Occiput posterior fetal head position increases the risk of anal sphincter injury in vacuum-assisted deliveries.

Published

Journal Article

OBJECTIVE: The purpose of this study was to determine whether an occiput posterior (OP) fetal head position increases the risk for anal sphincter injury when compared with an occiput anterior (OA) position in vacuum-assisted deliveries. STUDY DESIGN: We conducted a retrospective cohort study of 393 vacuum-assisted singleton vaginal deliveries. Maternal demographics and obstetric and neonatal data were collected from an obstetric database and chart review. RESULTS: Within the OP group, 41.7% developed a third- or fourth-degree laceration compared with 22.0% in the OA group (OR 2.5, 95% CI 1.4-4.7). In a logistic regression model that controlled for BMI, race, nulliparity, length of second stage, episiotomy, birth weight, head circumference, and fetal head position, OP position was 4.0 times (95% CI 1.7-9.6) more likely to be associated with an anal sphincter injury than OA position. CONCLUSION: Among vacuum deliveries, an OP head position confers an incrementally increased risk for anal sphincter injury over an OA position.

Full Text

Duke Authors

Cited Authors

  • Wu, JM; Williams, KS; Hundley, AF; Connolly, A; Visco, AG

Published Date

  • August 2005

Published In

Volume / Issue

  • 193 / 2

Start / End Page

  • 525 - 528

PubMed ID

  • 16098883

Pubmed Central ID

  • 16098883

Electronic International Standard Serial Number (EISSN)

  • 1097-6868

International Standard Serial Number (ISSN)

  • 0002-9378

Digital Object Identifier (DOI)

  • 10.1016/j.ajog.2005.03.059

Language

  • eng