Perineal body length and prevention of perineal lacerations during delivery in cameroonian primigravid patients.

Abstract

The rate of perineal tears in Cameroonian primiparous women is reported to be up to 59.7%. The present study aimed to assess the relationship between perineal length and perineal tears. We conducted a prospective study of primiparous women with singleton pregnancies of at least 36+6 weeks length. The admitting physician measured the length of the perineal body at the first stage of labor and this value was hidden from the delivery personnel until delivery occurred. The presence of perineal trauma and other delivery characteristics were recorded. Data were analyzed using univariate analyses and multiple logistic regression. The mean perineal body length was 3.21±0.75cm (range 1.5-5.5cm). 34 (33.0%) primiparous women sustained spontaneous perineal tears and 20 (19.4%) had episiotomies. No third- or fourth-degree perineal tears were observed. Perineal body length shorter than 2.5cm was a significant (P<0.04) predictor of spontaneous perineal lacerations (58.3% vs. 29.7% with relative risk 0.59). Both duration of second stage of labor longer than 60min and occiput posterior presentation were associated with an increased risk of episiotomy in primiparous patients. Perineal body length less than 2.5cm significantly predisposed to spontaneous perineal lacerations.