Article

Perineal body length and lacerations at delivery.

Department of Obstetrics and Gynecology, National Naval Medical Center, Bethesda, Maryland, USA.
The Journal of reproductive medicine (impact factor: 0.87). 05/2004; 49(4):306-10. pp.306-10
Source: PubMed

ABSTRACT To define normal perineal body length during labor and determine if a shortened perineal body is associated with perineal lacerations or operative vaginal delivery.
We reviewed charts of patients admitted for labor over a 4-month period. The perineal body was measured by the admitting physician and delivery outcomes obtained from inpatient records. Patients were excluded for malpresentation, multiple gestation, gestational age < 36 weeks, incomplete records and scheduled cesarean delivery. To determine if differences existed between patients with perineal body measurements available and those without, chi2 analysis was used, with P<.05 considered significant. Multiple logistic regression was used to control for confounding variables and determine if a shortened perineal body affected the incidence of operative vaginal delivery and significant lacerations at vaginal delivery.
A total of 234 patients met our inclusion criteria; perineal body measurements were available for 133 (57%). The average perineal body length was 3.90 cm (+/-0.70). Patients with a perineal body of < or = 2.5 cm had a significantly higher chance of sustaining a third- or fourth-degree laceration (40% vs. 5.6%, P=.004). This risk remained after controlling for both operative vaginal delivery and episiotomy. The incidence of operative vaginal delivery was greater (28.5% vs. 9.2%, P =.006) for patients with a perineal body < or = 3.5 cm.
There is an increased risk of significant lacerations and operative vaginal delivery in patients with a shortened perineal body.

0 0
 · 
0 Bookmarks
 · 
27 Views
  • Source
    Article: Episiotomy and vaginal trauma.
    John R Scott
    [show abstract] [hide abstract]
    ABSTRACT: The era of routine episiotomy is gradually ending. Previously perceived benefits gradually have been disproved as evidence-based scientific clinical studies have shown the detrimental effects of episiotomy; however, circumstances always will exist in which prudent clinical judgment may dictate the necessity for an episiotomy. In most of these situations, however, an episiotomy often can be avoided. Perhaps more hospital perinatal review committees should evaluate episiotomy rates and strive to convince their staff to reduce their rates. We can learn to be more patient and allow the natural forces of labor to gradually stretch the perineum. In reviewing the extensive volume of published literature on episiotomy and perineal-vaginal trauma, the best advice lies in the dictum "Don't just do something, sit there!"
    Obstetrics and Gynecology Clinics of North America 07/2005; 32(2):307-21, x. · 1.70 Impact Factor
  • Source
    Article: Operative vaginal deliveries: practical aspects.
    Alfredo F Gei, Luis D Pacheco
    [show abstract] [hide abstract]
    ABSTRACT: Forceps, vacuum, and cesarean sections are relatively recent additions to the obstetrician's armamentarium. The art of modern obstetrics is one that mandates from obstetricians the attentive vigilance of the development of natural processes and an active intervention when such processes fall outside normally accepted standards. What constitutes the "normal process" and the "accepted standard" is subject to discussion, and international variations in obstetric practice are in part the reflection of such controversies. This article presents a practical approach to the contemporary issue of instrumental deliveries, outlining supporting evidence (when available) and the most current position of professional colleges in obstetrics and gynecology.
    Obstetrics and Gynecology Clinics of North America 06/2011; 38(2):323-49, xi. · 1.70 Impact Factor
Data provided are for informational purposes only. Although carefully collected, accuracy cannot be guaranteed. The impact factor represents a rough estimation of the journal's impact factor and does not reflect the actual current impact factor. Publisher conditions are provided by RoMEO. Differing provisions from the publisher's actual policy or licence agreement may be applicable.

Keywords

4-month period
 
admitting physician
 
average perineal body length
 
chi2 analysis
 
define normal perineal body length
 
delivery outcomes
 
gestational age
 
higher chance
 
inclusion criteria
 
increased risk
 
inpatient records
 
multiple gestation
 
Multiple logistic regression
 
operative vaginal delivery
 
perineal body
 
perineal body measurements
 
perineal body measurements available
 
perineal lacerations
 
shortened perineal body
 
significant lacerations
 

Shad H Deering