E-Posters-Risk Factors and Associations of Third- and Fourth-degree Lacerations: An Urban Single Center Experience

Risk Factors and Associations of Third- and Fourth-degree Lacerations: An Urban Single Center Experience - Kimberley Chiu, MD

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This document summarizes the content of a study on risk factors and associations of third- and fourth-degree lacerations, also known as obstetric anal sphincter injuries (OASIS), in a single urban center. The study analyzed data from 23,362 deliveries between 2014 and 2017, identifying 241 cases of OASIS. The primary objective was to report the incidence rate of OASIS and to identify maternal, intrapartum, and fetal variables associated with these injuries. <br /><br />The study found that nulliparity, a history of diabetes, Asian race, race-adjusted Hispanics, Pitocin use, operative delivery and vaginal birth after cesarean (VBAC) were associated with an increased risk of OASIS. In contrast, obesity with a body mass index greater than 30 was found to be a protective factor. Other factors, such as epidural use, fetal weight, and induction of labor, did not show a significant association.<br /><br />The study also looked at immediate postpartum complications and found that 7% of patients with OASIS experienced complications, including granulation tissue excision and wound breakdown. However, more than half of patients did not receive any documented postpartum follow-up.<br /><br />The study's strengths include a diverse patient population and a sample size comparable to existing literature. Limitations include the retrospective nature of the study and lack of documentation on some variables.<br /><br />Overall, this study provides important insights into the risk factors and associations of OASIS, particularly in minority populations. It highlights the need for education on postpartum follow-up and further research on reducing the incidence and complications of OASIS.

Keywords

risk factors

associations

third-degree lacerations

fourth-degree lacerations

obstetric anal sphincter injuries

OASIS

urban center

incidence rate

maternal variables

intrapartum variables