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| Analysis of risk factors of perineal laceration of primipara during unprotected transvaginal delivery |
| Hangzhou Obstetrics and Gynecology Hospital, Hangzhou, Zhejiang Province, 310009 |
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Abstract To explore the risk factors of perineal laceration of primipara during unprotected transvaginal delivery so as to provide new evidences for the early prevention and intervention of perineal laceration during transvaginal delivery. Methods: A total of 376 primiparas who experienced unprotected transvaginal delivery were selected and were divided into 236 cases with perineal laceration in group A and 140 cases without perineal laceration in group B from January 2021 to December 2021. The risk factors of perineal laceration of the primiparas were analyzed by Logistic regression analysis model. Results: In 376 primiparas, there were 236 (62.8%) cases with perineal laceration, which included 219 cases (92.8%) with grade Ⅰof perineal laceration. Multivariate Logistic regression analysis showed that prolonged duration of the second stage of labor (OR=2.307, 95%CI 1.305-2.842), the prenatal perineal edema (OR=2.825, 95%CI 1.364-4.810), the neonatal weight ≥3.5kg (OR=3.570, 95%CI 1.601-5.825), and the fear of delivery (OR=1.542, 95%CI 1.240-2.133) of the primiparas were their independent risk factors of perineal lacerations. The seniority of midwife with working times ≥5 years (OR=0.410, 95%CI 0.265-0.730) and the adequate physical activity of the primiparas during pregnancy (OR=0.603, 95%CI 0.413-0.901) were their protective factors of perineal laceration. Conclusion: The rate of perineal laceration of the primiparas during unprotected transvaginal delivery is higher, which mainly is mild laceration. Clinical medical staff should pay attention to the risk factors related to perineal laceration before and during delivery, and should take preventive and intervention measures actively to reduce the incidence and severity of perineal laceration of the primiparas.
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