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Статті в журналах з теми "Third and fourth degree tears"

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Автор: Grafiati

Опубліковано: 10 грудня 2022

Оновлено: 29 січня 2023

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1

Jandér, Charlotte, and Sven Lyrenäs. "Third and fourth degree perineal tears." Acta Obstetricia et Gynecologica Scandinavica 80, no. 3 (January 2001): 229. http://dx.doi.org/10.1080/j.1600-0412.2001.080003229.x.

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2

Jandér, Charlotte, and Sven Lyrenäs. "Third and fourth degree perineal tears." Acta Obstetricia et Gynecologica Scandinavica 80, no. 3 (March 2001): 229–34. http://dx.doi.org/10.1034/j.1600-0412.2001.080003229.x.

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3

Andrews, Vasanth, Ranee Thakar, and Abdul H. Sultan. "Management of third and fourth degree tears." Reviews in Gynaecological Practice 3, no. 4 (December 2003): 188–95. http://dx.doi.org/10.1016/j.rigp.2003.08.003.

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4

Gommesen, Ditte, Ellen Nøhr, Niels Qvist, and Vibeke Rasch. "Obstetric perineal tears, sexual function and dyspareunia among primiparous women 12 months postpartum: a prospective cohort study." BMJ Open 9, no. 12 (December 2019): e032368. http://dx.doi.org/10.1136/bmjopen-2019-032368.

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ObjectiveSexuality is an important aspect of human identity and contributes significantly to the quality of life in women as well as in men. Impairment in sexual health after vaginal delivery is a major concern for many women. We aimed to examine the association between degree of perineal tear and sexual function 12 months postpartum.DesignA prospective cohort studySettingFour Danish hospitals between July 2015 and January 2019ParticipantsA total of 554 primiparous women: 191 with no/labia/first-degree tears, 189 with second-degree tears and 174 with third-degree/fourth-degree tears. Baseline data were obtained 2 weeks postpartum by a questionnaire and a clinical examination. Sexual function was evaluated 12 months postpartum by an electronic questionnaire (Pelvic Organ Prolapse/Urinary Incontinence Sexual Function Questionnaire (PISQ-12)) and a clinical examination.Primary outcome measuresTotal PISQ-12 score and dyspareuniaResultsEpisiotomy was performed in 54 cases and 95 women had an operative vaginal delivery. The proportion of women with dyspareunia was 25%, 38% and 53% of women with no/labia/first-degree, second-degree or third-degree/fourth-degree tears, respectively.Compared with women with no/labia/first-degree tears, women with second-degree or third-degree/fourth-degree tears had a higher risk of dyspareunia (adjusted relative risk (aRR) 2.05; 95% CI 1.51 to 2.78 and aRR 2.09; 95% CI 1.55 to 2.81, respectively). Women with third-degree/fourth-degree tears had a higher mean PISQ-12 score (12.2) than women with no/labia/first-degree tears (10.4).ConclusionsImpairment of sexual health is common among primiparous women after vaginal delivery. At 12 months postpartum, more than half of the women with a third-degree/fourth-degree tear experienced dyspareunia. Women delivering with no/labia/first-degree tears reported the best outcomes overall. Thus, it is important to minimise the extent of perineal trauma and to counsel about sexuality during and after pregnancy.

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5

Mechery, Joseph, and David Burch. "Management of third and fourth degree perineal tears." Morecambe Bay Medical Journal 4, no. 12 (September 1, 2005): 358–59. http://dx.doi.org/10.48037/mbmj.v4i12.910.

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6

Juul, Leonard, and Gerhard B. Theron. "Risk factors for third- and fourth-degree perineal tears during vaginal delivery." Urogynaecologia 25, no. 1 (July 18, 2011): 2. http://dx.doi.org/10.4081/uij.2011.e2.

