methods for pain relief and partograph) and obstetric interventions in labor and delivery among low-risk women. Data from the hospital-based survey Birth in Brazil conducted between 2011 and 2012 was used. Best practices during labor occurred in less than 50% of women and prevalence of the use of these p...

OBJECTIVE To describe obstetric procedures (episiotomy, forceps, vacuum extraction, caesarean section) and maternal outcomes for patients who gave birth in an isolated, rural hospital. DESIGN A retrospective cohort study. STUDY POPULATION Women beyond 20 weeks' gestation who gave birth between Mar. 7, 1940, and June 9, 2001, inclusive, at the Bella Coola General Hospital (BCGH). MAIN OUTC...

AIM To assess whether the introduction of episiotomy scissors specially designed to achieve a cutting angle of 60°, EPISCISSORS-60(®), in two hospitals in the UK would result in a reduction in obstetric anal sphincter injuries (OASIS) in nulliparous women. METHODS A structured training program for all doctors and midwives provided a theoretical framework around OASIS including risk factors an...

OBJECTIVE To evaluate the association between median episiotomy and severe (third- and fourth-degree) perineal lacerations in primiparous women. DESIGN Retrospective cohort study. SETTING University-affiliated hospital providing secondary obstetric care in Quebec City. PATIENTS A total of 6522 primiparous women who gave birth vaginally to a single live baby in cephalic position between 19...

OBJECTIVE To determine modifiable risk factors and incidence of obstetric anal sphincter injury (OASIS) in primiparous women. STUDY DESIGN We performed a population-based retrospective cohort study, using data from the Danish Medical Birth Registry. The population consisted of primiparous women with a vaginal delivery in the time period 2000-2010. Univariable and multivariable logistic regres...