Document Detail

Are obstetric anal sphincter ruptures preventable?- Large and consistent rupture rate variations between the Nordic countries and between delivery units in Norway.
MedLine Citation:
PMID:  23034015     Owner:  NLM     Status:  Publisher    
Objective: To study changes in obstetric anal sphincter rupture (OASR) incidences during the last years in Denmark, Finland, Sweden and Norway and hospital-based incidences in Norway for the last years. Design: Retrospective birth register study. Setting: Unselected population of delivering women in four Nordic countries. Population or Sample: All deliveries (574175) registered in Denmark, Finland, Norway and Sweden 2004-2010. Methods: Parity data, including maternal, obstetrical and fetal characteristics, were obtained. OASR incidence was calculated from vaginal deliveries. A chi-squared test was used to analyze differences between countries and time periods. Main outcome measures: Incidence of OASR. Results: During the study period, the OASR incidence in Finland was notably lower (0.7%-1.0%) than in the other three Nordic countries (4.2%-2.3%). A significant and constant reduction in OASR incidence was observed in Norway only (4.1%-2.3%, in 2004-10, p < 0.001). This reduction occurred simultaneously with a national intervention program of improved delivery techniques aiming at reducing OASR incidence. No major alterations in maternal or fetal risk factors for OASR or registration routines could explain this rapid OASR rate reduction. Differences in OASR incidence between Norwegian delivery units were significant, with a threefold difference when comparing the units with lowest and highest incidences. Conclusions: OASR seems to be preventable to a considerable extent, as indicated by rapid and lasting reduction of OASR incidence after implementation of perineal protection programs in Norway. Improved delivery techniques should be implemented in all delivery units to prevent OASR as much as possible.
Katariina Laine; Wenche Rotvold; Anne Cathrine Staff
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-10-4
Journal Detail:
Title:  Acta obstetricia et gynecologica Scandinavica     Volume:  -     ISSN:  1600-0412     ISO Abbreviation:  Acta Obstet Gynecol Scand     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-10-4     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370343     Medline TA:  Acta Obstet Gynecol Scand     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2012 The Authors Acta Obstetricia et Gynecologica Scandinavica© 2012 Nordic Federation of Societies of Obstetrics and Gynecology.
Department of Obstetrics and Department of Gynaecology, Oslo University Hospital, Ullevål, Oslo Faculty of Medicine, University of Oslo, Oslo Department of Obstetrics and Gynaecology, Østfold Hospital Trust, Fredrikstad, Norway.
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