Birth Lacerations in Different Genital Compartments and their Effect on Maternal Subjective Outcome: A Prospective Observational Study

Kimmich, Nina; Grauwiler, V; Richter, Anne; Zimmermann, Roland; Kreft, Martina

doi:10.1055/a-0858-0138

Cited by 10 publications

(11 citation statements)

References 38 publications

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“…High vaginal tear was fairly common in our study, affecting 14.0% of women. Our review of the literature found only two studies specifically reporting the incidence of vaginal tears, ranging 7.8-35.1%, irrespective of parity [32,33]. However, none of the studies reported the extension of vaginal tears, albeit one of the studies used a detailed protocol including information about the extension of vaginal tears [33].…”

Section: Discussionmentioning

confidence: 99%

Risk factors for perineal and vaginal tears in primiparous women – the prospective POPRACT-cohort study

Jansson

Franzén

Hiyoshi

et al. 2020

BMC Pregnancy Childbirth

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Background The aim of this study was to estimate the incidence of second-degree perineal tears, obstetric anal sphincter injuries (OASI), and high vaginal tears in primiparous women, and to examine how sociodemographic and pregnancy characteristics, hereditary factors, obstetric management and the delivery process are associated with the incidence of these tears. Methods All nulliparous women registering at the maternity health care in Region Örebro County, Sweden, in early pregnancy between 1 October 2014 and 1 October 2017 were invited to participate in a prospective cohort study. Data on maternal and obstetric characteristics were extracted from questionnaires completed in early and late pregnancy, from a study-specific delivery protocol, and from the obstetric record system. These data were analyzed using unadjusted and adjusted multinomial and logistic regression models. Results A total of 644 women were included in the study sample. Fetal weight exceeding 4000 g and vacuum extraction were found to be independent risk factors for both second-degree perineal tears (aOR 2.22 (95% CI: 1.17, 4.22) and 2.41 (95% CI: 1.24, 4.68) respectively) and OASI (aOR 6.02 (95% CI: 2.32, 15.6) and 3.91 (95% CI: 1.32, 11.6) respectively). Post-term delivery significantly increased the risk for second-degree perineal tear (aOR 2.44 (95% CI: 1.03, 5.77), whereas, maternal birth positions with reduced sacrum flexibility significantly decreased the risk of second-degree perineal tear (aOR 0.53 (95% CI 0.32, 0.90)). Heredity of pelvic floor dysfunction and/or connective tissue deficiency, induced labor, vacuum extraction and fetal head circumference exceeding 35 cm were independent risk factors for high vaginal tears (aOR 2.32 (95% CI 1.09, 4.97), 3.16 (95% CI 1.31, 7.62), 2.53 (95% CI: 1.07, 5.98) and 3.07 (95% CI 1.5, 6.3) respectively). Conclusion The present study corroborates previous findings of vacuum extraction and fetal weight exceeding 4000 g as risk factors of OASI. We found that vacuum extraction is a risk factor for second-degree tear, and vacuum extraction, fetal head circumference exceeding 35 cm and heredity of pelvic floor dysfunction and/or connective tissue deficiency were associated with increased risk of high vaginal tears. These findings have not been documented previously and should be confirmed by additional studies.

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Section: Discussionmentioning

confidence: 99%

Risk factors for perineal and vaginal tears in primiparous women – the prospective POPRACT-cohort study

Jansson

Franzén

Hiyoshi

et al. 2020

BMC Pregnancy Childbirth

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show abstract

“…High vaginal tear was fairly common in our study, affecting 14.0% of women. Our review of the literature found only two studies speci cally reporting the incidence of vaginal tears, ranging 7.8-35.1%, irrespective of parity [32,33]. However, none of the studies reported the extension of vaginal tears, albeit one of the studies used a detailed protocol including information about the extension of vaginal tears [33].…”

Section: Discussionmentioning

confidence: 99%

Risk factors for perineal and vaginal tears in primiparous women – the prospective POPRACT-cohort study

