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

Journal Article (Journal Article)

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.

Full Text

Duke Authors

Cited Authors

  • Jallad, K; Steele, SE; Barber, MD

Published Date

  • 2016

Published In

Volume / Issue

  • 22 / 4

Start / End Page

  • 276 - 279

PubMed ID

  • 27054788

Electronic International Standard Serial Number (EISSN)

  • 2154-4212

Digital Object Identifier (DOI)

  • 10.1097/SPV.0000000000000274

Language

  • eng

Conference Location

  • United States