Can perineal tear be predicted by severity of striae gravidarum score?

Authors

  • Nidhi Patel Department of Obstetrics and Gynecology, GMERS Medical College and Civil Hospital, Vadnagar, Gujarat, India
  • Nilesh Shah Department of Obstetrics and Gynecology, GMERS Medical College and Civil Hospital, Vadnagar, Gujarat, India
  • Gaurav Desai Department of Community Medicine, GMERS Medical College and Civil Hospital, Vadnagar, Gujarat, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20192160

Keywords:

Birth Weight, Episiotomy, Perineal tear, Skin, Striae gravidarum

Abstract

Background: The objective of this study was to wether perineal tear predicted by scoring of severity of striae gravidarum. The objective of this study was to predict perineal tear by simple non-invasive method and help to prevent maternal morbidity.

Methods: Three hundred ninety four patients delivered normally were included in this study. Striae gravidarum score was assessed using the Atwal numerical scoring system. The association was examined between striae and perineal tear as the outcome measure, defined by tears or laceration, and the total striae scores (TSS) was obtained.

Results: In present study population mean age was 25.16 years ranging from 16-40 , mean gravidity was 2.16 ranging from 1 -8 ,average baby birth weight was 2.713 kg ranging from  1.62-4.58 The only predictors of perineal tears that were found to be statistically significant in our study were severity of striae gravidarum and episiotomy given or not. In patients with moderate to severe striae there was tear in 90 patients as compared to 29 patients with no or mild striae. 224 patients belonging to no or mild striae group delivered without any perineal tear whereas 51 patients in moderate to severe striae group delivered without tear. Out of these 51 patients 5 were given episiotomy. 2 patients who were given episiotomy had perineal tear as compared to 117 patients who were not given episiotomy. This shows that patients who had an episiotomy were less likely to have perineal tear in most cases.

Conclusions: This study demonstrates a significant relation between severity of striae gravidarum and perineal tear. The findings suggest that striae gravidarum assessment may be used in the clinical setting even by paramedical staff as a simple and noninvasive tool to better define women at risk for perineal tear.

References

Atwal GS, Manku LK, Griffiths CE. Striae gravidarum in primiparae. Br J Dermatol. 2006;155:965-9.

Cho S, Park ES, Lee DH. Clinical features and risk factors for striae distensae in Korean adolescents. J Eur Acad Dermatol Venereol. 2006;20:1108-13.

Sisson WR. Colored striae in adolescent children. J Pediatr. 1954;45:520-30.

Kim BJ, Lee DH, Kim MN. Fractional photothermolysis for the treatment of striae distensae in asian skin. Am J Clin Dermatol. 2008;9:33-7.

Alves GF, Nogueira LS, Varella TC. Dermatology and pregnancy. Anias Brasilieros de Dermatologia. 2005;80:179-86.

Chang AL, Agrenado YZ, Kimball AB. Risk factors associated with striae gravidarum. J Am Acad Dermatol. 2004;51:881-5.

Osman H, Rubeiz N, Tamim H, Nassar AH. Risk factors for the development of striae gravidarum. Am J Obstet Gynecol. 2007;62:1-5.

Alves GF, Nogueira LS, Varella TC. Dermatology and pregnancy. Anias Brasilieros de Dermatologia. 2005;80:179-86.

Chang AL, Agrenado YZ, Kimball AB. Risk factors associated with striae gravidarum. J Am Acad Dermatol. 2004;51:881-5.

Osman H, Rubeiz N, Tamim H, Nassar AH. Risk factors for the development of striae gravidarum. Am J Obstet Gynecol. 2007;62:1-5.

Atwal GS, Manku LK, Griffiths CE, Polson DW. Striae gravidarum in primiparae. Br J Dermatol. 2006;155:965-9.

Angioli R, Gomez-Matin O, Cantuaria G, O’Sullivan MJ. Severe perineal lacerations during vaginal delivery: the University of Miami experience. Am J Obstet Gynecol. 2000;182:1083-5.

Klein MC, Gauthier RJ, Jorgensen SH, Robbins JM, Kaczorowski J, Johnson B, et al. Does episiotomy prevent perineal trauma and pelvic floor relaxation? Online J Curr Clin Trials. 1992;DocNo10:[6019 words; 65 paragraphs].

Helwig JT, Thorp JM, Bowes WA. Does midline episiotomy increase the risk of third- and fourth-degree lacerations in operative vaginal deliveries? Obstet Gynecol. 1993;82(2):276-9.

Thorp JM, Bowes WA, Brame RG. Selective use of midline episiotomy: effect on perineal trauma. Obstet Gynecol. 1987;70:240-4.

Gass MS, Dunn C, Stys SJ. Effect of episiotomy on the frequency of vaginal outlet lacerations. J Reprod Med. 1986;31(4):240-4.

Borghi J, Fox-Rushby J, Bergel E, Abalos E, Hutton G, Carroli G. The cost-effectiveness of routine versus restrictive episiotomy in Argentina. Am J Obstet Gynecol. 2002;186(2):221-8.

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Published

2019-05-28

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Original Research Articles