Perineal body length as a predictor of labor progress

Abstract

Background: Trauma to the genital tract does occur in about two thirds of women during the first and subsequent deliveries and the majority of these traumas require suturing. There is a continuous inverse relationship between the rate of episiotomy and the rate of spontaneous trauma. Perineal trauma is associated with a high prevalence of certain health problems. Perineal pain is the most significant with its impact on daily activities. Objective: The aim was to assess the relationship between the length of perineal body and mode of delivery, need for episiotomy and possibility of perineal and vaginal tears needing repair. Patients and Methods: This study was conducted at Maternity Hospital, Faculty of Medicine, Zagazig University. All patients were subjected to the following: Complete history taking, complete general examination and antenatal care. Procedure: The perineum was measured as the distance from the fourchette (the mid-point of the posterior edge of the vaginal interoitus at the muco-cutaneous junction) to the center of the anal orifice. Measurement was performed by trained research nurses using standard tape in dorsal lithotomy position. Results: This study showed that perineal tear, was present among 32.6% of the studied group. This study showed that need for episiotomy was 78.3%. The percentage of perineal tear was statistically lower among cases with perineal length > 4 cm than cases with perineal length < 4 cm (5.9% and 48.3%). The percentage for need of episiotomy was statistically lower among cases with perineal length > 4 cm than cases with perineal length < 4 cm (64.7% and 86.2%). Women with shortened perineal body length (< 4 cm) had a higher chance of a perineal laceration. Conclusion: Longer perineum is associated with increase in the duration of the second stage of labor. The incidence of episiotomy and perineal tears were increased in patients with a perineal length of <4 cm.