دورية أكاديمية
Factors Associated with Obstetric Anal Sphincter Injury During Vacuum-Assisted Vaginal Delivery.
| العنوان: | Factors Associated with Obstetric Anal Sphincter Injury During Vacuum-Assisted Vaginal Delivery. |
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| المؤلفون: | Chill HH; Female Pelvic Medicine and Reconstructive Surgery (FPMRS), Division of Urogynecology, University of Chicago, Northshore University Health System, 9650 Gross Point Road, Suite 3900, Skokie, IL, USA. henchill@gmail.com.; Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel. henchill@gmail.com., Dick A; Department of Obstetrics and Gynecology, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel., Zarka W; Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel., Vilk Ayalon N; Department of Obstetrics and Gynecology, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel., Rosenbloom JI; Department of Obstetrics and Gynecology, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel., Shveiky D; Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.; Department of Obstetrics and Gynecology, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel., Karavani G; Department of Obstetrics and Gynecology, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel. |
| المصدر: | International urogynecology journal [Int Urogynecol J] 2024 Jun; Vol. 35 (6), pp. 1183-1189. Date of Electronic Publication: 2024 May 04. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Springer Country of Publication: England NLM ID: 101567041 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1433-3023 (Electronic) Linking ISSN: 09373462 NLM ISO Abbreviation: Int Urogynecol J Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: London : Springer |
| مواضيع طبية MeSH: | Vacuum Extraction, Obstetrical*/adverse effects , Anal Canal*/injuries, Humans ; Female ; Pregnancy ; Adult ; Case-Control Studies ; Risk Factors ; Young Adult ; Adolescent ; Obstetric Labor Complications/etiology ; Obstetric Labor Complications/epidemiology ; Middle Aged ; Labor Stage, Second |
| مستخلص: | Introduction and Hypothesis: Obstetric anal sphincter injury (OASI) is a major complication associated with vacuum-assisted vaginal delivery (VAVD). The aim of this study was to evaluate risk factors related to vacuum extraction that are associated with OASI. Methods: This was a case-control study performed at a tertiary university teaching hospital. Included were patients aged 18-45 years who had a singleton pregnancy resulting in a live, term, VAVD. The study group consisted of women diagnosed with OASI following vacuum extraction. The control group included women following VAVD without OASI. Matching at a ratio of 1:2 was performed. Groups were compared regarding demographic, obstetric. and labor-related parameters, specifically focusing on variables related to the vacuum procedure itself. Results: One hundred and ten patients within the study group and 212 within the control group were included in the final analysis. Patients in the OASI group were more likely to undergo induction of labor, use of oxytocin during labor, increased second stage of labor, higher likelihood of the operator being a resident, increased number of pulls, procedure lasting under 10 min, occipito-posterior head position at vacuum initiation, episiotomy, increased neonatal head circumference, and birthweight. Multivariate logistic regression analysis revealed that increased week of gestation (OR 1.67, 95% CI 1.25-2.22, p < 0.001), unsupervised resident performing the procedure (OR 4.63, 95% CI 2.17-9.90), p < 0.001), indication of VAVD being fetal distress (OR 2.72, 95% CI 1.04-7.10, p = 0.041), and length of procedure under 10 min (OR 4.75, 95% CI 1.53-14.68, p = 0.007) were associated with OASI. Increased maternal age was associated with lower risk of OASI (OR 0.9, 95% CI 0.84-0.98, p = 0.012). Conclusions: When performing VAVD, increased week of gestation, unsupervised resident performing the procedure, fetal distress as vacuum indication, and vacuum procedure under 10 min were associated with OASI. In contrast, increased maternal age was shown to be a protective factor. (© 2024. The International Urogynecological Association.) |
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| فهرسة مساهمة: | Keywords: Obstetric anal sphincter injury; Operative vaginal delivery; Perineal lacerations; Vacuum delivery; Vacuum-assisted vaginal delivery |
| تواريخ الأحداث: | Date Created: 20240504 Date Completed: 20240712 Latest Revision: 20240712 |
| رمز التحديث: | 20240712 |
| DOI: | 10.1007/s00192-024-05785-5 |
| PMID: | 38703223 |
| قاعدة البيانات: | MEDLINE |
Find this article in full text from Springer Verlag. 
Full Text Finder | تدمد: | 1433-3023 |
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| DOI: | 10.1007/s00192-024-05785-5 |