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Archives of Gynecology and Obstetrics

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01-01-2010 | Original Article

Advanced age is a risk factor for higher grade perineal lacerations during delivery in nulliparous women

Authors: Amadeus Hornemann, Axel Kamischke, Doerte W. Luedders, Daniel A. Beyer, Klaus Diedrich, Michael K. Bohlmann

Published in: Archives of Gynecology and Obstetrics | Issue 1/2010

Abstract

Purpose

To identify risk factors for the development of severe perineal lacerations and to give recommendations for their prevention in nulliparous women.

Methods

A retrospective case–control analysis of deliveries at our University Hospital was performed. Multiparae, Caesarean sections, twin pregnancies, fetal breech position and preterm deliveries were excluded. Univariate and multivariate step forward regression analyses were performed; correlations between contributors were further analyzed by Spearman Rank Correlation. Differences between the degree of lacerations and maternal age were further analyzed with Friedman ANOVA followed by Dunn’s Multiple Comparison Test.

Results

A total of 2,967 deliveries fitted our inclusion criteria, 50 (1.7%) mothers had higher-grade lacerations. Mediolateral and median episiotomy, advanced maternal age, vaginal operative delivery, higher fetal birth weight and abnormal cephalic presentation were associated with severe lacerations.

Conclusions

Advanced maternal age plays an important role in the development of anal sphincter tears in nulliparous women. Episiotomy and operative vaginal deliveries should be restrictively performed when possible. To identify further preventive approaches in patients with accumulated risk factors prospective randomized studies are needed.

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Title: Advanced age is a risk factor for higher grade perineal lacerations during delivery in nulliparous women
Authors: Amadeus Hornemann
Axel Kamischke
Doerte W. Luedders
Daniel A. Beyer
Klaus Diedrich
Michael K. Bohlmann
Publication date: 01-01-2010
Publisher: Springer-Verlag
Published in: Archives of Gynecology and Obstetrics / Issue 1/2010
Print ISSN: 0932-0067
Electronic ISSN: 1432-0711
DOI: https://doi.org/10.1007/s00404-009-1063-7

At a glance: The STEP trials

Springer Medicine

Advanced age is a risk factor for higher grade perineal lacerations during delivery in nulliparous women

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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