干旱区生态环境知识资源中心(Arid): The impact of variations in obstetric practice on maternal birth trauma

Arid

DOI	10.1007/s00192-019-03887-z
	The impact of variations in obstetric practice on maternal birth trauma
	Atan, Ixora Kamisan 1,2; Lai, Shek Ka 1,3; Langer, Suzanne 1; Caudwell-Hall, Jessica 1; Dietz, Hans Peter 1
通讯作者	Atan, Ixora Kamisan
来源期刊	INTERNATIONAL UROGYNECOLOGY JOURNAL
ISSN	0937-3462
EISSN	1433-3023
出版年	2019
卷号	30 期号:6 页码:917-923
英文摘要	Introduction and hypothesisForceps delivery and length of second stage are risk factors of maternal birth trauma, i.e., levator ani muscle (LAM) avulsion and anal sphincter trauma. The cesarean section (CS) rate has recently become the key performance indicator because of its increase worldwide. Attempts to reduce CS rates seem to have led to an increase in forceps deliveries and longer second stages. This study aimed to determine the association between variations in obstetric practice (between hospitals) and maternal birth trauma.MethodsThis was a retrospective ancillary analysis involving 660 nulliparous women carrying an uncomplicated singleton term pregnancy in a prospective perinatal intervention trial at two Australian tertiary obstetric units. They had been seen antenatally and at 3-6months postpartum for a standardized clinical assessment between 2007 and 2014. Primary outcome measures were sonographically diagnosed LAM and external anal sphincter (EAS) trauma.ResultsThe incidence of LAM avulsion (11.5% vs. 21.3%, P=0.01) and composite trauma, i.e., LAM avulsion EAS injury (29.2% vs. 39.7%, P=0.03) were higher in one of the two hospitals, where the forceps delivery rate was also higher (10.9% vs. 2.6%, P<0.001). BMI (OR 0.9, P=0.02), length of second stage (OR 1.01, P=0.02) and forceps delivery (OR 5.24, P<0.001) were significant predictors of the difference in LAM avulsion incidence between the hospitals. Maternal age (OR 1.06, P<0.04) and forceps delivery (OR 8.66, P<0.001) were significant predictors for composite trauma.Conclusion>A higher incidence of LAM avulsion and composite trauma in one of the two hospitals was largely explained by a higher forceps delivery rate.
英文关键词	Maternal birth trauma Levator trauma Levator avulsion OASIS Anal sphincter trauma Forceps delivery
类型	Article
语种	英语
国家	Australia ; Malaysia
收录类别	SCI-E ; SSCI
WOS记录号	WOS:000467656700008
WOS关键词	ANAL-SPHINCTER INJURY ; PELVIC FLOOR ; RISK-FACTORS ; CESAREAN-SECTION ; LEVATOR TRAUMA ; ULTRASOUND ; DELIVERY ; FORCEPS ; PREVALENCE
WOS类目	Obstetrics & Gynecology ; Urology & Nephrology
WOS研究方向	Obstetrics & Gynecology ; Urology & Nephrology
资源类型	期刊论文
条目标识符	http://119.78.100.177/qdio/handle/2XILL650/216538
作者单位	1.Univ Sydney, Sydney Med Sch Nepean, Sydney, NSW, Australia; 2.Univ Kebangsaan Malaysia, Dept Obstet & Gynecol, Med Ctr UKMMC, Jalan Yaacob Latiff, Kuala Lumpur 56000, Malaysia; 3.Univ Western Sydney, Liverpool Clin Sch, Sydney, NSW, Australia
推荐引用方式 GB/T 7714	Atan, Ixora Kamisan,Lai, Shek Ka,Langer, Suzanne,et al. The impact of variations in obstetric practice on maternal birth trauma[J],2019,30(6):917-923.
APA	Atan, Ixora Kamisan,Lai, Shek Ka,Langer, Suzanne,Caudwell-Hall, Jessica,&Dietz, Hans Peter.(2019).The impact of variations in obstetric practice on maternal birth trauma.INTERNATIONAL UROGYNECOLOGY JOURNAL,30(6),917-923.
MLA	Atan, Ixora Kamisan,et al."The impact of variations in obstetric practice on maternal birth trauma".INTERNATIONAL UROGYNECOLOGY JOURNAL 30.6(2019):917-923.