Obstetric vulvar lacerations and postpartum dyspareunia

Gary Ventolini, Jerome L. Yaklic, Michael L. Galloway, R. Moss Hampton, James E. Maher

Research output: Contribution to journalArticle

Abstract

OBJECTIVE: To report the type and prevalence of obstetric lacerations in a primigravid patient population after term spontaneous vaginal delivery without episiotomy. We examined the characteristics of lacerations in patients with postpartum dyspareunia or vulvodynia. STUDY DESIGN: This was a retrospective cohort of primiparous patients who spontaneously delivered in the residents’ service at a large urban hospital under the supervision of Ob/Gyn faculty. Data was extracted from medical records using discharge diagnosis codes. Postpartum medical records and diagnostic codes of all patients with lacerations and postpartum dyspareunia were reviewed. The study was IRB approved. RESULTS: A cohort of 1,617 primiparous patients with spontaneous vaginal delivery met the inclusion criteria. No tears were recorded in 836 patients (51.7%), firstdegree tears in 413 cases (25.5%), second-degree tears in 271 cases (16.8%), third-degree tears in 58 cases (3.6%), fourth-degree in 21 cases (1.3%), and 18 cases (1.1%) were not further classified. Only 51 patients (3.2%) with first- and second-degree lacerations had postpartum complications, and merely 6 (0.4%) had vulvar pain and 6 (0.4%) had dyspareunia. However, 4 of those patients (33.3%) required vulvoplasty for complete dyspareunia remission. CONCLUSION: Almost half of patients with spontaneous vaginal delivery without episiotomy experienced some type of vaginal laceration. A first degree was documented in > 25% of cases; however, < 10% of those subsequently had complaints of vulvar pain or dyspareunia.

Original languageEnglish (US)
Pages (from-to)560-565
Number of pages6
JournalJournal of Reproductive Medicine
Volume59
Issue number6
StatePublished - Dec 2014
Externally publishedYes

Keywords

  • Episiotomy
  • Obstetric lacerations
  • Obstetric vulvar lacerations
  • Postpartum dyspareunia
  • Vaginal laceration
  • Vulvar lacerations
  • Vulvodynia
  • Vulvoplasty

ASJC Scopus subject areas

  • Reproductive Medicine
  • Obstetrics and Gynecology

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  • Cite this

    Ventolini, G., Yaklic, J. L., Galloway, M. L., Hampton, R. M., & Maher, J. E. (2014). Obstetric vulvar lacerations and postpartum dyspareunia. Journal of Reproductive Medicine, 59(6), 560-565.