干旱区生态环境知识资源中心(Arid): Risk factors for obstetric anal sphincter injuries at vaginal birth after caesarean: a retrospective cohort study

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DOI	10.1007/s00192-019-03978-x
	Risk factors for obstetric anal sphincter injuries at vaginal birth after caesarean: a retrospective cohort study
	D'; Souza, Joanna C.1,2; Monga, Ash 2; Tincello, Douglas G.3
通讯作者	D&#39 ; Souza, Joanna C.
来源期刊	INTERNATIONAL UROGYNECOLOGY JOURNAL
ISSN	0937-3462
EISSN	1433-3023
出版年	2019
卷号	30 期号:10 页码:1747-1753
英文摘要	Introduction and hypothesis Vaginal birth after caesarean (VBAC) is associated with an increased risk of obstetric anal sphincter injuries (OASIS). However, specific factors that influence the risk of OASIS at VBAC have not been studied, particularly whether there are specific baseline characteristics of the first delivery which affect the subsequent perineal outcomes. Methods Retrospective analysis of prospectively collected data from University of Southampton NHS Foundation Trusts' maternity database. This included secundiparous women with a previous caesarean delivery (CS) who achieved a singleton, term, cephalic vaginal delivery from 2004 to 2014. Univariate analysis compared maternal, intrapartum and neonatal factors of those who suffered OASIS at VBAC with those who did not. A binary logistic regression model calculated the adjusted, independent odds ratio (OR) of OASIS. Results A total of 1375 women met the inclusion criteria. The OASIS rate was 8.1%, a 1.4-fold increase compared with primiparous women [difference 2.4% (95% CI 1.1, 3.6)]. Those sustaining OASIS at VBAC were older (p = 0.011) and had infants of greater birth weight at initial caesarean (p < 0.001) and VBAC (p = 0.04). Analysis of odds ratios revealed that mediolateral episiotomy (MLE) at VBAC halved the risk of OASIS [37.5% VBAC with OASIS vs. 52.2% VBAC without OASIS (OR 0.51, 95% CI 0.32-0.81)], whereas an urgent CS at initial delivery doubled the risk [52.3% VBAC with OASIS vs. 34.9% VBAC without OASIS (OR 2.05, 95% CI 1.31-3.21)]. Conclusions Advanced maternal age, increased infant birth weight and an urgent category of initial CS increase the risk of OASIS at VBAC, whereas MLE is protective.
英文关键词	Vaginal birth after caesarean section (VBAC) Obstetric anal sphincter injuries (OASIS) Perineal trauma Mediolateral episiotomy (MLE)
类型	Article
语种	英语
国家	England
开放获取类型	Green Published, Green Accepted, hybrid
收录类别	SCI-E
WOS记录号	WOS:000490733000020
WOS关键词	PERINEAL TRAUMA ; LACERATIONS ; SECTION ; LENGTH
WOS类目	Obstetrics & Gynecology ; Urology & Nephrology
WOS研究方向	Obstetrics & Gynecology ; Urology & Nephrology
EI主题词	2019-10-01
资源类型	期刊论文
条目标识符	http://119.78.100.177/qdio/handle/2XILL650/310116
作者单位	1.Univ Southampton, Univ Hosp Southampton NHS Fdn Trust, Fac Med, Tremona Rd, Southampton SO16 6YD, Hants, England; 2.Univ Hosp Southampton NHS Fdn Trust, Princess Anne Hosp, Dept Urogynaecol, Coxford Rd, Southampton SO16 5YA, Hants, England; 3.Univ Leicester, Coll Life Sci, Dept Hlth Sci, Univ Rd, Leicester LE1 7RH, Leics, England
推荐引用方式 GB/T 7714	D',Souza, Joanna C.,Monga, Ash,et al. Risk factors for obstetric anal sphincter injuries at vaginal birth after caesarean: a retrospective cohort study[J],2019,30(10):1747-1753.
APA	D',Souza, Joanna C.,Monga, Ash,&Tincello, Douglas G..(2019).Risk factors for obstetric anal sphincter injuries at vaginal birth after caesarean: a retrospective cohort study.INTERNATIONAL UROGYNECOLOGY JOURNAL,30(10),1747-1753.
MLA	D',et al."Risk factors for obstetric anal sphincter injuries at vaginal birth after caesarean: a retrospective cohort study".INTERNATIONAL UROGYNECOLOGY JOURNAL 30.10(2019):1747-1753.