Third- and fourth-degree perineal tears – incidence and risk factors

Melamed, Nir; Gavish, Oz; Eisner, Michal; Wiznitzer, Arnon; Wasserberg, Nir; Yogev, Yariv

doi:10.3109/14767058.2012.746308

Cited by 33 publications

(36 citation statements)

References 23 publications

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“…Melamed et al15 reported an incidence of 0.6% for third- and fourth-degree perineal tears in single-ton, viable (≥24 weeks’ gestation, ≥500 g), vertex, vaginal deliveries. Independent predictors of OASIs were forceps delivery (OR, 5.5; 95% CI, 3.9–7.8), precipitate labor (OR, 5.2; 95% CI, 2.9–9.2), persistent occiput posterior position (OR, 2.6; 95% CI, 1.6–4.3), vacuum extraction (OR, 1.9; 95% CI, 1.4–2.6), large-for-gestational-age neonates (>90th percentile) (OR, 1.5; 95% CI, 1.1–2.0), and gestational age >40 weeks (OR, 1.4; 95% CI, 1.1–1.7).…”

Section: Resultsmentioning

confidence: 99%

Obstetric Anal Sphincter Injuries (OASIs) in Israel: A Review of the Incidence and Risk Factors

Ginath

Mizrachi

Bar

et al. 2017

Rambam Maimonides Med J

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Obstetric anal sphincter injuries (OASIs) following vaginal deliveries are the main reason for subsequent development of anal incontinence in women. The diagnosis of such tears is crucial for treating and preventing such a grave sequela. The reported rate of OASIs in Israel was between 0.1% and 0.6%, out of all vaginal births, which is 10-fold lower than that reported in Europe and the United States. Structured hands-on training in repair of OASIs in seven medical centers in Israel significantly increased the detection rate of third-degree perineal tears. The implementation of such programs is crucial for increasing awareness and detection rates of OASIs following vaginal deliveries.

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Section: Resultsmentioning

confidence: 99%

Obstetric Anal Sphincter Injuries (OASIs) in Israel: A Review of the Incidence and Risk Factors

Ginath

Mizrachi

Bar

et al. 2017

Rambam Maimonides Med J

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“…[10][11][12] To date, there is no consensus regarding the minimal set of maternal characteristics that improves detection of adverse outcomes through the use of customized charts. [13][14][15][16][17] So far, the single characteristic that has been shown to influence the size of newborns in this way is maternal country of birth.…”

Section: Resultsmentioning

confidence: 99%

Risk of adverse outcomes among infants of immigrant women according to birth-weight curves tailored to maternal world region of origin

Urquia

Berger

Ray

2014

CMAJ

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“…9 OASIS have been linked with a number of long-term complications such as faecal incontinence, urinary incontinence, perineal pain, dyspareunia, embarrassment and low self-esteem. 10 Instrumental delivery, increasing birthweight and prolonged second stage are all recognised risk factors for OASIS; 6,8,[11][12][13][14] however, the role of ethnicity remains uncertain.…”

Section: Introductionmentioning

confidence: 99%

The Great Divide: Country of birth as a risk factor for obstetric anal sphincter injuries

Brown

Kapurubandara

Gibbs

et al. 2017

Aust NZ J Obst Gynaeco

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BackgroundObstetric anal sphincter injuries (OASIS) can complicate up to 6% of births and are a major contributor to preventable maternal morbidity. Asian women have a risk of third and fourth degree perineal tears up to four times greater than women of other ethnicities in the same community, but the lack of differentiation of Asian women into regional groups has limited insight into the reasons behind their increased risk.AimsTo investigate risk of OASIS associated with country of birth.MethodsThis was a retrospective cohort study of all women with a singleton, nulliparous pregnancy who delivered vaginally by spontaneous vaginal birth or an instrumental delivery between 1 January 2009 and 31 December 2015. The demographics of women who experienced OASIS were compared with those women who had minor perineal trauma.ResultsFrom January 2009 to December 2015 there were 10 750 singleton, nulliparous and natural vaginal birth (NVB), forceps or vacuum deliveries. Of these deliveries, 581 (5.4%) werehad third degree tears and 36 (0.3%) fourth degree tears. Women born in South Asia were at a much higher risk of OASIS than other groups, including women born in other Asian countries, compared to the Australian/New Zealand cohort. One in every 10 nulliparous South Asian women having a singleton vaginal or instrumental delivery will sustain an OASIS.ConclusionsOur study further confirms the role of Asian ethnicity in the risk of OASIS, and is the second to confirm that South Asian women are at a dramatically increased risk.

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Third- and fourth-degree perineal tears – incidence and risk factors

Abstract: Despite the limited predictability of 34DPT by individual risk factors, the use of combinations of risk factors may assist obstetricians in identifying women who are at especially high risk for 34DPT.

Cited by 33 publications

References 23 publications

Obstetric Anal Sphincter Injuries (OASIs) in Israel: A Review of the Incidence and Risk Factors

Obstetric Anal Sphincter Injuries (OASIs) in Israel: A Review of the Incidence and Risk Factors

Risk of adverse outcomes among infants of immigrant women according to birth-weight curves tailored to maternal world region of origin

The Great Divide: Country of birth as a risk factor for obstetric anal sphincter injuries

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