EP27.29: Has the prevalence of avulsion after forceps delivery changed over time? Article Swipe

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S. Arcanjo , Jessica Caudwell‐Hall , Ka Lai Shek , Hans Peter Dietz ·

YOU? · · 2019 · Open Access · · DOI: https://doi.org/10.1002/uog.21675

Forceps delivery (FD) is a strong risk factor for avulsion. While rates of FD have declined, concerns have arisen over inadequate training, potentially leading to an increase in major pelvic floor trauma. The aim of this study was to determine whether there is an association between historical timing of forceps and avulsion prevalence after forceps. A retrospective analysis of 2026 patients seen between 2014 and 2018 for an interview, clinical examination and 4D translabial ultrasound (TLUS). 511 (25.2%) had had at least one FD. 14 were excluded due to missing data, leaving 497 for analysis. Levator avulsion was diagnosed if the three central slices on TLUS showed an abnormal muscle insertion. Mean age was 57 (23-91) years. Mean BMI was 29. Median vaginal parity was 2.5 (0-8). Mean age at first delivery was 25 years, and mean birth weight was 3450g. Mean time between delivery and review was 32 (0.3-64.8) years. On TLUS, 229 (46.3%) had a levator avulsion. On univariate analysis, time since FD, age at first delivery and increasing birth weight were associated with avulsion. On multivariate analysis, only age at first delivery (p < 0.0001; OR1.085; 95% CI 1.04–1.13) and birth weight (p = 0.001; OR 1.786; 95% CI 1.25–2.53) remained significant, while time since FD was non-significant (p = 0.86; odds ratio 1.014; 95% CI 0.86–1.18). Older age at first delivery and increasing neonatal weight are associated with levator avulsion at the time of FD, while time since forceps delivery was not significant. Once other factors are controlled for, a FD performed 50 years ago seems to have been just as likely to cause major pelvic floor trauma than it is today.

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Medicine Avulsion Vaginal delivery Forceps Birth weight Childbirth Univariate analysis Obstetrics Odds ratio Pregnancy Surgery Multivariate analysis Internal medicine Biology Genetics

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Type: article
Language: en
Landing Page: https://doi.org/10.1002/uog.21675
PDF: https://obgyn.onlinelibrary.wiley.com/doi/pdfdirect/10.1002/uog.21675
OA Status: bronze
Related Works: 10
OpenAlex ID: https://openalex.org/W2978978487

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OpenAlex ID: https://openalex.org/W2978978487

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DOI: https://doi.org/10.1002/uog.21675

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Title: EP27.29: Has the prevalence of avulsion after forceps delivery changed over time?

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Type: article

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Language: en

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Publication year: 2019

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Publication date: 2019-09-30

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Authors: S. Arcanjo, Jessica Caudwell‐Hall, Ka Lai Shek, Hans Peter Dietz

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Landing page: https://doi.org/10.1002/uog.21675

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OA URL: https://obgyn.onlinelibrary.wiley.com/doi/pdfdirect/10.1002/uog.21675

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Concepts: Medicine, Avulsion, Vaginal delivery, Forceps, Birth weight, Childbirth, Univariate analysis, Obstetrics, Odds ratio, Pregnancy, Surgery, Multivariate analysis, Internal medicine, Biology, Genetics

