Risk factors associated with anal sphincter tear: A comparison of primiparous patients, vaginal births after cesarean deliveries, and patients with previous vaginal delivery
Objective: This study was conducted to identify obstetric risk factors for anal sphincter tear in primiparous patients, patients with a previous cesarean delivery (VBAC), and patients with a previous vaginal delivery (PVD). Study Design: An obstetrics automated record system was accessed to retrospe...
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| Veröffentlicht in: | American journal of obstetrics and gynecology 2002-11, Vol.187 (5), p.1194-1198 |
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| container_title | American journal of obstetrics and gynecology |
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| creator | Richter, Holly E. Brumfield, Cynthia G. Cliver, Suzanne P. Burgio, Kathryn L. Neely, Cherry L. Varner, R.Edward |
| description | Objective: This study was conducted to identify obstetric risk factors for anal sphincter tear in primiparous patients, patients with a previous cesarean delivery (VBAC), and patients with a previous vaginal delivery (PVD). Study Design: An obstetrics automated record system was accessed to retrospectively review records of all singleton vaginal deliveries at greater than 36 weeks' gestation (excluding breech and stillbirth) from 1995 through 2000 (n = 10,928). A number of potential risk factors for anal sphincter tear (third- and fourth-degree episiotomy extensions and lacerations) were tested with use of multivariate logistic regression analysis. Results: The risk of anal sphincter tear was significantly increased with primiparity (relative risk [RR] 4.08) and VBAC (RR 5.46) compared with PVD, birth weight greater than 4000 g (RR 2.41), forceps delivery (RR 6.00), vacuum delivery (RR 2.18), shoulder dystocia (RR 3.28), and episiotomy (RR 2.59). Conclusion: Efforts to prevent anal sphincter tear might include reconsideration of modifiable risk factors such as episiotomy, operative vaginal delivery, and VBAC. (Am J Obstet Gynecol 2002;187:1194-8.) |
| doi_str_mv | 10.1067/mob.2002.126977 |
| format | Article |
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Study Design: An obstetrics automated record system was accessed to retrospectively review records of all singleton vaginal deliveries at greater than 36 weeks' gestation (excluding breech and stillbirth) from 1995 through 2000 (n = 10,928). A number of potential risk factors for anal sphincter tear (third- and fourth-degree episiotomy extensions and lacerations) were tested with use of multivariate logistic regression analysis. Results: The risk of anal sphincter tear was significantly increased with primiparity (relative risk [RR] 4.08) and VBAC (RR 5.46) compared with PVD, birth weight greater than 4000 g (RR 2.41), forceps delivery (RR 6.00), vacuum delivery (RR 2.18), shoulder dystocia (RR 3.28), and episiotomy (RR 2.59). Conclusion: Efforts to prevent anal sphincter tear might include reconsideration of modifiable risk factors such as episiotomy, operative vaginal delivery, and VBAC. (Am J Obstet Gynecol 2002;187:1194-8.)</description><identifier>ISSN: 0002-9378</identifier><identifier>EISSN: 1097-6868</identifier><identifier>DOI: 10.1067/mob.2002.126977</identifier><identifier>PMID: 12439502</identifier><identifier>CODEN: AJOGAH</identifier><language>eng</language><publisher>Philadelphia, PA: Mosby, Inc</publisher><subject>Adult ; African Americans ; Anal Canal - injuries ; Anal sphincter tear ; Biological and medical sciences ; Delivery, Obstetric ; Delivery. Postpartum. Lactation ; Disorders ; European Continental Ancestry Group ; Female ; Gynecology. Andrology. Obstetrics ; Humans ; Medical Records ; Medical sciences ; Obstetrical Forceps - adverse effects ; Parity ; Pregnancy ; primiparous versus vaginal birth after cesarean section versus previous vaginal delivery ; Retrospective Studies ; Risk Factors ; Rupture - ethnology ; Rupture - etiology ; Vaginal Birth after Cesarean</subject><ispartof>American journal of obstetrics and gynecology, 2002-11, Vol.187 (5), p.1194-1198</ispartof><rights>2002</rights><rights>2003 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c373t-324645191ced79fe3bb56f4dbd25dfa2e67981048da4312169f52ef9a02de1e23</citedby><cites>FETCH-LOGICAL-c373t-324645191ced79fe3bb56f4dbd25dfa2e67981048da4312169f52ef9a02de1e23</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0002937802003915$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>309,310,314,776,780,785,786,3537,23909,23910,25118,27901,27902,65306</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=14365159$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/12439502$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Richter, Holly E.