Risk Factors for the Development of Obstetric Anal Sphincter Injuries in Modern Obstetric Practice.

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 Gynecol

authors

Ramm O,Woo VG,Hung YY,Chen HC,Ritterman Weintraub ML

doi

10.1097/AOG.0000000000002444

subject

Has Abstract

pub_date

2018-02-01 00:00:00

pages

290-296

issue

2

eissn

0029-7844

issn

1873-233X

journal_volume

131

pub_type

杂志文章
  • Bias in the Peer Review Process: Can We Do Better?

    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

    authors: Tvina A,Spellecy R,Palatnik A

    更新日期:2019-06-01 00:00:00

  • Medical liability reform: a case study of Mississippi.

    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

    authors: Behrens MA

    更新日期:2011-08-01 00:00:00

  • Maternal Racial and Ethnic Disparities in Neonatal Birth Outcomes With and Without Assisted Reproduction.

    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

    authors: Crawford S,Joshi N,Boulet SL,Bailey MA,Hood ME,Manning SE,McKane P,Kirby RS,Kissin DM,Jamieson DJ,States Monitoring Assisted Reproductive Technology (SMART) Collaborative.

    更新日期:2017-06-01 00:00:00

  • Relaxin in human pregnancy serum measured with an homologous radioimmunoassay.

    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:

    authors: Bell RJ,Eddie LW,Lester AR,Wood EC,Johnston PD,Niall HD

    更新日期:1987-04-01 00:00:00

  • Sociodemographic disparities in advanced ovarian cancer survival and adherence to treatment guidelines.

    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

    authors: Bristow RE,Chang J,Ziogas A,Campos B,Chavez LR,Anton-Culver H

    更新日期:2015-04-01 00:00:00

  • A story of two miracles: the impact of the discovery of insulin on pregnancy in women with diabetes mellitus.

    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:

    authors: Gabbe SG

    更新日期:1992-02-01 00:00:00

  • Office screening test for intrinsic urethral sphincter deficiency: pediatric Foley catheter test.

    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

    authors: Arya LA,Myers DL,Jackson ND

    更新日期:2001-06-01 00:00:00

  • Successful treatment with recombinant factor VIIa for intractable bleeding at pelvic surgery.

    abstract:BACKGROUND:Postoperative bleeding may be complicated by failure to identify the site of bleeding, multiple bleeding points, and persistent hemorrhage despite surgical intervention. CASE:Activated recombinant factor VII was used successfully in a patient with life-threatening postsurgical bleeding after resection of tw...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:

    authors: Daniloś J,Goral A,Paluszkiewicz P,Przesmycki K,Kotarski J

    更新日期:2003-06-01 00:00:00

  • A protocol of dual prophylaxis for venous thromboembolism prevention in gynecologic cancer patients.

    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

    authors: Einstein MH,Kushner DM,Connor JP,Bohl AA,Best TJ,Evans MD,Chappell RJ,Hartenbach EM

    更新日期:2008-11-01 00:00:00

  • Discordant middle cerebral artery peak systolic velocity Doppler studies in a fetus with RhD alloimmunization.

    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

    authors: Berkley EM,Rappaport VJ,Hurley TJ

    更新日期:2007-08-01 00:00:00

  • A critical evaluation of transvaginal Doppler studies, transvaginal sonography, magnetic resonance imaging, and CA 125 in detecting ovarian cancer.

    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:

    authors: Hata K,Hata T,Manabe A,Sugimura K,Kitao M

    更新日期:1992-12-01 00:00:00

  • Ability of normal vaginal flora to produce detectable phosphatidylglycerol in amniotic fluid in vitro.

    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

    authors: Lambers DS,Brady K,Leist PA,Setser C,Helmchen R

    更新日期:1995-05-01 00:00:00

  • Fatal and Nonfatal Overdose Among Pregnant and Postpartum Women in Massachusetts.

    abstract:OBJECTIVE:To estimate fatal and nonfatal opioid overdose events in pregnant and postpartum women in Massachusetts, comparing rates in individuals receiving and not receiving pharmacotherapy for opioid use disorder (OUD). METHODS:We conducted a population-based retrospective cohort study using linked administrative and...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:10.1097/AOG.0000000000002734

    authors: Schiff DM,Nielsen T,Terplan M,Hood M,Bernson D,Diop H,Bharel M,Wilens TE,LaRochelle M,Walley AY,Land T

    更新日期:2018-08-01 00:00:00

  • Drive times to hospitals with perinatal care in the United States.

    abstract:OBJECTIVE:To evaluate access to inpatient obstetric care, we determined the proportions of women of reproductive age who resided within 30-minute and 60-minute driving times to the nearest hospital offering perinatal services. METHODS:Perinatal centers, identified from the 2007 American Hospital Association survey, we...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:10.1097/AOG.0b013e318242b4cb

    authors: Rayburn WF,Richards ME,Elwell EC

    更新日期:2012-03-01 00:00:00

  • Atraumatic fetal cervical spinal cord injury and cruciate paralysis.

