Influence of the disengagement of the forceps on levator ani muscle injuries in instrumental delivery: A multicenter study
Autor: | Camino Fernández-Fernández, Ismael Ortega, Ana Fernández-Palacín, José Antonio García-Mejido, Alfonso Fernández‐Corona, Margarita Medina, Enrique González-Diaz, Alicia Martín-Martínez, José Antonio Sainz |
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Rok vydání: | 2019 |
Předmět: |
Male
medicine.medical_specialty Forceps Levator ani muscle Anal Canal Risk Assessment Instrumental delivery Obstetrical Forceps Avulsion 03 medical and health sciences 0302 clinical medicine Pregnancy medicine Odds Ratio Humans Fetal head 030212 general & internal medicine Prospective Studies Disengagement theory Risk factor 030219 obstetrics & reproductive medicine business.industry Pregnancy Outcome Obstetrics and Gynecology Extraction Obstetrical General Medicine Delivery Obstetric United States Surgery Obstetric Labor Complications Pregnancy Complications Logistic Models Treatment Outcome Multicenter study Female business Monte Carlo Method Follow-Up Studies Maternal Age |
Zdroj: | Acta obstetricia et gynecologica ScandinavicaREFERENCES. 98(11) |
ISSN: | 1600-0412 |
Popis: | INTRODUCTION Forceps use is the main risk factor for levator ani muscle (LAM) injuries. We believe that the disengagement of the forceps branches before delivery of the fetal head could influence LAM injuries, so we aimed to determine the influence of the disengagement of the forceps on the occurrence of LAM avulsion during forceps delivery. MATERIAL AND METHODS A prospective, observational, multicenter study was conducted with 261 women who underwent forceps delivery. The women were classified according to whether the branches of the forceps had been disengaged before delivery of the fetal head. LAM avulsion was defined using a multislice mode (3 central slices). RESULTS In all, 255 women completed the study (160 without disengagement and 95 with disengagement). LAM avulsions were observed in 37.9% of women in the group with disengagement and in 41.9% of women in the group without disengagement. The crude OR (without disengagement vs with disengagement) for avulsion was 0.90 (95% CI 0.49-1.67, P = 0.757) and an adjusted OR of 0.82 (95% CI 0.40-1.69, P = 0.603). CONCLUSIONS We did not observe a statistically significant reduction in the LAM avulsion rate with disengagement of the forceps branches before delivery of the fetal head. |
Databáze: | OpenAIRE |
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