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Related Concept Videos

Teratogenicity01:07

Teratogenicity

The ability of a drug to produce structural deformations and functional abnormalities in the developing embryo or the fetus is called teratogenicity, and the drug producing this effect is known as a teratogen. Teratogenic effects include stillbirth, miscarriage, intrauterine growth restriction, and neurocognitive delay. A teratogen may affect the embryo at different stages of development, which is important in determining the type and extent of the damage. During blastocyst formation, the early...

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An Experimental Paradigm for the Prediction of Post-Operative Pain PPOP
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Predicting perineal trauma during childbirth using data from a general obstetric population.

Gillian M Maher1,2, Laura J O'Byrne1,3,4, Joye McKernan4

  • 1INFANT Research Centre, University College Cork, Cork, T12YE02, Ireland.

HRB Open Research
|November 6, 2023
PubMed
Summary

A new risk prediction model identifies key factors for severe perineal tears during childbirth. Nulliparity, forceps/ventouse delivery, and higher birthweight are significant predictors, aiding in individualized risk assessment.

Keywords:
Internal validationPerineal traumaPrediction model

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Area of Science:

  • Obstetrics and Gynecology
  • Maternal-Fetal Medicine
  • Epidemiology

Background:

  • Perineal trauma is a frequent childbirth complication with potential long-term health consequences.
  • Limited research has investigated the combined impact of multiple risk factors on severe perineal tears.
  • This study aimed to develop and validate a predictive model for third and fourth-degree perineal tears in a general obstetric population.

Purpose of the Study:

  • To develop and internally validate a risk prediction model for third and fourth-degree perineal tears.
  • To identify key predictors associated with severe perineal trauma during vaginal deliveries.
  • To create a tool for individualized risk assessment and counseling.

Main Methods:

  • A risk prediction model was developed using data from singleton vaginal deliveries (2019-2020).
  • Third/fourth-degree tears were defined as involving the anal sphincter complex.
  • Multivariable logistic regression and receiver operating characteristic (ROC) curve C-statistic were employed for model development and validation.

Main Results:

  • The final model included nulliparity, mode of delivery (forceps/ventouse), and increasing birthweight (per 100g increase).
  • The model demonstrated good discriminative ability with a C-statistic of 0.75 (95% CI: 0.71, 0.79).
  • A nomogram was developed for calculating individualized risk, with good internal performance indicated by bootstrapping.

Conclusions:

  • The developed nomogram provides an individualized risk assessment for third and fourth-degree perineal tears.
  • This tool can assist in counseling women regarding their potential risk of severe perineal trauma.
  • Further application of this model may improve patient care and informed decision-making during childbirth.