{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,14]],"date-time":"2026-03-14T19:57:31Z","timestamp":1773518251892,"version":"3.50.1"},"reference-count":17,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2020,10,30]],"date-time":"2020-10-30T00:00:00Z","timestamp":1604016000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aust NZ J Obst Gynaeco"],"published-print":{"date-parts":[[2021,2]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>The use of epidural as a form of analgesia is increasingly common in labour, but this has shown to have been associated with increased rates of instrumental delivery, and prolonged second stage, resulting in increased rates of OASIS (Obstetric Anal Sphincter Injury).<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>This study aimed to investigate the impact of epidural anaesthesia in multiparous women undergoing vaginal deliveries on OASIS and secondary maternal outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and Methods<\/jats:title><jats:p>A retrospective cohort study of multiparous women with singleton pregnancies delivering at term \u226537\u00a0weeks and the use of epidural analgesia in labour at a tertiary hospital in Melbourne, Victoria, Australia, the Royal Women's Hospital was undertaken between the period 2012\u20132018. Maternal outcomes were collated and dichotomised according to the presence of epidural use. Multiparous women with no prior history of a vaginal birth and non\u2010cephalic presentation during labour were excluded.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There were 14\u00a0124 multiparous women who met the inclusion criteria; spontaneous labour is associated with an increased risk of OASIS at adjusted odds ratio (aOR) 1.46, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.012. The overall rate of epidural use was 17%. Women with epidural use had significantly lower chances of sustaining OASIS in normal vaginal births and instrumental vaginal births. (1% vs 1.8%, aOR 0.49, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.004). Epidural is associated with increased rates of prolonged second stage (8.5% vs 3.8%, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.05), instrumental delivery (26.1% vs 4%, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.05), and episiotomy use (23.8% vs 10.2%, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The use of epidural analgesia in multiparous women is associated with a reduction in anal sphincter injuries.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ajo.13263","type":"journal-article","created":{"date-parts":[[2020,10,30]],"date-time":"2020-10-30T16:01:20Z","timestamp":1604073680000},"page":"30-34","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Obstetric anal sphincter injuries (OASIS) in multiparous women with the use of epidural anaesthesia: A retrospective cohort study"],"prefix":"10.1111","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3092-228X","authenticated-orcid":false,"given":"Inge","family":"Putri","sequence":"first","affiliation":[{"name":"Western Health Melbourne Victoria Australia"},{"name":"Royal Women\u2019s Hospital Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Koen","family":"Simons","sequence":"additional","affiliation":[{"name":"Western Health Melbourne Victoria Australia"},{"name":"University of Melbourne Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonathan","family":"Nettle","sequence":"additional","affiliation":[{"name":"Royal Women\u2019s Hospital Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anthony","family":"Woodward","sequence":"additional","affiliation":[{"name":"Royal Women\u2019s Hospital Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,10,30]]},"reference":[{"key":"e_1_2_6_2_1","volume-title":"Epidurals and Childbirth","author":"The Australian and New Zealand College of Anaesthetists"},{"key":"e_1_2_6_3_1","volume-title":"Obstetric Anal Sphincter Injury (OASIS)","author":"Weinstein MM","year":"2019"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006250-199908000-00020"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2006.10.893"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aeq311"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000002444"},{"key":"e_1_2_6_8_1","volume-title":"Perineal Tears: A Literature Review, Australian Commission On Safety And Quality In 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