{
    "abstract": "Incidence of complications following obstetrical anal sphincter injury (OASI) during vaginal delivery are poorly defined. They are only studied in high level maternities, small cohorts, all stages of perineal tear or in low-income countries. The aim of our study was to describe complications after primary OASI repair following a vaginal delivery in all French maternity wards at short and midterm and to assess factors associated with complication occurrence.\nWe conducted a historical cohort study using the French nationwide claim database (PMSI) from January 2013 to December 2021. All women who sustained an OASI repair following a vaginal delivery were included and virtually followed-up for 2 years. Then, we searched for OASIS complications. Finally, we evaluated factors associated with OASIS complication repaired or not and OASIS complication repairs.\nAmong the 61,833 included women, 2015 (2.8%) had an OASI complication and 842 (1.16%) underwent an OASI complication repair. Women were mainly primiparous (71.6%) and 44.3% underwent an instrumental delivery. During a follow-up of 2 years, 0.6% (n\u2009=\u2009463), 0.3% (n\u2009=\u2009240), 0.2% (n\u2009=\u2009176), 0.1% (n\u2009=\u200984), 0.06% (n\u2009=\u200943) and 0.01% (n\u2009=\u20095) of patients underwent second surgery for a perineal repair, a fistula repair, a sphincteroplasty, a perineal infection, a colostomy and a sacral nervous anal stimulation, respectively. Only one case of artificial anal sphincter was noticed. Instrumental deliveries (OR\u2009=\u20091.56 CI95%[1.29;1.9]), private for-profit hospitals (OR\u2009=\u20091.42 [1.11;1.82], reference group \"public hospital\"), obesity (OR\u2009=\u20091.36 [1;1.84]), stage IV OASIS (OR\u2009=\u20092.98 [2.4;3.72]), perineal wound breakdown (OR\u2009=\u20092.8 [1.4;5.48]), ages between 25 and 29 years old (OR\u2009=\u20091.59 [1.17;2.18], refence group \"age between 13 and 24 years old\") and 30 and 34 years old (OR\u2009=\u20091.57 [1.14; 2.16], refence group \"age between 13 and 24 years old\") were factors associated with OASIS complication repairs.\nMaternal age, stage IV OASIS, obesity, instrumental deliveries and private for-profit hospitals seemed to predict OASIS complications. Understanding factors associated with OASIS complications could be beneficial for the patient to inform them and to influence the patient's follow-up in order to prevent complications, repairs and maternal distress.",
    "authors": [
        {
            "affiliation": "Service de chirurgie gyn\u00e9cologique, CHU Lille, Lille, F-59000, France. marine.lallemant@chu-lille.fr.\nFacult\u00e9 de m\u00e9decine, Univ. Lille, Lille, F-59000, France. marine.lallemant@chu-lille.fr.\nUniv. Lille, CNRS, Centrale Lille, UMR 9013 - LaMcube - Laboratoire de M\u00e9canique, Multiphysique, Multi\u00e9chelle, Lille, F-59000, France. marine.lallemant@chu-lille.fr.\nDepartment of Applied Mechanics, Universit\u00e9 de Franche-Comt\u00e9, FEMTO-ST Institute, UMR 6174 CNRS, Besan\u00e7on, F-25000, France. marine.lallemant@chu-lille.fr.",
            "firstname": "Marine",
            "initials": "M",
            "lastname": "Lallemant"
        },
        {
            "affiliation": "Public health dept, Univ. Lille, CHU Lille, ULR 2694 - METRICS, CERIM, Lille, F-59000, France.\nGynecology-Obstetric Unit, Douai Hospital, Dechy, France.",
            "firstname": "St\u00e9phanie",
            "initials": "S",
            "lastname": "Bartolo"
        },
        {
            "affiliation": "Service de chirurgie gyn\u00e9cologique, CHU Lille, Lille, F-59000, France.\nFacult\u00e9 de m\u00e9decine, Univ. Lille, Lille, F-59000, France.\nUniv. Lille, CHU Lille, ULR 2694 - METRICS - Health Technology and Medical Practice Assessment, Lille, F-59000, France.",
            "firstname": "Louise",
            "initials": "L",
            "lastname": "Ghesquiere"
        },
        {
