The Incidence and Risk Factors of Obstetrics anal Sphincter Injuries at King Chulalongkorn Memorial Hospital during 2017-2019
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Abstract
Objectives: To study the incidence and risk factors of OASIS during 1 January 2017 to 31 December 2019
Materials and Methods: A retrospective study of all pregnant woman with vaginal delivery (6,714 cases) at King Chulalongkorn Memorial Hospital during 2017-2019 were conducted. We collected the data of all pregnant women who delivered in our hospital since 1 January 2017 to 31 December 2019, using International Classification of Diseases, Tenth Revision (ICD 10) codes for data extraction and review. The case group comprised of pregnant women with an OASIS (third- degree and fourth-degree perineal laceration). The control group comprised of pregnant women delivered vaginally without OASIS.
Results: The incidence of OASIS was 6% (403/6,714). The significant risk factors are nulliparity vs multiparity (adjusted odds ratio (aOR) 3.0, 95% confidence interval (CI) 2.3-4.0, p < 0.01), obesity vs normal BMI (aOR 0.5, 95%CI 0.3-0.7, p < 0.01), forceps extraction vs spontaneous delivery (aOR 4.5, 95% CI 3.1-6.5, p < 0.01), occiput posterior vs occiput anterior position (aOR 2.3, 95%CI 1.2-4.3, p = 0.01), median episiotomy vs no episiotomy (aOR 2.3, 95%CI 1.3-4.3, p = 0.01), staff vs nurses (aOR 11.1, 95%CI 5.0-25.0, p < 0.01), residents vs nurses (aOR 13.3, 95%CI 5.9-30.2, p < 0.01), and medical student vs nurses (aOR 3.5, 95%CI 1.3-9.6, p = 0.01).
Conclusion: The risk factors of OASIS were nulliparity, occiput posterior postition, forceps extraction, median episiotomy, residents and staffs (as the operators). The protective factors were obesity and nurses. Preventive strategies for these factors are advocated.
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