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abstract_inverted_index.birth	137, 171, 193
abstract_inverted_index.cause	267
abstract_inverted_index.data,	90
abstract_inverted_index.first	130, 167, 183, 223
abstract_inverted_index.floor	30, 270
abstract_inverted_index.least	81
abstract_inverted_index.major	28, 268
abstract_inverted_index.other	248
abstract_inverted_index.rates	11
abstract_inverted_index.ratio	215
abstract_inverted_index.seems	259
abstract_inverted_index.since	163, 207, 241
abstract_inverted_index.study	36
abstract_inverted_index.there	41
abstract_inverted_index.three	101
abstract_inverted_index.while	205, 239
abstract_inverted_index.years	257
abstract_inverted_index.(0-8).	126
abstract_inverted_index.0.001;	197
abstract_inverted_index.1.014;	216
abstract_inverted_index.1.786;	199
abstract_inverted_index.3450g.	140
abstract_inverted_index.Median	121
abstract_inverted_index.arisen	18
abstract_inverted_index.factor	7
abstract_inverted_index.likely	265
abstract_inverted_index.muscle	109
abstract_inverted_index.parity	123
abstract_inverted_index.pelvic	29, 269
abstract_inverted_index.review	146
abstract_inverted_index.showed	106
abstract_inverted_index.slices	103
abstract_inverted_index.strong	5
abstract_inverted_index.timing	47
abstract_inverted_index.today.	275
abstract_inverted_index.trauma	271
abstract_inverted_index.weight	138, 172, 194, 228
abstract_inverted_index.years,	134
abstract_inverted_index.years.	116, 150
abstract_inverted_index.(23-91)	115
abstract_inverted_index.(25.2%)	77
abstract_inverted_index.(46.3%)	154
abstract_inverted_index.(TLUS).	75
abstract_inverted_index.0.0001;	187
abstract_inverted_index.Forceps	0
abstract_inverted_index.Levator	95
abstract_inverted_index.between	45, 62, 143
abstract_inverted_index.central	102
abstract_inverted_index.factors	249
abstract_inverted_index.forceps	49, 242
abstract_inverted_index.leading	23
abstract_inverted_index.leaving	91
abstract_inverted_index.levator	157, 232
abstract_inverted_index.missing	89
abstract_inverted_index.trauma.	31
abstract_inverted_index.vaginal	122
abstract_inverted_index.whether	40
abstract_inverted_index.OR1.085;	188
abstract_inverted_index.abnormal	108
abstract_inverted_index.analysis	57
abstract_inverted_index.avulsion	51, 96, 233
abstract_inverted_index.clinical	69
abstract_inverted_index.concerns	16
abstract_inverted_index.delivery	1, 131, 144, 168, 184, 224, 243
abstract_inverted_index.excluded	86
abstract_inverted_index.forceps.	54
abstract_inverted_index.increase	26
abstract_inverted_index.neonatal	227
abstract_inverted_index.patients	60
abstract_inverted_index.remained	203
abstract_inverted_index.analysis,	161, 179
abstract_inverted_index.analysis.	94
abstract_inverted_index.avulsion.	9, 158, 176
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abstract_inverted_index.determine	39
abstract_inverted_index.diagnosed	98
abstract_inverted_index.performed	255
abstract_inverted_index.training,	21
abstract_inverted_index.(0.3-64.8)	149
abstract_inverted_index.associated	174, 230
abstract_inverted_index.controlled	251
abstract_inverted_index.historical	46
abstract_inverted_index.inadequate	20
abstract_inverted_index.increasing	170, 226
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abstract_inverted_index.interview,	68
abstract_inverted_index.prevalence	52
abstract_inverted_index.ultrasound	74
abstract_inverted_index.univariate	160
abstract_inverted_index.association	44
abstract_inverted_index.examination	70
abstract_inverted_index.potentially	22
abstract_inverted_index.translabial	73
abstract_inverted_index.1.04–1.13)	191
abstract_inverted_index.1.25–2.53)	202
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abstract_inverted_index.significant,	204
abstract_inverted_index.significant.	246
abstract_inverted_index.0.86–1.18).	219
abstract_inverted_index.retrospective	56
abstract_inverted_index.non-significant	210
cited_by_percentile_year
countries_distinct_count	1
institutions_distinct_count	4
sustainable_development_goals[0].id	https://metadata.un.org/sdg/5
sustainable_development_goals[0].score	0.5799999833106995
sustainable_development_goals[0].display_name	Gender equality
citation_normalized_percentile.value	0.1901797
citation_normalized_percentile.is_in_top_1_percent	False
citation_normalized_percentile.is_in_top_10_percent	False