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Federación Mexicana de Ginecología y Obstetricia, A.C.

2021, Number 06

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Ginecol Obstet Mex 2021; 89 (06)

Association between third- and fourth-degree perineal tears (OASIS) and non-intervened labor

Martínez-Villafaña E, Remba-Shapiro I, Rodríguez-Carrillo DL, Fernández-Corzas MF, Quesnel García-Benítez CA

Language: Spanish
References: 17
Page: 438-443
PDF size: 175.81 Kb.


ABSTRACT

Objective: To estimate the association between non-interventional delivery and the risk of obstetric anal sphincter injuries.
Materials and Methods: Case-control, observational, longitudinal, retrospective, and analytical study performed in patients attended between 2016 and 2019 at Hospital Ángeles Lomas, with term pregnancy who had non-interventional delivery. Dependent variables: third- and fourth-degree perineal tears, dilation at admission, labor hours and episiotomy. Independent variables: age, body mass index, pregnancies, deliveries, and newborn weight. Comparison of outcomes with a control group with interventional delivery. Tears were categorized using the Sultan classification. Patients with multiple pregnancy, preterm or instrumented delivery were excluded.
Results: A total of 253 non-intervened and 253 intervened deliveries were attended. Obstetric anal sphincter injury was present in 2.4% of patients with non-intervened delivery and in 4.0% without intervened delivery (RR: 1.66; 95%CI: 0.61-4.51). Labor was 3.50 hours in patients with non-intervened delivery and 4.41 hours in the control group. Episiotomy was performed in 22.9% of women with non-intervened delivery and in 44.3% of the control group (RR: 1.93; 95%CI: 1.48-2.51).
Conclusions: Women with non-intervened delivery had no increased risk of thirdor fourth-degree perineal tear. In those who had an interventional delivery, the risk of requiring episiotomy was higher.


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