Épisiotomie et extraction instrumentale : la mise à mort des RPC du CNGOF ? À propos de l’article Mediolateral episiotomy reduces the risk for anal sphincter injury during operative vaginal delivery. BJOG 2008;115:104–8

2009 ◽  
Vol 38 (1) ◽  
pp. 9-10 ◽  
Author(s):  
D. Riethmuller
Keyword(s):  
Vaginal Delivery ◽  
Anal Sphincter ◽  
Sphincter Injury ◽  
Mediolateral Episiotomy ◽  
Anal Sphincter Injury ◽  
Operative Vaginal Delivery

Prolonged Second Stage of Labor and Anal Sphincter Injury in a Contemporary Cohort of Term Nulliparas

2020 ◽  
Author(s):  
Mariam Naqvi ◽  
Elana F. Jaffe ◽  
Ilona T. Goldfarb ◽  
Allison S. Bryant ◽  
Blair J. Wylie ◽  
...  
Keyword(s):  
Vaginal Delivery ◽  
Anal Sphincter ◽  
Sphincter Injury ◽  
Predictive Capacity ◽  
Fourth Degree ◽  
Second Stage Of Labor ◽  
Second Stage ◽  
Anal Sphincter Injury ◽  
Operative Vaginal Delivery ◽  
Multivariable Regression

Objective This study aimed to assess whether a prolonged second stage of labor is an independent predictor of obstetric anal sphincter injury (OASI) in a contemporary cohort of nulliparous and term parturients, and to evaluate whether predelivery factors can accurately predict OASI. Study Design This was a nested case-control study within a cohort of consecutive nulliparous term parturients with a singleton gestation who underwent a vaginal delivery at a single institution between January 2014 and January 2015. Cases were defined as women with a third- or fourth-degree laceration at the time of delivery, and controls were women without a third- or fourth-degree laceration. A prolonged second stage was defined as a second stage of ≥3 hours. Univariable and multivariable regression analyses were performed to examine the relationship between prolonged second stage of labor and third- or fourth-degree lacerations. Receiver operator curves were developed to assess the predictive capacity of predelivery information for third- and fourth-degree lacerations. Results Of 1,197 births, 63 women had third- or fourth-degree lacerations (5.3%). With each additional hour of the second stage, the rate of OASI increased, with 2.9% of women with a second stage of <1 hour with OASI, 3.5% between 1 and 2 hours, 5.7% between 2 and 3 hours, 7.8% between 3 and 4 hours, 16.1% between 4 and 5 hours, and 28.6% among women with a second stage length >5 hours (p < 0.001). In multivariable regression analysis, operative vaginal delivery (adjusted odds ratio [aOR] = 5.92, 95% confidence interval [CI]: 3.17–11.07) and a prolonged second stage (aOR = 1.92, 95% CI: 1.06–3.51) were independent predictors of third- and fourth-degree lacerations. A predictive model was developed from these results (area under the curve [AUC] = 0.75, 95% CI: 0.68–0.81). Conclusion Prolonged second stage of labor is a predictor of OASI, after adjustment for operative vaginal delivery. A model using predelivery risk factors has a reasonable prediction of OASI. Key Points

scholarly journals Risk Factors and Outcome of Patients with Obstetric Anal Sphincter Injuries (OASIS)

2018 ◽  
Vol 1 (2) ◽  
pp. 69-72
Author(s):  
Rabindra D. Bhatt ◽  
S. Sitaula ◽  
T. Pradhan ◽  
T. Manandhar ◽  
T. Basnet
Keyword(s):  
Risk Factors ◽  
Birth Weight ◽  
Fecal Incontinence ◽  
Vaginal Delivery ◽  
Anal Sphincter ◽  
Obstetric Anal Sphincter Injuries ◽  
Sphincter Injury ◽  
Second Stage Of Labor ◽  
Anal Sphincter Injury ◽  
Operative Vaginal Delivery

Background: Anal incontinence is an embarrassing condition that is largely underreported. Obstetric anal sphincter injuries are the most important etiological factors. Anal sphincter injury during delivery is considered to be one of the major risk factors for fecal incontinence in women. After anal sphincter injury at the time of delivery, up to 50% women have complaints of fecal incontinence, mainly because of persisting sphincter defects. Objectives: To evaluate the risk factors for the occurrence of obstetric anal sphincter injuries during vaginal delivery. To evaluate the outcome of patients with obstetric anal sphincter injuries. Methodology: A retrospective descriptive study was conducted from 2014 to 2016. Data of all patients with Obstetric Anal Sphincter Injuries (OASIS) over 3 years was collected from the medical record section after ethical clearance from Institutional Review Committee (IRC), BPKIHS. The data was entered in the excel sheet and analyzed using SPSS 17. Results: The Most important risk factor of OASIS was operative vaginal delivery (vacuum assisted vaginal delivery), followed by birth weight of the baby greater than 3.5 Kg and primigravida. Conclusion: Patients undergoing operative vaginal delivery, primigravida and birth weight greater than 3 kg are the important risk factors for OASIS. So, patients with these conditions should be handled carefully during second stage of labor to prevent the occurrence of OASIS.

Impact of mediolateral episiotomy on incidence of obstetrical anal sphincter injury diagnosed by endoanal ultrasound

Midwifery ◽  
2017 ◽  
Vol 51 ◽  
pp. 40-43 ◽  
Author(s):  
Kristina Drusany Staric ◽  
Adolf Lukanovic ◽  
Petra Petrocnik ◽  
Vita Zacesta ◽  
Corrado Cescon ◽  
...  
Keyword(s):  
Anal Sphincter ◽  
Endoanal Ultrasound ◽  
Sphincter Injury ◽  
Mediolateral Episiotomy ◽  
Anal Sphincter Injury ◽  
Obstetrical Anal Sphincter Injury

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.

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