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Intact perineum: what are the predictive factors in spontaneous vaginal birth?

dc.contributor.authorRodrigues, Silvia
dc.contributor.authorSilva, Paulo
dc.contributor.authorAgius, Andee
dc.contributor.authorRocha, Fatima
dc.contributor.authorCastanheira, Rosa
dc.contributor.authorGross, Mechthild
dc.contributor.authorCalleja-Agius, Jean
dc.date.accessioned2024-01-08T13:44:31Z
dc.date.available2024-01-08T13:44:31Z
dc.date.issued2019
dc.description.abstractIntroduction: Perineal trauma at birth is distressing for women and can cause serious short and long term morbidity. Aim: Investigate the prevalence and predictive factors of intact perineum after normal vaginal birth among Portuguese women who had spontaneous vaginal births. Methods: A descriptive, cross-sectional, retrospective study was carried out among pregnant women who had spontaneous vaginal births, between January 1, 2017, and December 31, 2017, in a single birth centre in Portugal. Following ethical approval, the prevalence of intact perineum was calculated and multivariate analysis with logistic regression was carried out, to identify the predictive factors of having an intact perineum after spontaneous vaginal birth. Results: A total of 1748 pregnant women had spontaneous vaginal births. Four hundred and forty-one women (25.2%) had intact perineum whereas in 1307 (74.8%) of women, the perineum was not intact. First-degree tears occurred in 23.2% (405/1748) of women, second-degree tears occurred in 4% (70/1748) of women while three women (0.2%) experienced a third-degree tear. The rate of episiotomies was 43.8% (766/1748). Episiotomy and first-degree tears occurred in 2.6% (45/1748), episiotomy and second-degree tears occurred in 0.7% (12/1748), while episiotomy and third-degree tears occurred in 0.3% (6/1748) of women. Having a previous caesarean section reduced the odds of intact perineum by 60%, while nulliparity reduced the odds by 70%. For every 250 grams increase in birth weight, the odds of sustaining an intact perineum were decreased by 13%. Alternative birth positions (excluding lithotomy) doubled the odds of maintaining an intact perineum. Conclusion: The prevalence of intact perineum is 25,2%. Predictive factors for intact perineum include birth weight, parity, previous caesarean section and birthing po-sition. Recognizing these factors could support and facilitate the management of spontaneous vaginal birth to promote an intact perineum. Further research is needed to gain better understanding of this phenomenon.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.doi10.5455/msm.2019.31.25-30pt_PT
dc.identifier.eid85102552636
dc.identifier.issn1512-7680
dc.identifier.urihttp://hdl.handle.net/10400.14/43494
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.rights.urihttp://creativecommons.org/licenses/by-nc/4.0/pt_PT
dc.subjectCaesarean sectionpt_PT
dc.subjectParitypt_PT
dc.subjectParturitionpt_PT
dc.subjectPerineumpt_PT
dc.titleIntact perineum: what are the predictive factors in spontaneous vaginal birth?pt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage30pt_PT
oaire.citation.issue1pt_PT
oaire.citation.startPage25pt_PT
oaire.citation.titleMateria Socio-Medicapt_PT
oaire.citation.volume31pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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