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


Journal

International urogynecology journal
ISSN: 1433-3023
Titre abrégé: Int Urogynecol J
Pays: England
ID NLM: 101567041

Informations de publication

Date de publication:
Nov 2020
Historique:
received: 27 01 2020
accepted: 26 03 2020
pubmed: 8 4 2020
medline: 24 6 2021
entrez: 8 4 2020
Statut: ppublish

Résumé

High birth weight is strongly associated with OASIS; nevertheless, it has not been determined which biometric characteristics most affect OASIS occurrence. We aimed to evaluate the association of estimated fetal head circumference with OASIS occurrence among primiparous women delivering by unassisted vaginal delivery. A retrospective study included all primiparous women who delivered at term by spontaneous vaginal delivery from 2011-2019. Women were allocated to two groups: (1) those who experienced OASIS and (2) those who did not experience OASIS. Risk factors for OASIS were analyzed. Overall, 7646 women were included in the study cohort. Of those, 119/7646 (1.6%; 95% CI, 1.3-1.9%) experienced OASIS. Sonographic head circumference and birth weight did not vary between groups. Prolonged second stage was more common in the OASIS group [23 (19%) vs. 986 (13.3%), 1.58 OR (95% CI 1.003-2.51, p = 0.04)]. Absence of epidural analgesia was more common in the OASIS group [30 (25%) vs. 1197 (15.9%), 1.8 OR (95% CI 1.1-2.7, p = 0.006)]. On multivariate logistic regression analysis, the lack of epidural analgesia and duration of second stage of labor were both independently positively associated with OASIS [adjusted OR 2.67 (95% CI 1.55-4.62), p < 0.001, adjusted OR 1.23 (95% CI 1.11-1.43), p < 0.001, respectively)]. Sonographic head circumference and birth weight are not associated with OASIS occurrence among primiparous women delivering by an unassisted vaginal delivery. Prolonged second stage and the use of epidural analgesia are modifiable risk factors among these women.

Identifiants

pubmed: 32253487
doi: 10.1007/s00192-020-04296-3
pii: 10.1007/s00192-020-04296-3
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

2285-2290

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Auteurs

Raanan Meyer (R)

Department of Obstetrics and Gynecology, Chaim Sheba Medical Center, Ramat Gan, Israel.

Amihai Rottenstreich (A)

Department of Obstetrics and Gynecology, Hadassah-Hebrew University Medical Center, POB 12000, Jerusalem, Israel.

Michal Zamir (M)

Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Hadas Ilan (H)

Department of Obstetrics and Gynecology, Chaim Sheba Medical Center, Ramat Gan, Israel.

Edward Ram (E)

Department of Surgery and Transplantation, Chaim Sheba Medical Center, Ramat Gan, Israel.

Menachem Alcalay (M)

Department of Obstetrics and Gynecology, Chaim Sheba Medical Center, Ramat Gan, Israel.

Gabriel Levin (G)

Department of Obstetrics and Gynecology, Hadassah-Hebrew University Medical Center, POB 12000, Jerusalem, Israel. Levin.gaby@gmail.com.

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