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Created on : 02 Aug 2014
Modified on : 02 Aug 2014

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Bibliographical entry (without author) :

Third- and fourth-degree perineal tears: prevalence and risk factors in the third millennium - American Journal of Obstetrics & Gynecology - Vol. 204, 4 - ISBN: 0002-9378 - p.347.e1-347.e4

Author(s) :

Groutz, Asnat; Hasson, Joseph; Wengier, Anat; Gold, Ronen; Skornick-Rapaport, Avital; Lessing, Joseph B.; Gordon, David

Year of publication :

2011

URL(s) :

http://www.ajog.org/article/S0002-9378(10)02281-7/…
https://doi.org/10.1016/j.ajog.2010.11.019

Résumé (français)  :

Abstract (English)  :

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.

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Keywords :

➡ episiotomy

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Import 02/08/2014 — 02 Aug 2014