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Perineal trauma in women undergoing vaginal delivery following intra-uterine fetal demise: a case–control analysis

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Abstract

Introduction and hypothesis

This study aimed to evaluate any differences in the incidence of perineal trauma in women undergoing vaginal delivery following intrauterine fetal death (IUFD) versus live-births. This information would be of interest in evaluating the possible effect of fetal demise on the mechanism of labour in the second stage and thus may provide invaluable insights to contribute to our understanding of the impact of fetal tone on the mechanics of labour and delivery.

Methods

323 women who delivered vaginally following IUFD were matched with 1,000 women with a live-birth for age, parity, gestation and birth weight. Women undergoing assisted vaginal delivery and/or episiotomy were excluded.

Results

Women with an IUFD had a significantly lower risk of perineal trauma overall (relative risk 0.16) as well as a lower risk of obstetric anal sphincter injury specifically (RR 0.12).

Conclusions

Women delivering vaginally after IUFD have a lower incidence of perineal trauma compared with women delivering a live infant. This may be due to differences in biomechanics following an IUFD.

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References

  1. Magann E, Chauhan S, Bofill J, Waddell D, Rust O, Morrison J (2001) Maternal morbidity and mortality associated with intrauterine fetal demise: five year experience in a tertiary referral hospital. South Med J 94:493–495

    CAS  PubMed  Google Scholar 

  2. Ifnan F, Jameel M (2006) Maternal morbidity and mortality associated with delivery after intra-uterine fetal death. J Coll Phys Surg Pak 16:648–651

    Google Scholar 

  3. Cheng Y, Hopkins L, Caughey A (2004) How long is too long: does a prolonged second stage of labour in nulliparous women affect maternal and neonatal outcomes? Am J Obstet Gynecol 191:933–938

    Article  PubMed  Google Scholar 

  4. Raisanen S, Vehvilainen-Julkunen K, Gissler M, Heinonen S (2009) The increased incidence of obstetric anal sphincter rupture- an emerging trend in Finland. Prev Med 49:535–540

    Article  PubMed  Google Scholar 

  5. Ashton-Miller J, Delancey J (2009) On the biomechanics of vaginal birth and common sequelae. Annu Rev Biomed Eng 11:163–176

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  6. Parente M, Natal Jorge R, Mascarenhas T, Fernandes A, Silva-Filho A (2010) Computational modelling of approach to study the effects of fetal head flexion during vaginal delivery. Am J Obstet Gynecol 203(217):E1–E6

    PubMed  Google Scholar 

  7. Lien K, Mooney B, DeLancey J, Ashton-Miller J (2004) Levator ani muscle stretch induced by simulated vaginal birth. Obstet Gynecol 103:31–40

    Article  PubMed Central  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Urogynaecology and Pelvic Floor Reconstructive Surgery, St. George’s Hospital, London, SW17 0QT, UK

    M. Basu, S. Mukerji & S. K. Doumouchtsis

Authors
  1. M. Basu
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  2. S. Mukerji
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  3. S. K. Doumouchtsis
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Corresponding author

Correspondence to M. Basu.

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Basu, M., Mukerji, S. & Doumouchtsis, S.K. Perineal trauma in women undergoing vaginal delivery following intra-uterine fetal demise: a case–control analysis. Int Urogynecol J 25, 61–64 (2014). https://doi.org/10.1007/s00192-013-2148-1

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  • DOI: https://doi.org/10.1007/s00192-013-2148-1

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