TY - JOUR
T1 - Occiput posterior fetal head position increases the risk of anal sphincter injury in vacuum-assisted deliveries
AU - Wu, Jennifer M.
AU - Williams, Kathryn S.
AU - Hundley, Andrew F.
AU - Connolly, Anna Marie
AU - Visco, Anthony G.
AU - Stubbs, Thomas
PY - 2005/8
Y1 - 2005/8
N2 - Objective: The purpose of this study was to determine whether an occiput posterior (OP) fetal head position increases the risk for anal sphincter injury when compared with an occiput anterior (OA) position in vacuum-assisted deliveries. Study design: We conducted a retrospective cohort study of 393 vacuum-assisted singleton vaginal deliveries. Maternal demographics and obstetric and neonatal data were collected from an obstetric database and chart review. Results: Within the OP group, 41.7% developed a third- or fourth-degree laceration compared with 22.0% in the OA group (OR 2.5, 95% CI 1.4-4.7). In a logistic regression model that controlled for BMI, race, nulliparity, length of second stage, episiotomy, birth weight, head circumference, and fetal head position, OP position was 4.0 times (95% CI 1.7-9.6) more likely to be associated with an anal sphincter injury than OA position. Conclusion: Among vacuum deliveries, an OP head position confers an incrementally increased risk for anal sphincter injury over an OA position.
AB - Objective: The purpose of this study was to determine whether an occiput posterior (OP) fetal head position increases the risk for anal sphincter injury when compared with an occiput anterior (OA) position in vacuum-assisted deliveries. Study design: We conducted a retrospective cohort study of 393 vacuum-assisted singleton vaginal deliveries. Maternal demographics and obstetric and neonatal data were collected from an obstetric database and chart review. Results: Within the OP group, 41.7% developed a third- or fourth-degree laceration compared with 22.0% in the OA group (OR 2.5, 95% CI 1.4-4.7). In a logistic regression model that controlled for BMI, race, nulliparity, length of second stage, episiotomy, birth weight, head circumference, and fetal head position, OP position was 4.0 times (95% CI 1.7-9.6) more likely to be associated with an anal sphincter injury than OA position. Conclusion: Among vacuum deliveries, an OP head position confers an incrementally increased risk for anal sphincter injury over an OA position.
KW - Anal incontinence
KW - Anal sphincter injury
KW - Occiput posterior position
KW - Operative vaginal delivery
KW - Vacuum delivery
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U2 - 10.1016/j.ajog.2005.03.059
DO - 10.1016/j.ajog.2005.03.059
M3 - Article
C2 - 16098883
AN - SCOPUS:23844492575
SN - 0002-9378
VL - 193
SP - 525
EP - 528
JO - American Journal of Obstetrics and Gynecology
JF - American Journal of Obstetrics and Gynecology
IS - 2
ER -