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Adrian S. Fairey Wassim Kassouf Eric Estey Simon Tanguay Ricardo Rendon David Bell Jonathan Izawa Joseph Chin Anil Kapoor Edward Matsumoto Peter Black Alan So Jean‐Baptiste Lattouf Fred Saad Darrel Drachenberg Ilias Cagiannos Louis Lacombe Yves Fradet Niels‐Erik B. Jacobsen 《BJU international》2013,112(6):791-797
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Tina Sara Verghese Rita Champaneria Dharmesh S Kapoor Pallavi Manish Latthe 《International urogynecology journal》2016,27(10):1459-1467
Introduction
There is conflicting evidence on whether mediolateral episiotomy (MLE) reduces the risk of obstetric anal sphincter injuries (OASI) in spontaneous vaginal deliveries (SVD).Objectives
A systematic review was undertaken to compare rates of OASI amongst women who had undergone mediolateral episiotomy versus those who did not.Methods
?Search strategy
Electronic searches were performed in literature databases: CINAHL, Cochrane, EMBASE, Medline and MIDIRS from database inception to July 2015. Studies were eligible if MLE was compared to spontaneous tears and if OASI was the outcome of interest.Two reviewers independently selected and extracted data on study characteristics, quality and results. We computed events of OASI in those who did and did not have an episiotomy from individual studies and pooled these results in a meta-analysis where possible.Main results
Of the 2090 citations, 16 were included in the review. All were non-randomised, population based or retrospective cohort studies. There was great variation in quality amongst these studies. Data from 7 studies was used for meta-analysis. On collating data from these studies where the majority of women (636755/651114) were nulliparous, MLE reduced the risk of OASI (RR 0.67 95 % CI 0.49-0.92) in vaginal delivery.Conclusion
The pooled analysis of a large number of women undergoing vaginal birth, most of who were nulliparous, indicates that MLE has a beneficial effect in prevention of OASI. An accurately given MLE might have a role in reducing OASI and should not be withheld, especially in nulliparous women. Caution is advised as the data is from non-randomised studies.97.
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Summary Recently, we identified Batai virus as the M-segment reassortment partner of Ngari virus. Extension of genetic analyses to
other orthobunyaviruses related to the Bunyamwera serogroup indicates additional natural genome reassortments. Whereas the
relative phylogenetic positions of all three genome segment sequences were similar for Northway and Kairi viruses, the relative
positions of Potosi and Main Drain virus M-segment sequences diverged from those of their S- and L-segments. Our findings
indicate M-segment reassortment in Potosi and Main Drain viruses and demonstrate natural genome reassortment as a driving
force in the evolution of viruses of the Bunyamwera serogroup. 相似文献
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Slade M Taber D Clarke MM Johnson C Kapoor D Leikin JB Naylor M Neal DA Novak J Steiner D Temkin T Teodo P Tippy A Tronc V Yohanna D Zehr E Zun L;Illinois Hospital Association Behavioral Health Constituency Section Steering Committee its Best Practices Task Force 《Disease-a-month : DM》2007,53(11-12):536-580
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