Header

UZH-Logo

Maintenance Infos

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


Birri, Jana; Kreft, Martina; Zimmermann, Roland; Kimmich, Nina (2019). Assoziation zwischen Geburtsverletzungen und der Einführung geburtshilflicher Observationsmaßnahmen: eine retrospektive Kohortenstudie. Zeitschrift für Geburtshilfe und Neonatologie, 223(03):157-168.

Abstract

INTRODUCTION Lacerations are common in vaginal births. They can result in immense physical and psychological morbidity. Ongoing efforts are being made to reduce birth trauma. We implemented different obstetrical monitoring tools in the labor ward and evaluated their association with the incidence and distribution of different types of birth lacerations. MATERIAL AND METHODS We retrospectively analyzed nulliparous and multiparous women with singleton term pregnancies in vertex presentation, who gave birth vaginally in our tertiary care center between October 2014 and September 2015. We evaluated 3 different time intervals (T1=4 months before the implementation of the monitoring tools, T2=0-4 months and T3=5-8 months afterwards). Outcome parameters were the incidence and distribution of different types of birth lacerations during the 3 different time intervals. RESULTS The incidence of all types of birth trauma decreased from 95,52% in nulliparous and 68,53% in multiparous women at T1 to 89,92% and 62,27% non-significantly at T3, with a decrease in perineal and vulvar/labial lacerations and an increase in vaginal lacerations. The rate of episiotomies and third-/fourth-degree perineal tears remained stable for nulliparous (33 and 3%) and multiparous (10 and 0.4%) women between the time intervals. CONCLUSION 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.

Abstract

INTRODUCTION Lacerations are common in vaginal births. They can result in immense physical and psychological morbidity. Ongoing efforts are being made to reduce birth trauma. We implemented different obstetrical monitoring tools in the labor ward and evaluated their association with the incidence and distribution of different types of birth lacerations. MATERIAL AND METHODS We retrospectively analyzed nulliparous and multiparous women with singleton term pregnancies in vertex presentation, who gave birth vaginally in our tertiary care center between October 2014 and September 2015. We evaluated 3 different time intervals (T1=4 months before the implementation of the monitoring tools, T2=0-4 months and T3=5-8 months afterwards). Outcome parameters were the incidence and distribution of different types of birth lacerations during the 3 different time intervals. RESULTS The incidence of all types of birth trauma decreased from 95,52% in nulliparous and 68,53% in multiparous women at T1 to 89,92% and 62,27% non-significantly at T3, with a decrease in perineal and vulvar/labial lacerations and an increase in vaginal lacerations. The rate of episiotomies and third-/fourth-degree perineal tears remained stable for nulliparous (33 and 3%) and multiparous (10 and 0.4%) women between the time intervals. CONCLUSION 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.

Statistics

Citations

Dimensions.ai Metrics
1 citation in Web of Science®
1 citation in Scopus®
Google Scholar™

Altmetrics

Downloads

2 downloads since deposited on 18 Sep 2018
0 downloads since 12 months
Detailed statistics

Additional indexing

Other titles:Association of Birth Trauma with the Implementation of Obstetrical Monitoring Tools: A Retrospective Cohort Study
Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Obstetrics
Dewey Decimal Classification:610 Medicine & health
Scopus Subject Areas:Health Sciences > Pediatrics, Perinatology and Child Health
Health Sciences > Obstetrics and Gynecology
Health Sciences > Maternity and Midwifery
Language:German
Date:1 June 2019
Deposited On:18 Sep 2018 12:16
Last Modified:29 Jul 2020 07:42
Publisher:Georg Thieme Verlag
ISSN:0948-2393
OA Status:Closed
Free access at:PubMed ID. An embargo period may apply.
Publisher DOI:https://doi.org/10.1055/a-0660-4039
PubMed ID:30142688

Download

Closed Access: Download allowed only for UZH members