ArticleBMC pregnancy and childbirth2020
Risk factors for perineal and vaginal tears in primiparous women - the prospective POPRACT-cohort study.
Article in BMC pregnancy and childbirth, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 41 papers, 1 of them a synthesis that pooled it.
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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
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Who cites it
41 citing papers in PubMed, 1 synthesis or guideline pooled it, 92 citations in OpenAlex.
- Efficacy of obstetrics forceps and vacuum extractor to assist during vaginal delivery: systematic review and meta-analysis.Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia · 2025Pooled it
- Pelvic floor symptoms and quality of life 1 year postpartum in Swedish primiparous women-A follow-up of a randomized controlled trial.Acta obstetricia et gynecologica Scandinavica · 2026Trial
- Use of surgical glue versus suture to repair perineal tears: a randomised controlled trial.BMC pregnancy and childbirth · 2023Trial
- Impact of gestational weight gain on perineal injury and obstetric anal sphincter injury among underweight primiparous women.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2026Article
- Episiotomy and the risk of obstetric anal sphincter injury in nulliparous women with a prolonged second stage.Archives of gynecology and obstetrics · 2026Article
- Rectal buttonhole tear during parturition: A case report and literature review.BMC pregnancy and childbirth · 2026Review
- Impact of maternal age on the risk of perineal injury and obstetric anal sphincter injury in nulliparous women.Archives of gynecology and obstetrics · 2026Article
- Impact of gestational weight gain on perineal injury in overweight and obese primiparous women.Archives of gynecology and obstetrics · 2026Article
- Decellularization method and tissue region impact the structural properties and composition of porcine vaginal extracellular matrix.Acta biomaterialia · 2026Article
- The Impact of Maternal BMI on the Efficacy and Safety of Oral Misoprostol for Labor Induction.Pharmaceuticals (Basel, Switzerland) · 2025Article
- Clinical guidance paper VVOG-CRGOLFB prevention and management of obstetrical perineal trauma.European journal of obstetrics & gynecology and reproductive biology: X · 2025Article
- Maternal BMI and Diagnostic Accuracy of Using Estimated Fetal Growth to Predict Abnormal Birthweight: Results from NICHD Fetal Growth Studies.Diagnostics (Basel, Switzerland) · 2025Article
- Perspective on Perinatal Birth Canal Injuries: An Analysis of Risk Factors, Injury Mechanisms, Treatment Methods, and Patients' Quality of Life: A Literature Review.Journal of clinical medicine · 2025Review
- Levator Ani Deficiency and Pelvic Floor Dysfunction 1 Year Postpartum: A Prospective Nested Case-Control Study.BJOG : an international journal of obstetrics and gynaecology · 2025Article
- Bothersome Pelvic Floor Dysfunction and Quality of Life During Pregnancy and Postpartum in Primiparous Women.International urogynecology journal · 2025Article
- Strategies for improving maternal care for ethnic minority women with obstetric anal sphincter injuries in the UK.BMC health services research · 2025Article
- Parenting stress after perineal tear during childbirth: the role of physical health and depressive symptoms.Frontiers in psychology · 2025Article
- Antenatal Anovaginal Distance, a Potential Indicator of Perineal Damage during Pregnancy.Healthcare (Basel, Switzerland) · 2024Article
- Vacuum-assisted delivery outcomes: is advanced maternal age a factor?Archives of gynecology and obstetrics · 2024Article
- Analysis of Maternal Positions during the Dilation and Expulsive Phase and Their Relationship with Perineal Injuries in Eutocic Deliveries Attended by Midwives.Healthcare (Basel, Switzerland) · 2024Article
Corrections and comments
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Authors and funding
6 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundThe aim of this study was to estimate the incidence of second-degree perineal tears, obstetric anal sphincter injuries (OASI), and high vaginal tears in primiparous women, and to examine how sociodemographic and pregnancy characteristics, hereditary factors, obstetric management and the delivery process are associated with the incidence of these tears.
methodsAll nulliparous women registering at the maternity health care in Region Örebro County, Sweden, in early pregnancy between 1 October 2014 and 1 October 2017 were invited to participate in a prospective cohort study. Data on maternal and obstetric characteristics were extracted from questionnaires completed in early and late pregnancy, from a study-specific delivery protocol, and from the obstetric record system. These data were analyzed using unadjusted and adjusted multinomial and logistic regression models.
resultsA total of 644 women were included in the study sample. Fetal weight exceeding 4000 g and vacuum extraction were found to be independent risk factors for both second-degree perineal tears (aOR 2.22 (95% CI: 1.17, 4.22) and 2.41 (95% CI: 1.24, 4.68) respectively) and OASI (aOR 6.02 (95% CI: 2.32, 15.6) and 3.91 (95% CI: 1.32, 11.6) respectively). Post-term delivery significantly increased the risk for second-degree perineal tear (aOR 2.44 (95% CI: 1.03, 5.77), whereas, maternal birth positions with reduced sacrum flexibility significantly decreased the risk of second-degree perineal tear (aOR 0.53 (95% CI 0.32, 0.90)). Heredity of pelvic floor dysfunction and/or connective tissue deficiency, induced labor, vacuum extraction and fetal head circumference exceeding 35 cm were independent risk factors for high vaginal tears (aOR 2.32 (95% CI 1.09, 4.97), 3.16 (95% CI 1.31, 7.62), 2.53 (95% CI: 1.07, 5.98) and 3.07 (95% CI 1.5, 6.3) respectively).
conclusionThe present study corroborates previous findings of vacuum extraction and fetal weight exceeding 4000 g as risk factors of OASI. We found that vacuum extraction is a risk factor for second-degree tear, and vacuum extraction, fetal head circumference exceeding 35 cm and heredity of pelvic floor dysfunction and/or connective tissue deficiency were associated with increased risk of high vaginal tears. These findings have not been documented previously and should be confirmed by additional studies.
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