{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T00:52:00Z","timestamp":1776905520748,"version":"3.51.2"},"reference-count":35,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,4,19]],"date-time":"2026-04-19T00:00:00Z","timestamp":1776556800000},"content-version":"vor","delay-in-days":18,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Obstet and Gynaecol"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To estimate average perineal length during first and second stages of labor and its association with composite perineal tears.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A prospective observational study was conducted at a tertiary institute in Southern India. Perineal length was measured using a sterile flexible tape; an episiotomy was made when the perineum appeared stretched and thinned out. Composite tears and obstetric anal sphincter injuries (OASI) were detected clinically. Incidence of tears and their association with perineal length was analyzed using a chi\u2010squared test and log binomial regression was used to estimate adjusted relative risk (aRR). We used receiver operating characteristic curve to find the optimal cut off for predicting the occurrence of composite tears.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      We recruited 553 women. The mean perineal length was 3.5\u2009\u00b1\u20090.5 cm and 4.5\u2009\u00b1\u20090.5\u2009cm in the first and second stages of labor, respectively. The incidence of composite perineal tear and obstetric anal sphincter injuries (OSAIS) were 7.6% and 0.54%, respectively. OASIS was 2.5% in women who underwent instrumental delivery, and a shorter perineum (&lt;\u20093\u2009cm) involved the anal sphincter (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.01) during instrumental delivery. A perineal length of \u2264\u20093.2\u2009cm in the first stage was independently associated with composite perineal tears (aRR\u2009=\u20092.5) after adjusting for birth weight, duration of the second\u2010stage labor, and mode of delivery.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Mean perineal length at the first stage was 3.5\u2009cm and increased by a centimeter during the second stage. Perineal length of \u2264\u20093.2\u2009cm in the first stage significantly increases the risk of composite perineal tears.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jog.70287","type":"journal-article","created":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T00:49:34Z","timestamp":1776646174000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Estimation of Perineal Length in First and Second Stage of Labor Among South Indian Women and Its Association With Perineal Tears\u2014A Prospective Observational Study"],"prefix":"10.1111","volume":"52","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-5170-5663","authenticated-orcid":false,"given":"Ruchitha","family":"Krishnappa","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology Jawaharlal Institute of Postgraduate Medical Education &amp; Research (JIPMER)  Puducherry 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