2019, Number 03
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Ginecol Obstet Mex 2019; 87 (03)
Risk factors associated with obstetric anal sphincter injury: A retrospective cohort
Rodríguez-Colorado ES, Ramírez-Isarrara C, Granados-Martínez V, Gorbea-Chávez V, Olvera-Delgado JJ, Bravo-Canales GR
Language: Spanish
References: 11
Page: 186-189
PDF size: 194.30 Kb.
ABSTRACT
Objective: To analyze the associated risk factors of obstetric anal sphincter injury in
a population in which the use of forceps is well accepted.
Materials and Methods: A simple retrospective cohort was performed where
all women with vaginal delivery were identified in a period of 5 years (January 2013
to December 2017). Pregnancies older than 35 weeks were included, unique and in
cephalic presentation. The dependent variable of obstetric lesion of the anal sphincter
was classified in 3rd and 4th grade. The SPSS 23 program was used for the statistical
analysis. χ
2 test and Student's t test were used to compare the groups, as well as Odds
radio (OR) with a 95% confidence interval (95% CI).
Results: A total of 6199 women were included. The average age was 26.5 years,
birth weight of 2745 grams on average, forceps were placed in 6.9% (n = 428). The
frequency of obstetric lesion of the anal sphincter was 1.03% (n = 65) in the study
period. The following risk factors were found to be associated with anal sphincter injury:
use of forceps OR 22.4 (95% CI 13.3-36.7, p ‹0.001), primiparity OR 2.8 (95%
CI 1.68-4.93 p ‹ 0.001.
Conclusions: Maternal age of 20 to 30 years, fetal weight greater than 3500 grams,
births with forceps and primiparity are risk factors for obstetric anal sphincter injuries.
REFERENCES
Harvey MA, et al. Obstetrical anal sphincter injuries (OASIS): Prevention, recognition, and repair. J Obstet Gynaecol Can 2015;37(12):1131-48.
Jordan PA, et al. Effect of subsequent vaginal delivery on bowel symptoms and anorectal function in women who sustained a previous obstetric anal sphincter injury. Int Urogynecology J 2018;29(11):1579-1588. https://doi. org/10.1007/s00192-018-3601-y
Ott J, et al. A retrospective study on perineal lacerations in vaginal delivery and the individual performance of experienced mifwives. BMC Pregnancy Childbirth 2015;15(1). https://doi.org/10.1186/s12884-015-0703-0.
Low LK, et al. Predicting birth-related levator ani tear severity in primiparous women: Evaluating Maternal Recovery from Labor and Delivery (EMRLD Study). Open J Obstet Gynecol 2014;04(06):266-78. https://doi.org/10.4236/ ojog.2014.46043
Andrews V, et al. Risk Factors for obstetric anal sphincter injury: a prospective Study. Birth 2006;33(2):117-22. https:// doi.org/10.1111/j.0730-7659.2006.00088.x
Baghestan E, et al. Trends in risk factors for obstetric anal sphincter injuries in Norway: Obstet Gynecol 2010;116(1):25-34. https://doi.org/10.1097/ AOG.0b013e3181e2f50b
Gurol-Urganci I, et al. Third- and fourth-degree perineal tears among primiparous women in England between 2000 and 2012: time trends and risk factors. BJOG Int J Obstet Gynaecol 2013;120(12):1516-25. https://doi. org/10.1111/1471-0528.12363
Khan FG, et al. Risk factors for anal sphincter lacerations: a study by Lowder et al. Am J Obstet Gynecol 2007;196(4):415-6. https://doi.org/10.1016/j. ajog.2007.02.022
Marschalek ML, et al. Risk and protective factors for obstetric anal sphincter injuries: A retrospective nationwide study. Birth 2018;45(4):409-415. https://doi.org/10.1111/ birt.12346.
Blomberg M. Maternal body mass index and risk of obstetric anal sphincter injury. BioMed Res Int 2014;2014:1-8. https://doi.org/10.1155/2014/395803.
Laganà A, et al. The role of episiotomy in prevention of genital lacerations during vaginal deliveries- -results from two European centers. Pol Gynaecol 2015;86(3):168-75.