<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>1870-7203</journal-id>
<journal-title><![CDATA[Acta médica Grupo Ángeles]]></journal-title>
<abbrev-journal-title><![CDATA[Acta méd. Grupo Ángeles]]></abbrev-journal-title>
<issn>1870-7203</issn>
<publisher>
<publisher-name><![CDATA[Grupo Ángeles, Servicios de Salud]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S1870-72032021000200204</article-id>
<article-id pub-id-type="doi">10.35366/100443</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Factores de riesgo maternos y neonatales para desgarro perineal severo]]></article-title>
<article-title xml:lang="en"><![CDATA[Maternal and neonatal risk factors associated with obstetric anal sphincter injuries]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Woog Castañón]]></surname>
<given-names><![CDATA[Alberto]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Arvizu Armenta]]></surname>
<given-names><![CDATA[José Alan]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[González Aldeco]]></surname>
<given-names><![CDATA[Pablo Mariano]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Rodríguez Ayala]]></surname>
<given-names><![CDATA[Cecilio]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Chávez Loranca]]></surname>
<given-names><![CDATA[María de los Ángeles]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Juárez Tabares]]></surname>
<given-names><![CDATA[Joana Carolina]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Universidad La Salle Facultad Mexicana de Medicina ]]></institution>
<addr-line><![CDATA[Ciudad de México ]]></addr-line>
<country>Mexico</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Nuevo Sanatorio Durango Servicio de Ginecología y Obstetricia ]]></institution>
<addr-line><![CDATA[Ciudad de México ]]></addr-line>
<country>México</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Nuevo Sanatorio Durango Servicio de Ginecología y Obstetricia ]]></institution>
<addr-line><![CDATA[Ciudad de México ]]></addr-line>
<country>México</country>
</aff>
<aff id="Af4">
<institution><![CDATA[,Nuevo Sanatorio Durango  ]]></institution>
<addr-line><![CDATA[Ciudad de México ]]></addr-line>
<country>México</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>06</month>
<year>2021</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>06</month>
<year>2021</year>
</pub-date>
<volume>19</volume>
<numero>2</numero>
<fpage>204</fpage>
<lpage>207</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_arttext&amp;pid=S1870-72032021000200204&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_abstract&amp;pid=S1870-72032021000200204&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_pdf&amp;pid=S1870-72032021000200204&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen:  Introducción:  El desgarro perineal es una complicación del parto; los desgarros perineales constituyen soluciones de continuidad que pueden estar acompañadas de contusiones menores, desgarros de músculos o laceraciones mayores. Los desgarros de primer grado son daño en piel; de segundo grado en músculos perineales; el tercer grado se subclasifica en (A) que abarca menos de 50% del esfínter anal externo (EAE), (B) más de 50% del EAE, sin incluir el interno, y (C) incluye la pérdida del esfínter anal interno; y el de cuarto grado incluye los anteriores y la mucosa rectal.  Objetivo:  Identificar las características demográficas, obstétricas y neonatales que se relacionan con desgarros perineales e identificar los factores de riesgo asociados a la lesión del esfínter anal.  Material y métodos:  Estudio descriptivo, transversal, retrospectivo y observacional con revisión de la base de datos física de pacientes atendidas en un hospital privado en la Ciudad de México, en los cuales se buscó en complicaciones maternas desgarro perineal severo y éstos se compararon con desgarro perineal moderado.  Conclusiones:  No se encontró un factor de riesgo asociado con desgarro perineal severo.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract:  Introduction:  Perineal tear is a complication of labor; perineal tears are continuity solutions that may be accompanied by minor bruises, muscle tears, or major lacerations. Perineal tears are subclassified in first degree tears damage to skin; second degree perineal damage muscles; the third degree is subclassified in (A) that covers damage in less than 50% of the external anal sphincter (EAE), (B) more than 50% of EAE without including the internal one and (C) includes the loss of the internal anal sphincter; and the fourth degree includes the anterior and the damage of rectal mucosa.  Objective:  To identify the demographic, obstetric and neonatal characteristics that are related to perineal tears and to identify the risk factors associated with anal sphincter injury.  Material and methods:  Descriptive, retrospective, and observational study with review of the physical database of patients treated at a private hospital in Mexico City, which looked for severe perineal tear in maternal complications, which were compared with moderate perineal tear.  Conclusions:  No risk factor associated with severe perineal tear was found.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Desgarro perineal]]></kwd>
