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Related Experiment Video

Updated: Aug 5, 2025

Anogenital Distance and Perineal Measurements of the Pelvic Organ Prolapse POP Quantification System
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Anthropometric Features and Third-Fourth Degree Perineal Tears.

Arrigo Fruscalzo1, Alice Novak2, Camilla Somma2

  • 1Clinic of Obstetrics and Gynecology, University Hospital of Fribourg, 1752 Fribourg, Switzerland.

Journal of Personalized Medicine
|March 29, 2023
PubMed
Summary

Nulliparity and fetomaternal body-mass index (BMI) are key predictors of severe perineal tears. Identifying these risk factors can help reduce obstetric anal sphincter injuries during childbirth.

Keywords:
anal sphincter lacerationfeto-maternal body-mass indexobstetrical complicationsthird- and fourth-degree perineal tearsvaginal delivery

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Area of Science:

  • Obstetrics and Gynecology
  • Perinatal Research
  • Maternal-Fetal Medicine

Background:

  • Severe perineal tears (third- and fourth-degree) are significant obstetric complications.
  • Understanding risk factors is crucial for prevention and management strategies.

Purpose of the Study:

  • To investigate the association between maternal and fetal anthropometric characteristics and severe perineal tears.
  • To identify independent predictors of third- and fourth-degree perineal tears.

Main Methods:

  • Retrospective cohort study of 5397 singleton vaginal deliveries (2011-2017).
  • Inclusion criteria: singleton vaginal delivery, maternal pre-pregnancy weight, maternal height, and neonatal weight.
  • Calculation of feto-maternal body-mass index (BMI) and multivariate analysis.

Main Results:

  • Prevalence of third-fourth-degree perineal tears was 0.47%.
  • Predictive factors included nulliparity, feto-maternal BMI, neonatal weight, gestational age, and head circumference.
  • Independent predictors after adjustment were nulliparity and feto-maternal BMI (AUC 73.54%).

Conclusions:

  • Nulliparity and feto-maternal BMI are the strongest predictors of severe perineal tears.
  • Further research and integration into delivery algorithms may reduce obstetric anal sphincter injuries.