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Créée le : 21 Apr 2004
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Notice bibliographique (sans auteurs) :

Determinants of vaginal-perineal integrity and pelvic floor functioning in childbirth. Am J Obstet Gynecol. 1997 Feb;176(2):403-10.

Auteur·e(s) :

Klein MC, Janssen PA, MacWilliam L, Kaczorowski J, Johnson B.

Année de publication :

1997

URL(s) :

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=…

Résumé (français)  :

Abstract (English)  :

OBJECTIVES: Our purpose was to evaluate risk factors for severe vaginal-perineal trauma and to ascertain determinants of pelvic floor strength.

STUDY DESIGN: Secondary analysis of 459 nulliparous women enrolled in a randomized controlled trial of episiotomy was carried out. In a multivariate analysis we examined the association between (1) sulcus tears, (2) third- or fourth-degree tears, and (3) pelvic floor strength and selected demographic, physiologic, pregnancy-related, and intrapartum factors.

RESULTS: Unemployment and shorter second stage of labor were significant predictors of sulcus tears. Episiotomy, forceps use, and birth weight were important predictors of third- and fourth-degree tears. Whereas perineal intactness (use of episiotomy and spontaneous tears) was not influenced by exercise, a strong exercise profile was associated with fewer third- and fourth-degree tears in the presence of episiotomy. Exercise did not influence the rate of sulcus tears. A total of 35% of the variability in postpartum pelvic floor strength was explained by antepartum strength; however, we were only able to identify 5% of the factors contributing to antepartum pelvic floor strength.

CONCLUSIONS: Determinants of sulcus tears appear to be present before pregnancy; third- and fourth-degree tears are related to physician management. Exercise mitigates the potential for severe trauma induced by episiotomy.

Sumário (português)  :

Resumen (español)  :

Remarques :

Argument (français) :

L’exercice physique diminue les risques de traumatismes sévères induits par l’épisiotomie.

Argument (English):

Argumento (português):

Argumento (español):

Mots-clés :

➡ déchirures ; épisiotomie ; extraction instrumentale ; forceps

Auteur·e de cette fiche :

Cécile Loup — 21 Apr 2004