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Third- and fourth-degree perineal tears: prevalence and risk factors in the third millennium.

Abstract：

OBJECTIVE:We sought to assess the modern prevalence and risk factors for third- and fourth-degree perineal tears. STUDY DESIGN:The study population comprised 38,252 women who delivered in one medical center, from January 2005 through December 2009, and met the following inclusion criteria: singleton pregnancy, vertex presentation, and vaginal delivery. Of these, 96 women (0.25%) sustained third- or fourth-degree perineal tears. Maternal and obstetric variables were compared between women with vs without severe perineal tears. RESULTS:Five variables were found to be statistically significant independent risk factors: Asian ethnicity (odds ratio [OR], 8.9; 95% confidence interval [CI], 4.2-18.9), primiparity (OR, 2.4; 95% CI, 1.5-3.7), persistent occipito posterior (OR, 2.1; 95% CI, 1-4.5), vacuum delivery (OR, 2.7; 95% CI, 1.6-4.6), and heavier birthweight (OR, 1.001; 95% CI, 1-1.001). CONCLUSION:Severe perineal tears are uncommon in modern obstetric practice. Significant risk factors are Asian ethnicity, primiparity, persistent occipito posterior, vacuum delivery, and heavier birthweight.

journal_name

Am J Obstet Gynecol

journal_title

American journal of obstetrics and gynecology

authors

Groutz A,Hasson J,Wengier A,Gold R,Skornick-Rapaport A,Lessing JB,Gordon D

doi

10.1016/j.ajog.2010.11.019

subject

Has Abstract

pub_date

2011-04-01 00:00:00

pages

347.e1-4

issue

4

eissn

0002-9378

issn

1097-6868

pii

S0002-9378(10)02281-7

journal_volume

204

pub_type

杂志文章

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