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Anogenital Distance and Perineal Measurements of the Pelvic Organ Prolapse POP Quantification System
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Risk factors associated with severe perineal tears: A five-year study.

P von Theobald1, M Bohrer2, S Lorrain3

  • 1Centre d'Études Périnatales de l'Océan Indien (CEPOI) - EA7388, Centre Hospitalier Universitaire de la Réunion, Saint-Pierre Cedex, La Réunion, France; Service de Gynécologie et Obstétrique, CHU de la Réunion, Hôpital Félix Guyon, Allée des Topazes, CS 11021, 97405 Saint Denis de La Réunion Cedex, France.

Journal of Gynecology Obstetrics and Human Reproduction
|May 26, 2020
PubMed
Summary
This summary is machine-generated.

Risk factors for third and fourth-degree perineal tears (34DPT) differ between operative and non-operative vaginal deliveries. Mediolateral episiotomy may offer protection during operative deliveries, warranting further study.

Keywords:
Birth weightEpisiotomyGestational ageObstetric anal sphincter injuriesPerineal tearRisk factors

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Area of Science:

  • Obstetrics and Gynecology
  • Perinatal Care
  • Surgical Outcomes

Background:

  • Third and fourth-degree perineal tears (34DPT) are severe obstetric complications.
  • Understanding risk factors is crucial for prevention and management strategies.

Purpose of the Study:

  • To identify risk factors associated with 34DPT in both operative and non-operative vaginal deliveries.
  • To analyze these factors over a five-year period in a tertiary care setting.

Main Methods:

  • Retrospective cohort study of 39,227 vaginal deliveries (2013-2017).
  • Univariate and multivariate logistic regression analyses were employed.
  • Risk factors for 34DPT were evaluated in operative and non-operative delivery groups separately.

Main Results:

  • The rate of 34DPT remained stable (0.8-1.4%) despite rising overall perineal tear rates.
  • In non-operative deliveries, advanced gestational age (>39 weeks) and high birth weight (>3500g) were associated with 34DPT.
  • In operative deliveries, advanced gestational age, diabetes, and episiotomy were associated with 34DPT, with episiotomy showing a protective effect.

Conclusions:

  • Risk factors for 34DPT vary significantly between operative and non-operative vaginal deliveries.
  • The potential protective role of mediolateral episiotomy in operative deliveries requires further investigation.
  • These findings are relevant for tertiary care models with low cesarean section rates.