ArticleObstetrics and gynecology2011
Characteristics associated with severe perineal and cervical lacerations during vaginal delivery.
Article in Obstetrics and gynecology, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 68 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
68 citing papers in PubMed, 2 syntheses or guidelines pooled it, 179 citations in OpenAlex.
- Risk of cervical laceration in forceps vs vacuum delivery: A systematic review and meta-analysis.Acta obstetricia et gynecologica Scandinavica · 2025Pooled it
- Guidelines for the management of third and fourth degree perineal tears after vaginal birth from the Austrian Urogynecology Working Group.International urogynecology journal · 2013Guideline
- First and Second Stage Risk Factors Associated with Perineal Lacerations.Maternal and child health journal · 2024Trial
- Odon device for instrumental vaginal deliveries: results of a medical device pilot clinical study.Reproductive health · 2018Trial
- A multi-centre, non-inferiority, randomised controlled trial to compare a cervical pessary with a cervical cerclage in the prevention of preterm delivery in women with short cervical length and a history of preterm birth - PC study.BMC pregnancy and childbirth · 2017Trial
- Maternal body mass index and risk of obstetric anal sphincter injury.BioMed research international · 2014Trial
- Intrapartum point-of-care ultrasound for assisting diagnosis of fetal head descending through buttonhole cervical tear.Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology · 2026Article
- Overview of Silk Fibroin Injectable Hydrogels: Advances and Applications in Regenerative Medicine.Advanced healthcare materials · 2026Review
- IUGA International Guidelines on Obstetric Anal Sphincter Injuries.International urogynecology journal · 2026Article
- Is amniotomy a risk factor for severe perineal trauma? -A Swedish nationwide register study.BMC pregnancy and childbirth · 2026Article
- Sexual and bowel function in women with obstetric anal sphincter injuries after perineoplasty and sphincterorrhaphy.Narra J · 2026Article
- Incidence and Risk Factors of Obstetric Anal Sphincter Injury at a Tertiary Care Hospital in Thailand: A 10-Year Retrospective Cohort Study.International urogynecology journal · 2026Article
- Evaluation of cervical healing in a rat model using alginate hydrogel embedded with platelet-rich plasma.Molecular biology reports · 2026Article
- Impact of intrapartum cervical tear on subsequent pregnancy outcomes.BMC pregnancy and childbirth · 2025Article
- Inner myometrial laceration complicated by severe antepartum haemorrhage: a narrative review and case report.BMC pregnancy and childbirth · 2025Review
- Levator plate function may be important in maintaining fecal continence after obstetric anal sphincter injury repair: a pilot perineal and endovaginal ultrasound analysis.Journal of ultrasound · 2025Article
- Vaginal biomechanical function in premenopausal and postmenopausal women with and without pelvic organ prolapse.Scientific reports · 2025Article
- Racial and ethnic disparities in obstetric anal sphincter injury: cross-sectional study in the USA.Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology · 2025Article
- The effect of an exam-indicated cerclage before 24 weeks of gestation to prevent preterm birth: A systematic review and meta-analysis.European journal of obstetrics & gynecology and reproductive biology: X · 2025Review
- Utilizing machine learning to predict the risk factors of episiotomy in parturient women.AJOG global reports · 2025Article
8 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
21 authors at 1 institution in 1 country.
Funding
Abstract
objectiveTo characterize potentially modifiable risk factors for third- or fourth-degree perineal lacerations and cervical lacerations in a contemporary U.S. obstetric practice.
methodsThe Consortium on Safe Labor collected electronic medical records from 19 hospitals within 12 institutions (228,668 deliveries from 2002 to 2008). Information on patient characteristics, prenatal complications, labor and delivery data, and maternal and neonatal outcomes were collected. Only women with successful vaginal deliveries of cephalic singletons at 34 weeks of gestation or later were included; we excluded data from sites lacking information about lacerations at delivery and deliveries complicated by shoulder dystocia; 87,267 and 71,170 women were analyzed for third- or fourth-degree and cervical lacerations, respectively. Multivariable logistic regressions were used to adjust for other factors.
resultsThird- or fourth-degree lacerations occurred in 2,516 women (2,223 nulliparous [5.8%], 293 [0.6%] multiparous) and cervical lacerations occurred in 536 women (324 nulliparous [1.1%], 212 multiparous [0.5%]). Risks for third- or fourth-degree lacerations included nulliparity (7.2-fold risk), being Asian or Pacific Islander, increasing birth weight, operative vaginal delivery, episiotomy, and longer second stage of labor. Increasing body mass index was associated with fewer lacerations. Risk factors for cervical lacerations included young maternal age, vacuum vaginal delivery, and oxytocin use among multiparous women, and cerclage regardless of parity.
conclusionOur large cohort of women with severe obstetric lacerations reflects contemporary obstetric practices. Nulliparity and episiotomy use are important risk factors for third- or fourth-degree lacerations. Cerclage increases the risk for cervical lacerations. Many identified risk factors may not be modifiable.
Indexed as
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.