Type of publication:
Conference abstract
Author(s):
*Papoutsis D., *Henderson K., *Tapp A., *Qadri Z.
Citation:
BJOG: An International Journal of Obstetrics and Gynaecology, June 2016, vol./is. 123/(52)
Abstract:
Objective The aim of our study was to identify the incidence of and the risk factors for a repeat OASIS in the subsequent vaginal birth of a cohort of primiparous women who sustained an OASIS in their first vaginal delivery. Methods Retrospective collection of data from the obstetric database of our hospital for women having had singleton cephalic presentation vaginal deliveries between 2007 and 2015. Results We identified 603 primiparous women who sustained a first episode of OASIS in their first vaginal delivery (3a tear: 43%, 3b tear: 38.6%, 3c tear: 13.1%, 4th degree tear: 5.3%). This represents an incidence of first OASIS in the population of primiparous women delivering over the same time period of 5.4% (603/11 191). In the subgroup of women with a first episode of OASIS, the mean age was 27.8 years (SD = 5.7), 30.8% had an induction of labour and 38% had an instrumental delivery. Of this initial cohort of women, 243 (40.2%) had a subsequent pregnancy. In this subgroup, 190 (78.1%) had a vaginal delivery, 13 (5.4%) had an emergency CS delivery while in labour and 40 (16.5%) had an elective CS delivery. In those that delivered vaginally, 16 women had a repeat OASIS thus representing an incidence of 8.4%. After adjusting for several confounding factors, it was found in multivariable analysis that risk factors independently associated with the risk of a repeat OASIS were the use of epidural analgesia and an episiotomy in the first delivery, and a short labour (<3 h) in the second delivery. The time interval between the two vaginal births was not associated with any increased risk of a repeat OASIS. Conclusion We have found that 8.4% of women sustained a repeat OASIS in a subsequent vaginal birth with this risk being associated with the presence of a short second labour and certain features from the first labour.
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