{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,4]],"date-time":"2025-10-04T08:06:40Z","timestamp":1759565200868,"version":"3.36.0"},"reference-count":0,"publisher":"Scientific Foundation Spiroski (publications)","issue":"6","license":[{"start":{"date-parts":[[2018,6,17]],"date-time":"2018-06-17T00:00:00Z","timestamp":1529193600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Open Access Maced J Med Sci"],"abstract":"<jats:p>OBJECTIVES: Obstetric anal sphincter injury (OASIS) includes the third and fourth degree of perineal injury. The risk for OASIS is about 1% of all vaginal deliveries. If not recognised and treated properly, obstetric anal sphincter injury can have serious consequences for reproductive age woman.MATERIAL AND METHODS: We have retrospectively gathered and analysed data on obstetric anal sphincter injury in a four-year period at our department. The control group in this study included vaginal deliveries in 2012.RESULTS: We recorded 0.34% third and fourth degree of perineal injury in all vaginal deliveries, and 87.9% of those patients were primiparae. Episiotomy was performed in 57.6% of all women with obstetric anal sphincter injury. In 30.3% of cases, newborns were large for gestational age. Gestational diabetes was found in 9.1% of OASIS cases, occipitoposterior position was found in 9.1% of cases. Induced labour took place in 39.4%, and oxytocin infusion was applied in 60.6% of OASIS cases. Vacuum extraction was performed in 12.1% of deliveries with OASIS. The average BMI in 3a and 3b injuries was 29.9. In 3c degree it was 28.0, and in the fourth degree, it was 32.1. In 27.0% of OASIS cases due to the extent of the injury surgeon engagement was necessary. When compared with vaginal deliveries in 2012 we found a significant increase in OASIS in primiparas, large for gestational age, occipitoposterior position, induced labour, vacuum extraction and hypertension (P &lt; 0.01). There is also increased incidence of OASIS in episiotomy and oxytocin use group (P &lt; 0.05).CONCLUSION: Low incidence of OASIS in our department is a result of active management of delivery, manual perineal protection and timely episiotomy.<\/jats:p>","DOI":"10.3889\/oamjms.2018.253","type":"journal-article","created":{"date-parts":[[2018,6,19]],"date-time":"2018-06-19T21:48:31Z","timestamp":1529444911000},"page":"1067-1071","source":"Crossref","is-referenced-by-count":8,"title":["Third and Fourth Degree Perineal Tear in Four-Year Period at Sestre Milosrdnice University Hospital Center, Zagreb, Croatia"],"prefix":"10.3889","volume":"6","author":[{"given":"Ivka","family":"Djakovi\u0107","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emina","family":"Ejubovi\u0107","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ivan","family":"Bolan\u010da","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marina","family":"Marku\u0161 Sandri\u0107","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dino","family":"Be\u010di\u0107","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"\u017deljko","family":"Djakovi\u0107","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vesna","family":"Ko\u0161ec","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"52292","published-online":{"date-parts":[[2018,6,17]]},"container-title":["Open Access Macedonian Journal of Medical Sciences"],"original-title":[],"link":[{"URL":"https:\/\/spiroski.migration.publicknowledgeproject.org\/index.php\/mjms\/article\/download\/oamjms.2018.253\/2201","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/oamjms.eu\/index.php\/mjms\/article\/download\/oamjms.2018.253\/2177","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,4,19]],"date-time":"2023-04-19T21:25:28Z","timestamp":1681939528000},"score":1,"resource":{"primary":{"URL":"https:\/\/spiroski.migration.publicknowledgeproject.org\/index.php\/mjms\/article\/view\/oamjms.2018.253"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,6,17]]},"references-count":0,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2018,6,20]]}},"URL":"https:\/\/doi.org\/10.3889\/oamjms.2018.253","relation":{},"ISSN":["1857-9655"],"issn-type":[{"type":"electronic","value":"1857-9655"}],"subject":[],"published":{"date-parts":[[2018,6,17]]}}}