Int Urogynecol J (2018) 29:377–381 DOI 10.1007/s00192-017-3351-2 ORIGINAL ARTICLE Anal sphincter injury in vaginal deliveries complicated by shoulder dystocia 1,2 1 1 1 Mark P. Hehir & Zachary Rubeo & Karen Flood & Anne H. Mardy & 2 2 1 Colm O’Herlihy & Peter C. Boylan & Mary E. D’Alton Received: 2 December 2016 /Accepted: 24 April 2017 /Published online: 18 May 2017 The International Urogynecological Association 2017 Abstract factors. Episiotomy was negatively associated with sphincter Introduction and hypothesis Shoulder dystocia is an obstetric injury on multivariate regression analysis. emergency that occurs in 0.2–3% of all cephalic vaginal de- Conclusions In a retrospective cohort of 685 women with liveries. We hypothesized that because of the difficult nature shoulder dystocia, the risk of anal sphincter injury is 9%. of deliveries complicated by shoulder dystocia, the condition Risk factors include nulliparity, operative vaginal delivery, may be associated with anal sphincter injury. We sought to and use of internal maneuvers, whereas episiotomy was found identify risk factors for obstetric anal sphincter injury in wom- to have a protective effect against anal sphincter injury during en with shoulder dystocia. cases of shoulder dystocia. Methods This retrospective analysis included all cases of shoulder dystocia
International Urogynecology Journal – Springer Journals
Published: May 18, 2017
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