Choose your font:
 Arimo
 Merriweather
 Mukta Malar
 Open Sans Condensed
 Rokkitt
 Source Sans Pro
 Login


 English 
 Français 
 Português 

[Valid RSS] RSS
bar

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

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

https://afar.info/id=805

Created on : 12 Jun 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) :

Third degree perineal tears in a university medical center where midline episiotomies are not performed. Arch Gynecol Obstet. 2004 Mar 16

Author(s) :

Sheiner E, Levy A, Walfisch A, Hallak M, Mazor M.

Year of publication :

2004

URL(s) :

http://springerlink.metapress.com/media/FL9XAKWWLL…

Résumé (français)  :

Abstract (English)  :

OBJECTIVE. Midline episiotomy is a known major risk factor for severe perineal lacerations. The study was aimed to define obstetric risk factors for third-degree perineal tears in a university medical center where midline episiotomies are not performed.

STUDY DESIGN. A comparison between vaginal deliveries complicated with third-degree perineal tears and deliveries without third-degree perineal tears was performed. Deliveries occurred between the years 1988-1999 in a tertiary medical center. Multiple gestations, preterm deliveries (<37 weeks’ gestation), cesarean deliveries and cases of shoulder dystocia were excluded from the analysis. A multiple logistic regression model was constructed in order to find independent risk factors for third-degree perineal tears. Odds ratios (OR) and their 95% confidence interval (CI) were calculated from the regression coefficient.

RESULTS. During the study period, 79 (0.1%) consecutive cases of third degree perineal tears were identified. Significant risk factors from the univariate analysis were fetal macrosomia (OR 2.7, 95%CI 1.2-5.5), nulliparity (OR 2.9, 95%CI 1.8-4.6), labor induction (OR 1.9, 95%CI 1.0-3.5), failure of labor to progress during the second stage (OR 10.8, 95%CI 5.4-21.1), non-reassuring fetal heart rate patterns (OR 11.7, 95%CI 6.1-21.5), mediolateral episiotomy (OR 2.8, 95%CI 1.8-4.5), vacuum extraction (OR 10.6, 95%CI 6.1-18.3), and forceps delivery (OR 29.2, 95%CI 7.3-97.2). However, using a multivariable analysis, only fetal macrosomia (OR 2.5, 95%CI 1.2-4.9), vacuum extraction (OR 8.2, 95%CI 4.7-14.5), and forceps delivery (OR 26.7, 95%CI 8.0-88.5) remained as independent risk factors. The combined risk for instrumental deliveries of macrosomic newborns was 8.6 (95% CI 1.2-62.5; p=0.010).

CONCLUSIONS. After adjustment for possible confounding variables, mediolateral episiotomy per se was not an independent risk factor for third-degree perineal tears. Instrumental vaginal deliveries of macrosomic fetuses should be avoided whenever possible to decrease the occurrence of third-degree perineal tears.

Sumário (português)  :

Full text (private) :

 ➡ Access requires authorization

Comments :

Article en accès libre.

Argument (français) :

Argument (English):

Argumento (português):

Keywords :

➡ induction of labor ; physiology ; perineal/vaginal tears ; episiotomy ; instrumental delivery ; forceps delivery ; vacuum extraction (ventouse) ; post-term pregnancy

Author of this record :

Cécile Loup — 12 Jun 2004

Discussion (display only in English)
 
➡ Only identified users



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

barre

New expert query --- New simple query

Creating new record --- Importing records

User management --- Dump database --- Contact

bar

This database is managed by Alliance francophone pour l'accouchement respecté (AFAR, https://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) 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)gmail.com 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