Epidural Analgesia and Severe Perineal Laceration in a Community-based Obstetric Practice

Article Figures & Data

Table 1.

General Patient Population Characteristics.

Variable	Project Result No. (%)
Total patients	2,759
Nulliparous	1,059 (38.38)
Induction or augmentation	1,299 (47.08)
Vacuum assisted delivery	160 (5.8)
Forceps delivery	46 (1.67)
Episiotomy	609 (22.07)
Severe laceration in nulliparous patients	120 (11.3)
Total severe lacerations	176 (6.38)
Epidural analgesia	634 (22.98)
Severe laceration^* and epidural analgesia	65 (10.25)
Severe laceration^* without epidural analgesia	111 (5.22)

* Severe lacerations defined as third or fourth degree by standards set by the American College of Obstetricians and Gynecologists.

Table 2.

Clinical Characteristics According to Epidural Analgesia Use.

Table 3.

Multiple Logistic Regression Analysis: Odds Ratios of Confounders with Severe Laceration.

Variable	Project Without Instruments in Model Odds Ratio (CI)	Project with Instruments in Model Odds Ratio (CI)
Epidural analgesia	1.528 (1.092–2.137)	1.287 (0.907–1.826)
Induced labor	1.486 (1.077–2.051)	1.411 (1.018–1.956)
Nulliparous	3.904 (2.771–5.501)	3.468 (2.447–4.915)
Any instrument	—^*	3.245 (2.162–4.869)
Birth weight (>4 kg)	2.355 (1.465–3.788)	2.194 (1.353–3.556)
Maternal age	t Test procedure eliminated correlation	t Test procedure eliminated correlation

Table 4.

Number of Severe Lacerations in Patients, by Instruments Use and Epidural Analgesia.

Type of Delivery	Epidural Analgesia		No Epidural Analgesia
Type of Delivery	Total Patients No.	Patients with Severe Laceration No. (%)	Total Patients No.	Patients with Severe Laceration No. (%)
Instrument used	106	24 (22.64)	100	20 (20.0)
No instrument used	528	41 (7.77)	2,025	91 (4.49)