Correlation of perineal outcome at first and second vaginal deliveries

Perineal outcome in 1000 consecutive term non instrumental second vaginal deliveries was correlated with first delivery method and perineal outcome. Our aim was to determine the relationship between perineal outcome at first and second vaginal deliveries. Overall 75% of first non instrumental vaginal deliveries required sutures. Sutures were required at second delivery in 12% (24 of 199) of cases not sutured at first delivery compared with 60.4% (485 of 801) of those sutured. The rate of second perineal repair correlated with method of first delivery and perineal outcome, instrumental delivery--66.2% (145 of 219), first episiotomy-68.4% (238 of 348) and first sutured tear--43.6% (102 of 234). The incidence of third /fourth degree tear at first delivery was 1.3% (13/1000) (one recurred at second forceps delivery), compared with 0.6% at second delivery. First delivery outcome should be considered when conducting a second delivery as sixty per cent of women require perineal repair following repair at first delivery.