Here are a few studies I found on Pubmed... http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Ab stract&list_uids=11065029
Aust N Z J Obstet Gynaecol. 2000 Aug;40(3):244-8. Related Articles, Links Anal incontinence in women with third or fourth degree perineal tears and subsequent vaginal deliveries. Sangalli MR, Floris L, Faltin D, Weil A. Department of Obstetrics and Gynecology, University Hospital of Geneva, Switzerland. We contacted 208 women 13 years after they suffered an obstetrical anal sphincter tear in order to estimate the effect of subsequent vaginal deliveries on anal continence. Among the 177 eligible responders, 129 sustained a partial or complete 3rd degree and 48 a 4th degree tear; 114 women had subsequent vaginal deliveries. Anal incontinence was more common in women with 4th (25.0%) than with 3rd degree tears (11.5%, p = 0.049). Subsequent vaginal deliveries were associated with a higher prevalence of severe incontinence in women with 4th degree tears (p = 0.023). No aggravation or increase in prevalence of incontinence was observed in women with 3rd degree tears. These results suggest that in a subsequent pregnancy, careful evaluation is necessary and an abdominal delivery may be advisable for women with previous major sphincter trauma. PMID: 11065029 [PubMed - indexed for MEDLINE] http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Ab stract&list_uids=10190670 Int J Gynaecol Obstet. 1999 Jan;64(1):55-7. Related Articles, Links Prior third- or fourth-degree perineal tears and recurrence risks. Payne TN, Carey JC, Rayburn WF. Department of Obstetrics and Gynecology, The University of Oklahoma, Oklahoma City, USA. OBJECTIVE: The objective of the present study is to determine the recurrence risk of a third-degree (into the anal sphincter) or a fourth-degree (into the rectum) perineal tear in women with a prior extensive laceration. METHODS: Data were gathered from our computerized perinatal database between January 1990 and December 1994. Women who had two consecutive singleton deliveries were chosen as subjects. RESULTS: The rate of an extensive perineal laceration was greater if a tear had occurred in a previous pregnancy (19 of 178 cases, 10.7% vs. 56% of 1563 cases, 3.6%, odds ratio 3.4. A 95% confidence interval: 1.8-6.4; p < 0.0001). A prior tear remained a risk factor after controlling for other variables (epidural analgesia, episiotomy, oxytocin use, operative vaginal delivery, fetal macrosomia). CONCLUSION: A prior third-degree or fourth-degree perineal tear is associated with a 3.4-fold increased risk of a recurrent severe obstetrical laceration. PMID: 10190670 [PubMed - indexed for MEDLINE] Hope this helps Tania ----- Original Message ----- From: "Mary Murphy" <[EMAIL PROTECTED]> To: <[EMAIL PROTECTED]> Sent: Friday, August 13, 2004 5:51 PM Subject: Re: [ozmidwifery] 4th degree tear > I too will be interested in any research re subsequent births. I have a > woman who had a 4th degree tear and probems with a fissure for months. I > know she will be terrified to have another baby and terrified of a C/S. > there was quite a discussion on the list about a year ago (maybe?) but I > didn't save it. Maybe it is in the archives? How do we access those? MM > > Previous questions: > > Now we need to find some research on the the incidence of a another > 3rd/4th > > degree tear if she has another vaginal birth. > > >Does anyone have any evidence-based information on the liklihood of > > >another 4th degree tear and subsequent faecal incontinence?. > > > -- > This mailing list is sponsored by ACE Graphics. > Visit <http://www.acegraphics.com.au> to subscribe or unsubscribe. -- This mailing list is sponsored by ACE Graphics. Visit <http://www.acegraphics.com.au> to subscribe or unsubscribe.
