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].

Incidence and risk factors of third- and fourth-degree perineal tears in a single Italian scenario

Frigerio, M
;
Manodoro, S
;
Bernasconi, DP;Verri, D;Milani, R;Vergani, P.
2018

Abstract

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.
Articolo in rivista - Articolo scientifico
Obstetric anal sphincter injuries; Predictive model; Risk factors; Severe perineal tears;
Obstetric anal sphincter injuries; Predictive model; Risk factors; Severe perineal tears; Reproductive Medicine; Obstetrics and Gynecology
English
2018
221
139
143
none
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].
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10281/180308
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