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Related Experiment Videos

Obstetric anal sphincter lacerations.

V L Handa1, B H Danielsen, W M Gilbert

  • 1Department of Obstetrics and Gynecology, University of California Davis School of Medicine, Sacramento, California, USA.

Obstetrics and Gynecology
|August 17, 2001
PubMed
Summary

Obstetric anal sphincter lacerations occur in 5.85% of vaginal births, with primiparity and operative delivery as key risk factors. Modifiable factors like operative vaginal delivery significantly influence these severe perineal tears.

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Area of Science:

  • Obstetrics and Gynecology
  • Perinatal Epidemiology
  • Surgical Outcomes

Background:

  • Obstetric anal sphincter lacerations (OASIS) are severe perineal tears impacting maternal health.
  • Understanding OASIS frequency and risk factors is crucial for improving obstetric care.
  • Previous studies have identified several risk factors, but large-scale population data is needed.

Purpose of the Study:

  • To determine the incidence of OASIS in a large cohort of vaginal deliveries.
  • To identify patient characteristics and delivery factors associated with OASIS.
  • To evaluate modifiable risk factors for OASIS.

Main Methods:

  • Population-based retrospective study of over 2 million vaginal deliveries (1992-1997).
  • Data sourced from California birth certificates and hospital discharge summaries.

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  • Exclusion of preterm, stillbirth, breech, and multiple gestations; focus on third and fourth-degree lacerations.

    • Main Results:

    • OASIS occurred in 5.85% of deliveries, showing a significant decrease from 1992 to 1997.
    • Primiparity was the strongest risk factor (OR 0.15), while birth weight >4000g (OR 2.17) and operative vaginal delivery (vacuum OR 2.30, forceps OR 1.45) increased risk.
    • Indian and Filipina women had higher laceration rates; episiotomy reduced third-degree but increased fourth-degree laceration risk.

    Conclusions:

    • OASIS is significantly associated with primiparity, macrosomia, and operative vaginal delivery.
    • Operative vaginal delivery is the dominant modifiable risk factor for OASIS.
    • Findings highlight the need for targeted interventions to reduce OASIS incidence.