Effect of the type of maternal pushing during the second stage of labour on obstetric and neonatal outcome: a multicentre randomised trial—the EOLE study protocol

Barasinski, Chloé; Vendittelli, Françoise

doi:10.1136/bmjopen-2016-012290

Cited by 14 publications

(22 citation statements)

References 16 publications

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“…Hence, examination is done with the woman's bladder (and preferably rectum) empty, using the left lateral (Sims), or supine, standing, or lithotomy position, depending on which best demonstrates POP in that patient, and which the patient confirms is the maximal extent she has perceived. Forced expiration against a closed glottis (Valsalva) increases the accuracy of diagnosis CHANGE REFERENCE to a recent one/update the reference [10].…”

Section: Pelvic Organ Prolapsementioning

confidence: 99%

“…However, in POP, posture and gravity impact pelvic organ position, pelvic floor muscle integrity, degree of prolapse, and symptom severity. Indeed, the degree of prolapse may be worse after a lengthy time in the upright position and better when gravity is not a factor, e.g., when lying in the supine position [10]. Hence, one could question if measurement in the lying position is valid for assessment of muscle function or the evaluation of patients who are symptomatic in the standing position [24].…”

Section: Patient Positioningmentioning

confidence: 99%

“…Evaluation using imaging modalities is recommended in international guidelines when the appropriate indication(s) are present, and imaging is highly recommended in specific situations [10]. Imaging modalities employed currently include 2D and 3D ultrasound, computed tomography, and magnetic resonance imaging.…”

Section: Current Imaging Techniquesmentioning

confidence: 99%

“…All these structures are imaged in real time in the mid-sagittal plane. An exception is a high undescended uterus that may be hidden by a rectocele [10]. Because of its non-invasive nature, ready availability, and lack of distortion, perineal or translabial ultrasound is now commonly applied in clinical practice [30], and almost all gynecologists and urologists are trained in its use [19].…”

Section: Ultrasoundmentioning

confidence: 99%

“…The expense of MRI imaging and limited access to scanning facilities has impacted widespread application of this technology. Additionally, because of the dynamic nature of pelvic floor pathology, it is controversial whether even fast MRI imaging can capture reproducible results owing to the dissimilarity of Valsalva maneuvers between studies and possible variations in levator activity [10].…”

Section: Mrimentioning

confidence: 99%

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Effects of Posture and Gravity on Pelvic Organ Prolapse

Abdulaziz¹,

Stothers²,

Macnab³

2018

Pelvic Floor Disorders

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Female pelvic floor dysfunction occurs when the integrity of the pelvic floor muscles is compromised and impacts the position and function of the pelvic organs. Physicians use international guidelines to evaluate and treat women for POP taking into account that posture and gravity impact pelvic organ position, and degree of prolapse. Our clinical focuses on the description of surface anatomy. This examination alone is insufficient. Although imaging is recommended, the modalities currently available are recognized to have flaws. MRI is performed in the supine position regardless the effect of posture and gravity on POP. A literature search was performed using databases, searching MEDLINE and PubMed using the key terms ultrasound, MRI, and CT. We describe use of a new protocol and advanced technique to evaluate the changes of POP in different positions using open MRI (MRO). POP patients underwent MRO imaging of the pelvic floor using a 0.5 T MRO scanner. The extent of displacement of prolapsed organs was determined using validated reference lines drawn on the mid-sagittal images. Manual segmentation and surface modeling were used to construct the 3D models. MRO offers new levels of anatomic detail; 3D sequences based on 2D images are an additional refinement.

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Section: Pelvic Organ Prolapsementioning

confidence: 99%

Section: Patient Positioningmentioning

confidence: 99%

Section: Current Imaging Techniquesmentioning

confidence: 99%