Prevalence and risk factors of severe perineal injuries during childbirth in Saudi Arabia

Objectives: To estimate the prevalence and risk factors for obstetric anal sphincter injuries [OASIS] in Saudi Arabia using data in a tertiary care University Center

Design: A retrospective case-control study

Setting: King Khalid University Hospital, Kingdom of Saudi Arabia

Subjects: All women with third and fourth degree perineal tears over a 10-year period

Interventions: We conducted this study by creating an obstetric database compiled over a period of 10 years [2002-2012] screening all for third and fourth degree perineal tears and too control matched by the time of delivery and delivery team [midwife and obstetrician]

Main Outcome Measures: The prevalence of perineal injuries was calculated in cases and controls. Maternal and obstetric parameters were analyzed and compared between the two groups

Results: Of 31,665 vaginal deliveries, seventy-three patients [0.23 %, 95% Cl by the adjusted wald method: 0.18%-0.29%] had a recognized third [n=66] or fourth-degree [n=7] perineal tear. The following three variables were independently associated with OASIS on multivariate logistic regression models adjusting for potential confounders: primiparity [OR 3.32] instrumental delivery [OR 7.19] and episiotomy [OR 4.92]

Conclusion: The overall prevalence of third- and fourth-degree perineal tears in our population is low; avoidance of certain obstetric interventions including instrumental delivery and episiotomy may decrease such complications

Recurrent urinary tract infections management in women: a review

Urinary tract infections [UTIs] are one of the most frequent clinical bacterial infections in women, accounting for nearly 25% of all infections. Around 50-60% of women will develop UTIs in their lifetimes. Escherichia coli is the organism that causes UTIs in most patients. Recurrent UTIs [RUTI] are mainly caused by reinfection by the same pathogen. Having frequent sexual intercourse is one of the greatest risk factors for RUTIs. In a subgroup of individuals with coexisting morbid conditions, complicated RUTIs can lead to upper tract infections or urosepsis. Although the initial treatment is antimicrobial therapy, use of different prophylactic regimens and alternative strategies are available to reduce exposure to antibiotics