Choose your font:
 Mukta Malar
 Open Sans Condensed
 Source Sans Pro


[Valid RSS] RSS

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

Description of this bibliographical database (AFAR website)
Currently 3059 records
YouTube channel (tutorial)

Created on : 07 Jan 2004
Modified on : 02 Dec 2007

 Modify this record
Do not follow this link unless you know an editor’s password!

Share: Facebook logo   Tweeter logo   Hard

Bibliographical entry (without author) :

Epidural analgesia and third- or fourth-degree lacerations in nulliparas. Obstet Gynecol. 1999 Aug;94(2):259-62.

Author(s) :

Robinson JN, Norwitz ER, Cohen AP, McElrath TF, Lieberman ES.

Year of publication :


URL(s) :…

Résumé (français)  :

Abstract (English)  :

OBJECTIVE: To determine if epidural analgesia is associated with differences in rates of severe perineal trauma during vaginal deliveries.
METHODS: We studied 1942 consecutive, low-risk, term, vaginal deliveries in nulliparas, including spontaneous and induced labors, at a single institution from December 1994 to August 1995. The rate of third- and fourth-degree lacerations was compared for women who had and did not have epidural analgesia for labor-pain relief. Statistical significance was determined using chi2. Logistic regression analyses were used to evaluate associations while controlling for possible confounding variables.
RESULTS: Overall rates of third- and fourth-degree lacerations were 10.8% (n = 210) and 3.4% (n = 63), respectively. Epidural analgesia was given to 1376 (70.9%) women. Among women who had epidurals, 16.1% (221 of 1376) had severe perineal lacerations compared with 9.7% (n = 55) of the 566 women who did not have epidurals (P < .001; odds ratio [OR] 1.8, 95% confidence interval [CI] 1.3, 2.4). When controlling for birth weight, use of oxytocin, and maternal age in logistic regression analysis, epidural remained a significant predictor of severe perineal injury (OR 1.4, 95% CI 1.0, 2.0). Epidural use is consistently associated with increased operative vaginal deliveries and consequent episiotomies, so we constructed a logistic regression model to evaluate whether the higher rates of those procedures were responsible for the effect of epidurals on severe perineal traumas. With operative vaginal delivery and episiotomy in the model, epidural was no longer an independent predictor of perineal injury (OR 0.9, 95% CI 0.6, 1.3).
CONCLUSION: Epidural analgesia is associated with an increase in the rate of severe perineal trauma because of the more frequent use of operative vaginal delivery and episiotomy.

Sumário (português)  :

Comments :

Argument (français) :

Argument (English):

Argumento (português):

Keywords :

➡ evidence-based medicine/midwifery ; perineal/vaginal tears ; maternal age ; episiotomy ; instrumental delivery ; oxytocin ; epidural ; hormones

Author of this record :

Cécile Loup — 07 Jan 2004

Discussion (display only in English)
➡ Only identified users

 I have read the guidelines of discussions and I accept all terms (read guidelines)


New expert query --- New simple query

Creating new record --- Importing records

User management --- Dump database --- Contact


This database is managed by Alliance francophone pour l'accouchement respecté (AFAR,
affiliated with Collectif interassociatif autour de la naissance (CIANE,
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) contributing to this database if you have a minimum training in documentation
(2) or financially supporting AFAR (see below)
(3) or joining the AFAR (or another society affiliated with CIANE).
Sign in or create an account to follow changes or become an editor.
Contact afar.association(arobase) for more information.

Valid CSS! Valid HTML!
Donating to AFAR (click “Faire un don”) will help us to maintain and develop sites and public
databases towards the support of parents and caregivers’ informed decisions with respect to childbirth