Incidence and Risk Factors for Development of Third and Fourth Degree Perineal Tears: A Four Year Experience in a Single Saudi Center

Abstract

Background: Vaginal delivery is a physiological process that holds multiple complications. Perineal trauma and vaginal laceration is considered a common complication associated with vaginal delivery. Well established risk factors, recognized by the Royal College of Obstetricians and Gynecologists, are ethnicity, birth weight over 4 kg, persistent occipital posterior position, nulliparity, induction of labor, shoulder dystocia, instrumental delivery. There are other risk factors that were suggested in the literature but data are conflicting, such as Prolonged second stage of labor, episiotomy and obesity