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[RISK FACTORS FOR POSTPARTUM OCCULT INJURIES OF THE ANAL SPHINCTER.]

D L Cvetkov, S Stoykov, P Ignatov

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    Occult anal sphincter injuries (OASIS) are common after vaginal birth, affecting 33% of first-time mothers. Primiparity, advanced gestational age, and high fetal weight are identified risk factors for OASIS.

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    Area of Science:

    • Obstetrics and Gynecology
    • Pelvic Floor Disorders
    • Maternal Health

    Background:

    • Occult anal sphincter injuries (OASIS) affect 33% of primiparous women after vaginal birth.
    • Early diagnosis and treatment of OASIS can prevent long-term anal incontinence.
    • Identifying OASIS risk factors is crucial for targeted patient selection.

    Purpose of the Study:

    • To determine the role of common risk factors in the occurrence of OASIS.
    • To identify high-risk patients for early postpartum diagnosis and treatment.

    Main Methods:

    • Retrospective study of 80 patients diagnosed with OASIS via endoanal ultrasonography.
    • Data collected from Maternity Ljubljana and University Hospital - Pleven between January 2009 and November 2011.
    • Analysis of independent variables including primiparity, gestational age (>41 weeks), and fetal weight (>3500g).

    Main Results:

    • Primiparity was confirmed as a significant risk factor for OASIS.
    • Gestational age over 41 weeks was associated with an increased risk of OASIS.
    • Fetal weight exceeding 3500g was identified as a risk factor for OASIS.

    Conclusions:

    • The study identified primiparity, advanced gestational age, and high fetal weight as significant risk factors for OASIS.
    • These findings support the integration of identified risk factors into clinical guidelines for early OASIS diagnosis.
    • Implementing targeted screening and treatment can improve postpartum pelvic floor health and reduce incontinence.