Prevalence and Location of Obstetric Lacerations in Adolescent Mothers

Shveiky, David; Patchen, Loral; Chill, Henry H.; Pehlivanova, Marieta; Landy, Helain J.

doi:10.1016/j.jpag.2018.11.004

Cited by 10 publications

(9 citation statements)

References 12 publications

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“…This study evaluated data from 4 MedStar Health hospitals which were considered 1 of 19 medical centers in the CSL and included 203 young adolescents (15 years or younger) and 5753 adolescents (16–21 years) who were compared to the reference group of women ages 22–34. Teenage mothers were 50% less likely to have OASI compared to the control group (adjusted OR = 0.480, CI 0.320–0.720) [ 27 ]. In our current study we found a similar rate of OASI in adolescent and adult groups.…”

Section: Discussionmentioning

confidence: 99%

Obstetric anal sphincter injury in adolescent mothers

Chill

Lipschuetz

Atias

et al. 2021

BMC Pregnancy Childbirth

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Background Obstetric anal sphincter injury (OASI) is a debilitating complication of vaginal delivery which has yet to receive ample attention in adolescents. The aim of this study was to describe risk for OASI in adolescent mothers compared to adults. We further attempted to compare risk factors for OASI between these two age groups. Methods We performed a retrospective cohort study between 2003 and 2019. Primiparous women who delivered vaginally, 21 years and younger were compared to women ages 26–35. Excluded were preterm, multifetal, non-vertex, cesarean deliveries as well as intrauterine fetal death. Rate of OASI as well as obstetric and labor characteristics of women with OASI, were compared between groups. Finally, risk factors were assessed for each group separately. Univariate and multivariate logistic regression model were performed. Results Final analysis was performed on 5113 nulliparous adolescents and 13,845 nulliparous in the 26–35 age group. Allocation to study groups was according to OASI – Sixty-seven adolescents (1.3%) had a 3rd or 4th degree perineal tear and were defined as the OASI group, while 5046 patients (98.7%) did not have such a tear. In the adult group, 199 out of 13,845 patients (1.4%) were diagnosed with OASI. Occurrence of OASI did not differ between groups (p = 0.510). Comparison of women with OASI in the adolescent group vs. adult group found differences with regard to operative vaginal delivery, (20.9% vs. 36.2%, respectively; p = 0.023) and meconium stained amniotic fluid (9.1% vs. 21.3%, respectively; p = 0.027). Following multivariate analysis the only parameter independently associated with OASI in the adolescent age group was head circumference ≥ 90th percentile with an adjusted odds ratio of 3.08 (CI 1.48–6.38, p = 0.003). In the adult group the similar analysis revealed operative vaginal delivery (OR = 2.44, CI 1.72–3.47, p < 0.001) and a birthweight≥90th percentile (OR = 2.23, CI 1.19–4.18, p = 0.012) to be independent risk factors for OASI. Conclusion Adolescents have similar risk for OASI compared to adults but differ in risk factors leading to OASI. Head circumference ≥ 90th percentile was found to be associated with OASI in this age group.

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Section: Discussionmentioning

confidence: 99%

Obstetric anal sphincter injury in adolescent mothers

Chill

Lipschuetz

Atias

et al. 2021

BMC Pregnancy Childbirth

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“…5 Obstetric injuries are also a possible cause of perineal trauma in the pediatric population but they are usually classified as a different entity and addressed separately in all the reports that we encountered. 6,7 It is estimated that 5 to 21% of pediatric perineal trauma is secondary to sexual abuse. 1,5 However, the true incidence and prevalence is not known and is likely underestimated, since most cases of sexual assault are under-reported by the victims because of the associated stigma.…”

Section: Discussionmentioning

confidence: 99%

A Surgical Technique to Repair Perineal Body Disruption Secondary to Sexual Assault

