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Research ArticleOriginal Research

Epidural Analgesia and Any Vaginal Laceration

Timothy G. Myrick and Kelly J. Sandri
The Journal of the American Board of Family Medicine September 2018, 31 (5) 768-773; DOI: https://doi.org/10.3122/jabfm.2018.05.170400
Timothy G. Myrick
From the Department of Family and Community Medicine, University of Missouri–Kansas City, Kansas City, MO.
MD
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Kelly J. Sandri
From the Department of Family and Community Medicine, University of Missouri–Kansas City, Kansas City, MO.
MD
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Article Figures & Data

Tables

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    Table 1.

    Odds Ratios in Patients with Any Vaginal Laceration

    VariablePOR95% CI
    Birth weight (g).00311 to 1
    Epidural.0400.8060.655 to 0.991
    OVD.0031.9961.256 to 3.170
    Black race.0020.6670.516 to 0.863
    TMCLW location<.0010.6150.487 to 0.776
    Total parity<.0010.6700.624 to 0.719
    • CI, confidential interval; OR, odd ratio; OVD, operative vaginal delivery; TMCLW, Truman Medical Center Lakewood.

    • View popup
    Table 2.

    Odds Ratios in Patients with 2nd–4th Degree Lacerations

    VariablePOR95% CI
    Birth weight.01711 to 1
    OVD<.0013.4842.346 to 5.174
    Black race<.0010.6140.470 to 0.801
    TMCLW location<.0010.6090.482 to 0.769
    Total parity<.0010.6390.584 to 0.700
    • CI, confidential interval; OR, odd ratio; OVD, operative vaginal delivery; TMCLW, Truman Medical Center Lakewood.

    • View popup
    Table 3.

    Relationship between Epidural and Operative Vaginal Delivery

    Delivery TypeTotal
    SVDOVD
    EpiduralNoCount50140541
    Percentage92.67.4100.0%
    YesCount44647493
    Percentage90.59.5100.0%
    TotalCount947871034
    Percentage91.6%8.4100.0
    • OVD, operative vaginal delivery; SVD, Spontaneous Vaginal Delivery.

    • View popup
    Table 4.

    Comparison of Urban and Suburban Hospitals

    Truman Medical Center Hospital HillTruman Medical Center Lakewood
    Provider, type, %
        Obstetrics1006.3
        Certified nurse midwife1.9
        Family medicine91.8
    Patient race
        Black44.619.2
        White19.562.8
        Other35.817.8
    Any vaginal laceration requiring sutures rate
        n679628
        %61.760.9
    Severe (third-and fourth-degree) laceration rate
        n4423
        %4.02.2
    Vaginal laceration association with epidural
        PIndex for comparison<.001
        OR0.615
        CI0.487 to 0.776
    OVD rate
        n6049
        %5.54.8
    Epidural rate
        n369475
        %34.847.6
    • CI, confidential interval; OR, odd ratio; OVD, operative vaginal delivery.

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The Journal of the American Board of Family     Medicine: 31 (5)
The Journal of the American Board of Family Medicine
Vol. 31, Issue 5
September-October 2018
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Epidural Analgesia and Any Vaginal Laceration
Timothy G. Myrick, Kelly J. Sandri
The Journal of the American Board of Family Medicine Sep 2018, 31 (5) 768-773; DOI: 10.3122/jabfm.2018.05.170400

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Epidural Analgesia and Any Vaginal Laceration
Timothy G. Myrick, Kelly J. Sandri
The Journal of the American Board of Family Medicine Sep 2018, 31 (5) 768-773; DOI: 10.3122/jabfm.2018.05.170400
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Keywords

  • Epidural Analgesia
  • Family Physicians
  • Gynecology
  • Lacerations
  • Logistic Regression
  • Obstetrics
  • Parity
  • Urban Hospitals

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