Episiotomy characteristics and risks for obstetric anal sphincter injuries: a case-control study
Objectives To investigate the association between the geometrical properties of episiotomy and obstetric anal sphincter injuries (OASIS) because episiotomies angled at 40–60° are associated with fewer OASIS than episiotomies with more acute angles. Design Case–control study. Setting University Hospi...
Published in: | BJOG: An International Journal of Obstetrics & Gynaecology |
---|---|
Main Authors: | , , , , , |
Format: | Article in Journal/Newspaper |
Language: | English |
Published: |
Blackwell Science Ltd.
2012
|
Subjects: | |
Online Access: | https://hdl.handle.net/10037/5037 https://doi.org/10.1111/j.1471-0528.2012.03293.x |
id |
ftunivtroemsoe:oai:munin.uit.no:10037/5037 |
---|---|
record_format |
openpolar |
spelling |
ftunivtroemsoe:oai:munin.uit.no:10037/5037 2023-05-15T15:45:26+02:00 Episiotomy characteristics and risks for obstetric anal sphincter injuries: a case-control study Stedenfeldt, Mona Pirhonen, Jouko Blix, Ellen Wilsgaard, Tom Vonen, Barthold Øian, Pål 2012 https://hdl.handle.net/10037/5037 https://doi.org/10.1111/j.1471-0528.2012.03293.x eng eng Blackwell Science Ltd. BJOG: an International Journal of Obstetrics and Gynaecology 119(2012) nr. 6 s. 724-730 FRIDAID 958801 http://dx.doi.org/10.1111/j.1471-0528.2012.03293.x 1470-0328 https://hdl.handle.net/10037/5037 URN:NBN:no-uit_munin_4748 openAccess VDP::Medical disciplines: 700::Clinical medical disciplines: 750::Gynecology and obstetrics: 756 VDP::Medisinske Fag: 700::Klinisk medisinske fag: 750::Gynekologi og obstetrikk: 756 Journal article Tidsskriftartikkel Peer reviewed 2012 ftunivtroemsoe https://doi.org/10.1111/j.1471-0528.2012.03293.x 2021-06-25T17:53:32Z Objectives To investigate the association between the geometrical properties of episiotomy and obstetric anal sphincter injuries (OASIS) because episiotomies angled at 40–60° are associated with fewer OASIS than episiotomies with more acute angles. Design Case–control study. Setting University Hospital of North Norway, Tromsø and Nordland Hospital, Bodø, Norway. Sample Seventy-four women who had one vaginal birth and episiotomy. Cases (n = 37) have sustained OASIS at birth, while controls (n = 37) had not. The groups were matched for instrumental delivery. Methods Two groups of women with history of only one vaginal birth were compared. Episiotomy scar was identified and photographed and relevant measures were taken. Data were analysed using conditional logistic analysis. Main outcome measures Mean episiotomy angle, length, depth, incision point. Results The risk of sustaining OASIS decreased by 70% (odds ratio [OR] 0.30; 95% CI 0.14–0.66) for each 5.5-mm increase in episiotomy depth, decreased by 56% (OR 0.44; 95% CI 0.23–0.86) for each 4.5-mm increase in the distance from the midline to the incision point of the episiotomy, and decreased by 75% (OR 0.25; 95% CI 0.10–0.61) for each 5.5-mm increase in episiotomy length. Lastly, there was no difference in mean angle between groups but there was a “U-shaped” association between angle and OASIS (OR 2.09; 95% CI 1.02–4.28) with an increased risk (OR 9.00; 95% CI 1.1–71.0) of OASIS when the angle was either smaller than 15°or >60°. Conclusion The present study showed that scarred episiotomies with depth > 16 mm, length > 17 mm, incision point > 9 mm lateral of midpoint and angle range 30–60° are significantly associated with less risk of OASIS. Shrinkage of tissue must be considered. Article in Journal/Newspaper Bodø Bodø Nordland Nordland North Norway Tromsø Nordland University of Tromsø: Munin Open Research Archive Bodø ENVELOPE(14.405,14.405,67.280,67.280) Norway Tromsø BJOG: An International Journal of Obstetrics & Gynaecology 119 6 724 730 |
institution |
Open Polar |
collection |
University of Tromsø: Munin Open Research Archive |
op_collection_id |
ftunivtroemsoe |
language |
English |
topic |
VDP::Medical disciplines: 700::Clinical medical disciplines: 750::Gynecology and obstetrics: 756 VDP::Medisinske Fag: 700::Klinisk medisinske fag: 750::Gynekologi og obstetrikk: 756 |
spellingShingle |
