Article

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

Urogynecology and Pelvic Floor Unit, Department of Obstetrics and Gynecology, Lis Maternity Hospital, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
American journal of obstetrics and gynecology (impact factor: 3.28). 12/2010; 204(4):347.e1-4. DOI:10.1016/j.ajog.2010.11.019 pp.347.e1-4
Source: PubMed

ABSTRACT We sought to assess the modern prevalence and risk factors for third- and fourth-degree perineal tears.
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.
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).
Severe perineal tears are uncommon in modern obstetric practice. Significant risk factors are Asian ethnicity, primiparity, persistent occipito posterior, vacuum delivery, and heavier birthweight.

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Keywords

95% confidence interval [CI]
 
Asian ethnicity
 
following inclusion criteria
 
fourth-degree perineal tears
 
heavier birthweight
 
modern obstetric practice
 
modern prevalence
 
obstetric variables
 
persistent occipito posterior
 
risk factors
 
Significant risk factors
 
singleton pregnancy
 
statistically significant independent risk factors
 
study population
 
vaginal delivery