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<strong>Objective</strong>. To identify risk factors for thirdand fourth-degree perineal tears, so as to anticipate and intervene in order to prevent this complication that can severely affect a woman’s quality of life. The study design was a retrospective case control study. <strong>Method</strong>. Ninety-three cases of third- and fourth-degree perineal tears were identified from the birth register of a tertiary referral hospital (Tygerberg Hospital). One hundred and nine patients with normal vaginal deliveries in the same time period were used as control group. <strong>Results</strong>. An analysis of the results revealed that there were no significant differences between cases and controls with regards to age, body mass index (BMI), gestation at delivery, duration of second stage, episiotomy and birth weight. However, there were significantly more primigravidas, assisted deliveries (forceps and vacuum), occipitoposterior positions, HIV negative patients and shoulder dystocia in the study group. <strong>Conclusions</strong>. Antenatal risk factors for thirdand fourth-degree tears are difficult to identify. However, intrapartum occipitoposterior and assisted deliveries, especially in the primigravid patient, should warn the obstetrician/ midwife about the risk of a severe tear. A restrictive episiotomy policy should be practiced. Shoulder dystocia was invariably associated with third- and fourth-degree tears in this study. The higher incidence of HIV negative patients in the study group requires further research.

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7

Melamed, Nir, Oz Gavish, Michal Eisner, Arnon Wiznitzer, Nir Wasserberg, and Yariv Yogev. "Third- and fourth-degree perineal tears – incidence and risk factors." Journal of Maternal-Fetal & Neonatal Medicine 26, no. 7 (December 12, 2012): 660–64. http://dx.doi.org/10.3109/14767058.2012.746308.

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8

Payne, T. N., J. C. Carey, and W. F. Rayburn. "Prior third- or fourth-degree perineal tears and recurrence risks." International Journal of Gynecology & Obstetrics 64, no. 1 (January 1999): 55–57. http://dx.doi.org/10.1016/s0020-7292(98)00207-0.

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9

Maher, Gillian M., Laura O'Byrne, Joye McKernan, Paul Corcoran, Richard A. Greene, Ali S. Khashan, and Fergus P. McCarthy. "Predicting perineal trauma during childbirth using data from a general obstetric population." HRB Open Research 5 (December 1, 2022): 79. http://dx.doi.org/10.12688/hrbopenres.13656.1.

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Background: Perineal trauma is a common complication of childbirth and can have serious impacts on long-term health. Few studies have examined the combined effect of multiple risk factors. We developed and internally validated a risk prediction model to predict third and fourth degree perineal tears using data from a general obstetric population. Methods: Risk prediction model using data from all singleton vaginal deliveries at Cork University Maternity Hospital (CUMH), Ireland during 2019 and 2020. Third/fourth degree tears were diagnosed by an obstetrician or midwife at time of birth and defined as tears that extended into the anal sphincter complex or involved both the anal sphincter complex and anorectal mucosa. We used univariable and multivariable logistic regression with backward stepwise selection to develop the models. Candidate predictors included infant sex, maternal age, maternal body mass index, parity, mode of delivery, birthweight, post-term delivery, induction of labour and public/private antenatal care. We used the receiver operating characteristic (ROC) curve C-statistic to assess discrimination, and bootstrapping techniques were used to assess internal validation. Results: Of 8,403 singleton vaginal deliveries, 8,367 (99.54%) had complete data on predictors for model development. A total of 128 women (1.53%) had a third/fourth degree tear. Three variables remained in the final model: nulliparity, mode of delivery (specifically forceps delivery or ventouse delivery) and increasing birthweight (per 100 gram increase) (C-statistic: 0.75, 95% CI: 0.71, 0.79). We developed a nomogram to calculate individualised risk of third/fourth degree tears using these predictors. Bootstrapping indicated good internal performance. Conclusions: Use of our nomogram can provide an individualised risk assessment of third/fourth degree tears and potentially aid counselling of women on their potential risk.

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10

Djusad, Suskhan, Yuditiya Purwosunu, and Fadil Hidayat. "Relationship between Perineal Body Length and Degree of Perineal Tears in Primigravidas Undergoing Vaginal Delivery with Episiotomy." Obstetrics and Gynecology International 2021 (September 15, 2021): 1–5. http://dx.doi.org/10.1155/2021/2621872.

