Pato-Mosquera M, García-Lavandeira S, Liñayo-Chouza J

Language: Spanish
References: 0
Page: 13-20
PDF size: 216.20 Kb.

ABSTRACT

Objetive: to determinate the risk factors of intrapartum anal sphincter tear.
Material and Method: a retrospective case-control study which included a total of 97 patientes: 48 with anal sphincter tear and 49 without tear.
Results: There was an incidence of 1.6% of anal sphincter injury (1.3% in primiparous and 0.3% in multiparous). In bivariate analysis statistical significant differences was found in primiparity (p=0.003), labour induction (p‹0.001), instrumental delivery (p=0.006), dilatation duration (p=0.023), duration of expulsive stage (p=0.007), episiotomy (p‹0.001), fetal weight (p=0.006) and urinary incontinence (p=0.002). Univariate analysis showed a statistical difference in primiparous (OR 3.833, p=0.004), instrumental delivery (OR 3.214, p=0.007), episiotomy (OR 6.101, p‹0.001), fetal weight (OR 1.001 for each grams, p=0.009), dilatation duration (OR 1.004 for each minute, p=0.012), duration of expulsive stage (OR 1.007 for each minute, p=0.016). In the multivariate analysis significant difference was found in episiotomy with an OR=6.76 and CI 95% of 2.436-18.805, and fetal weight with an OR=1.001 and CI 95% of 1.000-1.002; the discrimination index area under the curve (AUC) showed a value of 0.762, CI=0.667-0.856.
Conclusions: the anal sphincter injury is multifactorial and difficult to predict. Intervention on modifiable risk factors should allow a reduction in its incidence.