Abstract
Objectives: To estimate the prevalence and risk factors for obstetric anal sphincter injuries (OASIS) in Saudi Arabia using data in a tertiary care University Center
Design: A retrospective case-control study
Setting: King Khalid University Hospital, Kingdom of Saudi Arabia
Subjects: All women with third and fourth degree perineal tears over a 10-year period Interventions: We conducted this study by creating an obstetric database compiled over a period of 10 years (2002 2012) screening all for third and fourth degree perineal tears and too control matched by the time of delivery and delivery team (midwife and obstetrician).
Main Outcome Measures: The prevalence of perineal injuries was calculated in cases and controls. Maternal and obstetric parameters were analyzed and compared between the two groups. Results: Of 31,665 vaginal deliveries, seventy-three patients (0.23 %, 95% CI by the adjusted wald method: 0.18% - 0.29%) had a recognized third (n = 66) or fourth-degree (n = 7) perineal tear. The following three variables were independently associated with OASIS on multivariate logistic regression models adjusting for potential confounders: primiparity (OR 3.32) instrumental delivery (OR 7.19) and episiotomy (OR 4.92).
Conclusion: The overall prevalence of third- and fourth-degree perineal tears in our population is low; avoidance of certain obstetric interventions including instrumental delivery and episiotomy may decrease such complications.