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Numéro de la fiche :
755
Date de saisie : 12/05/2004
Date de modification :
1/12/2007
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URL de la fiche / URL da ficha
: http://afar.info/id=755
spécialisé / hard / difícil
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Auteur(s) /
Author(s) / Autores :
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J.W. de Leeuw, P.C. Struijk, M.E. Vierhout, H.C.S. Wallenburg
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Année de
parution :
Publication year:
Ano de publicação :
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2001
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Notice bibliographique
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Biblio entry:
Nota bibliográfica:
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Risk factors for third degree perineal ruptures during delivery.
BJOG: An International Journal of Obstetrics and Gynaecology. Vol. 108 Issue 4 Page 383 April 2001
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Résumé
(français) :
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Abstract
(English):
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Objective
To determine risk factors for the occurrence of third degree perineal tears during vaginal delivery.
Design
A population-based observational study.
Population
All 284,783 vaginal deliveries in 1994 and 1995 recorded in the Dutch National Obstetric Database were included in the study.
Methods
Third degree perineal rupture was defined as any rupture involving the anal sphincter muscles.
Logistic regression analysis was used to assess risk factors.
Main outcome measures
An overall rate of third degree perineal ruptures of 1.94% was found. High fetal birthweight, long duration of the second stage of delivery and primiparity were associated with an elevated risk of anal sphincter damage. Mediolateral episiotomy appeared to protect strongly against damage to the anal sphincter complex during delivery (OR: 0.21, 95% CI: 0.20-0.23). All types of assisted vaginal delivery were associated with third degree perineal ruptures, with forceps delivery (OR: 3.33, 95%-CI: 2.97-3.74) carrying the largest risk of all assisted vaginal deliveries. Use of forceps combined with other types of assisted vaginal delivery appeared to increase the risk even further.
Conclusions
Mediolateral episiotomy protects strongly against the occurrence of third degree perineal ruptures and may thus serve as a primary method of prevention of faecal incontinence. Forceps delivery is a stronger risk factor for third degree perineal tears than vacuum extraction. If the obstetric situation permits use of either instrument, the vacuum extractor should be the instrument of choice with respect to the prevention of faecal incontinence.
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Sumário
(português):
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URL :
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http://www.blackwell-synergy.com/links/doi/10.1111/j.1471-0528.2001.00090.x/enhancedabs/
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CianeWiki
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http://ciane.net/wiki/pmwiki.php/Articles/755
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Remarques diverses
:
Misc remarks:
Observações diversas:
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Copie électronique disponible.
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Argument
(français) :
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Facteurs de risques des déchirures graves du périnée: nulliparité, taille du bébé, forceps, ventouse, expression abdominale, syntocinon.
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Argument
(English):
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Argumento
(português):
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Mots clés
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déchirures / épisiotomie / expression abdominale / incontinence/prolapsus /
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Keywords
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episiotomy / fundal pressure / incontinence/prolapsus / tears /
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Palavra-chaves
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/ rasgaduras / episiotomia / expressão abdominal / incontinência/prolapso
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