干旱区生态环境知识资源中心(Arid): Delivery mode, levator avulsion and obstetric anal sphincter injury: A cross-sectional study 20 years after childbirth

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DOI	10.1111/ajo.12948
	Delivery mode, levator avulsion and obstetric anal sphincter injury: A cross-sectional study 20 years after childbirth
	Lin, Sylvia 1,2; Atan, Ixora Kamisan 3,4; Dietz, Hans Peter 3; Herbison, Peter 5; Wilson, Peter Donald 6
通讯作者	Lin, Sylvia
来源期刊	AUSTRALIAN & NEW ZEALAND JOURNAL OF OBSTETRICS & GYNAECOLOGY
ISSN	0004-8666
EISSN	1479-828X
出版年	2019
卷号	59 期号:4 页码:590-596
英文摘要	Background Levator ani muscle (LAM) and anal sphincter injuries are common after vaginal birth and are associated with pelvic organ prolapse and anal incontinence. Aims Our objective was to investigate long-term association between delivery mode, LAM avulsion and obstetric anal sphincter injuries (OASIS) in women at least 20 years after their first birth. Methods All women recruited at 'index birth' of the Dunedin (New Zealand) arm of ProLong (PROlapse and incontinence LONG-term research) Study, were invited to have translabial and transperineal ultrasound assessment of LAM and anal sphincters. Post-processing analysis of imaging data was performed blinded against delivery data. Statistical analysis was performed using the chi(2) test and results are expressed as odds ratios (OR). Results Of the initial 1250 participants, 196 women returned for examination. Mean age was 50.8 years with a mean body mass index of 27.6 and median parity was three. They were seen on average 23 years after their first delivery. Four data sets were unavailable and one declined ultrasound assessment, leaving 191 for analysis. LAM avulsion was diagnosed in 29 (15.2%), and 24 women (12.6%) had significant anal sphincter defect. LAM avulsion was associated with forceps delivery (OR 2.45, 95% CI 1.04-5.80, P = 0.041). Forceps conveyed a greater risk of OASIS (21%) compared to a spontaneous vaginal delivery (11%) but did not reach statistical significance. Conclusions Forceps delivery is associated with long-term injurious effect on pelvic floor structures. Discussions of the long-term negative impact of pelvic floor structures and their functions are necessary to achieve an informed consent toward an operative vaginal delivery.
英文关键词	anal sphincter injury delivery mode forceps delivery instrumental delivery levator ani avulsion
类型	Article
语种	英语
国家	New Zealand ; Australia ; Malaysia
收录类别	SCI-E
WOS记录号	WOS:000478596500023
WOS关键词	PELVIC ORGAN PROLAPSE ; FECAL INCONTINENCE ; RISK-FACTORS ; TRAUMA ; ULTRASOUND ; DEFECTS ; URINARY ; WOMEN ; FLOOR
WOS类目	Obstetrics & Gynecology
WOS研究方向	Obstetrics & Gynecology
资源类型	期刊论文
条目标识符	http://119.78.100.177/qdio/handle/2XILL650/214559
作者单位	1.Womens Hlth Waikato DHB, Private Bag 3200, Hamilton 3240, New Zealand; 2.Univ Auckland, Dept Obstet & Gynaecol, Fac Med & Hlth Sci, Auckland, New Zealand; 3.Univ Sydney, Sydney Med Sch Nepean, Dept Obstet Gynaecol & Neonatol, Sydney, NSW, Australia; 4.Univ Kebangsaan Malaysia, Dept Obstet Gynaecol, Med Ctr, Kuala Lumpur, Malaysia; 5.Univ Otago, Dunedin Sch Med, Dept Prevent & Social Med, Dunedin, New Zealand; 6.Univ Otago, Dunedin Sch Med, Dept Womens & Childrens Hlth, Dunedin, New Zealand
推荐引用方式 GB/T 7714	Lin, Sylvia,Atan, Ixora Kamisan,Dietz, Hans Peter,et al. Delivery mode, levator avulsion and obstetric anal sphincter injury: A cross-sectional study 20 years after childbirth[J],2019,59(4):590-596.
APA	Lin, Sylvia,Atan, Ixora Kamisan,Dietz, Hans Peter,Herbison, Peter,&Wilson, Peter Donald.(2019).Delivery mode, levator avulsion and obstetric anal sphincter injury: A cross-sectional study 20 years after childbirth.AUSTRALIAN & NEW ZEALAND JOURNAL OF OBSTETRICS & GYNAECOLOGY,59(4),590-596.
MLA	Lin, Sylvia,et al."Delivery mode, levator avulsion and obstetric anal sphincter injury: A cross-sectional study 20 years after childbirth".AUSTRALIAN & NEW ZEALAND JOURNAL OF OBSTETRICS & GYNAECOLOGY 59.4(2019):590-596.