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Master Thesis

Facteurs pronostiques de lésions pelviennes suite aux interventions obstétricales

Abstract : Introduction: This literature review focuses on 3rd and 4th degree sphincter injuries following childbirth. Third degree lesions involve the external anal sphincter, over more or less 50% of its thickness, depending on the grade. The 4th degree lesions concern the internal anal sphincter, with a possibility of damage to the anal epithelium on the anterior anorectal wall. Aim: The objective of this review is to determine the prognostic factors of pelvic injuries following obstetric interventions during childbirth. Methods: The research was done on 5 databases and there are 6 included studies, which are retrospective cohort studies. The population concerns all cephalic vaginal deliveries of singleton infants. The characteristics of the delivery are studied, with particular attention to obstetrical interventions (forceps, vacuum, episiotomy). The outcome is the occurrence of obstetrical anal sphincter injuries. The scales used for risk of bias are Newcastle Ottawa for internal validity of studies, then the grade system for quality of evidence and AMSTAR for review quality. Results: It appears that primiparity, the use of forceps, especially in second intention after the use of vacuum, a second phase of prolonged labor, and an occipito-posterior fetal presentation could increase the rate of obstetric anal sphincter injuries (OASI). Conclusion: Obstetrical interventions appears to be prognostic factors of OASI.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-03358368
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Submitted on : Wednesday, September 29, 2021 - 12:27:06 PM
Last modification on : Tuesday, October 19, 2021 - 10:35:24 PM

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Manon Ruppenthal. Facteurs pronostiques de lésions pelviennes suite aux interventions obstétricales. Médecine humaine et pathologie. 2021. ⟨dumas-03358368⟩

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