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Childbirth Trauma pp 57–68Cite as

Mode of Delivery and Perineal Trauma

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Abstract

Perineal trauma during childbirth is common. Although in the majority of cases perineal trauma does not have a major impact in the woman’s future pelvic floor function, severe degrees of childbirth trauma such as levator ani trauma and obstetric anal sphincter injuries (OASIS) may result in significant pelvic floor dysfunction including urinary and faecal incontinence. Levator ani muscle trauma is diagnosed in one third of women who have vaginal birth. Levator trauma can lead to weakening of the pelvic floor muscles, widening of the urogenital hiatus and pelvic organ prolapse in the future. In this chapter, the biomechanics of the second stage of labour and its effects on the pelvic floor and levator ani complex are discussed along with the effects of prolonged second stage on the pelvic floor. Different modes of delivery including instrumental deliveries have a different impact on the risk of perineal trauma and levator ani complex. The effect of fetal malposition and malpresentation and multiple pregnancies on perineal trauma as well as the role of episiotomy are also discussed in this chapter.

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Author information

Authors and Affiliations

  1. Department of Urogynaecology, St. Georges University Hospitals, NHS Foundation Trust, Blackshaw Road, Tooting, London, SW17 0QT, UK

    Nivedita Gauthaman MBBS, MD, MRCOG

  2. Department of obstetrics and gynaecology, Epsom and St Helier University Hospitals NHS Trust, London, UK

    Stergios K. Doumouchtsis MSc, MPH, PhD, MRCOG

  3. University of Athens, Medical School, Athens, Greece

    Stergios K. Doumouchtsis MSc, MPH, PhD, MRCOG

Authors
  1. Nivedita Gauthaman MBBS, MD, MRCOG
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  2. Stergios K. Doumouchtsis MSc, MPH, PhD, MRCOG
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Corresponding author

Correspondence to Nivedita Gauthaman MBBS, MD, MRCOG .

Editor information

Editors and Affiliations

  1. St George's University of London, London, United Kingdom

    Stergios K Doumouchtsis

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Gauthaman, N., Doumouchtsis, S.K. (2017). Mode of Delivery and Perineal Trauma. In: Doumouchtsis, S. (eds) Childbirth Trauma. Springer, London. https://doi.org/10.1007/978-1-4471-6711-2_5

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  • DOI: https://doi.org/10.1007/978-1-4471-6711-2_5

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  • Publisher Name: Springer, London

  • Print ISBN: 978-1-4471-6710-5

  • Online ISBN: 978-1-4471-6711-2

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