Risk factors for perineal injury during delivery

Objective: We sought to identify risk factors for anal sphincter injury during vaginal delivery. Study Design: This was a retrospective, case-control study. We reviewed 2078 records of vaginal deliveries within a 2-year period from May 1, 1999, through April 30, 2001. Cases (n = 91) during the study...

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Bibliographic Details
Published in:American journal of obstetrics and gynecology 2003-07, Vol.189 (1), p.255-260
Main Authors: Christianson, L.M., Bovbjerg, V.E., McDavitt, E.C., Hullfish, K.L.
Format: Article
Language:English
Subjects:
Adult
Anal Canal - injuries
Anal sphincter injury
Analgesia, Epidural - adverse effects
Analgesia, Obstetrical - adverse effects
Biological and medical sciences
Case-Control Studies
Delivery, Obstetric - adverse effects
Delivery, Obstetric - methods
Delivery. Postpartum. Lactation
Disorders
Episiotomy - adverse effects
Female
Gynecology. Andrology. Obstetrics
Humans
incontinence
laceration
Medical sciences
Obstetrical Forceps - adverse effects
Oxytocin - adverse effects
perineal injury
Perineum - injuries
Pregnancy
Retrospective Studies
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Summary:Objective: We sought to identify risk factors for anal sphincter injury during vaginal delivery. Study Design: This was a retrospective, case-control study. We reviewed 2078 records of vaginal deliveries within a 2-year period from May 1, 1999, through April 30, 2001. Cases (n = 91) during the study period were defined as parturients who had documentation of greater than a second-degree perineal injury. Control subjects (n = 176), who were identified with the use of a blinded protocol, included women who were delivered vaginally with less than or equal to a second-degree perineal injury. For each patient, we reviewed medical and obstetrics records for the following characteristics: maternal age, race, weight, gestational age, parity, tobacco use, duration of first and second stages of labor, use of oxytocin, use of forceps or vacuum, infant birth weight, epidural use, and episiotomy use. Results: Of the 2078 deliveries that were reviewed, we discovered 91 cases (4.4%) of documented anal sphincter injury. The mean maternal age of our sample was 24.9 ± 5.9 years). Nearly two thirds (63.2%) were white; 26.7% were black, and 10.1% were of other racial backgrounds. Forceps were used in 51.6% of deliveries that resulted in tears (cases), compared to 8.6% of deliveries without significant tears (control subjects, P
ISSN:0002-9378
1097-6868
DOI:10.1067/mob.2003.547