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International Urogynecology Journal

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01-03-2019 | Original Article

Prospective comparison of obstetric anal sphincter injury incidence between an Asian and Western hospital

Authors: Lucy J. Bates, Jerome Melon, Robin Turner, Symphorosa S. C. Chan, Emmanuel Karantanis

Published in: International Urogynecology Journal | Issue 3/2019

Abstract

Introduction and hypothesis

Obstetric anal sphincter injury (OASIS) rates are reported to be higher in Asian women living in Western countries than in those living in Asia, but the reasons for the differences remain unclear. The objectives of this study were for a single examiner to prospectively compare OASIS rates in primiparous Asian women in an Asian and Western birth unit and determine potential birth factors that may influence the possible difference in OASIS incidence.

Methods

This was a prospective observational study based in Hong Kong, China, and Sydney, Australia, involving primiparous women > 36 weeks gestation of Asian descent undergoing vaginal delivery. A single examiner recorded basic patient demographics, observed all the deliveries at both sites, noting birthing techniques, and then examined the women, including a rectal examination, to determine OASIS incidence.

Results

Seventy births in Hong Kong and 66 in Sydney were studied. The incidence of OASIS was 34% in Sydney and 10% in Hong Kong (p = 0.001). Birthweight, epidural rate, body mass index, and instrumental delivery were higher in Sydney. Episiotomy rates were higher in Hong Kong (59.2% vs. 82.9%; p = 0.007). When comparing OASIS with no-OASIS, perineal length (OR = 0.36, 95% CI 0.17 to 0.76, p = 0.004) and birthweight (OR = 1.14, 95% CI 1.00 to 1.30, p = 0.039) were independent risk factors for OASIS.

Conclusions

The incidence of OASIS in Asian women is significantly higher in a Western than in an Asian setting. In Asian women, perineal length and birthweight can affect the risk of OASIS at the time of vaginal delivery.

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Title: Prospective comparison of obstetric anal sphincter injury incidence between an Asian and Western hospital
Authors: Lucy J. Bates
Jerome Melon
Robin Turner
Symphorosa S. C. Chan
Emmanuel Karantanis
Publication date: 01-03-2019
Publisher: Springer International Publishing
Published in: International Urogynecology Journal / Issue 3/2019
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI: https://doi.org/10.1007/s00192-018-3649-8

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Prospective comparison of obstetric anal sphincter injury incidence between an Asian and Western hospital

Abstract

Introduction and hypothesis

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction and hypothesis

Methods

Results

Conclusions

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