<kwd lng="es"><![CDATA[desgarro perineal severo]]></kwd>
<kwd lng="es"><![CDATA[factores de riesgo para desgarro perineal severo]]></kwd>
<kwd lng="es"><![CDATA[lesión esfínter anal]]></kwd>
<kwd lng="en"><![CDATA[Perineal tear]]></kwd>
<kwd lng="en"><![CDATA[severe perineal tear]]></kwd>
<kwd lng="en"><![CDATA[risk factors for severe perineal tear]]></kwd>
<kwd lng="en"><![CDATA[obstetric anal sphincter injury]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<label>1</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Casey]]></surname>
<given-names><![CDATA[JT]]></given-names>
</name>
<name>
<surname><![CDATA[Bj in]]></surname>
<given-names><![CDATA[MA]]></given-names>
</name>
<name>
<surname><![CDATA[Cheng]]></surname>
<given-names><![CDATA[EY]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Pediatric genital injury: an analysis of the national electronic injury surveillance system]]></article-title>
<source><![CDATA[Urology]]></source>
<year>2013</year>
<volume>82</volume>
<numero>5</numero>
<issue>5</issue>
<page-range>1125-30</page-range></nlm-citation>
</ref>
<ref id="B2">
<label>2</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Folch]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Parés]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Castillo]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Carreras]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Aspectos prácticos en el manejo de las lesiones obstétricas perineales de tercer y cuarto grado para minimizar el riesgo de incontinencia fecal]]></article-title>
<source><![CDATA[Cir Esp]]></source>
<year>2009</year>
<volume>85</volume>
<numero>6</numero>
<issue>6</issue>
<page-range>341-7</page-range></nlm-citation>
</ref>
<ref id="B3">
<label>3</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Eston]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Stephenson-Famy]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[McKenna]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
<name>
<surname><![CDATA[Fialkow]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Perineal laceration and episiotomy repair using a beef tongue model]]></article-title>
<source><![CDATA[MedEdPORTAL]]></source>
<year>2020</year>
<volume>16</volume>
<page-range>10881</page-range></nlm-citation>
</ref>
<ref id="B4">
<label>4</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Jango]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
<name>
<surname><![CDATA[Langhoff-Roos]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Rosthoj]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Sakse]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Mode of delivery after obstetric anal sphincter injury and the risk of long-term anal incontinence]]></article-title>
<source><![CDATA[Am J Obstet Gynecol]]></source>
<year>2016</year>
<volume>214</volume>
<numero>6</numero>
<issue>6</issue>
<page-range>733.e1-733.e13</page-range></nlm-citation>
</ref>
<ref id="B5">
<label>5</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Evers]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Blomquist]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[McDermott]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Handa]]></surname>
<given-names><![CDATA[V]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Obstetrical anal sphincter laceration and anal incontinence 5-10 years after childbirth]]></article-title>
<source><![CDATA[Am J Obstet Gynecol]]></source>
<year>2012</year>
<volume>207</volume>
<numero>5</numero>
<issue>5</issue>
<page-range>425.e1-425.e 6</page-range></nlm-citation>
</ref>
<ref id="B6">
<label>6</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Lowder]]></surname>
<given-names><![CDATA[JL]]></given-names>
</name>
<name>
<surname><![CDATA[Burrows]]></surname>
<given-names><![CDATA[LJ]]></given-names>
</name>
<name>
<surname><![CDATA[Krohn]]></surname>
<given-names><![CDATA[MA]]></given-names>
</name>
<name>
<surname><![CDATA[Weber]]></surname>
<given-names><![CDATA[AM]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Risk factors for primary and subsequent anal sphincter lacerations: a comparison of cohorts by parity and prior mode of delivery]]></article-title>
<source><![CDATA[Am J Obstet Gynecol]]></source>
<year>2007</year>
<volume>196</volume>
<numero>4</numero>
<issue>4</issue>
<page-range>344.e1-5</page-range></nlm-citation>
</ref>
<ref id="B7">
<label>7</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Faridi]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Willis]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Schelzig]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Siggelkow]]></surname>
<given-names><![CDATA[W]]></given-names>
</name>
<name>
<surname><![CDATA[Schumpelick]]></surname>
<given-names><![CDATA[V]]></given-names>
</name>
<name>
