Deering Shad H, Carlson Nicole, Stitely Michael, Allaire Alexander D, Satin Andrew J
Department of Obstetrics and Gynecology, National Naval Medical Center, Bethesda, Maryland, USA.
J Reprod Med. 2004 Apr;49(4):306-10.
To define normal perineal body length during labor and determine if a shortened perineal body is associated with perineal lacerations or operative vaginal delivery.
We reviewed charts of patients admitted for labor over a 4-month period. The perineal body was measured by the admitting physician and delivery outcomes obtained from inpatient records. Patients were excluded for malpresentation, multiple gestation, gestational age < 36 weeks, incomplete records and scheduled cesarean delivery. To determine if differences existed between patients with perineal body measurements available and those without, chi2 analysis was used, with P<.05 considered significant. Multiple logistic regression was used to control for confounding variables and determine if a shortened perineal body affected the incidence of operative vaginal delivery and significant lacerations at vaginal delivery.
A total of 234 patients met our inclusion criteria; perineal body measurements were available for 133 (57%). The average perineal body length was 3.90 cm (+/-0.70). Patients with a perineal body of < or = 2.5 cm had a significantly higher chance of sustaining a third- or fourth-degree laceration (40% vs. 5.6%, P=.004). This risk remained after controlling for both operative vaginal delivery and episiotomy. The incidence of operative vaginal delivery was greater (28.5% vs. 9.2%, P =.006) for patients with a perineal body < or = 3.5 cm.
There is an increased risk of significant lacerations and operative vaginal delivery in patients with a shortened perineal body.
确定分娩时正常会阴体长度，并确定会阴体缩短是否与会阴裂伤或阴道助产分娩相关。
我们回顾了4个月期间收治的分娩患者的病历。由入院医生测量会阴体，并从住院记录中获取分娩结局。排除胎位异常、多胎妊娠、孕周<36周、记录不完整及计划剖宫产的患者。为确定有会阴体测量值的患者与没有测量值的患者之间是否存在差异，采用卡方分析，P<0.05认为有统计学意义。采用多因素逻辑回归控制混杂变量，并确定会阴体缩短是否影响阴道助产分娩的发生率及阴道分娩时严重裂伤的发生率。
共有234例患者符合纳入标准；133例（57%）有会阴体测量值。会阴体平均长度为3.90 cm（±0.70）。会阴体≤2.5 cm的患者发生三度或四度裂伤的几率显著更高（40%对5.6%，P = 0.004）。在控制阴道助产分娩和会阴切开术后，这种风险仍然存在。会阴体≤3.5 cm的患者阴道助产分娩的发生率更高（28.5%对9.2%，P = 0.006）。
会阴体缩短的患者发生严重裂伤和阴道助产分娩的风险增加。
