LITERATURE REVIEW FACTORS RELATED TO THE INCIDENCE OF PERINEAL RUPTURE IN NORMAL CHILDBIRTH
Keywords:
Perineal Rupture, Normal Childbirth, Parity, Birth Weight, Maternal Risk Factors, Perineal ProtectionAbstract
Perineal rupture is a common complication during normal childbirth that can increase maternal morbidity, including postpartum hemorrhage, infection, prolonged perineal pain, dyspareunia, and reduced quality of life. This literature review analyzed ten research articles published between 2020 and 2025 to identify factors associated with perineal rupture. The review found that parity was the most dominant factor, with primiparous women experiencing a higher risk due to limited perineal tissue adaptation. Other important factors included high birth weight (≥4,000 grams), maternal age, fetal head circumference, prolonged second stage of labor, ineffective pushing techniques, perineal elasticity, and the skills of birth attendants. The findings suggest that prevention of perineal rupture requires antenatal education, early identification of risk factors, proper labor management, and the application of evidence-based perineal protection techniques by skilled healthcare providers.
References
Ardana Al Fitra, et al. (2024). The Relationship of Parity, Newborn Weight and Straining Techniques with the Incidence of Perineal Rupture.
Nasrun, E. K., et al. (2023). Prevalence and Predictors of Perineal Rupture Factors.
Oktavia, L., & Amelia, W. (2023). The Incidence of Perineal Rupture Reviewed from Parity and Infant Weight.
Masruroh, N., & Rina, D. W. (2025). The Relationship of Newborn Weight with the Incidence of Perineal Rupture.
Debora, et al. (2024). The Relationship of Birth Weight with Perineal Rupture.
Mar'atussaliha, et al. (2024). Overview of the Factors Causing Perineal Rupture.
Sumarni, et al. (2020). Effect of Maternal and Neonatal Factors on Perineal Rupture.
Prawitasari, E., et al. (2015). Causes of Perineal Rupture.
Sari, A. S., et al. (2016). The Relationship of Parity with the Occurrence of Perineum Rupture.
Aasheim, V., Nilsen, A. B. V., Lukasse, M., & Reinar, L. M. (2017). Perineal techniques during the second stage of labour for reducing perineal trauma. Cochrane Database of Systematic Reviews.
World Health Organization. (2018). WHO Recommendations: Intrapartum Care for a Positive Childbirth Experience. Geneva: WHO.
American College of Obstetricians and Gynecologists. (2018). Practice Bulletin No. 198: Prevention and Management of Obstetric Lacerations at Vaginal Delivery.
Royal College of Obstetricians and Gynaecologists. (2015). The Management of Third- and Fourth-Degree Perineal Tears (Green-top Guideline No. 29).
Kettle, C., & Tohill, S. (2021). Perineal Care and Prevention of Perineal Trauma During Childbirth: An Evidence-Based Review.
Pergialiotis, V., et al. (2020). Risk Factors for Severe Perineal Lacerations During Vaginal Delivery: A Systematic Review and Meta-analysis.
Azizah, Nur, Kismiasih Adethia, Lisa Putri Damanik, Rosmani Sinaga, and Diah Pitaloka. 2022. “THE RELATIONSHIP BEHAVIOR OF PREGNANT WOMEN TO THE UTILIZATION OF TRIPLE ELIMINATION EXAMINATION IN PUSKESMAS KUALA BANGKA KAB . LABUHAN BATU UTARA.” Int. J. Midwifery Res 2(1).
Brito, Ana Paula Almeida, Caroline Fernandes Caldeira, and Marina De Góes Salvetti. 2021. “Prevalence, Characteristics, and Impact of Pain During The Postpartum Period.” Revista da Escola de Enfermagem 55: 1–7. doi:10.1590/S1980-220X2019023303691.