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Background. Perineal tears are one of the most common complications of vaginal delivery. Severe perineal tears can cause various morbidities. There are many factors that affect the occurrence of perineal tears. One of the major factors related to the occurrence of perineal tears is the length of the perineal body. However, until now, no research in Indonesia has concluded that the length of perineal body can predict the perineal tears. Objective. To find the relationship between perineal body length and perineal tears, so it can provide a reference on the use of perineal body length to predict severe perineal tears in vaginal delivery with episiotomy. Methods. This nested case-control study was conducted at RSUD Tangerang and RSUD Karawang in Indonesia from February to September 2017. A total of 126 primigravida patients participated in the study consecutively. The length of the perineal body was then measured and followed until the start of the second stage of labor. Afterwards, the perineal length and degree of perineal tears were assessed using unpaired T-test for bivariate analysis, multivariate analysis, and scoring test to predict the occurrence of third- and fourth-degree of perineal tears with power calculation (β) 80% and Zβ 0.842. Results. There was a significant difference in mean length of the perineal body between the group with first- and second-degree perineal tears and the group with third- and fourth-degree perineal tears ( p < 0.001 ). From the multivariate analysis, adjusted OR was 5.26 (95% CI 1.52–18.17). Score test was performed to predict the occurrence of third- and fourth-grade perineal tears. Perineal body length and head circumference could be used as predicting factors of perineal tears. Perineum length ≤ 3.0 cm and head circumference ≥ 33.5 cm posed a risk of perineal tears of third and fourth degrees (70.52%). Conclusion. The length of the perineal body has a good ability to predict the occurrence of perineal tears.

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11

Lewicky, Christina E., Carl Valentin, and Theodore J. Saclarides. "Sexual Function Following Sphincteroplasty for Women With Third-Degree and Fourth-Degree Perineal Tears." Diseases of the Colon & Rectum 47, no. 10 (October 2004): 1650–54. http://dx.doi.org/10.1007/s10350-004-0648-2.

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12

Groutz, Asnat, Joseph Hasson, Anat Wengier, Ronen Gold, Avital Skornick-Rapaport, Joseph B. Lessing, and David Gordon. "Third- and fourth-degree perineal tears: prevalence and risk factors in the third millennium." American Journal of Obstetrics and Gynecology 204, no. 4 (April 2011): 347.e1–347.e4. http://dx.doi.org/10.1016/j.ajog.2010.11.019.

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13

Panigrahy, R., J. Welsh, F. MacKenzie, and P. Owen. "A complete audit cycle of management of third/fourth degree perineal tears." Journal of Obstetrics and Gynaecology 28, no. 3 (January 2008): 305–9. http://dx.doi.org/10.1080/01443610802054980.

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14

Al-Wahaibi, Suhaila, Nicholas Czuzoj-Shulman, and Haim Abenhaim. "Induction of labor and risk of third- and fourth-degree perineal tears." Journal of Obstetrics and Gynaecology Canada 42, no. 5 (May 2020): 665. http://dx.doi.org/10.1016/j.jogc.2020.02.011.

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15

Furuta, Marie. "Evidence-based practice for third- and fourth-degree perineal tears during birth." Midwifery 90 (November 2020): 102800. http://dx.doi.org/10.1016/j.midw.2020.102800.

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16

Bagade, P., and S. Mackenzie. "O79 The long term outcome of third and fourth degree perineal tears." International Journal of Gynecology & Obstetrics 107 (October 2009): S115. http://dx.doi.org/10.1016/s0020-7292(09)60451-3.

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17

Moini, Ashraf, Rita Emadi Allah Yari, and Bita Eslami. "Episiotomy and third- and fourth-degree perineal tears in primiparous Iranian women." International Journal of Gynecology & Obstetrics 104, no. 3 (January 20, 2009): 241–42. http://dx.doi.org/10.1016/j.ijgo.2008.10.025.

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18

Parveen, Rashida, Quratulain Sadiq, and Syeda Ali. "PERINEAL TEARS." Professional Medical Journal 25, no. 10 (October 10, 2018): 1532–36. http://dx.doi.org/10.29309/tpmj/18.3614.

