Prior third- or fourth-degree perineal tears and recurrence risks.

Abstract

OBJECTIVE:

The objective of the present study is to determine the recurrence risk of a third-degree (into the anal sphincter) or a fourth-degree (into the rectum) perineal tear in women with a prior extensive laceration.

METHODS:

Data were gathered from our computerized perinatal database between January 1990 and December 1994. Women who had two consecutive singleton deliveries were chosen as subjects.

RESULTS:

The rate of an extensive perineal laceration was greater if a tear had occurred in a previous pregnancy (19 of 178 cases, 10.7% vs. 56% of 1563 cases, 3.6%, odds ratio 3.4. A 95% confidence interval: 1.8-6.4; p < 0.0001). A prior tear remained a risk factor after controlling for other variables (epidural analgesia, episiotomy, oxytocin use, operative vaginal delivery, fetal macrosomia).

CONCLUSION:

A prior third-degree or fourth-degree perineal tear is associated with a 3.4-fold increased risk of a recurrent severe obstetrical laceration.

• Authors: T N Payne, J C Carey, W F Rayburn
• Journal: International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics (Int J Gynaecol Obstet) Vol. 64 Issue 1 Pg. 55-7 (Jan 1999) ISSN: 0020-7292 [Print] United States
• PMID: 10190670 (Publication Type: Journal Article)

Topics

• Adolescent
• Adult
• Female
• Humans
• Medical Records
• Obstetric Labor Complications (epidemiology)
• Perineum (injuries)
• Pregnancy
• Recurrence
• Retrospective Studies
• Risk Factors