Abstract:
Abstract
BACKGROUND AND AIMS: The objective of our study was to analyse the risk
factors in a cohort of women who suffered anal sphincter disruption (third-degree
tear) and compare the results with a similar cohort of women who underwent an
uncomplicated vaginal delivery (without a clinically detectable laceration) during
the same period.
MATERIALS AND METHODS: A retrospective analysis was carried out on 54
women (group 1) who suffered a third-degree tear and 71 women who had
undergone uncomplicated vaginal delivery during the same period (group 2). The
risk factors considered were forceps delivery, parity, second stage of labour longer
than 1 h, episiotomy, birth weight over 4 kg, gestational age and maternal age at
delivery. The Cleveland Incontinence Score was completed.
RESULTS: Multiple logistic regression analysis of obstetric risk factors for thirddegree
perineal tear indicated forceps delivery (p = 0.0001), primiparity (p =
0.004), foetal birth weight over 4 kg (p = 0.030) and delay in the second stage of
labour (p = 0.031) to be significant risk factors for a third-degree tear. Mediolateral
episiotomy was shown to be a significant protective factor (p = 0.0001).
Gestational age and the maternal age at delivery (p = 0.340) were not shown to be
significant risk factors (p = 0.336).
CONCLUSION: Primary prevention and identification of women with risk factors is
recommended. In some cases, counselling regarding the potential risks and
benefits of both vaginal and caesarean delivery may be appropriate.
