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Episiotomy in vacuu...
Episiotomy in vacuum extraction, do we cut the levator ani muscle? : A prospective cohort study
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- Ankarcrona, Victoria (författare)
- Karolinska Inst, Danderyd Hosp, Dept Clin Sci, Stockholm, Sweden.;Danderyd Hosp, Dept Obstet & Gynecol, S-18288 Stockholm, Sweden.
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- Karlstrom, Sofie (författare)
- Karolinska Univ Hosp, Dept Obstet & Gynecol, Huddinge, Sweden.
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- Sylvan, Sissela (författare)
- Karolinska Institutet
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- Starck, Marianne (författare)
- Skane Univ Hosp, Dept Surg, Pelv Floor Ctr, Malmö, Sweden.
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- Jonsson, Maria, 1966- (författare)
- Uppsala universitet,Klinisk obstetrik
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- Wendel, Sophia Brismar (författare)
- Karolinska Inst, Danderyd Hosp, Dept Clin Sci, Stockholm, Sweden.;Danderyd Hosp, Dept Obstet & Gynecol, S-18288 Stockholm, Sweden.
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Karolinska Inst, Danderyd Hosp, Dept Clin Sci, Stockholm, Sweden;Danderyd Hosp, Dept Obstet & Gynecol, S-18288 Stockholm, Sweden. Karolinska Univ Hosp, Dept Obstet & Gynecol, Huddinge, Sweden. (creator_code:org_t)
- 2022-04-25
- 2022
- Engelska.
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Ingår i: International Urogynecology Journal. - : Springer Nature. - 0937-3462 .- 1433-3023. ; 33:12, s. 3391-3399
- Relaterad länk:
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https://urn.kb.se/re...
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https://doi.org/10.1...
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http://kipublication...
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Abstract
Ämnesord
Stäng
- Introduction and hypothesis Vaginal delivery may lead to levator ani muscle (LAM) injury or avulsion. Episiotomy may reduce obstetric anal sphincter injury in operative vaginal delivery, but may increase the risk of LAM injury. Our aim was to assess whether lateral episiotomy in vacuum extraction (VE) in primiparous women causes LAM injury. Methods A prospective cohort study of 58 primiparous women with episiotomy nested within an ongoing multicenter randomized controlled trial of lateral episiotomy versus no episiotomy in VE (EVA trial) was carried out in Sweden. LAM injury was evaluated using 3D endovaginal ultrasound 6-12 months after delivery and Levator Ani Deficiency (LAD) score. Episiotomy scar properties were measured. Characteristics were described and compared using Chi-squared tests. We stipulated that if a lateral episiotomy cuts the LAM, >= 50% would have a LAM injury. Among those, >= 50% would be side specific. We compared the observed prevalence with a test of one proportion. Results Twelve (20.7%, 95% CI 10.9-32.9) of 58 women had a LAD (p < 0.001, compared with the stipulated 50%). Six (50.0%, 95% CI 21.1% to 78.9%) of 12 women had a LAD on the episiotomy side, including those with bilateral LAD (p = 1.00). Two (16.7%, 95% CI 2.1% to 48.4%) of 12 women had a LAD exclusively on the episiotomy side (p = 0.02). Conclusions There was no excessive risk of cutting the LAM while performing a lateral episiotomy. LAD was not seen in women with episiotomies shorter than 18 mm.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Reproduktionsmedicin och gynekologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Obstetrics, Gynaecology and Reproductive Medicine (hsv//eng)
Nyckelord
- Episiotomy
- Lateral episiotomy
- Levator ani deficiency score
- Levator ani muscle injury
- 3D endovaginal ultrasound
- Vacuum extraction
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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