    abstract:BACKGROUND:Congenital cervical spinal cord injury usually is attributed to intrapartum mechanical trauma. CASE:A fetal cervical spinal cord hemorrhage presented as congenital isolated upper extremity ("cruciate") paralysis and muscle atrophy after an atraumatic delivery. Timely neonatal diagnosis and surgery resulted ...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:10.1016/s0029-7844(97)00487-0

    authors: Berck DJ,Mussalli GM,Manning FA

    更新日期:1998-05-01 00:00:00

  • Human amniotic fluid motogenic activity for fetal alveolar type II cells by way of hepatocyte growth factor.

    abstract:OBJECTIVE:To find out if hepatocyte growth factor (HGF) in amniotic fluid (HGF-AF) has a direct effect on fetal lung development, we investigated the effects of AF as well as recombinant human HGF (rhHGF) on proliferation, migration, and morphogenesis of fetal alveolar type II cells in vitro. METHODS:Amniotic fluid sa...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:10.1016/s0029-7844(97)00083-5

    authors: Itakura A,Kurauchi O,Morikawa S,Furugori K,Mizutani S,Tomoda Y

    更新日期:1997-05-01 00:00:00

  • Varicella vaccine exposure during pregnancy: data from the first 5 years of the pregnancy registry.

    abstract:OBJECTIVE:To assess the risks of congenital varicella syndrome and other birth defects in offspring of women who inadvertently received varicella vaccine during pregnancy or within 3 months of conception. METHODS:Pregnant women inadvertently exposed to varicella vaccine, reported voluntarily, were enrolled in the Preg...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:10.1016/s0029-7844(01)01384-9

    authors: Shields KE,Galil K,Seward J,Sharrar RG,Cordero JF,Slater E

    更新日期:2001-07-01 00:00:00

  • Comparative efficacy of two sonographic measurements for the detection of aberrations in the amniotic fluid volume and the effect of amniotic fluid volume on pregnancy outcome.

    abstract:OBJECTIVE:To determine in pregnant women with preterm labor the relative efficacy of the amniotic fluid index (AFI) and the two-diameter pocket to detect abnormalities in amniotic fluid volume (AFV), and to relate these findings to pregnancy outcome. METHODS:Fifty-seven healthy women with preterm labor underwent amnio...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:10.1097/00006250-199406000-00012

    authors: Magann EF,Morton ML,Nolan TE,Martin JN Jr,Whitworth NS,Morrison JC

    更新日期:1994-06-01 00:00:00

  • Alcohol abuse during pregnancy: changes in frequency in a large urban hospital.

    abstract::The reported frequency of alcohol abuse during pregnancy was studied in a large urban public hospital in Dallas, Texas. During 1977-1980, 5602 pregnant women were surveyed and 0.7% (95% confidence interval 0.6-0.8%) reported abusing alcohol during pregnancy. In 1987, 1.4% (95% confidence interval 1.3-1.5%) of 1032 pre...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:

    authors: Little BB,Snell LM,Gilstrap LC 3rd,Gant NF,Rosenfeld CR

    更新日期:1989-10-01 00:00:00

  • Relationship between change in amniotic fluid index and volume of fluid removed at amnioreduction.

    abstract:OBJECTIVE:To determine the relationship between the change in amniotic fluid index (AFI) and the volume of fluid removed at amnioreduction. METHODS:In a prospective study of 20 twin and 19 singleton pregnancies undergoing amnioreduction for severe polyhydramnios, AFI was measured immediately before and after the proce...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:10.1016/s0029-7844(97)00356-6

    authors: Denbow ML,Sepulveda W,Ridout D,Fisk NM

    更新日期:1997-10-01 00:00:00

  • Cecal volvulus in pregnancy.

    abstract::Cecal volvulus in pregnancy is an uncommon complication. A case is reported of a 28-year-old white female, gravida 2, para 1, who presented at 36 weeks' gestation with flu-like symptoms accompanied by regular uterine contractions every 3 minutes; she underwent repeat cesarean section without incident. The patient did ...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:

    authors: Pratt AT,Donaldson RC,Evertson LR,Yon JL Jr

    更新日期:1981-06-01 00:00:00

  • Cordocentesis for the diagnosis and treatment of human fetal parvovirus infection.

    abstract::Human parvovirus B-19 infection was diagnosed by DNA hybridization in blood obtained by cordocentesis from two hydropic fetuses at 22 and 26 weeks' gestation; B-19-specific immunoglobulin M (IgM) in fetal blood was negative in both cases. Hematologic studies demonstrated severe anemia, which was treated by intravascul...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:

    authors: Peters MT,Nicolaides KH

    更新日期:1990-03-01 00:00:00

  • Timing of elective repeat cesarean delivery at term and maternal perioperative outcomes.

