Several studies have investigated the importance of maternal, fetal factors and intrapartum characteristics in predicting severe perineal lacerations. The purpose of the present systematic review is to evaluate on research regarding risk factors for perineal injury. We reviewed PubMed, Science-Direct, Cochrane Library, and Medline for published studies in the field for observational studies. Two researchers independently assessed the included studies and documented outcomes. Data extraction was performed using a modified data form. Twenty-nine articles were selected for inclusion in the present systematic review. Several factors contribute to the development of severe perineal injury. The most common risk factor investigated was parity, episiotomy, birth weight, maternal age, prolonged 2nd stage of labor, head circumference, and instrumental deliveries. The present systematic review presents accumulated data that may help birth attendant estimate risks and provide appropriate
intervention.
Key words: Perineal injury, Child-birth, Delivery.
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