            "affiliation": "Service de chirurgie gyn\u00e9cologique, CHU Lille, Lille, F-59000, France.\nFacult\u00e9 de m\u00e9decine, Univ. Lille, Lille, F-59000, France.\nUniv. Lille, CNRS, Centrale Lille, UMR 9013 - LaMcube - Laboratoire de M\u00e9canique, Multiphysique, Multi\u00e9chelle, Lille, F-59000, France.",
            "firstname": "Chryst\u00e8le",
            "initials": "C",
            "lastname": "Rubod"
        },
        {
            "affiliation": "Service de chirurgie gyn\u00e9cologique, CHU Lille, Lille, F-59000, France.",
            "firstname": "Alessandro Ferdinando",
            "initials": "AF",
            "lastname": "Ruffolo"
        },
        {
            "affiliation": "Service de chirurgie gyn\u00e9cologique, CHU Lille, Lille, F-59000, France.\nFacult\u00e9 de m\u00e9decine, Univ. Lille, Lille, F-59000, France.\nUniv. Lille, Unit\u00e9 Inserm U1189 - OncoThai : Laser Assisted Therapies and Immunotherapies for Oncology, Lille, 59000, France.",
            "firstname": "Yohan",
            "initials": "Y",
            "lastname": "Kerbage"
        },
        {
            "affiliation": "Public health dept, Univ. Lille, CHU Lille, ULR 2694 - METRICS, CERIM, Lille, F-59000, France.",
            "firstname": "Emmanuel",
            "initials": "E",
            "lastname": "Chazard"
        },
        {
            "affiliation": "Service de chirurgie gyn\u00e9cologique, CHU Lille, Lille, F-59000, France.\nFacult\u00e9 de m\u00e9decine, Univ. Lille, Lille, F-59000, France.\nUniv. Lille, CNRS, Centrale Lille, UMR 9013 - LaMcube - Laboratoire de M\u00e9canique, Multiphysique, Multi\u00e9chelle, Lille, F-59000, France.",
            "firstname": "Michel",
            "initials": "M",
            "lastname": "Cosson"
        }
    ],
    "conclusions": null,
    "copyrights": "\u00a9 2024. The Author(s).",
    "doi": "10.1186/s12884-024-06691-w\n10.1016/j.ajog.2012.12.025\n10.1016/0002-9378(93)90478-2\n10.1097/AOG.0000000000000833\n10.1016/s0039-6109(02)00055-5\n10.1016/j.ajog.2022.05.012\n10.1007/s00404-019-05165-1\n10.12968/bjon.2012.21.Sup5.S28\n10.1007/s00192-021-04841-8\n10.1016/j.ajog.2006.06.085\n10.3390/jcm12083036\n10.1016/j.jviscsurg.2020.10.010\n10.1155/2014/638936\n10.1007/s11892-011-0183-1\n10.1111/ajo.13261",
    "journal": "BMC pregnancy and childbirth",
    "keywords": [
        "Anal sphincter repair",
        "Perineal care",
        "Perineal trauma",
        "Wound breakdown",
        "Wound complication",
        "Wound infection"
    ],
    "methods": null,
    "publication_date": "2024-08-15",
    "pubmed_id": "39143527\n30385355\n23262251\n8438915\n25932836\n12516853\n35550375\n31004221\n22489339\n34003311\n37498432\n25923992\n16949409\n27098261\n16098885\n37109371\n21542810\n30543535\n33454307\n24701367\n21327583\n33058142",
    "results": "Among the 61,833 included women, 2015 (2.8%) had an OASI complication and 842 (1.16%) underwent an OASI complication repair. Women were mainly primiparous (71.6%) and 44.3% underwent an instrumental delivery. During a follow-up of 2 years, 0.6% (n\u2009=\u2009463), 0.3% (n\u2009=\u2009240), 0.2% (n\u2009=\u2009176), 0.1% (n\u2009=\u200984), 0.06% (n\u2009=\u200943) and 0.01% (n\u2009=\u20095) of patients underwent second surgery for a perineal repair, a fistula repair, a sphincteroplasty, a perineal infection, a colostomy and a sacral nervous anal stimulation, respectively. Only one case of artificial anal sphincter was noticed. Instrumental deliveries (OR\u2009=\u20091.56 CI95%[1.29;1.9]), private for-profit hospitals (OR\u2009=\u20091.42 [1.11;1.82], reference group \"public hospital\"), obesity (OR\u2009=\u20091.36 [1;1.84]), stage IV OASIS (OR\u2009=\u20092.98 [2.4;3.72]), perineal wound breakdown (OR\u2009=\u20092.8 [1.4;5.48]), ages between 25 and 29 years old (OR\u2009=\u20091.59 [1.17;2.18], refence group \"age between 13 and 24 years old\") and 30 and 34 years old (OR\u2009=\u20091.57 [1.14; 2.16], refence group \"age between 13 and 24 years old\") were factors associated with OASIS complication repairs.",
    "title": "Midterm complications after primary obstetrical anal sphincter injury repair in France.",
    "xml": "<Element 'PubmedArticle' at 0x7885050dcea0>"
}