Substantial Obstetric Anal Sphincter Injury during Vacuum Assisted Delivery: An Obstetrical Issue or Device Related?

Autor: Yoav Baruch, Ronen Gold, Hagit Eisenberg, Hadar Amir, Yariv Yogev, Asnat Groutz
Jazyk: angličtina
Rok vydání: 2022
Předmět:
Zdroj: Journal of Clinical Medicine; Volume 11; Issue 23; Pages: 6990
ISSN: 2077-0383
DOI: 10.3390/jcm11236990
Popis: Background: Obstetric anal sphincter injuries (OASIS) might be associated with long-term urinary and anorectal morbidities. The aim of the study was to investigate the risk factors and clinical implications of OASIS associated with vacuum-assisted deliveries versus normal vaginal deliveries. Methods: A series of 413 consecutive OASIS cases were retrospectively analyzed. A comparison was made between OASIS cases diagnosed following vacuum-assisted deliveries versus OASIS cases diagnosed following normal vaginal deliveries. Multivariable analysis was used to study the association between vacuum-assisted deliveries and superficial (3A and 3B) versus deep (3C and 4) perineal tears. Results: The study population comprised 88,123 singleton vaginal deliveries. Diagnosis of OASIS was made in 413 women (0.47% of the total cohort), 379 (91.8%) of whom had third-degree tears and 34 (8.2%) of whom had fourth-degree tears. Among the 7410 vacuum-assisted deliveries, 102 (1.37%) had OASIS, whereas, among the 80,713 normal vaginal deliveries, only 311 (0.39%) had OASIS. In a multivariate analysis, only vacuum-assisted delivery was found to be associated with a significant risk of deeper (3C or 4) perineal tears (OR = 1.72; 95% CI 1.02–2.91; p = 0.043). Conclusions: Vacuum-assisted instrumental intervention is a significant risk factor for OASIS and especially for deeper tears, independent of other maternal and obstetric risk factors.
Databáze: OpenAIRE
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