Related Experiment Video
Updated: Dec 20, 2025

Anogenital Distance and Perineal Measurements of the Pelvic Organ Prolapse POP Quantification System
Published on: September 20, 2018
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.
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.
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.
Related Concept Videos
Factors Affecting the Risk of Infection
The integrity and count of the white blood cells help the body resist pathogens and fight infection. When impaired, it reduces the body's resistance to pathogens. The acidic pH levels of the gastrointestinal, genitourinary tracts, and skin...
Esophageal Perforation-I: Introduction
The location of esophageal perforation can vary, occurring anywhere along the esophagus....
Muscles of the Pelvic Floor and Perineum
Perineal Layer
The perineum is a diamond-shaped area below the pelvic diaphragm, divided into an anterior urogenital triangle that contains the external genitals and a posterior anal triangle housing the anus. The urogenital...
Appendicitis-I: Introduction
Etiology: Appendicitis can arise from various causes, primarily rooted in the obstruction of the appendix lumen. Factors contributing to this obstruction include fecal accumulation, lymphoid hyperplasia and, in...

