Risk factors for the breakdown of perineal laceration repair after vaginal delivery

Am J Obstet Gynecol. 2006 Sep;195(3):755-9. doi: 10.1016/j.ajog.2006.06.085.


Objective: The purpose of this study was to identify risk factors that are associated with the breakdown of perineal laceration repair in the postpartum period.

Study design: We conducted a retrospective, case-control study to review perineal laceration repair breakdown in patients who were delivered between September 1995 and February 2005 at the University of Michigan. Bivariate analysis with chi-square test and t-test and stepwise logistic regression analysis were performed.

Results: Fifty-nine cases and 118 control deliveries were identified from a total of 14,124 vaginal deliveries. Risk factors were longer second stage of labor (142 vs 87 minutes; P = .001), operative vaginal delivery (odds ratio, 3.6; 95% CI, 1.8-7.3), mediolateral episiotomy (odds ratio, 6.9; 95% CI, 2.6-18.7), third- or fourth-degree laceration (odds ratio, 3.1; 95% CI, 1.5-6.4), and meconium-stained amniotic fluid (odds ratio, 3.0; 95% CI, 1.1-7.9). Previous vaginal delivery was protective (odds ratio, 0.38; 95% CI, 0.18-0.84). Logistic regression showed the most significant factor to be an interaction between operative vaginal delivery and mediolateral episiotomy (odd ratio, 6.36; 95% CI, 2.18-18.57).

Conclusion: The most significant events were mediolateral episiotomy, especially in conjunction with operative vaginal delivery, third- and fourth-degree lacerations, and meconium.

MeSH terms

  • Adult
  • Case-Control Studies
  • Episiotomy / adverse effects
  • Extraction, Obstetrical / adverse effects*
  • Female
  • Humans
  • Lacerations / surgery*
  • Logistic Models
  • Perineum / injuries*
  • Polyglactin 910
  • Postpartum Period
  • Pregnancy
  • Risk Factors
  • Surgical Wound Dehiscence / epidemiology*
  • Surgical Wound Dehiscence / etiology
  • Sutures


  • Polyglactin 910