Levator ani injury in primiparous women with forceps delivery for fetal distress, forceps for second stage arrest, and spontaneous delivery

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• 作者：Rohna Kearney ; Myra Fitzpatrick ; S ; ra Brennan ; Michael Behan ; Janis Miller ; Declan Keane ; Colm O'Herlihy ; John O.L. DeLancey
• 刊名：International Journal of Gynecology and Obstetrics
• 出版年：2010
• 出版时间：October 2010
• 年：2010
• 卷：111
• 期：1
• 页码：19-22
• 全文大小：415 K

文摘

Objective

To compare levator ani muscle injury rates in primiparous women who had a forceps delivery owing to fetal distress with women delivered by forceps for second stage arrest; and to compare these injury rates with a historical control group of women who delivered spontaneously.

Methods

Primiparous women who delivered by forceps were recruited retrospectively into 2 groups: forceps for fetal distress with short second stage (25 ± 11 minutes; n = 19); and forceps delivery for second stage arrest (137 ± 26 minutes; n = 19). MR images of the levator ani muscles were compared with a historical control group of women from a previous study who had delivered spontaneously (n = 129).

Results

Major defect rates were: 42 % for forceps and short second stage; 63 % for forceps and second stage arrest; and 6 % for spontaneous delivery. The odds ratios for major injury were: 11.0 for forceps and short second stage compared with spontaneous delivery; 25.9 for forceps and second stage arrest compared with spontaneous delivery; and 2.3 for forceps and second stage arrest compared with short second stage (P = 0.07).

Conclusion

Women delivered by forceps have a higher rate of levator ani injury compared with spontaneous delivery controls; the difference between the forceps groups did not reach significance.