Role of Perineal Length Estimation in The Prediction of Maternal and Fetal Outcomes

Abstract

Context: Female perineum is a significant part of females because perineal tears and episiotomy habitually happen in childbirth with first-time deliveries.
Aim: This study aimed to explore the role of perineal length (PL) estimation in the prediction of maternal and fetal outcomes.
Methods: A prospective cohort observational design was used to collect data from the Department of Obstetrics and Gynecology, Laboring room, Kafrelsheikh General Hospital, Kafrelsheikh City, Egypt. A purposive sample of 139 parturient women was recruited during the period from the first of December 2018 to the end of August 2019. Six tools were used to conduct this study. Maternal and newborn characteristics questionnaire, disposable standardized paper tape for measuring PL in centimeters, a standardized scale for measuring maternal height by meters, and body weight in kilograms to calculate Body Mass Index (BMI) (k/m2), REEDA scale, partograph for labor process and Apgar score.

Results: There were statistically significant differences regarding the mean age, previous episiotomy, and cesarean section of both studied groups (PL less than or equal to 4 cm and more than 4 cm) at p-value <0.001. Out of 139 parturient women, the two groups of PL less than or more than 4 cm had 16.7% versus 56.9%, respectively had a normal vaginal delivery, with a statistically significant difference between both groups, while 46.7% versus 6.3% respectively had an episiotomy. However, the mean duration of the second stage of labor had statistically significant differences between both studied groups, with 116.7 ± 44.3 versus 85.1 ± 42.0, respectively. Additionally; Mean birth weight/grams, cephalohematoma, caput succedaneum, and mean APGAR score after 5 minutes had a statistically significant difference between the two groups.

Conclusions: Short perineum accompanied by increased duration of the second stage of labor. Cesarean section delivery and perineal trauma are associated with primigravida with short perineum. Regarding the mean APGAR score after 5 minutes, there were statistically significant differences between both studied groups. Maternity and newborn health nursing need to improve the illustration of the risk factors that can lead to undesirable consequences. Further research in the area of perineal anatomy may help patients avoid severe tears and many complications.