Document Detail

Risk factors for birth-related perineal trauma: a cross-sectional study in a birth centre.
MedLine Citation:
PMID:  22646921     Owner:  NLM     Status:  MEDLINE    
AIM AND OBJECTIVES: To identify maternal, newborn and obstetric factors associated with birth-related perineal trauma in one independent birth centre.
BACKGROUND: Risk factors for birth-related perineal trauma include episiotomy, maternal age, ethnicity, parity and interventions during labour including use of oxytocin, maternal position at time of birth and infant birth weight. Understanding more about these factors could support the management of vaginal birth to prevent spontaneous perineal trauma, in line with initiatives to reduce routine use of episiotomy.
DESIGN: Cross-sectional study.
METHODS: Data were retrospectively collected from one independent birth centre in Brazil, during 2006-2009. The dependent variable (perineal trauma) was classified as: (1) intact perineum or first-degree laceration, (2) second-degree laceration and (3) episiotomy (right mediolateral or median).
RESULTS: There were 1079 births during the study period. Parity, use of oxytocin during labour, position at time of giving birth and infant birth weight were associated with second-degree lacerations and episiotomies. After adjusting for parity, oxytocin, maternal position at the expulsive stage of labour and infant birth weight influenced perineal outcomes among primiparae only.
CONCLUSIONS: Although the overall rate of episiotomies in this study was low compared with national data, it was observed that younger women were most vulnerable to this intervention. In this age group in particular, the use of oxytocin as well as semi-upright positions at the time of birth was associated with second-degree lacerations and episiotomies.
RELEVANCE TO CLINICAL PRACTICE: The use of upright alternative positions for birth and avoidance of use of oxytocin could reduce the risk of perineal trauma from lacerations and need to perform episiotomy.
Flora M B da Silva; Sonia M J V de Oliveira; Debra Bick; Ruth H Osava; Esteban F Tuesta; Maria L G Riesco
Publication Detail:
Type:  Journal Article     Date:  2012-05-31
Journal Detail:
Title:  Journal of clinical nursing     Volume:  21     ISSN:  1365-2702     ISO Abbreviation:  J Clin Nurs     Publication Date:  2012 Aug 
Date Detail:
Created Date:  2012-07-13     Completed Date:  2012-12-03     Revised Date:  2014-07-31    
Medline Journal Info:
Nlm Unique ID:  9207302     Medline TA:  J Clin Nurs     Country:  England    
Other Details:
Languages:  eng     Pagination:  2209-18     Citation Subset:  N    
Copyright Information:
© 2012 Blackwell Publishing Ltd.
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MeSH Terms
Birthing Centers*
Cross-Sectional Studies
Episiotomy / adverse effects,  classification
Lacerations / etiology*
Medical Audit
Pregnancy Complications / etiology*
Pudendal Nerve / injuries*
Retrospective Studies
Risk Factors
Young Adult

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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