{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,13]],"date-time":"2026-06-13T09:40:34Z","timestamp":1781343634030,"version":"3.54.1"},"reference-count":40,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2024,2,2]],"date-time":"2024-02-02T00:00:00Z","timestamp":1706832000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100012446","name":"Akershus Universitetssykehus","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100012446","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Birth"],"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The amount of tissue trauma within second\u2010degree perineal tears varies widely. Therefore, subcategorization of second\u2010degree tears and a better understanding of their occurrence and risk factors are needed. The aim of this study was to assess the occurrence of perineal tears when second\u2010degree tears were subcategorized. Furthermore, we aimed to assess the association between variables related to perineal anatomy and other potential risk factors, with second\u2010degree tear subcategories.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This prospective cohort study included 880 primiparous and multiparous women giving birth to one child vaginally. Perineal tears were categorized using the classification system recommended by the Royal College of Obstetricians and Gynaecologists. In addition, second\u2010degree tears were subcategorized as 2A, 2B, or 2C according to the percentage of damage to the perineal body. Selected variables related to perineal anatomy were as follows: length of genital hiatus; perineal body length; and previous perineal trauma. Risk factors for second\u2010degree tear subcategories were analyzed using a multinominal regression model.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Perineal tears occurred as follows: first\u2010degree: 35.6% (<jats:italic>n<\/jats:italic>\u2009=\u2009313), 2A: 16.3% (<jats:italic>n<\/jats:italic>\u2009=\u2009143), 2B: 9.1% (<jats:italic>n<\/jats:italic>\u2009=\u200980), 2C: 6.6% (<jats:italic>n<\/jats:italic>\u2009=\u200958), and third\u2010 or fourth\u2010degree: 1.6% (<jats:italic>n<\/jats:italic>\u2009=\u200914). In total, 169\/880 participants underwent an episiotomy. When episiotomies were excluded, the risk for 2B, or 2C tears increased with smaller genital hiatus, larger perineal body, previous perineal trauma, primiparity, higher gestational age, instrumental vaginal delivery and fetal presentation other than occiput anterior.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The occurrence of second\u2010degree tear subcategories was 16.3% for 2A tears, 9.1% for 2B tears, and 6.6% for 2C tears. Factors related to perineal anatomy increased the odds for experiencing a second\u2010degree tear in a more severe subcategory.<\/jats:p><\/jats:sec>","DOI":"10.1111\/birt.12817","type":"journal-article","created":{"date-parts":[[2024,2,2]],"date-time":"2024-02-02T12:03:56Z","timestamp":1706875436000},"page":"602-611","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Occurrence and risk factors for second\u2010degree perineal tears: A prospective cohort study using a detailed classification system"],"prefix":"10.1111","volume":"51","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0983-8603","authenticated-orcid":false,"given":"Marthe D.","family":"Macedo","sequence":"first","affiliation":[{"name":"Division Akershus University Hospital, Faculty of Medicine University of Oslo  Oslo Norway"},{"name":"Department of Obstetrics and Gynecology Akershus University Hospital  L\u00f8renskog Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeanette","family":"Risl\u00f8kken","sequence":"additional","affiliation":[{"name":"Division Akershus University Hospital, Faculty of Medicine University of Oslo  Oslo Norway"},{"name":"Department of Obstetrics and Gynecology Akershus University Hospital  L\u00f8renskog Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tuva","family":"Halle","sequence":"additional","affiliation":[{"name":"Division Akershus University Hospital, Faculty of Medicine University of Oslo  Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie","family":"Ellstr\u00f6m\u00a0Engh","sequence":"additional","affiliation":[{"name":"Division Akershus University Hospital, Faculty of Medicine University of Oslo  Oslo Norway"},{"name":"Department of Obstetrics and Gynecology Akershus University Hospital  L\u00f8renskog Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Franziska","family":"Siafarikas","sequence":"additional","affiliation":[{"name":"Division Akershus University Hospital, Faculty of Medicine University of Oslo  Oslo Norway"},{"name":"Department of Obstetrics and Gynecology Akershus University Hospital  L\u00f8renskog Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,2,2]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/birt.12389"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2393-13-59"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/birt.12267"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.0001-6349.2001.10182.x"},{"issue":"11","key":"e_1_2_7_6_1","first-page":"560","article-title":"Obstetric vulvar lacerations and postpartum dyspareunia","volume":"59","author":"Ventolini G","year":"2014","journal-title":"J Reprod Med"},{"key":"e_1_2_7_7_1","unstructured":"Royal College of Obstetricians and Gynaecologists (RCOG) NICE.The management of third\u2010 and fourth\u2010 degree perineal tears Green\u2010top guideline no. 29.2015. 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