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DOI	10.1016/j.ejogrb.2018.12.019
	Which characteristics of the episiotomy and perineum are associated with a lower risk of obstetric anal sphincter injury in instrumental deliveries
	Gonzalez-Diaz, Enrique 1; Fernandez Fernandez, Camino 2; Gonzalo Orden, Jose Manuel 3; Fernandez Corona, Alfonso 2
通讯作者	Gonzalez-Diaz, Enrique
来源期刊	EUROPEAN JOURNAL OF OBSTETRICS & GYNECOLOGY AND REPRODUCTIVE BIOLOGY
ISSN	0301-2115
EISSN	1872-7654
出版年	2019
卷号	233 页码:127-133
英文摘要	Objetive: Operative vaginal delivery (OVD) is the most important risk fact for obstetric anal sphincter injury (OASI). Knowledge of possible risk factors for their occurrence may therefore reduce the likelihood of faecal incontinence. The aim is to analyse the effect of mediolateral episitomy and perineum characteristics on the occurrence of OASI in OVD. Study Design: Case-control study, which included 958 OVD that were reviewed in Pelvic Floor and Puerperium Clinic. The episiotomy and perineum characteristics of those women who experienced OASIs (n = 150) were compared with those who had no evidence of anal sphincter injury (n = 788). Results: In multivariate logistic regression analysis the factors which were independently associated were nulliparity, persistent occipitoposterior position, birthweight >3500g, an angle of episiotomy <30 degrees, a distance episiotomy-fourchette <5 mm and a distance of perineal body <30 mm. The analysis of subgroups show that only the multiparous women does not benefit from any feature of the episiotomy, and an angle greater than 30 degrees and a distance episiotomy-fourchette >5 mm are associated with a risk reduction of OASI in nulliparous, perineal bodies <= 30 mm and occipitoanterior position. Conclusions: Two modifiable risk factors at the time of performing the episiotomy, the angle and distance episiotomy-fourchette, have been identified as the risk modification of OASI. It is necessary to achieve an adequate angle to reduce the probability of OASIs in OVD, and in nulliparous women with an anterior position and a distance of perineal body <= 30 mm could benefit from increasing the episiotomy-fourchette distance. (C) 2018 Elsevier B.V. All rights reserved.
英文关键词	Operative vaginal delivery Obstetric anal sphincter injuries Mediolateral episiotomy Episiotomy technique Episiotomy angle
类型	Article
语种	英语
国家	Spain
收录类别	SCI-E
WOS记录号	WOS:000458709500022
WOS关键词	OPERATIVE VAGINAL DELIVERY ; RANDOMIZED CONTROLLED-TRIAL ; MEDIOLATERAL EPISIOTOMY ; INCISION ANGLE ; WOMEN ; PROTECTS ; RUPTURES ; ROUTINE
WOS类目	Obstetrics & Gynecology ; Reproductive Biology
WOS研究方向	Obstetrics & Gynecology ; Reproductive Biology
资源类型	期刊论文
条目标识符	http://119.78.100.177/qdio/handle/2XILL650/215586
作者单位	1.Complejo Asistencial Univ Leon CAULE, Dept Obstet & Gynaecol, Pelv Floor Unit, Leon, Spain; 2.Complejo Asistencial Univ Leon CAULE, Dept Obstet & Gynaecol, Leon, Spain; 3.Univ Leon, Inst Biomed Leon IBIOMED, Leon, Spain
推荐引用方式 GB/T 7714	Gonzalez-Diaz, Enrique,Fernandez Fernandez, Camino,Gonzalo Orden, Jose Manuel,et al. Which characteristics of the episiotomy and perineum are associated with a lower risk of obstetric anal sphincter injury in instrumental deliveries[J],2019,233:127-133.
APA	Gonzalez-Diaz, Enrique,Fernandez Fernandez, Camino,Gonzalo Orden, Jose Manuel,&Fernandez Corona, Alfonso.(2019).Which characteristics of the episiotomy and perineum are associated with a lower risk of obstetric anal sphincter injury in instrumental deliveries.EUROPEAN JOURNAL OF OBSTETRICS & GYNECOLOGY AND REPRODUCTIVE BIOLOGY,233,127-133.
MLA	Gonzalez-Diaz, Enrique,et al."Which characteristics of the episiotomy and perineum are associated with a lower risk of obstetric anal sphincter injury in instrumental deliveries".EUROPEAN JOURNAL OF OBSTETRICS & GYNECOLOGY AND REPRODUCTIVE BIOLOGY 233(2019):127-133.