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Obstetric interventions and pelvic floor disorders
Rušavý, Zdeněk ; Kališ, Vladimír (advisor) ; Roztočil, Aleš (referee) ; Mašata, Jaromír (referee)
Obstetric interventions and pelvic floor disorders - Abstract One of the principal objectives of obstetric interventions in the second stage of labor is prevention of pelvic floor trauma and associated pelvic floor disorders. The most commonly used and also most frequently discussed interventions are manual perineal protection and episiotomy. The majority of pelvic floor disorders are of subjective nature. Therefore, tools for objectification and severity quantification of these disorders are the key to reliable comparison and identification of the most effective interventions. The aim of the dissertation was to find the most effective modification of manual perineal protection, to compare two frequently used types of episiotomy regarding all pelvic floor disorders and finally to find a consensus on the most suitable instrument for anal incontinence severity assessment. Our studies concerning manual perineal protection experimentally described the direction and extent of perineal deformation during vaginal delivery. The subsequent studies on biomechanical model demonstrated that the most effective method of manual perineal protection in peak perineal strain reduction is when the fingers are placed on the perineum 6 cm laterally and 2 cm ventrally from the posterior commissure at both sides and are...
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Technical Aspects of the Second Stage of Labor
Karbanová, Jaroslava ; Kališ, Vladimír (advisor) ; Procházka, Martin (referee) ; Záhumenský, Jozef (referee)
Obstetrical intervantion`s goal is to normalize an abnormal or pathological course of labour. In a certain case (e.g. fetal distress) this is not fully achievable. Then the goal is to accelerate the delivery without inadequate increase of risk of maternal or neonatal trauma. The aim of this dizertation thesis was to offer an up-to-date definition and to outline a proper performance of these interventions. Therefore, it was necessary to properly and timely describe the labour layout in which the accoucheur and/or the parturient happen to occurr when an intervention is to take place. It was essential to describe the quantity of perineal loading as well as to define the main vector of perineal strain and deformation. Based on the range of this deformation it was subsequently possible to adequately describe and execute some obstetrical interventions (e.g. a variety of types of episiotomy) or to evaluate a variety of modifications by means of computational modelling (e.g. manual perineal protection) that might have so tiny nuances between each other or differences that are difficult to measure because the clinical evaluation is impossible due to interindividual imprecision or very short duration of the intervention. We described the maximum strain on the perineal surface during vaginal delivery that...
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Obstetric interventions and pelvic floor disorders
Rušavý, Zdeněk ; Kališ, Vladimír (advisor) ; Roztočil, Aleš (referee) ; Mašata, Jaromír (referee)
Obstetric interventions and pelvic floor disorders - Abstract One of the principal objectives of obstetric interventions in the second stage of labor is prevention of pelvic floor trauma and associated pelvic floor disorders. The most commonly used and also most frequently discussed interventions are manual perineal protection and episiotomy. The majority of pelvic floor disorders are of subjective nature. Therefore, tools for objectification and severity quantification of these disorders are the key to reliable comparison and identification of the most effective interventions. The aim of the dissertation was to find the most effective modification of manual perineal protection, to compare two frequently used types of episiotomy regarding all pelvic floor disorders and finally to find a consensus on the most suitable instrument for anal incontinence severity assessment. Our studies concerning manual perineal protection experimentally described the direction and extent of perineal deformation during vaginal delivery. The subsequent studies on biomechanical model demonstrated that the most effective method of manual perineal protection in peak perineal strain reduction is when the fingers are placed on the perineum 6 cm laterally and 2 cm ventrally from the posterior commissure at both sides and are...
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