Sonographic fetal head circumference and the risk of obstetric anal sphincter injury following vaginal delivery

2020 ◽  
Vol 31 (11) ◽  
pp. 2285-2290 ◽  
Author(s):  
Raanan Meyer ◽  
Amihai Rottenstreich ◽  
Michal Zamir ◽  
Hadas Ilan ◽  
Edward Ram ◽  
...  
Keyword(s):  
Vaginal Delivery ◽  
Anal Sphincter ◽  
Head Circumference ◽  
Obstetric Anal Sphincter Injury ◽  
Fetal Head ◽  
Sphincter Injury ◽  
Anal Sphincter Injury

scholarly journals Obstetric anal sphincter injury in adolescent mothers

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Henry H. Chill ◽  
Michal Lipschuetz ◽  
Eyal Atias ◽  
Tzvika Shimonovitz ◽  
David Shveiky ◽  
...  
Keyword(s):  
Risk Factors ◽  
Vaginal Delivery ◽  
Anal Sphincter ◽  
Adolescent Mothers ◽  
Head Circumference ◽  
Obstetric Anal Sphincter Injury ◽  
Age Group ◽  
Adult Group ◽  
Sphincter Injury ◽  
Anal Sphincter Injury

Abstract Background Obstetric anal sphincter injury (OASI) is a debilitating complication of vaginal delivery which has yet to receive ample attention in adolescents. The aim of this study was to describe risk for OASI in adolescent mothers compared to adults. We further attempted to compare risk factors for OASI between these two age groups. Methods We performed a retrospective cohort study between 2003 and 2019. Primiparous women who delivered vaginally, 21 years and younger were compared to women ages 26–35. Excluded were preterm, multifetal, non-vertex, cesarean deliveries as well as intrauterine fetal death. Rate of OASI as well as obstetric and labor characteristics of women with OASI, were compared between groups. Finally, risk factors were assessed for each group separately. Univariate and multivariate logistic regression model were performed. Results Final analysis was performed on 5113 nulliparous adolescents and 13,845 nulliparous in the 26–35 age group. Allocation to study groups was according to OASI – Sixty-seven adolescents (1.3%) had a 3rd or 4th degree perineal tear and were defined as the OASI group, while 5046 patients (98.7%) did not have such a tear. In the adult group, 199 out of 13,845 patients (1.4%) were diagnosed with OASI. Occurrence of OASI did not differ between groups (p = 0.510). Comparison of women with OASI in the adolescent group vs. adult group found differences with regard to operative vaginal delivery, (20.9% vs. 36.2%, respectively; p = 0.023) and meconium stained amniotic fluid (9.1% vs. 21.3%, respectively; p = 0.027). Following multivariate analysis the only parameter independently associated with OASI in the adolescent age group was head circumference ≥ 90th percentile with an adjusted odds ratio of 3.08 (CI 1.48–6.38, p = 0.003). In the adult group the similar analysis revealed operative vaginal delivery (OR = 2.44, CI 1.72–3.47, p < 0.001) and a birthweight≥90th percentile (OR = 2.23, CI 1.19–4.18, p = 0.012) to be independent risk factors for OASI. Conclusion Adolescents have similar risk for OASI compared to adults but differ in risk factors leading to OASI. Head circumference ≥ 90th percentile was found to be associated with OASI in this age group.

scholarly journals Mode of Vaginal Delivery: A Modifiable Intrapartum Risk Factor for Obstetric Anal Sphincter Injury

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Marta Simó González ◽  
Oriol Porta Roda ◽  
Josep Perelló Capó ◽  
Ignasi Gich Saladich ◽  
Joaquim Calaf Alsina
Keyword(s):  
Risk Factor ◽  
Vaginal Delivery ◽  
Anal Sphincter ◽  
University Hospital ◽  
Obstetric Anal Sphincter Injury ◽  
Vacuum Extraction ◽  
Sphincter Injury ◽  
Anal Sphincter Injury ◽  
Vaginal Deliveries ◽  
Spontaneous Delivery

The aim of this study was to analyze the comparative risks of this anal sphincter injury in relation to the type of intervention in vaginal delivery. We performed an observational, retrospective study of all vaginal deliveries attended at a tertiary university hospital between January 2006 and December 2009. We analyzed the incidence of obstetric anal sphincter injury for each mode of vaginal delivery: spontaneous delivery, vacuum, Thierry spatulas, and forceps. We determined the proportional incidence between methods taking spontaneous delivery as the reference. Ninety-seven of 4526 (2.14%) women included in the study presented obstetric anal sphincter injury. Instrumental deliveries showed a significantly higher risk of anal sphincter injury (2.7 to 4.9%) than spontaneous deliveries (1.1%). The highest incidence was for Thierry spatulas (OR 4.804), followed by forceps (OR 4.089) and vacuum extraction (OR 2.509). The type of intervention in a vaginal delivery is a modifiable intrapartum risk factor for obstetric anal sphincter injury. Tearing can occur in any type of delivery but proportions vary significantly. All healthcare professionals attending childbirth should be aware of the risk for each type of intervention and consider these together with the obstetric factors in each case.

scholarly journals Is obstetric anal sphincter injury a risk factor for levator ani muscle avulsion in vaginal delivery?

2017 ◽  
Vol 49 (2) ◽  
pp. 257-262 ◽  
Author(s):  
M. Simó González ◽  
J. Cassadó Garriga ◽  
C. Dosouto Capel ◽  
O. Porta Roda ◽  
J. Perelló Capó ◽  
...  
Keyword(s):  
Risk Factor ◽  
Vaginal Delivery ◽  
Anal Sphincter ◽  
Levator Ani ◽  
Obstetric Anal Sphincter Injury ◽  
Levator Ani Muscle ◽  
Sphincter Injury ◽  
Anal Sphincter Injury ◽  
Levator Ani Muscle Avulsion
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