</creatorcontrib><creatorcontrib>Brumfield, Cynthia G.</creatorcontrib><creatorcontrib>Cliver, Suzanne P.</creatorcontrib><creatorcontrib>Burgio, Kathryn L.</creatorcontrib><creatorcontrib>Neely, Cherry L.</creatorcontrib><creatorcontrib>Varner, R.Edward</creatorcontrib><title>Risk factors associated with anal sphincter tear: A comparison of primiparous patients, vaginal births after cesarean deliveries, and patients with previous vaginal delivery</title><title>American journal of obstetrics and gynecology</title><addtitle>Am J Obstet Gynecol</addtitle><description>Objective: This study was conducted to identify obstetric risk factors for anal sphincter tear in primiparous patients, patients with a previous cesarean delivery (VBAC), and patients with a previous vaginal delivery (PVD). Study Design: An obstetrics automated record system was accessed to retrospectively review records of all singleton vaginal deliveries at greater than 36 weeks' gestation (excluding breech and stillbirth) from 1995 through 2000 (n = 10,928). A number of potential risk factors for anal sphincter tear (third- and fourth-degree episiotomy extensions and lacerations) were tested with use of multivariate logistic regression analysis. Results: The risk of anal sphincter tear was significantly increased with primiparity (relative risk [RR] 4.08) and VBAC (RR 5.46) compared with PVD, birth weight greater than 4000 g (RR 2.41), forceps delivery (RR 6.00), vacuum delivery (RR 2.18), shoulder dystocia (RR 3.28), and episiotomy (RR 2.59). Conclusion: Efforts to prevent anal sphincter tear might include reconsideration of modifiable risk factors such as episiotomy, operative vaginal delivery, and VBAC. (Am J Obstet Gynecol 2002;187:1194-8.)</description><subject>Adult</subject><subject>African Americans</subject><subject>Anal Canal - injuries</subject><subject>Anal sphincter tear</subject><subject>Biological and medical sciences</subject><subject>Delivery, Obstetric</subject><subject>Delivery. Postpartum. Lactation</subject><subject>Disorders</subject><subject>European Continental Ancestry Group</subject><subject>Female</subject><subject>Gynecology. Andrology. Obstetrics</subject><subject>Humans</subject><subject>Medical Records</subject><subject>Medical sciences</subject><subject>Obstetrical Forceps - adverse effects</subject><subject>Parity</subject><subject>Pregnancy</subject><subject>primiparous versus vaginal birth after cesarean section versus previous vaginal delivery</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Rupture - ethnology</subject><subject>Rupture - etiology</subject><subject>Vaginal Birth after Cesarean</subject><issn>0002-9378</issn><issn>1097-6868</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2002</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kUtv1DAUhS1ERYfCmh3yBlZkajtPs6sqXlIlpKqsrRv7mjEkcbA9g_qj-h9xlEBXrKwrf-f4-hxCXnG256xpL0ff7wVjYs9FI9v2CdlxJtui6ZruKdmxfFPIsu3OyfMYfyyjkOIZOeeiKmXNxI483Lr4k1rQyYdIIUavHSQ09LdLBwoTDDTOBzfphIEmhPCeXlHtxxmCi36i3tI5uNHl2R8jnSE5nFJ8R0_w3S3q3oV0yM52MdAYISBM1ODgThgcZhIm80-3PjsHPLnF7q_Jht-_IGcWhogvt_OCfPv44e76c3Hz9dOX66ubQpdtmYpSVE1Vc8k1mlZaLPu-bmxleiNqY0Fg08qOs6ozUJVc8EbaWqCVwIRBjqK8IG9X3zn4X0eMSY0uahwGmDDvpdqcdl3VLIOXK6iDjzGgVUsaEO4VZ2ppSOWG1NKQWhvKiteb9bEf0TzyWyUZeLMBEDUMNsCkXXzkqrKpeS0zJ1cOcxAnh0FFnTPMX3YBdVLGu_8u8Qcl-bEb</recordid><startdate>20021101</startdate><enddate>20021101</enddate><creator>Richter, Holly E.</creator><creator>Brumfield, Cynthia G.</creator><creator>Cliver, Suzanne P.</creator><creator>Burgio, Kathryn L.</creator><creator>Neely, Cherry L.