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Objectives: To arbitrate the frequency and severity of perineal tears amongthe patients of Vaginal delivery. Study Design: A Cross-sectional study. Place and Durationof Study: Nishtar Hospital Multan from 29 December 2014 to 28 June 2015. Methodology:The study was conducted after obtaining the approval of ethical committee for collecting datafrom patients. The patients aged 20-40 years were included in the study, both multipara andprimipara. An examination was performed on the perineum, vulva, vagina, and cervix at thethird stage of labor in order to discover any tears or injuries. All the informations were collectedon per designed Performa. Collected data was entered and analyzed by using SPSS software.Results: The incidence of perineal tears was calculated to be 79.89%. The most commonlyobserved injury was the first-degree perineal tear. it accounted for 101(68.70%) cases. whilethe second-degree perineal tear was found to be 39(26.53%) cases. third and fourth degreeperineal tear remained the least in observed frequency as in 2.72% and 2.04% of casesrespectively. Conclusion: The observations of our study concluded that majority of patientsdelivered vaginally experienced perineal tear, among those first degree perineal tear was moreprevalent.

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19

Yogev, Yariv, Liran Hiersch, Lance Maresky, Nir Wasserberg, Arnon Wiznitzer, and Nir Melamed. "Third and fourth degree perineal tears – the risk of recurrence in subsequent pregnancy." Journal of Maternal-Fetal & Neonatal Medicine 27, no. 2 (June 14, 2013): 177–81. http://dx.doi.org/10.3109/14767058.2013.806902.

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20

Al-Wahaibi, Suhaila, Nicholas Czuzoj-Shulman, and Haim A. Abenhaim. "Induction of Labor and Risk of Third- and Fourth-Degree Perineal Tears [18P]." Obstetrics & Gynecology 135 (May 2020): 172S. http://dx.doi.org/10.1097/01.aog.0000663904.38403.5f.

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21

Farrell, Scott A., Gordon Flowerdew, Donna Gilmour, Geoffrey K. Turnbull, Matthias H. Schmidt, Thomas F. Baskett, and Cora A. Fanning. "Overlapping Compared With End-to-End Repair of Complete Third-Degree or Fourth-Degree Obstetric Tears." Obstetrical & Gynecological Survey 68, no. 1 (January 2013): 26–27. http://dx.doi.org/10.1097/ogx.0b013e31827d7bb3.

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22

Farrell, Scott A., Gordon Flowerdew, Donna Gilmour, Geoffrey K. Turnbull, Matthias H. Schmidt, Thomas F. Baskett, and Cora A. Fanning. "Overlapping Compared With End-to-End Repair of Complete Third-Degree or Fourth-Degree Obstetric Tears." Obstetrics & Gynecology 120, no. 4 (October 2012): 803–8. http://dx.doi.org/10.1097/aog.0b013e31826ac4bb.

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23

Aigmueller, T., W. Umek, K. Elenskaia, A. Frudinger, J. Pfeifer, H. Hellmer, H. Huemer, et al. "Guidelines for the Management of Third and Fourth Degree Perineal Tears After Vaginal Birth." Geburtshilfe und Frauenheilkunde 73, no. 05 (June 6, 2013): 407–11. http://dx.doi.org/10.1055/s-0032-1328338.

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24

Cola, Alice, Matteo Frigerio, Stefano Manodoro, Debora Verri, Maria Lieta Interdonato, Elena Nicoli, Martina Sicuri, Federico Spelzini, Patrizia Vergani, and Rodolfo Milani. "Third and fourth degree perineal tears: incidence and risk factors in an Italian setting." European Journal of Obstetrics & Gynecology and Reproductive Biology 206 (November 2016): e27. http://dx.doi.org/10.1016/j.ejogrb.2016.07.095.

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25

Bagade, P., and S. Mackenzie. "Outcomes from medium term follow-up of patients with third and fourth degree perineal tears." Journal of Obstetrics and Gynaecology 30, no. 6 (August 2010): 609–12. http://dx.doi.org/10.3109/01443615.2010.494205.

