=> [Français]
=> [Português]

Database - Alliance francophone pour l'accouchement respecté (AFAR)

Record ID : 571
Created on : 8/03/2004
Modified on : 2/12/2007

Modify this record
Do not follow this link unless you know the admin password!

URL of this record : http://afar.info/id=571

=> hard

Author(s) :

Peleg D, Kennedy CM, Merrill D, Zlatnik FJ.

Year of publication :

1999

Bibliographical entry (without author) :

Risk of repetition of a severe perineal laceration.
Obstet Gynecol. 1999 Jun;93(6):1021-4.

Résumé (français) :

Abstract (English):

OBJECTIVE: To compare the outcome of subsequent delivery in women with a history of a third- or fourth-degree laceration with outcomes in women without such a history.

METHODS: This retrospective study used a perinatal database and chart review from 1978 to 1995. Only women whose first delivery was at our institution at more than 36 weeks' gestation, vaginal singleton, vertex presentation, and birth weight greater than 2500 g, with a subsequent delivery were included. The women were grouped by presence or absence of a third- or fourth-degree (severe) perineal laceration in their first delivery. The subsequent delivery was analyzed for maternal age, weight, birth weight, gestational age, method of delivery, use of episiotomy, and occurrence of a severe laceration. Comparison of data was by Fisher exact and t tests.

RESULTS: Four thousand fifteen women met our starting criteria. In their first delivery, the average birth weight, use of instrumentation, and episiotomy rate were significantly higher in those women sustaining a severe laceration. When compared with women without a history of severe perineal laceration, women with such a history were at more than twice the risk for another in their subsequent delivery. The women at highest risk (21.4%) were those sustaining a laceration in their first delivery who underwent instrumental vaginal delivery with episiotomy in their subsequent delivery. When episiotomy or instrumental delivery was performed in the second vaginal birth, 52 (11.6%) of 449 women with a history of a severe perineal laceration sustained another, compared with 98 (6.5%) of 1509 without such a history (P < .001, odds ratio 1.9, 95% confidence interval 1.3, 2.7).

CONCLUSION: Women delivering their second baby, and in whom episiotomy or instrumentation is used, are at increased risk of severe perineal laceration compared with women delivery spontaneously.

Sumário (português):

URL :

http://www.greenjournal.org/cgi/content/abstract/93/6/1021

Comments :

Argument (français) :

Les femmes qui accouchent pour la deuxième fois avec épisiotomie et/ou extraction instrumentale courent plus de risques de déchirures graves.

Argument (English):

Argumento (português):

Keywords :

perineal/vaginal tears ; episiotomy ; instrumental delivery ; evidence-based medicine/midwifery ; maternal age

Author of this record :

C. Loup

New expert query ---  New simple query

Creating new record --- Importing records

This database is managed by Alliance francophone pour l'accouchement respecté (AFAR, http://afar.info)
affiliated with Collectif interassociatif autour de la naissance (CIANE, http://ciane.net).
It is fed by the voluntary contributions of persons interested in the sharing of scientific data.
If you agree with this project, you can support us in several ways:
(1) becoming a member of AFAR
(2) financially supporting AFAR
(3) contributing to this database if you have a minimum training in scientific documentation.