Perineal length: norms in gravid women in the first stage of labour

Abstract

This is the first paper to report normative data for perineal length in Caucasian and Asian women in labour. We found a negative correlation between perineal length and third-degree tear in primigravid women. These data may be useful in clinical practice to determine the risk of significant perineal tears in labour.

Reasons for routine episiotomy: A mixed-methods study in a large maternity hospital in Phnom Penh, Cambodia

“…22 This was the result of "managerial choices to accelerate and operationalize universal access to care". 25 An "expanding primary health care network, a monetary incentive for facility-based midwives for every live birth, and an expanding system of health equity funds, making health care free of cost for poor people" also contributed to improving the health system. 21 The improvements in skilled birth attendance contributed to the reduction of maternal mortality ratio.…”

“…Births delivered by trained staff at health facilities increased from 39% to 80% between 2008 and 2014, 22 despite the persistence of socio-cultural, economic and geographical barriers to accessing health services in Cambodia. 26 A consequence of this was an increase in the workload in maternity units.…”

“…In 2014 Van Lerberghe et al 25 reported that Cambodia's maternity care was characterized by an expansion in the network of birthing facilities, the scaling up of training for midwives, and a reduction in financial barriers. This perfectly describes Calmette hospital, where new buildings are built almost every year and where a large number of midwives have been deployed to cope with the increasing number of deliveries.…”

“…They explain that Cambodia has deployed "partly connected initiatives and measures to adapt to and improve on a changing environment, where strategies emerged and were self-organised over time, rather than as implementations of a predefined comprehensive plan". 25 Pretty genitals and a tight vagina Some midwives and obstetricians cited conjugal expectations and the "wish" of patients to have pretty genitals as reasons for a high episiotomy rate. The health professionals referred to the "aesthetic" aspect of the perineum: a perineum cut and sutured is nicer than a sutured perineal tear:…”

Obstetric anal sphincter injuries: review of anatomical factors and modifiable second stage interventions

“…Table 1 shows the studies involving PL measurements antenatally, and in the first and/or second stage of labour. The average PL is 39 mm (range 37-41 mm) in the late antenatal period or first stage of labour [26][27][28][29][30][31] and PL has increased by 50-60 % at crowning to 60 mm [31][32][33]. Patients with PL ≤25 mm (measured during the first stage) had a significantly greater risk of OASI (40 % vs. 5.6 %, p= 0.004) [26].…”