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26

Sangalli, M. R., L. Floris, D. Faltin, and A. Weil. "Anal incontinence in women with third or fourth degree perineal tears and subsequent vaginal deliveries." Australian and New Zealand Journal of Obstetrics and Gynaecology 40, no. 3 (August 2000): 244–48. http://dx.doi.org/10.1111/j.1479-828x.2000.tb03330.x.

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27

Wilson, Alyce N., and Caroline S. E. Homer. "Third‐ and fourth‐degree tears: A review of the current evidence for prevention and management." Australian and New Zealand Journal of Obstetrics and Gynaecology 60, no. 2 (April 2020): 175–82. http://dx.doi.org/10.1111/ajo.13127.

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28

Bagade, P., and M. Lawrence. "P216 Management of third and fourth degree perineal tears in a district general hospital setting." International Journal of Gynecology & Obstetrics 107 (October 2009): S472. http://dx.doi.org/10.1016/s0020-7292(09)61706-9.

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29

Penneycard, JM, Y. Cunningham, and C. Love. "Third and fourth degree perineal tear audit, NHS Lothian." Archives of Disease in Childhood - Fetal and Neonatal Edition 97, Suppl 1 (April 2012): A101.3—A102. http://dx.doi.org/10.1136/fetalneonatal-2012-301809.331.

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30

Barca, Juan A., Coral Bravo, Maria P. Pintado-Recarte, Ignacio Cueto-Hernández, Javier Ruiz-Labarta, Yolanda Cuñarro, Julia Buján, Melchor Alvarez-Mon, Miguel A. Ortega, and Juan A. De León-Luis. "Risk Factors in Third and Fourth Degree Perineal Tears in Women in a Tertiary Centre: An Observational Ambispective Cohort Study." Journal of Personalized Medicine 11, no. 8 (July 21, 2021): 685. http://dx.doi.org/10.3390/jpm11080685.

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Анотація:

Objectives: To analyze the main risk factors associated with third and fourth degree postpartum perineal tears in women attended to in our obstetrics service. Methods: An observational, retrospective, hospital cohort study was carried out in women whose deliveries were attended to in the obstetrics service of the Hospital General Universitario Gregorio Marañón de Madrid (HGUGM), during the period from January 2010 to April 2017. Results: During the study period, a total of 33,026 patients were included in the study. For maternal variables, the associated increased risk of severe perineal tearing in nulliparous women is OR = 3.48, for induced labor OR = 1.29, and for instrumental delivery by forceps OR = 4.52 or spatulas OR = 4.35; for the obstetric variable of episiotomy, it is OR = 3.41. For the neonatal variables, the weight of the newborns has a directly proportional relationship with the risk of severe tears, and for birth weights of 3000 g (OR = 2.41), 3500 g (OR = 1.97), and 4000 g (OR = 2.17), statistically significant differences were found in each of the groups (p < 0.05). Conclusion: Primiparity, induction of labor, episiotomy, instrumental delivery with forceps or spatula, and a birth weight of 3000 g or more are significantly associated with an increased risk of third and fourth degree perineal tears.

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31

Valsky, Dan V., Sarah M. Cohen, Michal Lipschuetz, Drorith Hochner-Celnikier, Hagit Daum, Itai Yagel, and Simcha Yagel. "Third- or Fourth-Degree Intrapartum Anal Sphincter Tears Are Associated With Levator Ani Avulsion in Primiparas." Journal of Ultrasound in Medicine 35, no. 4 (March 9, 2016): 709–15. http://dx.doi.org/10.7863/ultra.15.04032.

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32

Al Ghamdi, Deama. "A retrospective study of the incidence and predisposing factors of third- and fourth-degree perineal tears." Saudi Medical Journal 41, no. 11 (November 1, 2020): 1241–44. http://dx.doi.org/10.15537/smj.2020.11.25498.

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33

Tjandra, J. J., M. K. Y. Chan, S. Y. Kwok, C. H. Yeh, J. J. Y. Tan, K. Sloane, and M. P. Carey. "Predictive factors for faecal incontinence after third or fourth degree obstetric tears: a clinico-physiologic study." Colorectal Disease 10, no. 7 (August 21, 2008): 681–88. http://dx.doi.org/10.1111/j.1463-1318.2007.01467.x.

