OBJECTIVE: To compare the outcome of subsequent delivery in @entity1 with a history of a third- or fourth-degree laceration with outcomes in @entity1 without such a history. METHODS: This retrospective study used a perinatal database and chart review from 1978 to 1995. Only @entity1 whose first delivery was at our institution at more than 36 weeks' gestation, vaginal singleton, vertex presentation, and birth weight greater than 2500 g, with a subsequent delivery were included. The @entity1 were grouped by presence or absence of a third- or fourth-degree (severe) @entity4551 in their first delivery. The subsequent delivery was analyzed for maternal age, weight, birth weight, gestational age, method of delivery, use of episiotomy, and occurrence of a severe laceration. Comparison of data was by Fisher exact and t tests. RESULTS: Four thousand fifteen @entity1 met our starting criteria. In their first delivery, the average birth weight, use of instrumentation, and episiotomy rate were significantly higher in those @entity1 sustaining a severe laceration. When compared with @entity1 without a history of severe @entity4551 , @entity1 with such a history were at more than twice the risk for another in their subsequent delivery. The @entity1 at highest risk (21.4%) were those sustaining a laceration in their first delivery who underwent instrumental vaginal delivery with episiotomy in their subsequent delivery. When episiotomy or instrumental delivery was performed in the second vaginal birth, 52 (11.6%) of 449 @entity1 with a history of a severe @entity4551 sustained another, compared with 98 (6.5%) of 1509 without such a history (P < .001, odds ratio 1.9, 95% confidence interval 1.3, 2.7). CONCLUSION: @entity1 delivering their second baby, and in whom episiotomy or instrumentation is used, are at increased risk of severe @entity4551 compared with @entity1 delivery spontaneously.

Risk of repetition of a severe XXXX .

@entity1 :: ('9606', 'Species') :: ['women', 'Women'] @entity4551 :: ('MESH:D022125', 'Disease') :: ['perineal laceration']
@entity4551 :: (MESH:D022125,Disease) :: ['perineal laceration']
