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

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Currently 3046 records
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Created on : 21 Apr 2004
Modified on : 02 Dec 2007

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Bibliographical entry (without author) :

Determinants of vaginal-perineal integrity and pelvic floor functioning in childbirth. Am J Obstet Gynecol. 1997 Feb;176(2):403-10.

Author(s) :

Klein MC, Janssen PA, MacWilliam L, Kaczorowski J, Johnson B.

Year of publication :


URL(s) :…

Résumé (français)  :

Abstract (English)  :

OBJECTIVES: Our purpose was to evaluate risk factors for severe vaginal-perineal trauma and to ascertain determinants of pelvic floor strength.

STUDY DESIGN: Secondary analysis of 459 nulliparous women enrolled in a randomized controlled trial of episiotomy was carried out. In a multivariate analysis we examined the association between (1) sulcus tears, (2) third- or fourth-degree tears, and (3) pelvic floor strength and selected demographic, physiologic, pregnancy-related, and intrapartum factors.

RESULTS: Unemployment and shorter second stage of labor were significant predictors of sulcus tears. Episiotomy, forceps use, and birth weight were important predictors of third- and fourth-degree tears. Whereas perineal intactness (use of episiotomy and spontaneous tears) was not influenced by exercise, a strong exercise profile was associated with fewer third- and fourth-degree tears in the presence of episiotomy. Exercise did not influence the rate of sulcus tears. A total of 35% of the variability in postpartum pelvic floor strength was explained by antepartum strength; however, we were only able to identify 5% of the factors contributing to antepartum pelvic floor strength.

CONCLUSIONS: Determinants of sulcus tears appear to be present before pregnancy; third- and fourth-degree tears are related to physician management. Exercise mitigates the potential for severe trauma induced by episiotomy.

Sumário (português)  :

Comments :

Argument (français) :

L’exercice physique diminue les risques de traumatismes sévères induits par l’épisiotomie.

Argument (English):

Argumento (português):

Keywords :

➡ perineal/vaginal tears ; episiotomy ; instrumental delivery ; forceps delivery

Author of this record :

Cécile Loup — 21 Apr 2004

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