Do Unsutured Second-Degree Perineal Lacerations Affect Postpartum Functional Outcomes?

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Figure 1.
FACT study participant flow chart.

Table 1.

Demographic, Maternal, and Labor Characteristics

	No Trauma (n = 89)	Second-Degree Lacerations		P
	No Trauma (n = 89)	Unsutured (n = 37)	Sutured (n = 46)	P
Age ± SD (years)	24.5 ± 4.9	24.5 ± 5.6	26.1 ± 5.2	NS
Education ± SD (years)	12.3 ± 2.1	13.6 ± 3.0	14.6 ± 3.1	<.0001
Weight gain ± SD (kg)	29.5 ±13.6	34.5 ± 16.1	33.6 ± 10.8	NS
BMI ± SD (kg/m2)	25.3 ± 5.8	25.7 ± 6.3	24.5 ± 5.0	NS
Fetal weight ± SD	3276 ± 434	3373 ± 420	3584 ± 342	.0003
Active pushing (n [%])	15 (17)	9 (24)	14 (30)	NS
Sitting position while pushing (n [%])	80 (90)	28 (76)	38 (83)	NS
Nulliparous (n [%])	9 (10)	29 (78)	31 (78)	<.001
Ethnicity (%)
Non-Hispanic white	21	15	26	0.0008^*
Hispanic	52	17	15
Native American	10	0	4
Other	6	5	1

* The difference is between intact and second-degree lacerations, which were more common in Hispanic patients.
BMI, body mass index.

Table 2.

Pelvic Floor Complaints Up to 3 Months Postpartum

Pelvic Floor Dysfunction	Intact (n = 89)	Second-Degree Lacerations		P
Pelvic Floor Dysfunction	Intact (n = 89)	Unsutured (n = 37)	Sutured (n = 46)	P
Urinary
Leaked urine since birth	26 (29%)	13 (36%)	14 (30%)	NS
IIQ-7 > 0	15 (17%)	5 (14%)	7 (15%)	NS
Anal
Incontinence flatus or stool	21 (24%)	14 (38%)	14 (30%)	NS
Fecal Incontinence	10 (11%)	0 (0%)	3 (7%)	NS
Both urinary and anal incontinence	10 (11%)	7 (19%)	6 (13%)	NS
Pain
Pain meds at hospital discharge	26 (23%)	15 (35%)	27 (52%)	<.002
Pain at time of hospital discharge^†	1.55 ± 1.63	2.13 ± 1.39	2.37 ± 1.96	.02^*
Any perineal pain (6 weeks–3 months)	8 (9%)	8 (22%)	3(7%)	.07
Sexual
Sexually inactive	12 (21%)	3 (11%)	10 (27%)	NS
IRS score	33.1 ± 9.2	33.1 ± 6.3	30.6 ± 7.9	NS

* Sutured and unsutured groups are not different and both sutured and unsutured are different than intact. Suturing does not affect pain at the time of discharge.
† Visual Analog Scale of the short-form McGill pain questionnaire.
All data presented as N (%) unless otherwise indicated. IRS, Intimacy Relationship Scale.

Table 3.

Perineal Exam Findings at 6 Weeks Postpartum

Perineal Exam	Intact (n = 53)	Second-Degree Lacerations		P
Perineal Exam	Intact (n = 53)	Unsutured (n = 28)	Sutured (n = 31)	P
Perineum appears gaping, asymmetrical or open (n = 132)	2 (4)	5 (17)	4 (13)	NS
Weak pelvic floor exercise strength (n = 112)	15 (28)	13 (47)	18 (58)	.03^†
Vaginal Opening ≥ 5 cm^* (n = 104)	2 (4)	3 (11)	4 (13)	NS
Perineal body ≤ 2.5 cm^* (n = 104)	15 (32)	7 (26)	8 (27)	NS

* Measurements taken according to the POPQ¹³; values were chosen from normal reported ranges.^{20, 21}
† Statistical significance is between the intact and nonintact groups. No difference in comparison between sutured and unsutured.
Data presented as n (%).