<surname><![CDATA[Rath]]></surname>
<given-names><![CDATA[W]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Anal sphincter injury during vaginal delivery-- an argument for cesarean section on request?]]></article-title>
<source><![CDATA[J Perinat Med]]></source>
<year>2002</year>
<volume>30</volume>
<numero>5</numero>
<issue>5</issue>
<page-range>379-87</page-range></nlm-citation>
</ref>
<ref id="B8">
<label>8</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Hehir]]></surname>
<given-names><![CDATA[MP]]></given-names>
</name>
<name>
<surname><![CDATA[O&#8217;Connor]]></surname>
<given-names><![CDATA[HD]]></given-names>
</name>
<name>
<surname><![CDATA[Higgins]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Robson]]></surname>
<given-names><![CDATA[MS]]></given-names>
</name>
<name>
<surname><![CDATA[McAuliffe]]></surname>
<given-names><![CDATA[FM]]></given-names>
</name>
<name>
<surname><![CDATA[Boylan]]></surname>
<given-names><![CDATA[PC]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Obstetric anal sphincter injury, risk factors and method of delivery - an 8-year analysis across two tertiary referral centers]]></article-title>
<source><![CDATA[J Matern Fetal Neonatal Med]]></source>
<year>2013</year>
<volume>26</volume>
<numero>15</numero>
<issue>15</issue>
<page-range>1514-6</page-range></nlm-citation>
</ref>
<ref id="B9">
<label>9</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Jango]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
<name>
<surname><![CDATA[Langhoff-Roos]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Rosthoj]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Sakse]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Modifiable risk factors of obstetric anal sphincter injury in primiparous women: a population-based cohort study]]></article-title>
<source><![CDATA[Am J Obstet Gynecol]]></source>
<year>2014</year>
<volume>210</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>59.e1-6</page-range></nlm-citation>
</ref>
<ref id="B10">
<label>10</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Peleg]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Kennedy]]></surname>
<given-names><![CDATA[CM]]></given-names>
</name>
<name>
<surname><![CDATA[Merrill]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Zlatnik]]></surname>
<given-names><![CDATA[FJ]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Risk of repetition of a severe perineal laceration]]></article-title>
<source><![CDATA[Obstet Gynecol]]></source>
<year>1999</year>
<volume>93</volume>
<page-range>1021-411</page-range></nlm-citation>
</ref>
<ref id="B11">
<label>11</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Johanson]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Menon]]></surname>
<given-names><![CDATA[V]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Soft versus rigid vacuum extractor cups for assisted vaginal delivery. Cochrane Database Syst]]></article-title>
<source><![CDATA[Rev]]></source>
<year>2000</year>
<volume>2</volume>
<page-range>CD000446</page-range></nlm-citation>
</ref>
<ref id="B12">
<label>12</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Vathanan]]></surname>
<given-names><![CDATA[V]]></given-names>
</name>
<name>
<surname><![CDATA[Ashokkumar]]></surname>
<given-names><![CDATA[O]]></given-names>
</name>
<name>
<surname><![CDATA[McAree]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Obstetric anal sphincter injury risk reduction: a retrospective observational analysis]]></article-title>
<source><![CDATA[J Perinat Med]]></source>
<year>2014</year>
<volume>42</volume>
<numero>6</numero>
<issue>6</issue>
</nlm-citation>
</ref>
<ref id="B13">
<label>13</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Christianson]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Bovbjerg]]></surname>
<given-names><![CDATA[V]]></given-names>
</name>
<name>
<surname><![CDATA[McDavitt]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Hullfish]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Risk factors for perineal injury during delivery]]></article-title>
<source><![CDATA[Am J Obstet Gynecol]]></source>
<year>2003</year>
<volume>189</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>255-60</page-range></nlm-citation>
</ref>
<ref id="B14">
<label>14</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Harvey]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Pierce]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Walter]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Chou]]></surname>
<given-names><![CDATA[Q]]></given-names>
</name>
<name>
<surname><![CDATA[Diamond]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Epp]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Obstetrical anal sphincter injuries (OASIS): prevention, recognition, and repair]]></article-title>
<source><![CDATA[J Obstet Gynaecol Can]]></source>
<year>2015</year>
<volume>37</volume>
<numero>12</numero>
<issue>12</issue>
<page-range>1131-48</page-range></nlm-citation>
</ref>
</ref-list>
</back>
</article>
