Occiput posterior fetal head position increases the risk of anal sphincter injury in vacuum-assisted deliveries

Obstetric anal sphincter injuries: review of anatomical factors and modifiable second stage interventions

“…There are modifiable risk factors for OASI including length of the second stage, occipitoposterior position [7][8][9][10][11], use of oxytocin and epidural analgesia, which do not have credible alternatives. Common intervention choices made in the second stage of labour such as the decision to allow spontaneous tears versus performing an episiotomy, the geometric characteristics of the episiotomy performed, and the choice of instrument for operative vaginal deliveries are to an extent modifiable and can be critical factors in the causation of OASIs.…”

Vaginal Delivery With Vacuum Extraction

“…Gerekli durumlarda sezeryanla do¤um geciktirilmeden uygulanmal›d›r (12) . (17,18) . 228 gebenin enstrumental do¤um sonras› 5 y›ll›k takiplerini inceleyen di¤er bir çal›flmada % 47 idrar inkontinans deneyimi, % 44 defekasyon kontrol zorlu¤u, % 20 total fekal inkontinans saptanm›flt›r.…”

Three-dimensional transperineal ultrasonography for evaluation of the anal sphincter complex: another dimension in understanding peripartum sphincter trauma

“…Primiparity, episiotomy 5 , forceps delivery, fetal macrosomia 6 , occipital-posterior presentation during instrumental delivery 7,8 , prolonged second stage of labor 9 , and prior sphincter lacerations 10,11 are now well recognized risk factors for anal sphincter tears. However, prediction of intrapartum sphincter damage in individual women is still inaccurate; our efforts should therefore be directed to postpartum evaluation of the perineum: clinical and sonographic examination offered routinely to all high-risk postpartum patients.…”