A cut in the perineum, during delivery with a ventouse, reduces the risk of severe perineal trauma, according to a new study from the Karolinska Institute and Danderyds Hospital.
In first-time mothers, a lateral cut in the vaginal opening during delivery with a ventouse can more than halve the risk of a severe tear between the vagina and anus, a so-called sphincter injury.
This can help doctors and pregnant women make informed decisions about a potential preventative lateral cut, says Sophia Brismar Wendel, who is, among other things, a lecturer in obstetrics and gynaecology at Danderyds Hospital and the Karolinska Institute.
Sphincter injuries can cause persistent difficulties in controlling gas and faeces. It can also negatively affect quality of life and cause sexual problems. The incidence of this severe tear has decreased but is still more common in Sweden than in many other countries.
Around five per cent of all first-time mothers in Sweden who undergo a vaginal delivery are affected.
The study's results have been published in the British journal MBJ.
The lateral cut, during delivery with a ventouse, reduced the risk of sphincter injury by an average of 53 per cent. Among women who were randomly assigned to receive a lateral cut, 6.1 per cent suffered a sphincter injury, compared with 13.1 per cent among women who did not receive a cut in the vaginal opening.
The procedure did not increase the risk of severe bleeding, negative delivery experience, prolonged hospital stay, or more complications. However, the risk of various wound complications was more than double among women who received a lateral cut.
In the near future, the results of the one-year follow-up will be analysed, which can provide answers on differences in, among other things, anal incontinence and sexual problems.
Source: Karolinska Institute