Jansson

Fransén²,

Hiyoshi

et al. 2020

Preprint

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Background The aim of this study was to estimate the incidence of second-degree perineal tears, obstetric anal sphincter injuries (OASI), and high vaginal tears in primiparous women, and to examine how sociodemographic and pregnancy characteristics, hereditary factors, obstetric management and the delivery process are associated with the incidence of these tears.Methods All nulliparous women registering at the maternity health care in Region Örebro County, Sweden, in early pregnancy between 1 October 2014 and 1 October 2017 were invited to participate in a prospective cohort study. Data on maternal and obstetric characteristics were extracted from questionnaires completed in early and late pregnancy, from a study-specific delivery protocol, and from the obstetric record system. These data were analyzed using unadjusted and adjusted multinomial and logistic regression models.Results A total of 644 women were included in the study sample. Fetal weight exceeding 4000 g and vacuum extraction were found to be independent risk factors for both second-degree perineal tears (aOR 2.22 (95% CI: 1.17, 4.22) and 2.41 (95% CI: 1.24, 4.68) respectively) and OASI (aOR 6.02 (95% CI: 2.32, 15.6) and 3.91 (95% CI: 1.32, 11.6) respectively). Post-term delivery significantly increased the risk for second-degree perineal tear (aOR 2.44 (95% CI: 1.03, 5.77), whereas, maternal birth positions with reduced sacrum flexibility significantly decreased the risk of second-degree perineal tear (aOR 0.53 (95% CI 0.32, 0.90)). Heredity of pelvic floor dysfunction and/or connective tissue deficiency, induced labor, vacuum extraction and fetal head circumference exceeding 35 cm were independent risk factors for high vaginal tears (aOR 2.32 (95% CI 1.09, 4.97), 3.16 (95% CI 1.31, 7.62), 2.53 (95% CI: 1.07, 5.98) and 3.07 (95% CI 1.5, 6.3) respectively).Conclusion The present study corroborates previous findings of vacuum extraction and fetal weight exceeding 4000 g as risk factors of OASI. We found that vacuum extraction is a risk factor for second-degree tear, and vacuum extraction, fetal head circumference exceeding 35 cm and heredity of pelvic floor dysfunction and/or connective tissue deficiency were associated with increased risk of high vaginal tears. These findings have not been documented previously and should be confirmed by additional studies.

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“…Ausserdem muss bedacht werden, dass die Sonographie stark untersucherabhängig ist und die Plazentalokalisationen an unserer Klinik von verschiedenen Fachpersonen beurteilt wurden. Durch eine detailgetreuere Dokumentationsmaske zur genauen Skizzierung der Plazentalokalisation, die standardmässig im unmittelbaren Anschluss an die Ultraschalluntersuchung in eine anatomische Grafik in Anlehnung an die von Kimmich und Kollegen benutzte Dokumentation von Geburtsverletzungen [32,33] eingezeichnet werden könnte, könnte diese Fehlerquelle minimiert werden.…”

Section: Schwächen Der Studieunclassified

Plazentalokalisationen in aufeinanderfolgenden Schwangerschaften – eine retrospektive Kohortenstudie

Egli¹,

Kimmich²,

Zimmermann³

et al. 2020

Z Geburtshilfe Neonatol

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Zusammenfassung Einführung Die Plazentalokalisation ist mit Risiken während einer Schwangerschaft (SS) und Geburt assoziiert. Kenntnisse über die Lage der Plazenta ermöglichen eine auf Risikofaktoren angepasste weitere Betreuung der SS. Verschiedene Studien beschreiben ein höheres Risiko für eine wiederholte Plazenta prävia, gleichartige Daten zu anderen Plazentalokalisationen fehlen. Ziel dieser Studie war es, die Häufigkeitsverteilung der verschiedenen Plazentalokalisationen zu evaluieren und Korrelationen zwischen Plazentalokalisationen in aufeinanderfolgenden SS zu analysieren. Material und Methodik In einer retrospektiven Kohortenstudie wurden Frauen mit Einlings-SS ≥ 24+0 Schwangerschaftswochen (SSW), mindestens 1 Ultraschalluntersuchung zur Identifikation der Plazentalokalisation sowie Geburt ihres Erstgeborenen und mindestens eines direkt aufeinanderfolgenden Kindes in unserer Klinik zwischen 2007 und 2016 analysiert. Ausschlusskriterien waren Mehrlingsschwangerschaften, Aborte/intrauteriner Fruchttod/Frühgeburten <24+0 SSW. Resultate Unter 1657 Frauen befand sich die Plazenta am häufigsten anterior gefolgt von posterior, fundal, lateral und dann als prävia. Es zeigten sich keine statistisch signifikanten Korrelationen bezüglich der Plazentalokalisationen in aufeinanderfolgenden SS und kein signifikanter Einfluss einer vorangegangen Curettage oder Sectio. Konklusion Die Plazentalokalisation scheint nicht durch den Plazentasitz in der vorherigen Schwangerschaft beeinflusst zu werden. Daher kann keine Prognose hinsichtlich der Plazentalokalisation in aufeinanderfolgenden Schwangerschaften gestellt werden.

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Birth Lacerations in Different Genital Compartments and their Effect on Maternal Subjective Outcome: A Prospective Observational Study

Cited by 10 publications

References 38 publications

Risk factors for perineal and vaginal tears in primiparous women – the prospective POPRACT-cohort study

Risk factors for perineal and vaginal tears in primiparous women – the prospective POPRACT-cohort study

Risk factors for perineal and vaginal tears in primiparous women – the prospective POPRACT-cohort study

Plazentalokalisationen in aufeinanderfolgenden Schwangerschaften – eine retrospektive Kohortenstudie

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