Abstract:
OBJECTIVE:To characterize the rate of obstetric anal sphincter injuries and identify key risk factors of obstetric anal sphincter injuries, including duration of the second stage of labor. METHODS:This retrospective cohort study included all singleton, term, cephalic vaginal deliveries within Kaiser Permanente Northern California between January 2013 and December 2014 (N=22,741). Incidence of obstetric anal sphincter injuries, defined as third- or fourth-degree perineal lacerations, was the primary outcome. Multiple logistic regression models were conducted to identify obstetric anal sphincter injury risk factors and high-risk subpopulations. RESULTS:The overall incidence rate of obstetric anal sphincter injuries was 4.9% (3.6% of women who delivered spontaneously vs 24.0% of women who had a vacuum-assisted vaginal delivery, P<.001, CI 18.1-22.6%). In bivariate and multivariate analyses, obstetric anal sphincter injury incidence was higher among women with second stage of labor longer than 2 hours, Asian race, nulliparity, vaginal birth after cesarean delivery, episiotomy, and vacuum delivery. Women with a vacuum-assisted vaginal delivery had four times the odds of obstetric anal sphincter injury (adjusted odds ratio [OR] 4.23, 95% CI 3.59-4.98) and those whose second stage of labor lasted at least 180 minutes vs less than 60 minutes had three times the odds of incurring obstetric anal sphincter injury (adjusted OR 3.20, 95% CI 2.62-3.89). CONCLUSION:Vacuum-assisted vaginal delivery conferred the highest odds of obstetric anal sphincter injury followed by prolonged duration of the second stage of labor, particularly among certain subpopulations. Understanding these risk factors and their complex interactions can inform antepartum and intrapartum decision-making with the goal of reducing obstetric anal sphincter injury incidence.
journal_name
Obstet Gynecoljournal_title
Obstetrics and gynecologyauthors
Ramm O,Woo VG,Hung YY,Chen HC,Ritterman Weintraub MLdoi
10.1097/AOG.0000000000002444subject
Has Abstractpub_date
2018-02-01 00:00:00pages
290-296issue
2eissn
0029-7844issn
1873-233Xjournal_volume
131pub_type
杂志文章abstract::Peer review is the major method used by the scientific community to evaluate manuscripts and decide what is suitable for publication. However, this process in its current design is not bulletproof and is prone to reviewer and editorial bias. Its lack of objectivity and transparency raise concerns that manuscripts migh...
journal_title:Obstetrics and gynecology
pub_type: 社论
doi:10.1097/AOG.0000000000003260
更新日期:2019-06-01 00:00:00
abstract::Mississippi enacted medical negligence and other tort reform legislation that generally became effective for causes of action filed on or after January 1, 2003, and September 1, 2004. Data regarding lawsuits against physicians insured by the Medical Assurance Company of Mississippi (MACM), the largest medical liabilit...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0b013e318226ba47
更新日期:2011-08-01 00:00:00
abstract:OBJECTIVE:To explore disparities in prematurity and low birth weight (LBW) by maternal race and ethnicity among singletons conceived with and without assisted reproductive technology (ART). METHODS:We performed a retrospective cohort study using resident birth certificate data from Florida, Massachusetts, and Michigan...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0000000000002031
更新日期:2017-06-01 00:00:00
abstract::This study reports serum levels of relaxin in normal and special-interest pregnancies using an homologous radioimmunoassay for human relaxin. The mean levels in uncomplicated antenatal patients were lower than those reported in studies using heterologous assays, but the trend in serum levels was similar. Serum levels ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1987-04-01 00:00:00
abstract:OBJECTIVE:To estimate whether race or ethnic and socioeconomic strata are independently associated with advanced-stage ovarian cancer-specific survival after adjusting for adherence to National Comprehensive Cancer Network treatment guidelines. METHODS:The design was a retrospective population-based cohort study of pa...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0000000000000643
更新日期:2015-04-01 00:00:00
abstract::Before the discovery of insulin in 1921, pregnancies in women with diabetes mellitus were a rarity because most reproductive-age patients died soon after diagnosis of this illness. In the limited number of pregnancies reported in the pre-insulin era, both perinatal and maternal mortality were approximately 50%, with s...
