干旱区生态环境知识资源中心(Arid): Passive management of labour may predispose to anal sphincter injury

Arid

DOI	10.1007/s00192-019-04183-6
	Passive management of labour may predispose to anal sphincter injury
	Beale, Mark; Petros, Peter
通讯作者	Petros, P
来源期刊	INTERNATIONAL UROGYNECOLOGY JOURNAL
ISSN	0937-3462
EISSN	1433-3023
出版年	2020
卷号	31 期号:9 页码:1943-1947
英文摘要	Introduction and hypothesis To compare anal sphincter damage in two groups of primigravid women in Sydney: one passively managed in public hospitals, the other more actively managed in adjacent private hospitals. Data from actively managed labours at the National Women's Hospital, Dublin, served as an independent control. Methods We carried out a comparative study of third and fourth degree anal sphincter tears in all primiparas delivering at term in the years 2010-2015 in six Sydney public teaching hospitals with data from patients delivered in six adjacent Sydney private hospitals. A second comparator was published data from the National Women's Hospital, Dublin, where active management is still performed under the direction of midwives. All data was publicly available from. The difference between the two groups: public hospitals were under MANDATORY (NSW DG's upper case emphasis) direction from the Director General of NSW Health (PD 2010-045 File no 09/638-3) for labour to proceed without any augmentation. Results The study comprised 130,000 women. The mean third and fourth degree anal sphincter tear rate was 8.17% for the public hospitals and 1.52% for the private hospitals in the same period (p < 0.0003). Dublin's rate was 2.6%. There was no significant difference in the emergency Caesarean section rate 2010-2015 (13.7% private vs 12.7% public, 7.9% in National Women's Hospital Dublin) as well as an increase in epidurals, forceps/ventouse and lower Apgar scores. Conclusion Passive management of labour instituted in Sydney public hospitals by government directive seems to be associated with a higher rate of obstetric anal sphincter injuries than was observed with active management. In addition, there were more epidurals, forceps/ventouse, and lower Apgar scores. Our hypothesis of deflexion of the head causing deficient powers is logically appealing, but needs further proof.
英文关键词	OASIS Perineal tears Passive management of labour Active management of labour
类型	Article
语种	英语
收录类别	SCI-E
WOS记录号	WOS:000561039000029
WOS类目	Obstetrics & Gynecology ; Urology & Nephrology
WOS研究方向	Obstetrics & Gynecology ; Urology & Nephrology
来源机构	University of Western Australia
资源类型	期刊论文
条目标识符	http://119.78.100.177/qdio/handle/2XILL650/325714
作者单位	[Beale, Mark] Univ New South Wales, VMO POW Hosp Sydney, Sydney, NSW, Australia; [Petros, Peter] Univ Western Australia, Sch Mech & Chem Engn, Perth, WA, Australia
推荐引用方式 GB/T 7714	Beale, Mark,Petros, Peter. Passive management of labour may predispose to anal sphincter injury[J]. University of Western Australia,2020,31(9):1943-1947.
APA	Beale, Mark,&Petros, Peter.(2020).Passive management of labour may predispose to anal sphincter injury.INTERNATIONAL UROGYNECOLOGY JOURNAL,31(9),1943-1947.
MLA	Beale, Mark,et al."Passive management of labour may predispose to anal sphincter injury".INTERNATIONAL UROGYNECOLOGY JOURNAL 31.9(2020):1943-1947.