scholarly journals Is it the manual perineal support or the slowing of the fetal head descent that reduces anal sphincter injury?

2020 ◽  
Vol 99 (4) ◽  
pp. 557-557
Author(s):  
Gabriel Levin ◽  
Amihai Rottenstreich ◽  
Raanan Meyer
Keyword(s):  
Anal Sphincter ◽  
Fetal Head ◽  
Sphincter Injury ◽  
Anal Sphincter Injury ◽  
Perineal Support

scholarly journals Which elements were significant in reducing obstetric anal sphincter injury? A prospective follow-up study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ole Bredahl Rasmussen ◽  
Annika Yding ◽  
Charlotte Sander Andersen ◽  
Jane Boris ◽  
Finn Friis Lauszus
Keyword(s):  
Anal Sphincter ◽  
Nulliparous Woman ◽  
Obstetric Anal Sphincter Injury ◽  
Care Bundle ◽  
Fetal Head ◽  
Sphincter Injury ◽  
Follow Up Study ◽  
Anal Sphincter Injury ◽  
Perineal Support

Abstract Background To examine which elements of an obstetric anal sphincter injury (OASI) care bundle were protective for OASI. Several interventional trials showed that application of a care bundle involving a hands-on approach to perineal protection may reduce the risk of OASI. Previously, we found that only the element “hand on the fetal head” in itself was protective, although the risk of a type 2 error was calculated to be 50%. Methods A prospective follow-up study in an obstetric department in Denmark with 3200 deliveries per year. We included a cohort of 10,383 women giving birth vaginally from gestational week 22 + 0 from 2016 through 2019. We documented on a person-level the five elements of the care bundle together with maternal and obstetrical characteristics. The elements were 1) communication, 2) visible perineum, 3) hand on fetal head, 4) perineal support and 5) certification. Regression analysis was used for analysis of associations. The primary outcome measure was OASI. Results The total rate of OASI in vaginally delivering women was 1.9%. The incidence was 3.2% in nulliparous women giving birth vaginally. The rate of cesarean section was 16.5% and for episiotomy 2.4%. The reduction in the incidence of OASI was sustained since 2013. Hand on the fetal head and perineal support both were protective factors for OASI. In case of a nulliparous woman with a neonate weighing 3500 g giving birth spontaneously, the relative risk (RR) for OASI was 0.50 (95% CI 0.49- 0.51) with use of hand on the fetal head together with perineal support against no use. Similarly, with a nulliparous woman giving birth to a neonate of 3500 g by vacuum extraction, the RR for OASI was 0.65 (95% CI 0.62-0.68) against no use. Conclusions Both hand on the fetal head and perineal support were associated with a reduced risk of OASI.

The impact of occiput posterior fetal head position on the risk of anal sphincter injury in forceps-assisted vaginal deliveries

2005 ◽  
Vol 192 (5) ◽  
pp. 1702-1706 ◽  
Author(s):  
Lorena Benavides ◽  
Jennifer M. Wu ◽  
Andrew F. Hundley ◽  
Thomas S. Ivester ◽  
Anthony G. Visco
Keyword(s):  
Anal Sphincter ◽  
Head Position ◽  
Fetal Head ◽  
Sphincter Injury ◽  
Anal Sphincter Injury ◽  
Vaginal Deliveries ◽  
The Impact ◽  
Fetal Head Position

Sonographic fetal head circumference and the risk of obstetric anal sphincter injury following vaginal delivery

2020 ◽  
Vol 31 (11) ◽  
pp. 2285-2290 ◽  
Author(s):  
Raanan Meyer ◽  
Amihai Rottenstreich ◽  
Michal Zamir ◽  
Hadas Ilan ◽  
Edward Ram ◽  
...  
Keyword(s):  
Vaginal Delivery ◽  
Anal Sphincter ◽  
Head Circumference ◽  
Obstetric Anal Sphincter Injury ◽  
Fetal Head ◽  
Sphincter Injury ◽  
Anal Sphincter Injury

Occiput posterior fetal head position increases the risk of anal sphincter injury in vacuum-assisted deliveries

2005 ◽  
Vol 193 (2) ◽  
pp. 525-528 ◽  
Author(s):  
Jennifer M. Wu ◽  
Kathryn S. Williams ◽  
Andrew F. Hundley ◽  
AnnaMarie Connolly ◽  
Anthony G. Visco
Keyword(s):  
Anal Sphincter ◽  
Head Position ◽  
Fetal Head ◽  
Sphincter Injury ◽  
Anal Sphincter Injury ◽  
Fetal Head Position
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