VDP::Medical disciplines: 700::Clinical medical disciplines: 750::Gynecology and obstetrics: 756 VDP::Medisinske Fag: 700::Klinisk medisinske fag: 750::Gynekologi og obstetrikk: 756 Stedenfeldt, Mona Pirhonen, Jouko Blix, Ellen Wilsgaard, Tom Vonen, Barthold Øian, Pål Episiotomy characteristics and risks for obstetric anal sphincter injuries: a case-control study |
topic_facet |
VDP::Medical disciplines: 700::Clinical medical disciplines: 750::Gynecology and obstetrics: 756 VDP::Medisinske Fag: 700::Klinisk medisinske fag: 750::Gynekologi og obstetrikk: 756 |
description |
Objectives To investigate the association between the geometrical properties of episiotomy and obstetric anal sphincter injuries (OASIS) because episiotomies angled at 40–60° are associated with fewer OASIS than episiotomies with more acute angles. Design Case–control study. Setting University Hospital of North Norway, Tromsø and Nordland Hospital, Bodø, Norway. Sample Seventy-four women who had one vaginal birth and episiotomy. Cases (n = 37) have sustained OASIS at birth, while controls (n = 37) had not. The groups were matched for instrumental delivery. Methods Two groups of women with history of only one vaginal birth were compared. Episiotomy scar was identified and photographed and relevant measures were taken. Data were analysed using conditional logistic analysis. Main outcome measures Mean episiotomy angle, length, depth, incision point. Results The risk of sustaining OASIS decreased by 70% (odds ratio [OR] 0.30; 95% CI 0.14–0.66) for each 5.5-mm increase in episiotomy depth, decreased by 56% (OR 0.44; 95% CI 0.23–0.86) for each 4.5-mm increase in the distance from the midline to the incision point of the episiotomy, and decreased by 75% (OR 0.25; 95% CI 0.10–0.61) for each 5.5-mm increase in episiotomy length. Lastly, there was no difference in mean angle between groups but there was a “U-shaped” association between angle and OASIS (OR 2.09; 95% CI 1.02–4.28) with an increased risk (OR 9.00; 95% CI 1.1–71.0) of OASIS when the angle was either smaller than 15°or >60°. Conclusion The present study showed that scarred episiotomies with depth > 16 mm, length > 17 mm, incision point > 9 mm lateral of midpoint and angle range 30–60° are significantly associated with less risk of OASIS. Shrinkage of tissue must be considered. |
format |
Article in Journal/Newspaper |
author |
Stedenfeldt, Mona Pirhonen, Jouko Blix, Ellen Wilsgaard, Tom Vonen, Barthold Øian, Pål |
author_facet |
Stedenfeldt, Mona Pirhonen, Jouko Blix, Ellen Wilsgaard, Tom Vonen, Barthold Øian, Pål |
author_sort |
Stedenfeldt, Mona |
title |
Episiotomy characteristics and risks for obstetric anal sphincter injuries: a case-control study |
title_short |
Episiotomy characteristics and risks for obstetric anal sphincter injuries: a case-control study |
title_full |
Episiotomy characteristics and risks for obstetric anal sphincter injuries: a case-control study |
title_fullStr |
Episiotomy characteristics and risks for obstetric anal sphincter injuries: a case-control study |
title_full_unstemmed |
Episiotomy characteristics and risks for obstetric anal sphincter injuries: a case-control study |
title_sort |
episiotomy characteristics and risks for obstetric anal sphincter injuries: a case-control study |
publisher |
Blackwell Science Ltd. |
publishDate |
2012 |
url |
https://hdl.handle.net/10037/5037 https://doi.org/10.1111/j.1471-0528.2012.03293.x |
long_lat |
ENVELOPE(14.405,14.405,67.280,67.280) |
geographic |
Bodø Norway Tromsø |
geographic_facet |
Bodø Norway Tromsø |
genre |
Bodø Bodø Nordland Nordland North Norway Tromsø Nordland |
genre_facet |
Bodø Bodø Nordland Nordland North Norway Tromsø Nordland |
op_relation |
BJOG: an International Journal of Obstetrics and Gynaecology 119(2012) nr. 6 s. 724-730 FRIDAID 958801 http://dx.doi.org/10.1111/j.1471-0528.2012.03293.x 1470-0328 https://hdl.handle.net/10037/5037 URN:NBN:no-uit_munin_4748 |
op_rights |
openAccess |
op_doi |
https://doi.org/10.1111/j.1471-0528.2012.03293.x |
container_title |
BJOG: An International Journal of Obstetrics & Gynaecology |
container_volume |
119 |
container_issue |
6 |
container_start_page |
724 |
op_container_end_page |
730 |
_version_ |
1766379822922072064 |