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The impact of maternal body mass index on pelvic floor during labor and after childbirth, and a new anesthetic approach for repair of perineal lacerations

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اقرأ أكثر حفظ في قائمتي
  • المؤلفون: Hjertberg, Linda
  • نوع التسجيلة:
    Electronic Resource
  • الدخول الالكتروني :
    http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-199818
    Linköping University Medical Dissertations, 0345-0082 ; 1890
  • معلومة اضافية
    • Publisher Information:
      Linköpings universitet, Avdelningen för barns och kvinnors hälsa Linköpings universitet, Medicinska fakulteten Region Östergötland, Kvinnokliniken ViN Linköping 2024
    • نبذة مختصرة :
      Objectives: This thesis aimed to assess the impact of maternal body mass index (BMI) on pelvic floor during labor and focusing on pelvic floor function following an anal sphincter injury (OASI). Additionally, the objective was to design a study protocol for a randomized controlled trial (RCT) with the objective to evaluate the impact of supplementary anesthesia during the examination and repair of obstetric perineal lacerations. Material and Methods: Study I was an observational prospective cohort study, conducted at the maternity ward Linköping University Hospital, including 207 primiparous women in the active phase of labor. Transperineal ultrasound was used for measurement of the anovaginal distance (AVD) during active phase of labor, with AVD measurements analyzed in relation to the women's BMI groups. Study II and III were nationwide Swedish register studies, including 6595 women with a first time vaginal birth complicated by an OASI. Data was sourced from the Swedish Perineal Laceration Register (PLR), based on medical records and patient reported outcome measurements (PROM). Women were categorized by BMI, and analyses were performed on PROM data at the 8 week follow-up (Study II), and at the 12 month follow-up (Study III), after an OASI. Study IV, a study protocol for a RCT, with parallel groups. Women who undergo examination and repair of obstetric perineal lacerations (grade I and II) are randomized into two arms (1:1); analgesia with pudendal nerve block (PNB) with Ropivacaine®-the PNB group or analgesia with PNB in combination with patient-controlled sedation (PCS) with propofol, the PCS group. Results: Obese women exhibited a higher AVD compared to normal weight women. The mean AVD was 25 mm for primiparous women in the active phase of labor. Overweight and obese women reported fewer wound complications than normal weight women at 8 weeks postpartum. Additionally, overweight and obese women had a lower risk of anal incontinence (AI) at 8 weeks after an O
    • الموضوع:
      Obstetrics, Gynecology and Reproductive Medicine; Reproduktionsmedicin och gynekologi; Doctoral thesis, comprehensive summary; info:eu-repo/semantics/doctoralThesis; text
    • الرقم المعرف:
      10.3384.9789180754606
    • Availability:
      Open access content. Open access content
      info:eu-repo/semantics/openAccess
    • Note:
      application/pdf
      English
    • Other Numbers:
      UPE oai:DiVA.org:liu-199818
      urn:isbn:9789180754590
      urn:isbn:9789180754606
      doi:10.3384/9789180754606
      1416061143
    • Contributing Source:
      UPPSALA UNIV LIBR
      From OAIster®, provided by the OCLC Cooperative.
    • الرقم المعرف:
      edsoai.on1416061143
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