No abstract

Introduction: Perineal trauma at birth is distressing for women and can cause serious short and long term morbidity. Aim: Investigate the prevalence and predictive factors of intact perineum after normal vaginal birth among Portuguese women who had spontaneous vaginal births. Methods: A descriptive, cross-sectional, retrospective study was carried out among pregnant women who had spontaneous vaginal births, between January 1, 2017, and December 31, 2017, in a single birth centre in Portugal. Following ethical approval, the prevalence of intact perineum was calculated and multivariate analysis with logistic regression was carried out, to identify the predictive factors of having an intact perineum after spontaneous vaginal birth. Results: A total of 1748 pregnant women had spontaneous vaginal births. Four hundred and forty-one women (25.2%) had intact perineum whereas in 1307 (74.8%) of women, the perineum was not intact. First-degree tears occurred in 23.2% (405/1748) of women, second-degree tears occurred in 4% (70/1748) of women while three women (0.2%) experienced a third-degree tear. The rate of episiotomies was 43.8% (766/1748). Episiotomy and first-degree tears occurred in 2.6% (45/1748), episiotomy and second-degree tears occurred in 0.7% (12/1748), while episiotomy and third-degree tears occurred in 0.3% (6/1748) of women. Having a previous caesarean section reduced the odds of intact perineum by 60%, while nulliparity reduced the odds by 70%. For every 250 grams increase in birth weight, the odds of sustaining an intact perineum were decreased by 13%. Alternative birth positions (excluding lithotomy) doubled the odds of maintaining an intact perineum. Conclusion: The prevalence of intact perineum is 25,2%. Predictive factors for intact perineum include birth weight, parity, previous caesarean section and birthing position. Recognizing these factors could support and facilitate the management of spontaneous vaginal birth to promote an intact perineum. Further research is needed to gain better understanding of this phenomenon.

Successive waves of the coronavirus (COVID-19) pandemic lockdowns resulted in significant reduction in face-to-face teaching, with an adverse effect especially on sectors requiring direct skill acquisition. Despite the fact that augmented reality (AR) presents an equitable, cost-effective solution which reduces crowding in the confined spaces of the dissection theater, the benefits of AR-supported undergraduate medical education have been poorly investigated. We conducted a validated survey to explore the value of AR in the dissection theater and assess its impact from the learner's perspective. Further to a validated pilot (n = 30), a larger scale study (n = 130) was conducted to assess the introduction of AR across three different learning domains: retaining anatomy detail, perception of spatial anatomical relations, and speed of learning. A response rate of 85.4% was reported. Our results suggest

This article has been peer reviewed and published immediately upon acceptance.It is an open access article, which means that it can be downloaded, printed, and distributed freely, provided the work is properly cited. Articles in "Ginekologia Polska" are listed in PubMed.

Oxytocin is a small peptide usually associated with its effects in the reproductive system such as induction of labor and lactation. However, recent evidence has indicated that oxytocin plays an important role in social behavior in mammals, including humans. This review article outlines the basics of the role of oxytocin in parental-fetal bond formation and pair-bonding. Social recognition forms the basis of all social interaction and therefore the role of oxytocin in recognition is also discussed. Most studies done as of yet have been conducted of mammals such as prairie voles and rats. However, there has been some evidence which shows that similar mechanisms occur in humans. Pair-bonding and parent-fetal bond formation have very similar mechanisms and oxytocin plays an important role in both. For both processes to occur, there needs to be social recognition and memory of the infant or the partner, both of which are aided by oxytocin and other neurotransmitters, especially arginine vasopressin (AVP) and dopamine. Moreover, once the bond has been established, oxytocin plays a role in persistence of the bond even in the absence of the fetus/parent or the partner. There are similarities between the behavior and mechanisms of social bonding and addiction, therefore oxytocin could play a future role in treatment of social diseases, such as autism and addiction.