Factors Associated with Obstetric Anal Sphincter Injury During Vacuum-Assisted Vaginal Delivery

Introduction and Hypothesis Obstetric anal sphincter injury (OASI) is a major complication associated with vacuum-assisted vaginal delivery (VAVD). The aim of this study was to evaluate risk factors related to vacuum extraction that are associated with OASI. Methods This was a case–control study per...

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Bibliographic Details
Published in:International Urogynecology Journal 2024-06, Vol.35 (6), p.1183-1189
Main Authors: Chill, Henry H., Dick, Aharon, Zarka, Wajdy, Vilk Ayalon, Naama, Rosenbloom, Joshua I., Shveiky, David, Karavani, Gilad
Format: Article
Language:English
Subjects:
Childbirth & labor
Gynecology
Medicine
Medicine & Public Health
Obstetrics
Original Article
Urology
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Summary:Introduction and Hypothesis Obstetric anal sphincter injury (OASI) is a major complication associated with vacuum-assisted vaginal delivery (VAVD). The aim of this study was to evaluate risk factors related to vacuum extraction that are associated with OASI. Methods This was a case–control study performed at a tertiary university teaching hospital. Included were patients aged 18–45 years who had a singleton pregnancy resulting in a live, term, VAVD. The study group consisted of women diagnosed with OASI following vacuum extraction. The control group included women following VAVD without OASI. Matching at a ratio of 1:2 was performed. Groups were compared regarding demographic, obstetric. and labor-related parameters, specifically focusing on variables related to the vacuum procedure itself. Results One hundred and ten patients within the study group and 212 within the control group were included in the final analysis. Patients in the OASI group were more likely to undergo induction of labor, use of oxytocin during labor, increased second stage of labor, higher likelihood of the operator being a resident, increased number of pulls, procedure lasting under 10 min, occipito-posterior head position at vacuum initiation, episiotomy, increased neonatal head circumference, and birthweight. Multivariate logistic regression analysis revealed that increased week of gestation (OR 1.67, 95% CI 1.25–2.22, p  
ISSN:0937-3462
1433-3023
1433-3023
DOI:10.1007/s00192-024-05785-5