Risk Indicators Associated With the Incidence of Obstetric Injury of the Anal Sphincter During Vaginal Labor

Abstract

Obstetrical lesions of the anal sphincter (LOEA) consists of third and fourth degree lacerations that can happen during vaginal labor. Its incidence is related to unfavorable outcomes in the health of the postpartum, such as anal incontinence, dyspareunia, sexual dysfunction, and negative repercussions on emotional and psychological health. Objective: To describe the main risk indicators associated with incidence of anal obstetric injury during vaginal labor. Methodology: This is an integrative review of the literature carried out in the indexed materials in the Medical Literature Analysis and Retrieval System Online (MEDLINE), Latin American and Caribbean Literature in Health Sciences (LILACS), Nursing Database - BDENF, Index Medicus for the Western Pacific (WPRIM) and Bibliographic Index Español en Ciencias de la Salud (IBECS), used the Health Sciences Descriptors (DeCS) in cross-over with the Boolean operator AND and OR, after the application of eligibility criteria were selected 13 studies to compose this review: are: It was evidenced that among the maternal risk indicators associated with LOEA, primiparity, episiotomy, body mass index (?), maternal age < 20 years of age, Asian ethnicity, due to shorter perineal bodies, instrumental delivery, second stage of prolonged labor and previous pregnancy cesarean section history. Fetal factors such as vaginal delivery of pelvic presentation, use of maneuvers to facilitate expulsion and macrosomy, weight > 4 kg were related to an increased risk for anal sphincter lesions. Concluding Considerations: It is observed that maternal and fetal factors are associated with a greater risk of developing anal sphincter lesions, so the identification by health professionals of the main risk indicators in a timely manner is of great importance in the prevention of greater maternal complications.