</creator><creator>Varner, R.Edward</creator><general>Mosby, Inc</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20021101</creationdate><title>Risk factors associated with anal sphincter tear: A comparison of primiparous patients, vaginal births after cesarean deliveries, and patients with previous vaginal delivery</title><author>Richter, Holly E. ; Brumfield, Cynthia G. ; Cliver, Suzanne P. ; Burgio, Kathryn L. ; Neely, Cherry L. ; Varner, R.Edward</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c373t-324645191ced79fe3bb56f4dbd25dfa2e67981048da4312169f52ef9a02de1e23</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2002</creationdate><topic>Adult</topic><topic>African Americans</topic><topic>Anal Canal - injuries</topic><topic>Anal sphincter tear</topic><topic>Biological and medical sciences</topic><topic>Delivery, Obstetric</topic><topic>Delivery. Postpartum. Lactation</topic><topic>Disorders</topic><topic>European Continental Ancestry Group</topic><topic>Female</topic><topic>Gynecology. Andrology. Obstetrics</topic><topic>Humans</topic><topic>Medical Records</topic><topic>Medical sciences</topic><topic>Obstetrical Forceps - adverse effects</topic><topic>Parity</topic><topic>Pregnancy</topic><topic>primiparous versus vaginal birth after cesarean section versus previous vaginal delivery</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Rupture - ethnology</topic><topic>Rupture - etiology</topic><topic>Vaginal Birth after Cesarean</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Richter, Holly E.</creatorcontrib><creatorcontrib>Brumfield, Cynthia G.</creatorcontrib><creatorcontrib>Cliver, Suzanne P.</creatorcontrib><creatorcontrib>Burgio, Kathryn L.</creatorcontrib><creatorcontrib>Neely, Cherry L.</creatorcontrib><creatorcontrib>Varner, R.Edward</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>American journal of obstetrics and gynecology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Richter, Holly E.</au><au>Brumfield, Cynthia G.</au><au>Cliver, Suzanne P.</au><au>Burgio, Kathryn L.</au><au>Neely, Cherry L.</au><au>Varner, R.Edward</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Risk factors associated with anal sphincter tear: A comparison of primiparous patients, vaginal births after cesarean deliveries, and patients with previous vaginal delivery</atitle><jtitle>American journal of obstetrics and gynecology</jtitle><addtitle>Am J Obstet Gynecol</addtitle><date>2002-11-01</date><risdate>2002</risdate><volume>187</volume><issue>5</issue><spage>1194</spage><epage>1198</epage><pages>1194-1198</pages><issn>0002-9378</issn><eissn>1097-6868</eissn><coden>AJOGAH</coden><abstract>Objective: This study was conducted to identify obstetric risk factors for anal sphincter tear in primiparous patients, patients with a previous cesarean delivery (VBAC), and patients with a previous vaginal delivery (PVD). Study Design: An obstetrics automated record system was accessed to retrospectively review records of all singleton vaginal deliveries at greater than 36 weeks' gestation (excluding breech and stillbirth) from 1995 through 2000 (n = 10,928). A number of potential risk factors for anal sphincter tear (third- and fourth-degree episiotomy extensions and lacerations) were tested with use of multivariate logistic regression analysis. Results: The risk of anal sphincter tear was significantly increased with primiparity (relative risk [RR] 4.08) and VBAC (RR 5.46) compared with PVD, birth weight greater than 4000 g (RR 2.41), forceps delivery (RR 6.00), vacuum delivery (RR 2.18), shoulder dystocia (RR 3.28), and episiotomy (RR 2.59). Conclusion: Efforts to prevent anal sphincter tear might include reconsideration of modifiable risk factors such as episiotomy, operative vaginal delivery, and VBAC. (Am J Obstet Gynecol 2002;187:1194-8.)</abstract><cop>Philadelphia, PA</cop><pub>Mosby, Inc</pub><pmid>12439502</pmid><doi>10.1067/mob.2002.126977</doi><tpages>5</tpages></addata></record> |
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| identifier | ISSN: 0002-9378 |
| ispartof | American journal of obstetrics and gynecology, 2002-11, Vol.187 (5), p.1194-1198 |
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| source | MEDLINE; Elsevier ScienceDirect Journals |
| subjects | Adult African Americans Anal Canal - injuries Anal sphincter tear Biological and medical sciences Delivery, Obstetric Delivery. Postpartum. Lactation Disorders European Continental Ancestry Group Female Gynecology. Andrology. Obstetrics Humans Medical Records Medical sciences Obstetrical Forceps - adverse effects Parity Pregnancy primiparous versus vaginal birth after cesarean section versus previous vaginal delivery Retrospective Studies Risk Factors Rupture - ethnology Rupture - etiology Vaginal Birth after Cesarean |
| title | Risk factors associated with anal sphincter tear: A comparison of primiparous patients, vaginal births after cesarean deliveries, and patients with previous vaginal delivery |
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