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Farrell, Scott A., Donna Gilmour, Geoffrey K. Turnbull, Matthias H. Schmidt, Thomas F. Baskett, Gordon Flowerdew, and Cora A. Fanning. "Overlapping Compared With End-to-End Repair of Third- and Fourth-Degree Obstetric Anal Sphincter Tears." Obstetrics & Gynecology 116, no. 1 (July 2010): 16–24. http://dx.doi.org/10.1097/aog.0b013e3181e366ef.

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35

Frigerio, Matteo, Stefano Manodoro, Davide P. Bernasconi, Debora Verri, Rodolfo Milani, and Patrizia Vergani. "Incidence and risk factors of third- and fourth-degree perineal tears in a single Italian scenario." European Journal of Obstetrics & Gynecology and Reproductive Biology 221 (February 2018): 139–43. http://dx.doi.org/10.1016/j.ejogrb.2017.12.042.

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36

Abbasi, Amber, Saira Talpur, Sehrish Khan, Shazia Awan, Geeta Bai, and Rashida Akbar. "Perineal Injury with Vaginal Delivery; What are the Risks." Pakistan Journal of Medical and Health Sciences 16, no. 2 (February 26, 2022): 1227–29. http://dx.doi.org/10.53350/pjmhs221621227.

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Objective: To observe the severity of the perineal trauma and its risk factors among women who developed perineal tears during vaginal delivery. Material and methods: This descriptive cross-sectional study was conducted at the Obstetrics and genecology department of LUMHS, Hyderabad, Pakistan, from September 2016 to August 2017. All the women who developed perineal trauma during vaginal delivers, age 18–40 years, singleton pregnancy, both primiparous and multiparous were included. After delivery, patients who had developed perineal tears were assessed for its severity and risk factors. Perineal tears were categorized as per severity in four categories All the data were collected via study proforma and for the analysis of data, the 26 versions of SPSS were employed. Results: A total of 100 cases were studied in the study and most of the patients 45.0% were in the age group of 15–25 years. The average gestational age was 38.2+4.1 weeks. Primiparous cases were 65.0%. Un-booked women were 65.0%. 30.0% underwent mediolateral episiotomy and 19.0% with a midline cut extension. Most of the women 41.0% were delivered by NVD, followed by 26.0% by assist vaginal delivery and while 33.0% women underwent instrumental vaginal delivery. According to the birth weight the 40.0% babies weighing more than 2.5 kg. 40.0% females had a first-degree perineal tear, followed by 32.0 percent had a second-degree tear, 19.0 percent had third-degree tear, and 10.0 percent had a fourth-degree perineal tear. Conclusion: Perineal trauma of 3rd and 4th degree were observed to be 19% and 10%, respectively. Maternal age less than 25 years, primiparity, un-booked status, use of the oxytocin, previous history of the vaginal surgeries and fetal weight >2.5 kg were observed the risk factors of the perineal tear. Key words: NVD, Severity of perineal tears, risk factors.

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Edozien, LC, I. Gurol-Urganci, DA Cromwell, EJ Adams, DH Richmond, TA Mahmood, and JH van der Meulen. "Impact of third- and fourth-degree perineal tears at first birth on subsequent pregnancy outcomes: a cohort study." BJOG: An International Journal of Obstetrics & Gynaecology 121, no. 13 (July 9, 2014): 1695–703. http://dx.doi.org/10.1111/1471-0528.12886.

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Folch, Marina, David Parés, Maite Castillo, and Ramon Carreras. "Practical issues in the management of third and fourth degree tears to minimise the incidence of faecal incontinence." Cirugía Española (English Edition) 85, no. 6 (January 2009): 341–47. http://dx.doi.org/10.1016/s2173-5077(09)70151-6.

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Dahlen, Hannah G. "Perineal warm compress reduces risk of third- and fourth- degree tears and should be part of second stage care." Evidence Based Nursing 15, no. 4 (June 12, 2012): 103–4. http://dx.doi.org/10.1136/ebnurs-2012-100685.