Brisighelli

Levitt

Wood

et al. 2020

European J Pediatr Surg Rep

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Perineal trauma is uncommon in the pediatric population and it is estimated that 5 to 21% is secondary to sexual abuse. We aim to present a proposed surgical technique to repair perineal injuries secondary to sexual assault in female children. The technique is based on the posterior sagittal anorectoplasty (PSARP) for repairing anorectal malformations and, between 2017 and 2019, it was used to treat three girls (2 months, 2 years, and 8 years of age) with fourth-degree perineal injuries secondary to sexual assault. One of them underwent laparotomy and Hartmann's colostomy for an acute abdomen. Two underwent wound debridement and suturing and only had a stoma fashioned at 5 days and 6 weeks posttrauma, respectively. The perineal repair was performed 2, 6, and 7 weeks postinjury and done as follows: with the child prone in jack-knife position, stay-sutures are placed on the common wall between the rectum and the vagina. Using a needle tip diathermy, a transverse incision is performed below the sutures lifting the anterior rectal wall up. Stay sutures are then positioned on the posterior wall of the vaginal mucosa. The incision between the walls is deepened until the rectum and the vagina are completely separated. The deep and superficial perineal body is then reconstructed using absorbable sutures and an anterior anoplasty and an introitoplasty are performed. The stoma in each was closed 6 weeks postreconstruction. At follow-up, now 1 year or more postrepair, all patients have an excellent cosmetic outcome and are fully continent for stools.

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“…10 Studies carried out by Shveiky et al report that young adolescents and adolescents had significantly higher rates of labial and periurethral lacerations compared to individuals aged 22-34 years. 11 The authors showed that severe preeclampsia accounted for 6.0% of all live births (excluding multiple pregnancies and other forms of hypertension), 13.5% of which were adolescents. 12 Teenage motherhood is a complex phenomenon that can be viewed from a social, legal, medical and psychological perspective.…”

Section: Introductionmentioning

confidence: 99%

“…[11][12][13] Our own material demonstrated that in 2014 and 2017-2018, adolescent mothers gave birth to more children than mothers at the age of 18-19 (approx. 60% vs. approx.…”

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confidence: 99%

Comparison of the course of labour in adolescent mothers (aged ≤17 years) and young women (aged 18-19 years)

et al. 2021

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Introduction: Adolescent motherhood is associated with a high risk of health problems due to the unfinished process of biological development of the body. Aim: To compare the course of labour among adolescent mothers (aged up to 17 years) and young women (aged 18–19 years). Material and methods: The study was performed on the basis of a retrospective analysis of medical records from 2010 to 2018 in one of the clinical hospitals in Poland. The analysis included the births given by 133 adolescent mothers and 169 young women. Results and discussion: There was a downward trend in the percentage of births given by adolescent mothers and young women over a 9-year period. The placenta of adolescent women was lighter, by 25 g on average (P = 0.011), and had a smaller size (P = 0.038) than the placenta of young women. In adolescent women, pregnancy-related complications were significantly more often associated with pregnancy-induced hypertension (P = 0.037), and in young women with gestational diabetes (P = 0.003). The rapture of membranes was observed significantly more often at the first stage of labour among mothers aged 18–19 years than in mothers aged up to 17 years (P = 0.043). Conclusions: A decrease in the number of births given by adolescent mothers and young women over 9 years was demonstrated. Among adolescent mothers a pregnancy-related complication was pregnancy-induced hypertension. The placenta of adolescent mothers was significantly lighter and smaller than of young women. The rapture of membranes (in the first stage of labour) concerned more often women aged 18–19 years.

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Prevalence and Location of Obstetric Lacerations in Adolescent Mothers

Cited by 10 publications

References 12 publications

Obstetric anal sphincter injury in adolescent mothers

Obstetric anal sphincter injury in adolescent mothers

A Surgical Technique to Repair Perineal Body Disruption Secondary to Sexual Assault

Comparison of the course of labour in adolescent mothers (aged ≤17 years) and young women (aged 18-19 years)

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