Guarga Montori, M., A. Álvarez Martínez, C. Luna Álvarez, N. Abadía Cuchí, P. Mateo Alcalá, and S. Ruiz-Martínez. 2021. “Advanced Maternal Age and Adverse Pregnancy Outcomes: A Cohort Study.” Taiwanese Journal of Obstetrics and Gynecology 60(1): 119–24. doi:10.1016/j.tjog.2020.11.018.
Lee, Derek, and Tara A Lynch. 2025. “PPROM in the Late Preterm Period: An Argument for Expectant Management.” American Journal of Obstetrics & Gynecology MFM 7(1). doi:10.1016/j.ajogmf.2024.101563.
Manurung, Herna Rinayanti, Siti Nurmawan Sinaga, Gracia Dinda A Sinaga, and Yuli Hermaliza. 2024. “EDUKASI PEMENUHAN NUTRISI PADA IBU DENGAN KEKURANGAN ENERGI KRONIS (KEK) DI UPTPUSKESMAS SUKARAMAI KECAMATAN MEDAN AREATAHUN 2024.” 2(4): 2–6.
Marsh, Anna, Vanora A Hundley, Ann Luce, and Yana Richens. 2023. “The Perfect Birth : A Content Analysis of Midwives ’ Posts about Birth on Instagram.” BMC Pregnancy and Childbirth: 1–12. doi:10.1186/s12884-023-05706-2.
Putri, Lisa, Utami Damanik, Afni Veronika Tambunan, Herna Rinayanti Manurung, Siti Nurmawan Sinaga, Zulkarnain Batu Bara, Magdalena Barus, et al. 2024. “Pengaruh Mobilisasi Dini Pasien Post Sectio Caesarea Terhadap Gangguan Mobilitas Fisik Di Puskesmas Danau Paris Kabupaten Aceh Singkil Tahun 2024 Prodi Sarjana Sekolah Tinggi Ilmu Kesehatan Mitra Husada Medan , Indonesia Menyebabkan Gangguan Pada Organ Gi.” 1(2).
Saragih, Hotna Rohdearni, Ingka Kristina Pangaribuan, Ribur Sinaga, Stikes Mitra, and Husada Medan. 2023. “The Relationship of Mother’s Age and Parity with the Incident of Premate Labor at the Adam Malik Hajj Center General Hospital Year 2023.”
Sinaga, Asnita, Rumondang Sitorus, Imran Surbakti, Kamelia Sinaga, Elli Tamba, and Yemina Siadari. 2023. “Hubungan Jenis Dan Lama Penggunaan Kontrasepsi Hormonal Terhadap Gangguan Menstruasi Pada Wanita Usia Subur Di Klinik Pratama Vina Kecamatan Medan Baru Kota Medan Tahun 2023.” Jurnal Inovasi Riset Ilmu Kesehatan 1(2).
Sorrenti, Sara, Daniele Di Mascio, Asma Khalil, Francesco D Antonio, Giuseppe Rizzo, Fabrizio Zullo, Elena D Alberti, et al. 2024. “Systematic Review Outcome of Prelabor Rupture of Membranes before or at the Limit of Viability : Systematic Review and Meta-Analysis.” American Journal of Obstetrics & Gynecology MFM 6(6): 101370. doi:10.1016/j.ajogmf.2024.101370.
Wahyuni, Retno, Isyos Sari Sembiring, Herna Rinayanti Manurung, and Marliani. 2020. “… Peningkatan Berat Badan Bayi Dan Keterampilan Ibu Pasca Bersalin Dengan Bblr (Dismatur) Setelah Kelas Perawatan Metode Kanguru Di Rumah Sakit Haji ….” Dinamika Kesehatan Jurnal Kebidanan dan Keperawatan 11(2): 635–43.
WHO. 2025. “Maternal Mortality.”
Xue, Rui, and Zhongming Yun. 2025. “An Evaluation of Macrosomia Risk Factors in a Cohort of Chinese Women and Neonates.” Journal of International Medical Research 53(8). doi:10.1177/03000605251365806.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Juita Deli Nduru, Khairunnisa Situmorang, Humaida Hanim, Afrida Yanti, Dian Nirmala
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
