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Breakdown of Perineal Laceration Repair After Vaginal Delivery: A Case-Control Study.

Publication ,  Journal Article
Jallad, K; Steele, SE; Barber, MD
Published in: Female Pelvic Med Reconstr Surg
2016

OBJECTIVE: The aim of the study was to estimate risk factors associated with breakdown of perineal laceration repair after vaginal delivery. METHODS: This is a case-control study of women who sustained a breakdown of perineal laceration repair after vaginal delivery between 2002 and 2015. Cases were patients who sustained a perineal wound breakdown after vaginal delivery and repair of a second-, third-, or fourth-degree laceration. Controls, matched 1:1, were patients who either sustained a second-, third-, or fourth-degree perineal laceration and repair without evidence of breakdown and who delivered on the same day and institution as the case. RESULTS: A total of 104,301 deliveries were assessed for breakdown of perineal laceration. One hundred forty-four met the inclusion criteria. These were matched with 144 controls. Logistic regression analysis demonstrated that smoking is associated with increased risk for breakdown of perineal laceration (adjusted odds ratio [adj. OR], 6.4; 95% confidence interval [CI], 1.2-38.5), whereas a previous vaginal delivery is protective (adj. OR, 0.14; 95% CI, 0.05-0.3). In addition, third- or fourth-degree laceration (adj. OR, 4.0; 95% CI, 1.1-15.7), presence of episiotomy at time of delivery (adj. OR, 11.1; 95% CI, 2.9-48.8), operative delivery (adj. OR, 3.4; 95% CI, 1.2-10.3), midwife performing the laceration repair (adj. OR, 4.7; 95% CI, 1.5-15.8), and use of chromic suture (adj. OR, 3.9; 95% CI, 1.6-9.8) were independent risk factors for breakdown of perineal laceration. CONCLUSIONS: Smoking, nulliparity, episiotomy, operative delivery, third- or fourth-degree laceration, repair by a midwife, and use of chromic suture are independent risk factors for breakdown of perineal laceration repair after vaginal delivery.

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Published In

Female Pelvic Med Reconstr Surg

DOI

EISSN

2154-4212

Publication Date

2016

Volume

22

Issue

4

Start / End Page

276 / 279

Location

United States

Related Subject Headings

  • Risk Factors
  • Retrospective Studies
  • Regression Analysis
  • Pregnancy
  • Perineum
  • Parity
  • Obstetric Labor Complications
  • Midwifery
  • Lacerations
  • Humans
 

Citation

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Jallad, K., Steele, S. E., & Barber, M. D. (2016). Breakdown of Perineal Laceration Repair After Vaginal Delivery: A Case-Control Study. Female Pelvic Med Reconstr Surg, 22(4), 276–279. https://doi.org/10.1097/SPV.0000000000000274
Jallad, Karl, Sarah E. Steele, and Matthew D. Barber. “Breakdown of Perineal Laceration Repair After Vaginal Delivery: A Case-Control Study.Female Pelvic Med Reconstr Surg 22, no. 4 (2016): 276–79. https://doi.org/10.1097/SPV.0000000000000274.
Jallad K, Steele SE, Barber MD. Breakdown of Perineal Laceration Repair After Vaginal Delivery: A Case-Control Study. Female Pelvic Med Reconstr Surg. 2016;22(4):276–9.
Jallad, Karl, et al. “Breakdown of Perineal Laceration Repair After Vaginal Delivery: A Case-Control Study.Female Pelvic Med Reconstr Surg, vol. 22, no. 4, 2016, pp. 276–79. Pubmed, doi:10.1097/SPV.0000000000000274.
Jallad K, Steele SE, Barber MD. Breakdown of Perineal Laceration Repair After Vaginal Delivery: A Case-Control Study. Female Pelvic Med Reconstr Surg. 2016;22(4):276–279.

Published In

Female Pelvic Med Reconstr Surg

DOI

EISSN

2154-4212

Publication Date

2016

Volume

22

Issue

4

Start / End Page

276 / 279

Location

United States

Related Subject Headings

  • Risk Factors
  • Retrospective Studies
  • Regression Analysis
  • Pregnancy
  • Perineum
  • Parity
  • Obstetric Labor Complications
  • Midwifery
  • Lacerations
  • Humans