Publication:

Prediction of perineal tear during childbirth by assessment of striae gravidarum score

Background The objective of this study was to explore the association between striae gravidarum and the risk for perineal tear during childbirth.

Methods Three hundred patients delivered normally were included in this study. Striae gravidarum score was assessed using the Atwal numerical scoring system. The association was examined between striae and perineal tear as the outcome measure, defined by tears or laceration, and the total striae scores (TSS) was obtained.

Results Mean age was 25.41 years ranging from 20 - 30 years, mean gravidity was 2.27 ranging from 1 - 5, mean weight gain was 9.72 Kg ranging from 5 - 16 Kgs and average baby birth weight was 2.8 Kg ranging from 2.1 - 3.5 Kg. The only predictors of perineal tears that were found to be statistically significant in our study were Severity of striae gravidarum and Episiotomy given or not. In patients with moderate to severe striae there was tear in 105 patients as compared to 45 patients with no or mild striae. 89 patients belonging to no or mild striae group delivered without any perineal tear whereas 61 patients in moderate to severe striae group delivered without perineal tear. It is observed that episiotomy has some protective effect against perineal tear.

Conclusions This study demonstrates a significant relation between severity of striae gravidarum and perineal tear. The findings suggest that striae gravidarum assessment may be used in the clinical setting even by paramedical staff as a simple and noninvasive tool to better define women at risk for perineal tear.