<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0300-9041</journal-id>
<journal-title><![CDATA[Ginecología y obstetricia de México]]></journal-title>
<abbrev-journal-title><![CDATA[Ginecol. obstet. Méx.]]></abbrev-journal-title>
<issn>0300-9041</issn>
<publisher>
<publisher-name><![CDATA[Federación Mexicana de Colegios de Obstetricia y Ginecología A.C.]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0300-90412017000100004</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[El desgarro intraparto del esfínter anal ¿Puede prevenirse?]]></article-title>
<article-title xml:lang="en"><![CDATA[Intrapartum anal sphyncter tear: is it preventable?]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Pato-Mosquera]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[García-Lavandeira]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Liñayo-Chouza]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Complexo Hospitalario Universitario de Ourense Servicio de Obstetricia y Ginecología ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>España</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>01</month>
<year>2017</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>01</month>
<year>2017</year>
</pub-date>
<volume>85</volume>
<numero>1</numero>
<fpage>13</fpage>
<lpage>20</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_arttext&amp;pid=S0300-90412017000100004&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_abstract&amp;pid=S0300-90412017000100004&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_pdf&amp;pid=S0300-90412017000100004&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen  OBJETIVO: determinar los factores de riesgo asociados con el desgarro intraparto del esfínter anal  MATERIAL Y MÉTODO:  análisis retrospectivo, de casos y controles con desgarro del esfínter anal y sin éste. Se aplicó análisis bivariante.  RESULTADOS: se incluyeron 97 pacientes: 48 casos de desgarro del esfínter anal y 49 controles sin éste. La incidencia de desgarros fue de 1.6% (1.3% en primíparas y 0.3% en multíparas). En el análisis bivariante se encontraron diferencias estadísticamente significativas en primiparidad (p=0.003), parto inducido (p&lt;0.001), parto instrumentado (p=0.006), duración de la dilatación (p=0.023), tiempo de expulsión (p=0.007), episiotomía (p&lt;0.001), peso del recién nacido (p=0.006) e incontinencia urinaria (p=0.002). Con el análisis univariante se obtuvo una diferencia estadísticamente significativa en las variables de primiparidad (RM de 3.833, p=0.004), parto instrumentado (RM de 3.214, p=0.007), episiotomía (RM de 6.101, p&lt;0.001), peso del recién nacido (RM de 1.001 por cada gramo, p=0.009), duración de la dilatación (RM de 1.004 por cada minuto, p=0,012) y del tiempo de expulsión (RM 1.007 por cada minuto, p=0.016). En el análisis multivariado sólo se encontró asociación con la episiotomía (RM de 6.76 e IC 95% de 2.436-18.805) y peso del recién nacido (RM de 1.001 e IC 95% de 1.000-1.002); el área bajo la curva ROC fue de 0.762 (IC=0.667-0.856).  CONCLUSIONES: el desgarro del esfínter es multifactorial y difícil de predecir. Para intentar reducir la incidencia debe intervenirse en los factores de riesgo modificables.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  OBJETIVE:  to determinate the risk factors of intrapartum anal sphincter tear.  MATERIAL AND METHOD:  a retrospective case-control study which included a total of 97 patientes: 48 with anal sphincter tear and 49 without tear.  RESULTS:  There was an incidence of 1.6% of anal sphincter injury (1.3% in primiparous and 0.3% in multiparous). In bivariate analysis statistical significant differences was found in primiparity (p=0.003), labour induction (p&lt;0.001), instrumental delivery (p=0.006), dilatation duration (p=0.023), duration of expulsive stage (p=0.007), episiotomy (p&lt;0.001), fetal weight (p=0.006) and urinary incontinence (p=0.002). Univariate analysis showed a statistical difference in primiparous (OR 3.833, p=0.004), instrumental delivery (OR 3.214, p=0.007), episiotomy (OR 6.101, p&lt;0.001), fetal weight (OR 1.001 for each grams, p=0.009), dilatation duration (OR 1.004 for each minute, p=0.012), duration of expulsive stage (OR 1.007 for each minute, p=0.016). In the multivariate analysis significant difference was found in episiotomy with an OR=6.76 and CI 95% of 2.436-18.805, and fetal weight with an OR=1.001 and CI 95% of 1.000-1.002; the discrimination index area under the curve (AUC) showed a value of 0.762, CI=0.667-0.856.  CONCLUSIONS: the anal sphincter injury is multifactorial and difficult to predict. Intervention on modifiable risk factors should allow a reduction in its incidence.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[desgarro del esfínter anal]]></kwd>
<kwd lng="es"><![CDATA[parto vaginal]]></kwd>
<kwd lng="es"><![CDATA[incidencia]]></kwd>
<kwd lng="es"><![CDATA[factores de riesgo]]></kwd>
<kwd lng="en"><![CDATA[Anal sphincter injury]]></kwd>
<kwd lng="en"><![CDATA[Vaginal delivery]]></kwd>
<kwd lng="en"><![CDATA[Incidence]]></kwd>
<kwd lng="en"><![CDATA[Risk factors]]></kwd>
</kwd-group>
</article-meta>
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