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Incidence and risk factors of severe lacerations during forceps delivery in a single teaching hospital where simulation training is held annually
Author(s) -
Sano Yasuko,
Hirai Chihiro,
Makino Shintaro,
Li Xianglan,
Takeda Jun,
Itakura Atsuo,
Takeda Satoru
Publication year - 2018
Publication title -
journal of obstetrics and gynaecology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 50
eISSN - 1447-0756
pISSN - 1341-8076
DOI - 10.1111/jog.13558
Subject(s) - medicine , forceps , forceps delivery , incidence (geometry) , odds ratio , obstetrics , logistic regression , confidence interval , birth weight , cephalic presentation , medical record , episiotomy , surgery , pregnancy , vaginal delivery , physics , pathology , biology , optics , genetics
Aim This study was conducted to evaluate the incidence of severe lacerations during forceps delivery and the risk factors associated with such delivery in a hospital where simulation training is held annually. Methods The medical records of 857 women who underwent forceps delivery at term with singleton cephalic presentation from 2010 to 2015 were reviewed. The relationship between clinical characteristics and birth canal trauma was analyzed. Birth canal trauma included third and fourth degree perineal lacerations. Univariable and multivariable models of logistic regression were employed to estimate the raw odds ratio and were adjusted for cofactors with 95% confidence intervals. Statistical significance was defined as P < 0.05. Results The incidence of severe lacerations was 10.1%. Birth weight, fetal head station, the rate of malrotation and the number of extractions were higher in women with severe lacerations ( P < 0.01), whereas the use of obstetric anesthesia was lower in women with such lacerations ( P < 0.01). Neither the indication for forceps delivery nor the qualifications of the operator had any influence on the incidence of severe lacerations. Conclusion The incidence of severe lacerations was relatively low. Risk factors for severe lacerations with forceps delivery were identified as birth weight, fetal head station, malrotation and the number of extractions. Obstetric anesthesia may protect against severe lacerations.