Format

Send to

Choose Destination
See comment in PubMed Commons below
J Clin Nurs. 2012 Aug;21(15-16):2209-18. doi: 10.1111/j.1365-2702.2012.04133.x. Epub 2012 May 31.

Risk factors for birth-related perineal trauma: a cross-sectional study in a birth centre.

Author information

1
National Council for Scientific and Technological Development (CNPq) Scholarship, University of São Paulo, São Paulo, SP, Brazil. floramaria@usp.br

Abstract

AIM AND OBJECTIVES:

To identify maternal, newborn and obstetric factors associated with birth-related perineal trauma in one independent birth centre.

BACKGROUND:

Risk factors for birth-related perineal trauma include episiotomy, maternal age, ethnicity, parity and interventions during labour including use of oxytocin, maternal position at time of birth and infant birth weight. Understanding more about these factors could support the management of vaginal birth to prevent spontaneous perineal trauma, in line with initiatives to reduce routine use of episiotomy.

DESIGN:

Cross-sectional study.

METHODS:

Data were retrospectively collected from one independent birth centre in Brazil, during 2006-2009. The dependent variable (perineal trauma) was classified as: (1) intact perineum or first-degree laceration, (2) second-degree laceration and (3) episiotomy (right mediolateral or median).

RESULTS:

There were 1079 births during the study period. Parity, use of oxytocin during labour, position at time of giving birth and infant birth weight were associated with second-degree lacerations and episiotomies. After adjusting for parity, oxytocin, maternal position at the expulsive stage of labour and infant birth weight influenced perineal outcomes among primiparae only.

CONCLUSIONS:

Although the overall rate of episiotomies in this study was low compared with national data, it was observed that younger women were most vulnerable to this intervention. In this age group in particular, the use of oxytocin as well as semi-upright positions at the time of birth was associated with second-degree lacerations and episiotomies.

RELEVANCE TO CLINICAL PRACTICE:

The use of upright alternative positions for birth and avoidance of use of oxytocin could reduce the risk of perineal trauma from lacerations and need to perform episiotomy.

[Indexed for MEDLINE]
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Wiley
    Loading ...
    Support Center