Role of Measuring the Perineal body Length as a Predictor of Labor progress and Obstetric Trauma

Abstract

Background:Perineal trauma is associated with a high prevalence of certain health problems. Perineal pain is the most significant with its impact on daily activities. Episiotomy is usually performed for the sake of protection against these complications. Longer perineum is associated with increase in the duration of the second stage of labor. The study aimed to evaluate the relationship between the length of perineal body and duration of the second stage of labor, the need for episiotomy and the possibility of perineal and vaginal tears needing repair. Methods: This study was conducted at Maternity Hospital, Faculty of Medicine, Zagazig University.  All patients were subjected in the following :  Complete history taking. Complete general examination.  Antenatal care. Procedure: The perineum was measured as the distance from the fourchette (the mid-point of the posterior edge of the vaginal interoitus at the muco-cutaneous junction) to the centre of the anal orifice. Measurement were performed by trained research nurses using standard tape in dorsal lithotomy position.  Results: The present study shows that regarding perineal length, it ranged between 2.5 and 4.5 with mean (3.49± .614). The present study shows that regarding perineal length categories, Perineal length >4was 17 (37.0%) and Perineal length <4 was 29 (63.0%). This work showed that there was statistically significant difference between Cases with Perineal length >4 and Cases with Perineal length <4 regarding perineal tear. The percentage of perineal tear was statistically lower among Cases with Perineal length >4 than Cases with Perineal length <4 (5.9%, 48.3%) p value= 0.003. The current study showed that there was statistically significant difference between Cases with Perineal length >4 and Cases with Perineal length <4 regarding need of episiotomy. The percentage of need of episiotomy was statistically lower among Cases with Perineal length >4 than Cases with Perineal length <4 (64.7%, 86.2%) p value= 0.048. This work showed that women with shortened perineal body length (<4 cm) had a higher chance of a perineal laceration. Conclusion:            Regarding incidence of perineal length > 4 was about one third in our patients. Longer perineum is associated with increase in the duration of the second stage of labor. The incidence of episiotomy and perineal tears were increased in patients with a perineal length of <4 cm.