{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T06:17:57Z","timestamp":1789107477098,"version":"build-2803163510"},"reference-count":34,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2010,12,31]],"date-time":"2010-12-31T00:00:00Z","timestamp":1293753600000},"content-version":"vor","delay-in-days":1644,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2006,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p><jats:italic>Background.<\/jats:italic> To determine risk factors for third\u2010degree and complete third\u2010 or fourth\u2010degree anal sphincter tears in vaginal delivery.<\/jats:p><jats:p><jats:italic>Methods.<\/jats:italic> This is a retrospective comparative study. Fifty\u2010three women who had sustained an anal sphincter tear were compared with 9,178 women without such a complication between August 1997 and October 2001. Obstetric data was collected from an electronic database. The main outcome measures were odds ratios.<\/jats:p><jats:p><jats:italic>Results.<\/jats:italic> In the whole study population, odds ratios (ORs) for third\u2010degree tears were: primiparity, 8.34 (95% confidence interval [CI] 3.98\u201317.48); vacuum extraction, 5.22 (95% CI 2.69\u201310.13); parietal presentation, 3.97 (95% CI 1.16\u201313.64); and birth weight &gt;4,000 g, 3.77 (95% CI 2.11\u20136.68); and for complete third\u2010 or fourth\u2010degree tears odds ratios were 5.42, 2.98, 5.64, and 3.01, respectively. In multivariate analysis, mediolateral episiotomy appeared to be protective as regards third\u2010degree tears (OR 0.37 [95% CI 0.2020\u20130.70]).<\/jats:p><jats:p><jats:italic>Conclusions.<\/jats:italic> Vacuum\u2010assisted vaginal delivery bears an increased risk of third\u2010degree anal sphincter tears in a maternity unit where forceps are not used. Restricted use of mediolateral episiotomy may have a protective effect on the perineum.<\/jats:p>","DOI":"10.1080\/00016340500408283","type":"journal-article","created":{"date-parts":[[2009,12,8]],"date-time":"2009-12-08T17:34:46Z","timestamp":1260293686000},"page":"856-860","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":39,"title":["The role of mediolateral episiotomy during labour. 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