Escolha sua fonte:
 Arimo
 Merriweather
 Mukta Malar
 Open Sans Condensed
 Rokkitt
 Source Sans Pro
 Login


 Português 
 Français 
 English 

[Valid RSS] RSS
bar

Banco de dados - Alliance francophone pour l'accouchement respecté (AFAR)

Descrição deste banco de dados documental (Site da AFAR)
Atualmente 3046 fichas
Canal do YouTube (tutorial)

https://afar.info/id=56

Criado em : 23 Sep 2003
Alterado em : 02 Dec 2007

 Modificar esta ficha
Siga este link somente se você tiver um palavra chave de editor!


Compartilhar: Facebook logo   Tweeter logo   Difícil

Nota bibliográfica (sem autor) :

Risk factors for perineal injury during delivery. American Journal of Obstetrics & Gynecology 2003 Jul,189(1):255-60

Autores :

Christianson LM, Bovbjerg VE, McDavitt EC, Hullfish KL

Ano de publicação :

2003

URL(s) :

http://www2.us.elsevierhealth.com/scripts/om.dll/s…

Résumé (français)  :

Abstract (English)  :

OBJECTIVE: We sought to identify risk factors for anal sphincter injury during vaginal delivery.

STUDY DESIGN: This was a retrospective, case-control study. We reviewed 2078 records of vaginal deliveries within a 2-year period from May 1, 1999, through April 30, 2001. Cases (n = 91) during the study period were defined as parturients who had documentation of greater than a second-degree perineal injury. Control subjects (n = 176), who were identified with the use of a blinded protocol, included women who were delivered vaginally with less than or equal to a second-degree perineal injury. For each patient, we reviewed medical and obstetrics records for the following characteristics: maternal age, race, weight, gestational age, parity, tobacco use, duration of first and second stages of labor, use of oxytocin, use of forceps or vacuum, infant birth weight, epidural use, and episiotomy use.

RESULTS: Of the 2078 deliveries that were reviewed, we discovered 91 cases (4.4%) of documented anal sphincter injury. The mean maternal age of our sample was 24.9 +/- 5.9 years). Nearly two thirds (63.2%) were white; 26.7% were black, and 10.1% were of other racial backgrounds. Forceps were used in 51.6% of deliveries that resulted in tears (cases), compared to 8.6% of deliveries without significant tears (control subjects, P <.05). Using cases and control subjects with complete data (cases, 82; control subjects, 144), delivery with forceps was associated with a 10-fold increased risk of perineal injury (odds ratio, 10.8; 95% CI, 5.2-22.3) compared to noninstrumented deliveries. The association was similar after adjustment for age, race, parity, mode of delivery, tobacco use, episiotomy, duration of labor (stages 1 and 2), infant birth weight, epidural, and oxytocin use (odds ratio, 11.9; 95% CI, 4.7-30.4). Nulliparous women were at increased risk for tears (adjusted odds ratio, 10.0; 95% CI, 3.0-33.3) compared with multiparous patients, but parity did not reduce the association between forceps-assisted deliveries and anal sphincter injuries. Increasing fetal weight was also a risk factor in both unadjusted and adjusted analyses.

The performance of a midline episiotomy was associated with an increased risk of anal sphincter tear compared with delivery without an episiotomy in the univariate analysis (odds ratio, 4.9; 95% CI, 2.5-9.6), but this association was reduced in the adjusted analysis (odds ratio, 2.5; 95% CI, 1.0-6.0). The increased duration of both the first and second stages of labor increased injury risk in the unadjusted, but not adjusted, analysis. No significant association was observed between case status and the use of oxytocin or epidural anesthesia. Greater, but not significant, increased risk was associated with maternal indications for operative delivery compared with fetal indications.

CONCLUSION: Our results are consistent with recent reports that identify forceps delivery and nulliparity as risk factors for recognized anal sphincter injury at the time of vaginal delivery. Further investigation should focus on the determination of whether the association of injury to instrumentation is causal or, in fact, modifiable. Because of the established association between sphincteric muscular damage and anal incontinence, patients should be counseled about the risk of anal sphincter injury when operative vaginal delivery is contemplated. Such patients should be followed closely in the postpartum setting to assess for the development of potential anorectal complaints.

Sumário (português)  :

Comentários :

Resume en libre acces, texte complet payant.

Argument (français) :

Argument (English):

Argumento (português):

Palavras-chaves :

➡ rasgaduras ; idade materna ; dor ; episiotomia ; medicamentos contra a dor ; extracção instrumental ; forceps

Autor da esta ficha :

Cécile Loup — 23 Sep 2003

Discussão (exibir apenas português)
 
➡ Reservado para usuários identificados



 Li a carta de discussões e aceito as condições (leia as diretrizes)

barre

Efectuar uma nova consulta especialista --- Outro pedido simples

Criação de uma ficha --- Importar registros

Gerenciamento de usuários --- Fazer backup do banco de dados --- Contato

bar

Esta base de dados é gerida pela Alliance francophone pour l'accouchement respecté (AFAR, https://afar.info)
filiados Collectif interassociatif autour de la naissance (CIANE, https://ciane.net).
Ele é alimentado pelas contribuições de voluntários interessados ​​em compartilhar informações científicas.
Se você aprovar este projeto, você pode nos ajudar de várias maneiras:
(1) tornar-se um colaborador com base nisso, se você tem um pouco experiência na literatura científica
(2) ou apoio financeiro AFAR (veja abaixo)
(3) ou tornar-se um membro da AFAR (ou outra associação afiliada à CIANE).
Faça login ou crie uma conta para seguir as alterações ou se tornar um editor.
Contato afar.association(arobase)gmail.com para mais informações.

Valid CSS! Valid HTML!
Doar para a AFAR (clique em “Faire un don”) nos ajudará a manter e desenvolver sites e bancos de dados
públicos para o apoio das decisões informadas dos pais e cuidadores com relação ao parto