The impact of occiput posterior fetal head position on the risk of anal sphincter injury in forceps-assisted vaginal deliveries

Benavides, L; Wu, Jennifer M.; Hundley, Andrew F.; Ivester, Thomas; Visco, Anthony G.

doi:10.1016/j.ajog.2004.11.047

Cited by 81 publications

(62 citation statements)

References 18 publications

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“…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.…”

Section: Introductionmentioning

confidence: 99%

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

2015

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Section: Introductionmentioning

confidence: 99%

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

2015

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“…Furthermore, while some findings have shown that, on average, nulliparous women report greater pain than parous women during labour (32,33), others have not found such an association (34). Other obstetric factors that have been shown to be associated with pain include foetal presentation (35), dystocia (36), higher foetal weight (32), and the artificial induction of labour (37). A history of dysmenorrhoea and menstrual back pain has also been documented as a gynaecological predictor for obstetric pain (8,32).…”

Section: Introductionmentioning

confidence: 99%

The Role of Maternal Attachment in the Experience of Labor Pain

Costa-Martins

Pereira

Martins

et al. 2014

Psychosomatic Medicine

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Objective: To examine the influence of attachment dimensions and sociodemographic and physical predictors in the experience of labour pain. Methods: Eighty-one pregnant women were assessed during their third trimester of pregnancy and during labour. The perceived intensity of pain in the early stages of labour (3 cm of cervical dilatation) and before the administration of patient-controlled epidural analgesia (PCEA) was measured using a visual analogue scale (VAS). Pain was also assessed based on the consumption of anaesthetics. Attachment was assessed using the Adult Attachment Scale -Revised (AAS-R). Results: Attachment anxiety and avoidance were positively and significantly correlated with labour pain and anaesthetic consumption. In the multivariate models, attachment anxiety was a significant predictor of higher pain at 3 cm of cervical dilatation (β = 0.36, p = .042) and before the administration of PCEA (β = 0.51, p = .002). Older age (β = 0.31, p = .005), a shorter duration of labour (β = -0.41, p = .001) and attachment avoidance (β = 0.41, p = .004) were significant predictors of higher anaesthetic consumption. Conclusions: The study findings suggest that perceived labour pain and anaesthetic consumption are strongly associated with attachment, rather than demographic and physical factors. These data support the importance of understanding the experience of labour pain within an attachment theoretical framework.

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“…Benavides found that 35% of women who had forceps deliveries developed third or fourth degree tears [39]. OP positions were associated with an incidence of tears of 51.5% while the occiput anterior tear frequency was much lower at 32.9%.…”

Section: Risk Factors For Anal Sphincter Injurymentioning

confidence: 97%

Anal incontinence

Bartolo

Paterson

2009

Best Practice & Research Clinical Gastroenterology

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Anal incontinence is a life restricting condition that is sometimes challenging to treat. There is an equal gender prevalence, however women are more likely to present particularly early in life, as a result of obstetric injury. This is still one of the leading causes of anal incontinence and sphincter tears can be missed at the time of delivery. As a result, there is a heightened awareness for sphincter injury based on risk assessment, digital rectal examination and an endo-anal ultrasound. Surgical repair is still invaluable in the presence of disruption and salvage procedures for severe refractory incontinence such as the dynamic gracilloplasty and the artificial bowel sphincter continue to be perfected. Mini invasive procedures such as rectal irrigation and sacral neuromodulaton have had a successful outcome and we have had to depend less on the more invasive treatments. Above all there is a growing need to protect not only the baby but also the pelvic floor and anal sphincter from traumatic deliveries, through early risk assessment and research.

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The impact of occiput posterior fetal head position on the risk of anal sphincter injury in forceps-assisted vaginal deliveries

Cited by 81 publications

References 18 publications

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

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

The Role of Maternal Attachment in the Experience of Labor Pain

Anal incontinence

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