journal_title:Obstetrics and gynecology
pub_type: 历史文章,杂志文章
doi:
更新日期:1992-02-01 00:00:00
abstract:OBJECTIVE:To evaluate an office-based test as a screening method for intrinsic sphincter deficiency. METHODS:One hundred seventy-three women with urinary incontinence were evaluated prospectively by complete urodynamic studies. After catheterization, the pediatric Foley catheter test was performed on an empty bladder ...
journal_title:Obstetrics and gynecology
pub_type: 临床试验,杂志文章
doi:10.1016/s0029-7844(01)01344-8
更新日期:2001-06-01 00:00:00
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journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:2003-06-01 00:00:00
abstract:OBJECTIVE:To evaluate a quality improvement protocol for venous thromboembolism prevention in postoperative gynecologic cancer patients. METHODS:On January 1, 2006, we initiated a universal protocol of dual prophylaxis with sequential compression devices and three times daily heparin (or daily low molecular weight hep...
journal_title:Obstetrics and gynecology
pub_type: 临床试验,杂志文章
doi:10.1097/AOG.0b013e31818b1486
更新日期:2008-11-01 00:00:00
abstract:BACKGROUND:Doppler measurement of the fetal middle cerebral artery peak systolic velocity is a valuable tool in detecting the presence of fetal anemia in Rh-sensitized pregnancies. We present a case in which discordant left and right middle cerebral artery Dopplers complicated clinical management. CASE:An RhD-alloimmu...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/01.AOG.0000263463.09931.40
更新日期:2007-08-01 00:00:00
abstract:OBJECTIVE:To evaluate whether transvaginal Doppler ultrasound is more valid than transvaginal sonography, magnetic resonance imaging (MRI), and CA 125 in differentiating malignant from benign ovarian tumors. METHODS:Sixty-three patients with ovarian tumors (36 benign and 27 malignant) were studied with transvaginal Do...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1992-12-01 00:00:00
abstract:OBJECTIVE:To determine if bacteria are capable of producing phosphatidylglycerol in amniotic fluid (AF) and the number of colony forming units (CFU) of bacteria necessary to produce this result. METHODS:Eleven species of bacteria and one species of yeast, common to the female genital tract and implicated in chorioamni...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0029-7844(95)00032-m
更新日期:1995-05-01 00:00:00
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journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0000000000002734
更新日期:2018-08-01 00:00:00
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journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0b013e318242b4cb
更新日期:2012-03-01 00:00:00
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journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(97)00487-0
更新日期:1998-05-01 00:00:00
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journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(97)00083-5
更新日期:1997-05-01 00:00:00
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journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(01)01384-9
更新日期:2001-07-01 00:00:00
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journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/00006250-199406000-00012
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journal_title:Obstetrics and gynecology
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doi:
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doi:10.1016/s0029-7844(97)00356-6
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journal_title:Obstetrics and gynecology
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doi:
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pub_type: 杂志文章
doi:10.1097/AOG.0b013e3182078115
更新日期:2011-02-01 00:00:00
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pub_type: 杂志文章
doi:10.1097/AOG.0b013e31826994ec
更新日期:2012-10-01 00:00:00
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pub_type: 杂志文章
doi:10.1016/s0029-7844(01)01611-8
更新日期:2001-11-01 00:00:00
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journal_title:Obstetrics and gynecology
pub_type: 杂志文章,多中心研究
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pub_type: 杂志文章
doi:
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doi:10.1097/AOG.0000000000004021
更新日期:2020-10-01 00:00:00
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pub_type: 杂志文章
doi:10.1097/AOG.0b013e3181834660
更新日期:2009-02-01 00:00:00
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journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1972-08-01 00:00:00