{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,20]],"date-time":"2025-07-20T04:04:05Z","timestamp":1752984245372,"version":"3.37.3"},"reference-count":23,"publisher":"Federa\u00e7\u00e3o das Associa\u00e7\u00f5es de Ginecologia e Obstetr\u00edcia","issue":"10","license":[{"start":{"date-parts":[[2019,10,28]],"date-time":"2019-10-28T00:00:00Z","timestamp":1572220800000},"content-version":"vor","delay-in-days":27,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Rev Bras Ginecol Obstet"],"published-print":{"date-parts":[[2019,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Objective\u2003To evaluate the association between the upright and supine maternal positions for birth and the incidence of obstetric anal sphincter injuries (OASIs).<\/jats:p><jats:p>\n          Methods\u2003Retrospective cohort study analyzed the data of 1,728 pregnant women who vaginally delivered live single cephalic newborns with a birth weight of 2,500 g. Multiple regression analyses were used to investigate the effect of the supine and upright positions on the incidence of OASIs after adjusting for risk factors and obstetric interventions.<\/jats:p><jats:p>\n          Results\u2003In total, 239 (13.8%) births occurred in upright positions, and 1,489 (86.2%) in supine positions. Grade-III lacerations occurred in 43 (2.5%) patients, and grade-IV lacerations occurred in 3 (0.2%) women. Supine positions had a significant protective effect against severe lacerations, odds ratio [95% confidence interval]: 0,47 [0.22\u20130.99], adjusted for the use of forceps 4.80 [2.15\u201310.70], nulliparity 2.86 [1.44\u20135.69], and birth weight 3.30 [1.56\u20137.00]. Anesthesia (p\u2009&lt;\u20090.070), oxytocin augmentation (p\u2009&lt;\u20090.228), shoulder dystocia (p\u2009&lt;\u20090.670), and episiotomy (p\u2009&lt;\u20090.559) were not associated with the incidence of severe lacerations.<\/jats:p><jats:p>\n          Conclusion\u2003Upright birth positions were not associated with a lower rate of perineal tears. The interpretation of the findings regarding these positions raised doubts about perineal protection that are still unanswered.<\/jats:p>","DOI":"10.1055\/s-0039-1697986","type":"journal-article","created":{"date-parts":[[2019,10,28]],"date-time":"2019-10-28T23:31:14Z","timestamp":1572305474000},"page":"581-587","source":"Crossref","is-referenced-by-count":2,"title":["Do We Know How to Avoid OASIs in Non-Supine Birth Positions? A Retrospective Cohort Analysis"],"prefix":"10.61622","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6374-9295","authenticated-orcid":false,"given":"Zilma Silveira Nogueira","family":"Reis","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, MG, Brazil"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4697-5295","authenticated-orcid":false,"given":"Glaucia Miranda Varella","family":"Pereira","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, MG, Brazil"}]},{"given":"Anna Laura Freitas","family":"Vianini","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, MG, Brazil"}]},{"given":"Marilene Vale Castro","family":"Monteiro","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, MG, Brazil"}]},{"given":"Regina Am\u00e9lia Lopes Pessoa","family":"Aguiar","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, MG, Brazil"}]}],"member":"47794","published-online":{"date-parts":[[2019,10,28]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"252","DOI":"10.1186\/s12884-015-0689-7","article-title":"Birth position and obstetric anal sphincter injury: a population-based study of 113 000 spontaneous births","volume":"15","author":"C Elvander","year":"2015","journal-title":"BMC Pregnancy Childbirth"},{"issue":"04","key":"ref2","doi-asserted-by":"crossref","first-page":"409","DOI":"10.1111\/birt.12346","article-title":"Risk and protective factors for obstetric anal sphincter injuries: A retrospective nationwide study","volume":"45","author":"M L Marschalek","year":"2018","journal-title":"Birth"},{"issue":"03","key":"ref3","doi-asserted-by":"crossref","first-page":"391","DOI":"10.1007\/s00192-017-3398-0","article-title":"Risk factors for obstetric anal sphincter injuries (OASI) at a tertiary centre in south India","volume":"29","author":"S R Gundabattula","year":"2018","journal-title":"Int Urogynecol J Pelvic Floor Dysfunct"},{"issue":"05","key":"ref4","first-page":"CD002006","article-title":"Position in the second stage of labour for women without epidural anaesthesia","author":"J K Gupta","year":"2012","journal-title":"Cochrane Database Syst Rev"},{"issue":"09","key":"ref5","doi-asserted-by":"crossref","first-page":"e008346","DOI":"10.1136\/bmjopen-2015-008346","article-title":"Does the Finnish intervention prevent obstetric anal sphincter injuries? 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