Predicting obstetric anal sphincter injuries in a modern obstetric population

Risk and protective factors for obstetric anal sphincter injuries: A retrospective nationwide study

“…The overall incidence of obstetric anal sphincter injuries was 2.6%, which is low compared with other reports. 8,11 Similar to other European countries, there was an increase in the rate of obstetric anal sphincter injuries in primiparous women, from 2.1% in 2008 to 3.1% in 2014, which is possibly the result of improved awareness, diagnostic recognition, and documentation. 12 In the same time period, the episiotomy rate decreased from 35.9% to 26.4%.…”

Effect of body mass index on the incidence of perineal trauma

“…The secondary outcome measures were the associations between perineal lacerations and BMI, age (<20, 21-25, 26-30, 31-35, 36-40, and >40 years), ethnicity (white, black, Subcontinental Asian, Southeastern Asian, and other), smoking, parity (nulliparous and multiparous), pregnancy length, episiotomy, instrumental delivery, and birth weight (cutoff point 4 kg); these variables have previously been associated with childbirth perineal trauma and might be confounders. 9 The data were analyzed using SPSS version 21 (IBM, Armonk, NY, USA). Multivariate logistic regression was performed to assess the associations between perineal trauma and BMI with normal weight used as the reference group.…”

“…However, there are conflicting reports regarding the association between obesity and childbirth‐related perineal trauma. Some studies have reported a lower risk of obstetric anal sphincter injuries (OASIS) with increasing BMI by comparison with women with a normal BMI (odds ratio [OR] 0.47, 95% confidence interval [CI] 0.28–0.78), whereas others have demonstrated a significant association between obesity and significant perineal trauma, whereby the probability of trauma is increased by 78% for obese women . These discrepancies could reflect differences both in the study populations and in obstetric practice.…”

Effectiveness of antenatal perineal massage in reducing perineal trauma and post‐partum morbidities: A randomized controlled trial

“…It is associated with significant morbidities, including post‐partum hemorrhage, precarious maternal bonding with her baby, post‐partum perineal pain, post‐partum urinary incontinence (UI), anal incontinence (AI), sexual dysfunction and delayed time to resume sexual intercourse . The risk factors include nulliparity, macrosomia, mal‐presentation, malposition and operative vaginal deliveries, among others . Antenatal perineal massage (APM) is thought to improve perineal outcomes by stretching out the vaginal tissues, promoting perineal relaxation and improving circulation to the tissues .…”

“…[1][2][3] The risk factors include nulliparity, macrosomia, mal-presentation, malposition and operative vaginal deliveries, among others. [4][5][6][7] Antenatal perineal massage (APM) is thought to improve perineal outcomes by stretching out the vaginal tissues, promoting perineal relaxation and improving circulation to the tissues. 8 The overall effect of all these methods is that the parturient is able to 'push her baby out' more easily, thus reducing the risk of trauma to her perineum and vagina.…”