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Notice bibliographique (sans auteurs) :

A prospective observational study on tears during vaginal delivery: occurrences and risk factors Acta Obstetricia et Gynecologia Scandinavica Volume 81 Issue 1 Page 44 - January 2002

Auteur·e(s) :

Ellen Samuelsson, Lars Ladfors, Britta Gåreberg Lindblom AND Henrik Hagberg

Année de publication :

2002

URL(s) :

http://www.blackwell-synergy.com/links/doi/10.1046…

Résumé (français)  :

Abstract (English)  :

Background. To ascertain the occurrence and distribution of various types of I-IV degree tears, during
childbirth, and analyze risk factors for perineal II degree tears.

Materials and methods. A total of 2883 consecutive vaginal deliveries, during 1995-97 at Sahlgrenska
University Hospital in Göteborg Sweden, were included. All tears were classified according to an especially
designed protocol, and risk factors for II degree tears were evaluated by use of univariate and logistic
regression analysis.

Results. Only 6.6% of nulliparous parturients had no detectable tear as compared to 34.2% in parous
women. Almost half of the women suffered from a II degree tear during birth, and a higher proportion of
nulliparous (16.6%) than parous (9.4%) women had extensive perineal lacerations. In addition, nulliparous
were more likely than parous parturients to be subjected to a perineotomy (18.1% versus 5.6%). Stepwise
logistic regression analysis revealed that the following factors remained independently associated with II
degree tear: slight perineal edema, high infant weight, excellent visualization of perineum, increasing age of
the mother, excellent cooperation of the women, protracted second phase (> 60 min) and duration of second
phase < 30 min.

Conclusions. The majority of women (78%) undergoing childbirth had a tear and 47.1% suffered from perineal
lacerations. Nulliparous women were more likely to have severe perineal lacerations or episiotomies. Similar
risk factors were found for II degree tears as previously shown for III/IV degree tears.

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➡ médecine factuelle ; déchirures

Auteur·e de cette fiche :

Bernard Bel — 13 May 2004