The incidence and risk factors of obstetrics anal sphincter injuries (OASIS) in at King Chulalongkorn Memorial hospital during 2017-2019
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Abstract
Aim: to study the incidence and risk factors of obstetrics anal sphincter injuries (OASIS) during 1 January 2017 to 31 December 2019
Methods: A retrospective study of all pregnant woman with vaginal delivery (6714 cases) in at King Chulalongkorn Memorial 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 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 is 6% (403/6,714).The significant risk factors are nulliparity vs multiparity[OR: 3.0, 95% CI 2.3-4.0, p < 0.01], obesity vs normal BMI[OR: 0.5, 95% CI 0.3-0.7, p < 0.01], forceps extraction vs spontaneous delivery[OR: 4.5, 95% CI 3.1-6.5, p < 0.01], occiput posterior vs occiput anterior position [OR: 2.3, 95% CI 1.2-4.3, p = 0.01], median episiotomy vs no episiotomy[OR: 2.3, 95% CI 1.3-4.3, p = 0.01], staff vs nurses[OR: 11.1, 95% CI 5.0-25.0, p < 0.01], residents vs nurses[OR: 13.3, 95% CI 5.9-30.2, p < 0.01], and medical student vs nurses[OR: 3.5, 95% CI 1.3-9.6, p = 0.01].
Conclusion: The risk factors of OASIS are nulliparity, occiput posterior postition, forceps extraction, median episiotomy, residents and staffs (as the operators). The protective factors are obesity and nurses. Preventive strategies for these factors are advocated.
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