Clinical analysis of 83 cases of perineal Ⅲ-Ⅳ degree laceration / 中国实用妇科与产科杂志

ABSTRACT

OBJECTIVE: To investigate the reasons and prevention and treatment measures of acute third-and fourthdegree obstetric lacerations.METHODS: A retrospective analysis of 83 cases of acute third-and fourth-degree obstetric lacerations in the First Affiliated Hospital of Kunming Medical University from 2010 to 2016 was performed.RESULTS:(1)The incidence of 3 rd or 4 th degree laceration was 0.394%(83/21 083),which was 0.433%(72/16 620)in primiparas and 0.246%(11/4463)in multiparous women,there being a statistical difference(P<0.05).(2)The incidence of 3 rd or 4 th degree laceration was significantly increased in the group with episiotomy than without episiotomy[0.583%(48/8229)vs.0.272%(35/12 854),P<0.05].(3)The incidence of 3 rd or 4 th degree laceration was significantly increased in the group with Forceps delivery than without Forceps deliery[3.120%(37/1186)vs.0.231%(46/19 897),P<0.05].(4)In patients with forceps delivery,the incidence of 3 rd or 4 th degree laceration was 2.911%(28/962)in episiotomy group and 4.018%(9/224)in without episiotomy group,there being a significant difference(P<0.05).(5)The incidence of 3 rd or 4 th degree laceration was significantly increased in the macrosomia group than in the non-macrosomia group[1.225%(11/898)vs.0.357%(72/20 185),P<0.05].(6)The incidence of 3 rd or 4 th degree laceration was significantly increased in the prolonged second stage group than in the normal second stage group[2.381%(24/1008)vs.0.294%(59/20 075),P<0.05].CONCLUSION: The incidence of third-and fourth-degree obstetric lacerations is increased in primiparous women,episiotomy,forceps delivery,forceps delivery without episiotomy,big fetal weight and prolonged second stage.