Factors associated with increased risk:
(1) mediolateral episiotomy
(2) operative delivery if mediolateral episiotomy performed
(3) third or fourth degree laceration
(4) presence of meconium
(5) second stage of labor > 60 minutes
where:
• Operative delivery involved low or outlet vacuum or forceps.
Factors associated with decreased risk:
(1) previous vaginal delivery (unless second stage of labor > 60 minutes, page 757)
(2) operative delivery together with midline episiotomy
The authors noted that early repair of the laceration could be done successfully if there was an intensive program of wound irrigation, debridement and sitz baths over a period of 4-10 days.