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40

Ganiga, Pradeep, Ritu A. Sharma, and Nikita Pitty. "Relationship between perineal body length and the occurrence of perineal lacerations in low risk primigravidae: a prospective observational study." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 11, no. 2 (January 28, 2022): 420. http://dx.doi.org/10.18203/2320-1770.ijrcog20220164.

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Background: Birth canal lacerations include the injuries to cervix, vagina or perineum. Those of the perineum often follow vaginal delivery, and most are first-and second-degree lacerations. Third- and fourth- degree lacerations are considered Obstetrical anal sphincter injuries (OASIS), and their combined incidence varies from 0.5-5%. Risk factors for these more complex perineal injuries have been studied. One important risk factor includes the length of the perineal body which plays an important role in determining the degree of perineal tears. The aim of the study was to assess the relationship between perineal body length and other characteristics, and occurrence of perineal lacerations during delivery in low risk primigravidae in an institution which advocates routine episiotomy for primigravidae.Methods: This was a prospective observational study carried out in the department of obstetrics and gynaecology at AJ Institute of medical sciences among primigravidae who met the selection criteria and delivered between September 2021 and November 2021. A total of 80 women were recruited in this study. In this study, we measured the perineal body length at rest, while the patient was in a dorsal lithotomy position during 1st stage of labor, after delivery the new born’s weight and head circumference were noted. The duration of second stage was noted. These parameters were studied in relation to the occurrence of perineal lacerations and the data was analysed.Results: In the present study it was noted that 10 participants (12.50%) had 3rd degree perineal tears and none had 4th degree perineal tears. With the perineal body length cut off of 3 cm, the sensitivity to predict 3rd and 4th degree perineal tears were found to be 80%, specificity of 90%, positive predictive value of 53.33% and a negative predictive value of 96.92%. The study concluded that a shorter perineal body length, was associated with the occurrence of a 3rd or 4th degree tear, p value of less than 0.00001. The study also showed increased incidence of higher degree perineal tears with higher birth weight and head circumference of the newborn with p value of 0.015 and 0.02 respectively.Conclusions: It can be concluded that Perineal body length of less than 3 cm, higher birth weight and head circumference is associated with an increased incidence of higher order perineal tears. Perineal body length hence has a good ability to predict the occurrence of perineal tears.

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Baruch, Yoav, Ronen Gold, Hagit Eisenberg, Hadar Amir, Yariv Yogev, and Asnat Groutz. "Substantial Obstetric Anal Sphincter Injury during Vacuum Assisted Delivery: An Obstetrical Issue or Device Related?" Journal of Clinical Medicine 11, no. 23 (November 26, 2022): 6990. http://dx.doi.org/10.3390/jcm11236990.

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Background: Obstetric anal sphincter injuries (OASIS) might be associated with long-term urinary and anorectal morbidities. The aim of the study was to investigate the risk factors and clinical implications of OASIS associated with vacuum-assisted deliveries versus normal vaginal deliveries. Methods: A series of 413 consecutive OASIS cases were retrospectively analyzed. A comparison was made between OASIS cases diagnosed following vacuum-assisted deliveries versus OASIS cases diagnosed following normal vaginal deliveries. Multivariable analysis was used to study the association between vacuum-assisted deliveries and superficial (3A and 3B) versus deep (3C and 4) perineal tears. Results: The study population comprised 88,123 singleton vaginal deliveries. Diagnosis of OASIS was made in 413 women (0.47% of the total cohort), 379 (91.8%) of whom had third-degree tears and 34 (8.2%) of whom had fourth-degree tears. Among the 7410 vacuum-assisted deliveries, 102 (1.37%) had OASIS, whereas, among the 80,713 normal vaginal deliveries, only 311 (0.39%) had OASIS. In a multivariate analysis, only vacuum-assisted delivery was found to be associated with a significant risk of deeper (3C or 4) perineal tears (OR = 1.72; 95% CI 1.02–2.91; p = 0.043). Conclusions: Vacuum-assisted instrumental intervention is a significant risk factor for OASIS and especially for deeper tears, independent of other maternal and obstetric risk factors.

