{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T19:41:50Z","timestamp":1789501310673,"version":"build-2803163510"},"reference-count":34,"publisher":"Federa\u00e7\u00e3o das Associa\u00e7\u00f5es de Ginecologia e Obstetr\u00edcia","issue":"08","license":[{"start":{"date-parts":[[2021,9,21]],"date-time":"2021-09-21T00:00:00Z","timestamp":1632182400000},"content-version":"vor","delay-in-days":51,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Rev Bras Ginecol Obstet"],"published-print":{"date-parts":[[2021,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Objective\u2003In around 85% of vaginal births, the parturients undergo perineal lacerations and\/or episiotomy. The present study aimed to determine the incidence of lacerations and episiotomies among parturients in 2018 in a habitual-risk public maternity hospital in southern Brazil, and to determine the risk and protective factors for such events.<\/jats:p><jats:p>\n          Methodology\u2003A retrospective cross-sectional study. Data were obtained from medical records and analyzed using the Stata software. Univariate and multivariate logistic regressions were performed. Values of p\u2009&lt;\u20090.05 were considered significant.<\/jats:p><jats:p>\n          Results\u2003In 2018, there were 525 vaginal births, 27.8% of which were attended by obstetricians, 70.7% by obstetric nurses, and 1.5% evolved without assistance. Overall, 55.2% of the parturients had some degree of laceration. The professional who attended the birth was a significant variable: a greater number of first- and second-degree lacerations, as well as more severe cases, occurred in births attended by nurses (odds ratio [OR]: 2,95; 95% confidence interval [95%CI]: 1,74 to 5,03). Positions at birth that did not enable perineal protection techniques (expulsive period with the \u201chands-off\u201d method), when analyzed in isolation, determined the risk; however, in the final regression model, this relationship was not confirmed. Although reported in the literature, there were no associations between the occurrence of laceration and age, skin color, or birth weight. In 24% of the births, episiotomy was performed, and doctors performed 63.5% of them.<\/jats:p><jats:p>\n          Conclusion\u2003Births attended by nurses resulted in an increased risk of perineal lacerations, of varying degrees. In turn, those assisted by physicians had a higher occurrence of episiotomy.<\/jats:p>","DOI":"10.1055\/s-0041-1735227","type":"journal-article","created":{"date-parts":[[2021,9,21]],"date-time":"2021-09-21T22:42:27Z","timestamp":1632264147000},"page":"588-594","source":"Crossref","is-referenced-by-count":10,"title":["Perineal Lacerations: A Retrospective Study in a Habitual-Risk Public Maternity"],"prefix":"10.61622","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9898-6079","authenticated-orcid":false,"given":"Lauro Henrique Heinsch","family":"Domenighi","sequence":"additional","affiliation":[{"name":"Medical School, Universidade Franciscana, Santa Maria, Rio Grande do Sul, RS, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2381-9396","authenticated-orcid":false,"given":"Angela Regina Maciel","family":"Weinmann","sequence":"additional","affiliation":[{"name":"Medical School, Universidade Franciscana, Santa Maria, Rio Grande do Sul, RS, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8798-4345","authenticated-orcid":false,"given":"Leris Salete Bonfanti","family":"Haeffner","sequence":"additional","affiliation":[{"name":"Medical School, Universidade Franciscana, Santa Maria, Rio Grande do Sul, RS, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4842-1093","authenticated-orcid":false,"given":"Marcelo Lorensi","family":"Feltrin","sequence":"additional","affiliation":[{"name":"Medical School, Universidade Franciscana, Santa Maria, Rio Grande do Sul, RS, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"47794","published-online":{"date-parts":[[2021,9,21]]},"reference":[{"issue":"06","key":"ref1","doi-asserted-by":"publisher","first-page":"1051","DOI":"10.1080\/14767058.2018.1512574","article-title":"Perineal massage during labor: a systematic review and meta-analysis of randomized controlled trials","volume":"33","author":"C I Aquino","year":"2020","journal-title":"J Matern Fetal Neonatal Med"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"59","DOI":"10.1186\/1471-2393-13-59","article-title":"Incidence of and risk factors for perineal trauma: a prospective observational study","volume":"13","author":"L A Smith","year":"2013","journal-title":"BMC Pregnancy Childbirth"},{"issue":"09","key":"ref3","doi-asserted-by":"publisher","first-page":"1157","DOI":"10.1111\/1471-0528.13472","article-title":"Manual perineal support at the time of childbirth: a systematic review and meta-analysis","volume":"122","author":"S Bulchandani","year":"2015","journal-title":"BJOG"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"10","DOI":"10.1186\/1471-2393-10-10","article-title":"PErineal Assessment and Repair Longitudinal Study (PEARLS): protocol for a matched pair cluster trial","volume":"10","author":"D E Bick","year":"2010","journal-title":"BMC Pregnancy Childbirth"},{"key":"ref5","first-page":"1401","article-title":"Perineal care","volume":"2008","author":"C Kettle","year":"2008","journal-title":"BMJ Clin Evid"},{"issue":"01","key":"ref6","doi-asserted-by":"publisher","first-page":"61","DOI":"10.1007\/s00192-015-2795-5","article-title":"Risk factors for severe obstetric perineal lacerations","volume":"27","author":"M Vale de Castro Monteiro","year":"2016","journal-title":"Int Urogynecol J Pelvic Floor Dysfunct"},{"issue":"01","key":"ref7","doi-asserted-by":"publisher","first-page":"39","DOI":"10.20513\/2447-6595.2019v59n1p39-43","article-title":"[Analysis of the incidence and prevalence of obstetric cause perineal laceration in a tertiary maternity hospital from Fortaleza-CE]","volume":"59","author":"S V Aguiar","year":"2019","journal-title":"Rev Med UFC."},{"key":"ref8","volume-title":"[National guidelines for delivery care: short version]","author":"Minist\u00e9rio da Sa\u00fade","year":"2017"},{"issue":"01","key":"ref9","doi-asserted-by":"publisher","first-page":"e1","DOI":"10.1097\/AOG.0000000000001523","article-title":"Committee on Practice Bulletins-Obstetrics. 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