title: Perineal trauma after vaginal delivery in healthy pregnant women.
abstract: OBJECTIVE
  Despite all the medical care provided during delivery labor, perineal injury is still prevalent and may lead to diverse pelvic floor disorders. The aim here was to investigate the prevalence of obstetric and anal sphincter injuries (OASIS) in healthy pregnant women after vaginal delivery.
  
  
  METHODS
  Cross-sectional study involving 3,034 patients with singletons in a secondary hospital for low-risk cases.
  
  
  METHODS
  A standardized questionnaire was prepared and applied to medical files that had been completely filled out (classification of the Royal College of Obstetricians and Gynecologists, RCOG) in order to identify OASIS and analyze risk factors associated with mild and severe perineal lacerations.
  
  
  RESULTS
  The women's mean age was 25 years; more than half (54.4%) were primiparae. Almost 38% of the participants had perineal lacerations; these were severe in 0.9% of the cases. Previous vaginal delivery (odds ratio, OR: 1.64 [1.33-2.04]) and forceps delivery (OR: 2.04 [1.39-2.97]) were risk factors associated with mild perineal injuries (1st and 2nd OASIS classifications). Only remaining standing for prolonged periods during professional activity (OR: 2.85 [1.34-6.09]) was associated with severe perineal injuries.
  
  
  CONCLUSIONS
  The prevalence of severe perineal injuries was concordant with data in the literature. The variable of standing position was considered to be a risk factor for severe perineal injury and should be further investigated.
authors: Department of Gynecology and Obstetrics, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, São Paulo, Brazil.
authors: Larissa Santos
authors: LS
authors: Oliveira
authors: Department of Gynecology and Obstetrics, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, São Paulo, Brazil.
authors: Luiz Gustavo Oliveira
authors: LG
authors: Brito
authors: Department of Gynecology and Obstetrics, Universidade de São Paulo, Ribeirão Preto, São Paulo, Brazil.
authors: Silvana Maria
authors: SM
authors: Quintana
authors: Department of Gynecology and Obstetrics, Universidade de São Paulo, Ribeirão Preto, São Paulo, Brazil.
authors: Geraldo
authors: G
authors: Duarte
authors: Department of Gynecology and Obstetrics, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, São Paulo, Brazil.
authors: Alessandra Cristina
authors: AC
authors: Marcolin
mesh_terms: D000328:Adult; D001003:Anal Canal / Q000293:injuries*; D001938:Brazil / Q000453:epidemiology; D003430:Cross-Sectional Studies; D036861:Delivery, Obstetric / Q000009:adverse effects*; D004841:Episiotomy / Q000009:adverse effects; D005260:Female; D006801:Humans; D007748:Labor Stage, Second; D022125:Lacerations / Q000145:classification / Q000453:epidemiology*; D015999:Multivariate Analysis; D007744:Obstetric Labor Complications / Q000453:epidemiology*; D016017:Odds Ratio; D010502:Perineum / Q000293:injuries*; D011187:Posture / Q000502:physiology; D011247:Pregnancy; D015995:Prevalence; D012307:Risk Factors; D011795:Surveys and Questionnaires; D055815:Young Adult