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Titolo:
Risk factors for third-degree perineal tears in vaginal delivery, with an analysis of episiotomy types
Autore:
Bodner-Adler, B; Bodner, K; Kaider, A; Wagenbichler, P; Leodolter, S; Husslein, P; Mayerhofer, K;
Indirizzi:
Univ Vienna, Sch Med, Dept Obstet & Gynecol, A-1090 Vienna, Austria Univ Vienna Vienna Austria A-1090 stet & Gynecol, A-1090 Vienna, Austria Univ Vienna, Sch Med, Dept Med Comp Sci, A-1090 Vienna, Austria Univ Vienna Vienna Austria A-1090 t Med Comp Sci, A-1090 Vienna, Austria Semmelweis Frauenklin, Dept Obstet & Gynecol, Vienna, Austria Semmelweis Frauenklin Vienna Austria Obstet & Gynecol, Vienna, Austria
Titolo Testata:
JOURNAL OF REPRODUCTIVE MEDICINE
fascicolo: 8, volume: 46, anno: 2001,
pagine: 752 - 756
SICI:
0024-7758(200108)46:8<752:RFFTPT>2.0.ZU;2-5
Fonte:
ISI
Lingua:
ENG
Soggetto:
VACUUM EXTRACTION; PRIMARY REPAIR; SPHINCTER; LACERATIONS; 3RD-DEGREE; MIDLINE; TRAUMA; MORBIDITY; FORCEPS; LABOR;
Keywords:
perineum; episiotomy; delivery; third-degree perineal tears;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
22
Recensione:
Indirizzi per estratti:
Indirizzo: Mayerhofer, K Univ Vienna, Sch Med, Dept Obstet & Gynecol, Wahringer Gurtel 18-20, A-1090 Vienna, Austria Univ Vienna Wahringer Gurtel 18-20 Vienna Austria A-1090 ia
Citazione:
B. Bodner-Adler et al., "Risk factors for third-degree perineal tears in vaginal delivery, with an analysis of episiotomy types", J REPRO MED, 46(8), 2001, pp. 752-756

Abstract

OBJECTIVE: To determine the risk factors for third-degree perineal tears during vaginal delivery and to investigate the relation between different types of episiotomy and the occurrence of such tears. STUDY DESIGN: This retrospective multicenter study consisted of an analysis of data from the delivery databases of the University Hospital of Vienna and Semmelweis Frauenklinic Wien between February and July 1999. The study was restricted to a sample that included all women with uncomplicated pregnancy as well as uncomplicated first and second stages of labor, gestationalage > 37 weeks and a pregnancy with cephalic presentation. Women with multiple gestations, noncephalic presentation, cesarean deliveries, shoulder dystocia and gestational age less than or equal to 37 weeks were excluded from the study. RESULTS: Among the 1,118 births, 37 women (3.3%) experienced third-degree perineal tears. The use of episiotomy per se and the type of episiotomy (midline) as well as forceps delivery, primiparity, large infant head diameter, prolonged second stage of labor and use of oxytocin were identified as risk factors for third-degree perineal tears during vaginal delivery. When analyzing different types of episiotomy, there was approximately a sixfold-higher risk of third-degree perineal tears in women undergoing midline episiotomy as compared to mediolateral episiotomy. A stepwise logistic regressionanalysis revealed that episiotomy, prolonged second stage of labor and large infant head diameter remained independent risk factors for third-degree perineal tears. CONCLUSION: We found several risk factors for third-degree perineal tears. The use of midline episiotomy was associated especially with an increased risk of severe anal sphincter tears. To prevent women from long-term sequelae due to third-degree perineal tears, avoidable risk factors should be minimized whenever possible.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 25/09/20 alle ore 00:28:09