The Relation Between Perineal Length and Lacerations During Labor

Abstract

Background: Perineal length is thought to affect the risk of perineal lacerations in vaginally delivered women Aim of research: to investigate the possible role of perineal length as a risk factor for development of perineal lacerations during vaginal delivery. Study design: correlation descriptive. The study was conducted at Elhelal Elahmar hospitals in Alexandria . Subjects and methods: A convenience sample of Eighty women with singleton pregnancies who went into spontaneous labor at term during the study period were included in the study. All participants were subjected to general examination, abdominal palpation and vaginal examination was performed to assess cervical effacement/length, dilatation, cervical position, consistency, membranes, liquor, presentation, position, caput, moulding and station. Perineal measurements (to the nearest 0.5 cm) were taken at the beginning of the active phase of labor (effacement of 80-100% and 3-4cm dilatation). The length of the perineum was determined as the distance between the fourchette and center of the anal orifice. Results: Comparison between women with perineal length  3.5 cm (group I) and those with perineal length > 3.5 cm (group II) revealed that women in GI had significantly longer 2nd stage of labor and significantly higher frequency of perineal lacerations. Comparison between those with perineal lacerations (PL) and women without in those who didn't have episiotomy has shown that women with perineal lacerations had significantly longer 2nd stage of labor and larger head circumferences of the newborn baby. Conclusions: Women with short perineal length are at increased risk of perineal lacerations during vaginal delivery. Other factors associated with increased prevalence of perineal lacerations are prolonged 2nd stage of labor and increased neonatal head circumference.

Keywords

• perineal length – perineal lacerations