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Legino LJ, Woods MP, Rayburn WF, McGoogan LS. Third- and fourth-degree perineal tears. 50 year's experience at a university hospital. J Reprod Med 1988; 33:423. Poen AC, Felt-Bersma RJ, Dekker GA, et al. Third degree obstetric perineal tears: risk factors and the preventive role of mediolateral episiotomy. Br J Obstet Gynaecol 1997; 104:563. Anthony S, Buitendijk SE, Zondervan KT, et al. Episiotomies and the occurrence of severe perineal lacerations. Br J Obstet Gynaecol 1994; 101:1064. de Vogel J, van der Leeuw-van Beek A, Gietelink D, et al. The effect of a mediolateral episiotomy during operative vaginal delivery on the risk of developing obstetrical anal sphincter injuries. Am J Obstet Gynecol 2012; 206:404.e1. de Leeuw JW, de Wit C, Kuijken JP, Bruinse HW. Mediolateral episiotomy reduces the risk for anal sphincter injury during operative vaginal delivery. BJOG 2008; 115:104. Stones RW, Paterson CM, Saunders NJ. Risk factors for major obstetric haemorrhage. Eur J Obstet Gynecol Reprod Biol 1993; 48:15. Combs CA, Murphy EL, Laros RK Jr. Factors associated with postpartum hemorrhage with vaginal birth. Obstet Gynecol 1991; 77:69. May JL. Modified median episiotomy minimizes the risk of third-degree tears. Obstet Gynecol 1994; 83:156. Owen, J, Hauth, JC. Episiotomy infection and dehiscence. In: Gilstrap, LC III, Faro, S (eds) Infections in Pregnancy, Alan R Liss, New York 1990. Hudelist G, Gelle'n J, Singer C, et al. Factors predicting severe perineal trauma during childbirth: role of forceps delivery routinely combined with mediolateral episiotomy. Am J Obstet Gynecol 2005; 192:875. Jones KD. Incidence and risk factors for third degree perineal tears. Int J Gynaecol Obstet 2000; 71:227. Angioli R, Gómez-Marín O, Cantuaria G, O'sullivan MJ. Severe perineal lacerations during vaginal delivery: the University of Miami experience. Am J Obstet Gynecol 2000; 182:1083. Nager CW, Helliwell JP. Episiotomy increases perineal laceration length in primiparous women. Am J Obstet Gynecol 2001; 185:444. de Leeuw JW, Struijk PC, Vierhout ME, Wallenburg HC. Risk factors for third degree perineal ruptures during delivery. BJOG 2001; 108:383. Bodner-Adler B, Bodner K, Kaider A, et al. Risk factors for third-degree perineal tears in vaginal delivery, with an analysis of episiotomy types. J Reprod Med 2001; 46:752.

Nager CW, Helliwell JP. Episiotomy increases perineal laceration length in primiparous women. Am J Obstet Gynecol 2001; 185:444. de Leeuw JW, Struijk PC, Vierhout ME, Wallenburg HC. Risk factors for third degree perineal ruptures during delivery. BJOG 2001; 108:383. Bodner-Adler B, Bodner K, Kaider A, et al. Risk factors for third-degree perineal tears in vaginal delivery, with an analysis of episiotomy types. J Reprod Med 2001; 46:752. Hamilton EF, Smith S, Yang L, et al. Third- and fourth-degree perineal lacerations: defining high-risk clinical clusters. Am J Obstet Gynecol 2011; 204:309.e1. Ramin SM, Gilstrap LC 3rd. Episiotomy and early repair of dehiscence. Clin Obstet Gynecol 1994; 37:816. Goldaber KG, Wendel PJ, McIntire DD, Wendel GD Jr. Postpartum perineal morbidity after fourth-degree perineal repair. Am J Obstet Gynecol 1993; 168:489. Ramin SM, Ramus RM, Little BB, Gilstrap LC 3rd. Early repair of episiotomy dehiscence associated with infection. Am J Obstet Gynecol 1992; 167:1104. Hankins GD, Hauth JC, Gilstrap LC 3rd, et al. Early repair of episiotomy dehiscence. Obstet Gynecol 1990; 75:48. Arona AJ, al-Marayati L, Grimes DA, Ballard CA. Early secondary repair of third- and fourth-degree perineal lacerations after outpatient wound preparation. Obstet Gynecol 1995; 86:294. Topic 4478 Version 18.0 © 2013 UpToDate, Inc. All rights reserved. | Subscription and License Agreement | Release: 21.3 - C21.34 Licensed to: Morehouse School of Medicine | Support Tag: [1103-41.222.196.37-062E1C4994-S473950.14]