Risk factors for obstetric anal sphincter injury: To prolong or to vacuum?

Midwifery
Gali GarmiRaed Salim

Abstract

An awareness of risk factors for obstetric anal sphincter injuries (OASIS) is essential in order to reduce the occurrence of the primary event. These risk factors are demographic, obstetric and intrapartum related. We aimed to identify the risk factors for OASIS and to examine how modifiable risk factors may be used in order to reduce the incidence of OASIS. A retrospective, matched case-control study was conducted in the delivery ward of a single university teaching hospital in Israel, using data from January 2004 to July 2012. All singleton vaginal deliveries at term with OASIS were included. The controls included women matched at a ratio of 1:2 based on gestational age and deliveries that occurred immediately before and after the delivery of the women in the study group. Overall, 113 OASIS were identified. Stepwise conditional logistic regression revealed that the first vaginal birth (OR = 7.6; 95% confidence interval (CI), 3.5-16.3; p < 0.001) particularly after a previous caesarean section (OR = 13.6; 95% CI, 4.7-39.3; p < 0.001) and the length of the second stage (OR 1.5; 95% CI, 1.1-2.1, p = 0.045) were the only risk factors for OASIS. Among 24 primiparous women who already had a prolonged second stage, 15 delivered by v...Continue Reading

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Citations

Sep 21, 2018·The Journal of Maternal-fetal & Neonatal Medicine : the Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians·David SegalAdi Y Weintraub
Jul 4, 2019·International Urogynecology Journal·Joanna C D'SouzaDouglas G Tincello
Jun 23, 2020·European Journal of Obstetrics, Gynecology, and Reproductive Biology·Vasilios PergialiotisGeorge Daskalakis
Jun 26, 2020·Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland·S GinathA Y Weintraub

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