Prospective comparison of obstetric anal sphincter injury incidence between an Asian and Western hospital

Bates, Lucy; J, Mélon; Turner, Robin; Chan, Symphorosa Shing Chee; Karantanis, Emmanuel

doi:10.1007/s00192-018-3649-8

Cited by 12 publications

(17 citation statements)

References 24 publications

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“…Either firm pressure or pressure with squeezing of the perineum, also known as the modified Ritgen manoeuvre, was used. 6 Warm compresses were not commonly used by midwives and doctors in our study.…”

Section: Discussionmentioning

confidence: 66%

“…Compared with previous studies, the rate of OASIS determined by endoanal US in our study (6.5%) was lower than the rate of 10% determined by a single examiner in a prospective observational study conducted in the same unit. 6 This could be a result of the small sample size (70 subjects) in the prior study. Furthermore, most patients with OASIS (5/7) in that study were reported to have small 3a tears.…”

Section: Discussionmentioning

confidence: 97%

“…Furthermore, these tears might not result in long-term consequences. 6,21 The finding of an overall lower OASIS rate in Hong Kong, compared with that in Asian women who deliver in Caucasian countries, is not new. 6 Asian women who deliver in locations with more restrictive policies regarding episiotomy have shown higher rates of OASIS.…”

Section: Discussionmentioning

confidence: 99%

“…6,21 The finding of an overall lower OASIS rate in Hong Kong, compared with that in Asian women who deliver in Caucasian countries, is not new. 6 Asian women who deliver in locations with more restrictive policies regarding episiotomy have shown higher rates of OASIS. [22][23][24] In a study conducted in the United States, OASIS was found significantly more frequently in Asian women than in women of other ethnicities.…”

Section: Discussionmentioning

confidence: 99%

“…Importantly, it is also possible that the reduced incidence of OASIS in Hong Kong is a result of underdetection. In a recent local prospective observational study, women were assessed by a single experienced clinician via rectal examination after either normal or instrumental vaginal delivery; the results of that study showed that the incidence of OASIS in primiparous Asian women in Hong Kong was 10%, 6 which suggests that the OASIS rate might be higher than previously published. Obstetric anal sphincter injuries that are identified after an extended interval (such as during postnatal follow-up) is regarded as occult OASIS.…”

Section: Implications For Clinical Practice or Policymentioning

confidence: 93%

See 4 more Smart Citations

Prevalence of obstetric anal sphincter injury following vaginal delivery in primiparous women: a retrospective analysis

et al. 2019

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Introduction: Obstetric anal sphincter injuries (OASIS) may be underdetected in primiparous women. This study evaluated the prevalence of OASIS in primiparous women after normal vaginal delivery or instrumental delivery using endoanal ultrasound (US) during postnatal follow-up. Methods: This study retrospectively analysed endoanal US data collected during postnatal follow-up (6-12 months after vaginal delivery) at a tertiary hospital in Hong Kong. Offline analysis to determine the prevalence of OASIS was performed by two researchers who were blinded to the clinical diagnosis. Symptoms of faecal and flatal incontinence were assessed with the Pelvic Floor Distress Inventory. Results: Of 542 women included in the study, 205 had normal vaginal delivery and 337 had instrumental delivery. The prevalence of OASIS detected by endoanal US was 7.8% (95% confidence interval [CI]=4.1%-11.5%) in the normal vaginal delivery group and 5.6% (95% CI=3.1%-8.1%) in the instrumental delivery group. Overall, 82.9%

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Section: Discussionmentioning

confidence: 66%

Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Implications For Clinical Practice or Policymentioning

confidence: 93%

See 3 more Smart Citations

Prevalence of obstetric anal sphincter injury following vaginal delivery in primiparous women: a retrospective analysis

et al. 2019

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Maternal origin matters: Country of birth as a risk factor for obstetric anal sphincter injuries

André,

Stuart,

Källén

2024

Intl J Gynecology & Obste

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ObjectiveObstetric anal sphincter injuries (OASIS) are severe complications to vaginal births with potential long‐term consequences. Maternal origin has been proposed to affect the overall risk, but the association and underlying explanation are uncertain. The objective was to assess the association between maternal country of birth and OASIS.MethodsA Swedish nationwide cohort study including singleton term vaginal births during 2005–2016. Data were extracted from the Swedish Medical Birth Registry and Statistics Sweden. Modified Poisson regression analyses were performed to obtain crude and adjusted risk ratios (RRs). Adjustments were made in four cumulative steps. Sub‐analyses were performed to investigate the risk of OASIS associated with female genital circumcision (FGC).ResultsIn all, 988 804 births were included. The rate of OASIS in Swedish‐born women was 3.5%. Women from East/Southeast Asia had an increased risk of OASIS (adjusted RR [aRR] 1.71, 95% confidence interval [CI] 1.60–1.83), as did women born in Sub‐Saharan Africa (aRR 1.60, 95% CI 1.49–1.72). The risk remained significantly increased also after adjustment for maternal height. By contrast, women from South/Central America had a decreased risk of OASIS (aRR 0.65, 95% CI 0.56–0.76). FGC was associated with an increased risk of OASIS (aRR 3.05, 95% CI 2.60–3.58). Episiotomy appeared to have an overall protective effect (aRR 0.95, 95% CI 0.92–0.98), but not significantly more protective among women with female genital mutilation.ConclusionsCountry of birth plays an important role in the risk of OASIS. Women from East/Southeast Asia and Sub‐Saharan Africa are at significantly increased risk as compared with Swedish‐born women, whereas women from South/Central America are at lower risk. FGC is also a significant risk factor for OASIS.

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What are the factors that may predict the severity of perineal tears in obstetric anal sphincter injuries and how are their outcomes? A 10-year retrospective analysis in a Southeast Asian population

Tan

Yusoff

et al. 2022

Int Urogynecol J

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Prospective comparison of obstetric anal sphincter injury incidence between an Asian and Western hospital

Abstract: The incidence of OASIS in Asian women is significantly higher in a Western than in an Asian setting. In Asian women, perineal length and birthweight can affect the risk of OASIS at the time of vaginal delivery.

Cited by 12 publications

References 24 publications

Prevalence of obstetric anal sphincter injury following vaginal delivery in primiparous women: a retrospective analysis

Prevalence of obstetric anal sphincter injury following vaginal delivery in primiparous women: a retrospective analysis

Maternal origin matters: Country of birth as a risk factor for obstetric anal sphincter injuries

What are the factors that may predict the severity of perineal tears in obstetric anal sphincter injuries and how are their outcomes? A 10-year retrospective analysis in a Southeast Asian population

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