Anal sphincter injury in vaginal deliveries complicated by shoulder dystocia.

Introduction And Hypothesis: Shoulder dystocia is an obstetric emergency that occurs in 0.2-3% of all cephalic vaginal deliveries. We hypothesized that because of the difficult nature of deliveries complicated by shoulder dystocia, the condition may be associated with anal sphincter injury.

Obstetric anal sphincter injury, risk factors and method of delivery - an 8-year analysis across two tertiary referral centers.

Objective: Obstetric anal sphincter injury (OASIS) represents a major cause of maternal morbidity and is a risk factor for the development of fecal incontinence. We set out to analyze the incidence of OASIS and its association with mode of delivery in two large obstetric hospitals across an 8-year study period.

Methods: This was a prospective observational study carried out at two large tertiary referral centers serving a single urban population, from 2003 to 2010.

Changes in vaginal breech delivery rates in a single large metropolitan area.

Objective: Vaginal breech delivery rates have been accepted widely to be in decline and the Term Breech Trial (TBT) has recommended delivery of a breech-presenting infant by elective cesarean section delivery. Our aim was to examine the rate of vaginal delivery of term breech pregnancies in the 8 years before and after the publication of the TBT.

Study Design: We retrospectively examined vaginal delivery rates of breech presentations over a 16-year period in 3 large tertiary maternity hospitals that serve a single large metropolitan population.