{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T01:15:43Z","timestamp":1789780543953,"version":"4.0.1"},"reference-count":14,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2013,12,17]],"date-time":"2013-12-17T00:00:00Z","timestamp":1387238400000},"content-version":"vor","delay-in-days":16,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Birth"],"published-print":{"date-parts":[[2013,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>To assess whether the presence of an episiotomy or spontaneous perineal trauma at the first delivery increases the risk of perineal trauma at the following one.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We studied 2,695 women who gave birth twice at Virgen de las Nieves University Hospital of Granada, Spain. All second deliveries were from 2004 to 2011 and prenatal database records were used to obtain information about the first deliveries. All births, first and second, were single, vaginal, unassisted, and in a cephalic presentation. Two groups were made as follows: Intact perineum (no perineal trauma or first\u2010degree spontaneous tear at the first delivery) and perineal trauma (episiotomy or second\u2010degree or higher spontaneous tear at the first delivery). Both groups were compared according to the degree of perineal trauma at the second delivery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Women included in the perineal trauma group were significantly older and a higher proportion was attended by a midwife with an obstetrician present in the delivery room. No differences were observed according to gestational age, epidural analgesia or fetal birth weight. Adjusting for these possible compounding factors and the year of birth, the risk of undergoing a second\u2010degree or higher spontaneous tear at their next delivery was fivefold (adjusted <jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content> 5.15, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 3.11\u20138.54), and the risk of undergoing an episiotomy in the second delivery was threefold (adjusted <jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content> 3.20, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 2.19\u20134.69) for the perineal trauma group.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The risk of undergoing a spontaneous perineal tear or an episiotomy in the second delivery is increased by the practice of episiotomy in the first one.<\/jats:p><\/jats:sec>","DOI":"10.1111\/birt.12077","type":"journal-article","created":{"date-parts":[[2013,12,17]],"date-time":"2013-12-17T18:52:26Z","timestamp":1387306346000},"page":"307-311","source":"Crossref","is-referenced-by-count":12,"title":["Risk of Episiotomy and Perineal Lacerations Recurring After First Delivery"],"prefix":"10.1111","volume":"40","author":[{"given":"Sebastian","family":"Manzanares","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology Virgen de las Nieves University Hospital Granada Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Davinia","family":"Cobo","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Virgen de las Nieves University Hospital Granada Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Dolores","family":"Moreno\u2010Mart\u00ednez","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Virgen de las Nieves University Hospital Granada Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar","family":"S\u00e1nchez\u2010Gila","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Virgen de las Nieves University Hospital Granada Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alicia","family":"Pineda","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Virgen de las Nieves University Hospital Granada Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2013,12,17]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0020-7292(98)00207-0"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006250-199906000-00025"},{"key":"e_1_2_7_4_1","first-page":"333","article-title":"The association between perineal trauma and spontaneous perineal tears","volume":"50","author":"Martin S","year":"2001","journal-title":"J Fam Pract"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9378(94)90070-1"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2007.06.005"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1159\/000293161"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.3109\/00016349309021127"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9378(96)70579-3"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006254-199511000-00020"},{"key":"e_1_2_7_11_1","first-page":"240","article-title":"Effect of episiotomy on the frequency of vaginal outlet lacerations","volume":"31","author":"Gass MS","year":"1986","journal-title":"J Reprod Med"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.289.6445.587"},{"key":"e_1_2_7_13_1","first-page":"260","article-title":"Selected use of midline episiotomy: effect on perineal trauma","volume":"70","author":"Thorp JM","year":"1987","journal-title":"Obstet Gynecol"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e31816de899"},{"key":"e_1_2_7_15_1","first-page":"302","article-title":"Correlation of perineal outcome at first and second vaginal deliveries","volume":"101","author":"Mahony R","year":"2008","journal-title":"Ir Med 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