Document Detail

Risk factors for severe perineal tear: can we do better?
MedLine Citation:
PMID:  12152139     Owner:  NLM     Status:  MEDLINE    
Our aim was to investigate the risk factors associated with severe perineal tears defined as either third- or forth-degree tears and, ultimately, find strategies for prevention. We carried a retrospective analysis of a computerized perinatal database, collected prospectively, from a single county hospital between January 1, 1993 and June 30, 1998. Singleton vaginal vertex deliveries were analyzed for potential risk factors using univariate and multiple logistic regression analysis including all two-way interactions. Severe perineal tear occurred in 1905 (8.2%) of 23,244 vaginal deliveries. In the multiple logistic regression analysis, the following factors carried a significantly higher risk for severe laceration: midline episiotomy, primary vaginal delivery, use of pudendal block, forceps deliveries, and birth weight more than 4000 g. The study of interactions demonstrated that mediolateral episiotomy was associated with an increased risk for severe tear only during the first vaginal delivery, but not during a repeat vaginal delivery. Our data suggest that primary vaginal delivery, fetal weight above 4000 g, and the use of pudendal analgesia can help identify in advance patients at highest risk for severe perineal tear. During the delivery of these patients usage of vacuum (instead of forceps) and restricting the use of midline episiotomy might reduce the incidence of severe perineal tear. In cases where episiotomy seems crucial, the use of a mediolateral episiotomy may reduce the likelihood of severe perineal tear.
Shlomit Riskin-Mashiah; E O'Brian Smith; Isabelle A Wilkins
Related Documents :
2714129 - The effect of pregnancy and delivery on the ileal pouch-anal anastomosis functions.
15950369 - Comparison of maternal satisfaction following vaginal delivery after caesarean section ...
16343169 - Rupture of a right sinus of valsalva aneurysm into the right ventricle during vaginal d...
20347079 - Crinone vaginal gel is equally effective and better tolerated than intramuscular proges...
17197599 - Biomechanical adaptations of the rat vagina and supportive tissues in pregnancy to acco...
10968599 - Effect of intravaginal clindamycin cream on pregnancy outcome and on abnormal vaginal m...
9469739 - Earlier thermoregulation and consequences for pup growth in the siberian versus djungar...
24974159 - First chinese case of successful pregnancy with combined methylmalonic aciduria and hom...
15295819 - Heat, sex, and sugar: pregnancy and childbearing in the slave quarters.
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  American journal of perinatology     Volume:  19     ISSN:  0735-1631     ISO Abbreviation:  Am J Perinatol     Publication Date:  2002 Jul 
Date Detail:
Created Date:  2002-08-01     Completed Date:  2002-09-26     Revised Date:  2005-11-17    
Medline Journal Info:
Nlm Unique ID:  8405212     Medline TA:  Am J Perinatol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  225-34     Citation Subset:  IM    
Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas, USA.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Age Distribution
Age Factors
Birth Weight
Episiotomy / adverse effects*,  methods
Injury Severity Score
Obstetric Labor Complications / epidemiology*,  etiology*,  prevention & control
Perineum / injuries*,  surgery
Prospective Studies
Regression Analysis
Retrospective Studies
Risk Factors
Texas / epidemiology

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

Previous Document:  Phoniatric aspects in cleft lip patients.
Next Document:  Acyclovir treatment of primary herpes in pregnancy complicated by second trimester preterm premature...