    abstract:OBJECTIVE:Elective repeat cesarean delivery at 37 or 38 weeks compared with 39 completed weeks of gestation is associated with adverse neonatal outcomes. We assessed whether delivery before 39 weeks is justifiable on the basis of decreased adverse maternal outcomes. METHODS:We conducted a cohort study of women with li...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:10.1097/AOG.0b013e3182078115

    authors: Tita ATN,Lai Y,Landon MB,Spong CY,Leveno KJ,Varner MW,Caritis SN,Meis PJ,Wapner RJ,Sorokin Y,Peaceman AM,O'Sullivan MJ,Sibai BM,Thorp JM,Ramin SM,Mercer BM,Eunice Kennedy Shriver National Institute of Child Health and Hum

    更新日期:2011-02-01 00:00:00

  • Pregnancy outcomes in women with and without gestational diabetes mellitus according to the International Association of the Diabetes and Pregnancy Study Groups criteria.

    abstract:OBJECTIVE:To estimate the incidence of gestational diabetes mellitus (GDM) according to The International Association of the Diabetes and Pregnancy Study Groups (IADPSG) criteria and the pregnancy complications in women fulfilling these criteria but who are not considered diabetic according to the Canadian Diabetes Ass...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:10.1097/AOG.0b013e31826994ec

    authors: Bodmer-Roy S,Morin L,Cousineau J,Rey E

    更新日期:2012-10-01 00:00:00

  • Group A streptococcal puerperal sepsis preceded by positive surveillance cultures.

    abstract:BACKGROUND:Screening of pregnant women for vaginal and rectal carriage of group B streptococci may also identify group A streptococcal carriers. The clinical significance of prenatal group A streptococcal carriage is unknown. CASES:Two women developed group A streptococcal puerperal sepsis after delivery at one hospit...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:10.1016/s0029-7844(01)01611-8

    authors: Stefonek KR,Maerz LL,Nielsen MP,Besser RE,Cieslak PR

    更新日期:2001-11-01 00:00:00

  • Poststerilization regret: findings from the United States Collaborative Review of Sterilization.

    abstract:OBJECTIVE:To evaluate the cumulative probability of regret after tubal sterilization, and to identify risk factors for regret that are identifiable before sterilization. METHODS:We used a prospective, multicenter cohort study to evaluate the cumulative probability of regret within 14 years after tubal sterilization. P...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章,多中心研究

    doi:10.1016/s0029-7844(98)00539-0

    authors: Hillis SD,Marchbanks PA,Tylor LR,Peterson HB

    更新日期:1999-06-01 00:00:00

  • Pituitary response to a new analog of luteinizing hormone releasing factor during the menstrual cycle.

    abstract::A new analog of luteinizing-hormone-releasing factor, (Des-Gly-NH-2-10, Pro-ethylamide-9)-LHRF, was tested in healthy women with regular menstrual cycles. This synthetic nonapeptide amide was injected intravenously in a dose of 200 mug into 15 normal female volunteers in the follicular, preovulatory, and luteal phases...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:

    authors: Nakano R,Takekida H,Kotsuji F,Tojo S

    更新日期:1975-03-01 00:00:00

  • Occupational Exposure to Human Papillomavirus and Vaccination for Health Care Workers.

    abstract::Multiple studies suggest that health care workers treating human papillomavirus (HPV)-associated conditions may experience occupational exposure to the virus. Case reports describe the development of cancer and other disease in health care professionals at low risk for such conditions except for their work. Despite li...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:10.1097/AOG.0000000000004021

    authors: Harrison R,Huh W

    更新日期:2020-10-01 00:00:00

  • Uterine arteriovenous fistula as a long-term complication of hysterectomy: presentation and management.

    abstract:BACKGROUND:A rare complication of hysterectomy is the formation of a high-flow fistula between the uterine artery and uterine vein. Historically, these lesions were treated surgically. CASE:Two women with histories including hysterectomy presented with symptoms and physical examination signs suggestive of uterine arte...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:10.1097/AOG.0b013e3181834660

    authors: Sharma A,Vogelzang RL

    更新日期:2009-02-01 00:00:00

  • Removal of intrauterine contraceptive devices after uterine perforation.

    abstract::Rates of perforation for different types of IUDs vary from 1 per 150 insertions with the bow to 1 per 2500 with the loop. Incidence of perforation varies with insertion technic. Not all perforations occur at the time of insertion but most do. These perforations may be partial or complete, with or without symptoms, ...

    journal_title:Obstetrics and gynecology

    pub_type: 杂志文章

    doi:

    authors: Allen JR,Shemwell RE,Macleod DP Jr,Weed JC

    更新日期:1972-08-01 00:00:00