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Gurol-Urganci, I., DA Cromwell, LC Edozien, TA Mahmood, EJ Adams, DH Richmond, A. Templeton, and JH van der Meulen. "Third- and fourth-degree perineal tears among primiparous women in England between 2000 and 2012: time trends and risk factors." BJOG: An International Journal of Obstetrics & Gynaecology 120, no. 12 (July 3, 2013): 1516–25. http://dx.doi.org/10.1111/1471-0528.12363.

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Farrell, Scott A., Donna Gilmour, Geoffrey K. Turnbull, Matthias H. Schmidt, Thomas F. Baskett, Gordon Flowerdew, and Cora A. Fanning. "Overlapping Compared With End-to-End Repair of Third- and Fourth-Degree Obstetric Anal Sphincter Tears: A Randomized Controlled Trial." Obstetrical & Gynecological Survey 65, no. 10 (October 2010): 605–6. http://dx.doi.org/10.1097/ogx.0b013e3182021ee6.

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Woolner, Andrea Mary, Dolapo Ayansina, Mairead Black, and Sohinee Bhattacharya. "The impact of third- or fourth-degree perineal tears on the second pregnancy: A cohort study of 182,445 Scottish women." PLOS ONE 14, no. 4 (April 11, 2019): e0215180. http://dx.doi.org/10.1371/journal.pone.0215180.

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Ioannou, Christos. "Overlapping Compared With End-to-End Repair of Third- and Fourth-Degree Obstetric Anal Sphincter Tears: A Randomized Controlled Trial." Obstetrics & Gynecology 116, no. 5 (November 2010): 1223. http://dx.doi.org/10.1097/aog.0b013e3181faa818.

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Farrell, Scott A., Donna Gilmour, Geoffrey K. Turnbull, Matthias H. Schmidt, Thomas F. Baskett, Gordon Flowerdew, and Cora A. Fanning. "Overlapping Compared With End-to-End Repair of Third- and Fourth-Degree Obstetric Anal Sphincter Tears: A Randomized Controlled Trial." Obstetrics & Gynecology 116, no. 5 (November 2010): 1223. http://dx.doi.org/10.1097/aog.0b013e3181faa92c.

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Sultan, Abdul, and Ruwan Fernando. "Overlapping Compared With End-to-End Repair of Third- and Fourth-Degree Obstetric Anal Sphincter Tears: A Randomized Controlled Trial." Obstetrics & Gynecology 117, no. 2, Part 1 (February 2011): 408. http://dx.doi.org/10.1097/aog.0b013e3182095487.

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48

Farrell, Scott A., Donna Gilmour, Geoffrey K. Turnbull, Matthias H. Schmidt, Thomas F. Baskett, Gordon Flowerdew, and Cora A. Fanning. "Overlapping Compared With End-to-End Repair of Third- and Fourth-Degree Obstetric Anal Sphincter Tears: A Randomized Controlled Trial." Obstetrics & Gynecology 117, no. 2, Part 1 (February 2011): 408–9. http://dx.doi.org/10.1097/aog.0b013e3182095b6a.

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Quiroz, Lieschen H., and Robert A. Wild. "Overlapping Compared With End-to-End Repair of Third- and Fourth-Degree Obstetric Anal Sphincter Tears: A Randomized Controlled Trial." Obstetrics & Gynecology 117, no. 2, Part 1 (February 2011): 409. http://dx.doi.org/10.1097/aog.0b013e31820967f3.

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50

Farrell, Scott A., Donna Gilmour, Geoffrey K. Turnbull, Matthias H. Schmidt, Thomas F. Baskett, Gordon Flowerdew, and Cora A. Fanning. "Overlapping Compared With End-to-End Repair of Third- and Fourth-Degree Obstetric Anal Sphincter Tears: A Randomized Controlled Trial." Obstetrics & Gynecology 117, no. 2, Part 1 (February 2011): 409–10. http://dx.doi.org/10.1097/aog.0b013e3182096ea0.

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