Certain risk factors increase the risk of a perineal laceration extending to involve the anal sphincter. A woman with multiple risk factors may benefit from interventions directed at reducing the overall risk of laceration.
Risk factors:
(1) macrosomia, typically > 4,000 grams
(2) maternal race
(3) primigravida status
(4) type of delivery
(5) presentation of the infant
Maternal race associated with greater risk:
(1) Indian (Asia)
(2) Filipino
Manner of delivery:
(1) vacuum delivery
(2) forceps delivery
Presentation:
(1) occiput posterior
(2) breech
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