Objective This study aimed to evaluate III and IV degree tears rates and related risk factors in a single Italian centre. The secondary goal was to build a predictive model based on identified risk factors. Study design This was a retrospective cohort study. All vaginal deliveries from 2011 to 2015 in a single Italian University Hospital were analysed. Univariate analysis was applied to evaluate the overall association between each factor and severe tear. Multivariate logistic regression was used to build a predictive model for the absolute risk of severe tear. We computed a resampling validated measure (AUC) of the predictive accuracy of the model and we provided a nomogram for the risk calculation in clinical practice. Results 62 out of 10133 patients (0.61%) had a severe perineal tear. Univariate analysis identified gestational age >40 weeks, nulliparity, moderate/severe obesity, oxytocin use in pushing stage, sinciput presentation, instrumental delivery, shoulder dystocia, pushing stage ≥90 min, lithotomy position, birth weight >4 kg, head circumference at birth >34 cm and length at birth >50 cm as risk factors. Multivariate analysis identify moderate/severe obesity (OR = 2.8), instrumental delivery (OR = 2.6) and birth weight (OR = 1.1/hg) as independent risk factors. Using the predicted risk score from the final model (bootstrap-validated AUC 70%), we designed a nomogram for severe perineal tears absolute risk calculation. Conclusion Moderate/severe obesity, instrumental delivery and foetal weight resulted as independent risk factors for severe obstetrical tears.
Frigerio, M., Manodoro, S., Bernasconi, D., Verri, D., Milani, R., & Vergani, P. (2018). Incidence and risk factors of third- and fourth-degree perineal tears in a single Italian scenario. EUROPEAN JOURNAL OF OBSTETRICS, GYNECOLOGY, AND REPRODUCTIVE BIOLOGY, 221, 139-143 [10.1016/j.ejogrb.2017.12.042].
Citazione: | Frigerio, M., Manodoro, S., Bernasconi, D., Verri, D., Milani, R., & Vergani, P. (2018). Incidence and risk factors of third- and fourth-degree perineal tears in a single Italian scenario. EUROPEAN JOURNAL OF OBSTETRICS, GYNECOLOGY, AND REPRODUCTIVE BIOLOGY, 221, 139-143 [10.1016/j.ejogrb.2017.12.042]. | |
Tipo: | Articolo in rivista - Articolo scientifico | |
Carattere della pubblicazione: | Scientifica | |
Presenza di un coautore afferente ad Istituzioni straniere: | No | |
Titolo: | Incidence and risk factors of third- and fourth-degree perineal tears in a single Italian scenario | |
Autori: | Frigerio, M; Manodoro, S; Bernasconi, D; Verri, D; Milani, R; Vergani, P | |
Autori: | ||
Data di pubblicazione: | 2018 | |
Lingua: | English | |
Rivista: | EUROPEAN JOURNAL OF OBSTETRICS, GYNECOLOGY, AND REPRODUCTIVE BIOLOGY | |
Digital Object Identifier (DOI): | http://dx.doi.org/10.1016/j.ejogrb.2017.12.042 | |
Appare nelle tipologie: | 01 - Articolo su rivista |