How do sustained birth tears after vaginal birth affect birth tear patterns in a subsequent birth?
-
Nina Kimmich
,
Audrey Yeo Te-ying
Abstract
Background
Tears are common after vaginal birth, and different impact factors are known. However, the impact of tears from a previous birth to the tears of a subsequent birth is unknown. Therefore, we aimed to evaluate the distribution of birth tear patterns according to the sustained tears in a previous birth, in addition to other impact factors.
Methods
In a retrospective cohort study, we evaluated all women up to parity 4 with subsequent vaginal, singleton births of vertex presentation at ≥37 + 0 gestational weeks between 1/2005 and 12/2016. Their tears were grouped into tear patterns and were analyzed by parity. Tear patterns in the subsequent births were analyzed in association to the patterns of the previous births and impact factors were evaluated.
Results
We counted 4017 births in 1855 women [P1: 1368 (34.1%), P2: 1730 (43.1%), P3: 741 (18.4%), P4: 178 (4.4%)]. The frequency of tears and episiotomies decreased with higher parity, whereas the frequency of intact perineum increased. Twenty-eight different unique tear patterns were found. We could show that birth tear patterns changed with increasing parity and were associated with sustained tears in a previous birth. In addition, some impact factors on tear patterns could be identified.
Conclusion
The distribution of the single tear types is in accordance with the current literature. However, it is new that distinct tear patterns are associated to sustained tear patterns of previous births. Furthermore, we demonstrated some weak associations of tear patterns to certain impact factors, such as more episiotomies, low-grade perineal or vaginal tears isolated or in combination with other tears with increasing fetal weight and head circumference in the higher parities, and with a longer duration of the second stage and the pushing phase in lower parities.
Author contributions: NK: project development, data collection and management, manuscript writing; AY: data management, statistical analysis, manuscript editing; RZ: project development, manuscript editing; EF: data management, statistical analysis, manuscript editing. All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.
Research funding: None declared.
Employment or leadership: None declared.
Honorarium: None declared.
Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.
Ethical approval: The study was approved by the ethical board of the district (KEK-ZH-No. 2016-02079).
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Articles in the same Issue
- Frontmatter
- Editorial
- Women and children first: the need for ringfencing during the COVID-19 pandemic
- Review
- The decline of amniocentesis and the increase of chorionic villus sampling in modern perinatal medicine
- Original Articles – Obstetrics
- Fetal renal artery impedance in pregnancies affected by preeclampsia
- The effect of maternal position on fetal middle cerebral artery Doppler indices and its association with adverse perinatal outcomes: a pilot study
- Interpregnancy interval and the risk for recurrence of placental mediated pregnancy complications
- Short- and long-term outcomes of preterm spontaneous twin anemia-polycythemia sequence
- How do sustained birth tears after vaginal birth affect birth tear patterns in a subsequent birth?
- Disorders of placental villous maturation in fetal death
- Atrial septal aneurysm in pregnancy: echocardiography and obstetric outcomes
- Appropriate delivery method for cardiac disease pregnancy based on noninvasive cardiac monitoring
- Original Articles – Fetus
- Success rate of five fetal cardiac views using HDlive Flow with spatiotemporal image correlation at 18–21 and 28–31 weeks of gestation
- Fetal brain development in small-for-gestational age (SGA) fetuses and normal controls
- Can fetal fractions in the cell-free DNA test predict the onset of fetal growth restriction?
- Original Articles – Newborns
- Presence of neonatal intensive care services at birth hospital and early intervention enrollment in infants ≤1500 g
- The contribution of twins conceived by in vitro fertilization to preterm birth rate: observations from a quarter of century
- Burnout in neonatal intensive care unit nurses: relationships with moral distress, adult attachment insecurities, and proneness to guilt and shame
Articles in the same Issue
- Frontmatter
- Editorial
- Women and children first: the need for ringfencing during the COVID-19 pandemic
- Review
- The decline of amniocentesis and the increase of chorionic villus sampling in modern perinatal medicine
- Original Articles – Obstetrics
- Fetal renal artery impedance in pregnancies affected by preeclampsia
- The effect of maternal position on fetal middle cerebral artery Doppler indices and its association with adverse perinatal outcomes: a pilot study
- Interpregnancy interval and the risk for recurrence of placental mediated pregnancy complications
- Short- and long-term outcomes of preterm spontaneous twin anemia-polycythemia sequence
- How do sustained birth tears after vaginal birth affect birth tear patterns in a subsequent birth?
- Disorders of placental villous maturation in fetal death
- Atrial septal aneurysm in pregnancy: echocardiography and obstetric outcomes
- Appropriate delivery method for cardiac disease pregnancy based on noninvasive cardiac monitoring
- Original Articles – Fetus
- Success rate of five fetal cardiac views using HDlive Flow with spatiotemporal image correlation at 18–21 and 28–31 weeks of gestation
- Fetal brain development in small-for-gestational age (SGA) fetuses and normal controls
- Can fetal fractions in the cell-free DNA test predict the onset of fetal growth restriction?
- Original Articles – Newborns
- Presence of neonatal intensive care services at birth hospital and early intervention enrollment in infants ≤1500 g
- The contribution of twins conceived by in vitro fertilization to preterm birth rate: observations from a quarter of century
- Burnout in neonatal intensive care unit nurses: relationships with moral distress, adult attachment insecurities, and proneness to guilt and shame
