<?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>0300-9041</journal-id>
<journal-title><![CDATA[Ginecología y obstetricia de México]]></journal-title>
<abbrev-journal-title><![CDATA[Ginecol. obstet. Méx.]]></abbrev-journal-title>
<issn>0300-9041</issn>
<publisher>
<publisher-name><![CDATA[Federación Mexicana de Colegios de Obstetricia y Ginecología A.C.]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0300-90412019000700005</article-id>
<article-id pub-id-type="doi">10.24245/gom.v87i7.2892</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Prevalencia de desgarros perineales en pacientes con aplicación de vacuum]]></article-title>
<article-title xml:lang="en"><![CDATA[Prevalence of perineal tars in patients submitted to the application of vacuum]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Arvizu-Armenta]]></surname>
<given-names><![CDATA[José Alan]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</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[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[Aguilera-Cervantes]]></surname>
<given-names><![CDATA[Sandra Magdalena]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Sánchez-Huesca]]></surname>
<given-names><![CDATA[Ramiro]]></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[,Hospital Nuevo Sanatorio Durango Servicio de Ginecología y Obstetricia ]]></institution>
<addr-line><![CDATA[Ciudad de México ]]></addr-line>
<country>Mexico</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,CEBECI Farmacología Clínica Sociedad Civil Departamento de Investigación en Medicina ]]></institution>
<addr-line><![CDATA[Ciudad de México ]]></addr-line>
<country>Mexico</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>00</month>
<year>2019</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>00</month>
<year>2019</year>
</pub-date>
<volume>87</volume>
<numero>7</numero>
<fpage>447</fpage>
<lpage>453</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_arttext&amp;pid=S0300-90412019000700005&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_abstract&amp;pid=S0300-90412019000700005&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_pdf&amp;pid=S0300-90412019000700005&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen  OBJETIVO:  Estimar la prevalencia de desgarro perineal en pacientes a quienes se aplicó vacuum e identificar los factores de riesgo de lesión del esfínter anal.  MATERIALES Y MÉTODOS:  Estudio descriptivo, transversal, retrospectivo y observacional. Se seleccionaron todos los partos en los que se aplicó vacuum del total de partos instrumentados en un hospital de segundo nivel de la Ciudad de México. Se incluyeron mujeres con embarazo de término, únicos y de evolución normal. Las lesiones perineales se clasificaron según la OMS. Se calcularon la prevalencia y el intervalo de confianza. Las variables se describen mediante medias y desviaciones estándar o frecuencias absolutas y relativas. Los desgarros se compararon con &#967;22 y los valores con significación estadística fueron los de p &lt; 0.05.  RESULTADOS:  Se estudiaron 74 partos instrumentados en 708 partos totales, de los que 70 de 74 fueron con vacuum. En relación solo con estos últimos, los desgarros más prevalentes fueron de primer y segundo grado con valores de 40.0% (IC95%: 29-51) y 38.6% (IC95%: 27-50), respectivamente. No se identificaron factores de riesgo asociados con desgarros perineales severos.  CONCLUSIONES:  La prevalencia en la población estudiada fue similar a la de países industrializados y los desgarros moderados fueron los de mayor prevalencia.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  OBJECTIVES:  To estimate the prevalence of perineal tears in patients which delivery was instrumented by vacuum and to identify the risk factors that lead to a tear in the anal sphincter.  MATERIAL AND METHOD:  Descriptive, cross-sectional, retrospective and observational study. All vacuum deliveries were selected among the instrumental deliveries of the population in a secondary care hospital in Mexico City. The inclusion criteria were women who delivered vaginally at term with sole and normoevolutive pregnancies. The perineal tears were classified according to WHO. The statistical analysis included the estimation of prevalences with their corresponding confidence intervals. Variables were described by means and standard deviations or absolute and relative frequencies. Tears were compared using &#967;2 tests considering a statistical significance of p &lt; 0.05.  RESULTS:  The number of instrumented deliveries was 74 out of 708 cases of total deliveries, those with vacuum were 70 out of 74. Considering the instrumented deliveries with vacuum, the most prevalent tears were those of first and second degree with values of 40.0% (CI 29-51) and 38.6% (CI 27-50) respectively. There were not associated risk factors to severe perineal tears.  CONCLUSIONS:  Prevalence in the studied population was similar to developed countries and moderate tears are the most prevalent.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Desgarro perineal]]></kwd>
<kwd lng="es"><![CDATA[Vacuum]]></kwd>
<kwd lng="es"><![CDATA[factores de riesgo]]></kwd>
<kwd lng="es"><![CDATA[esfínter anal]]></kwd>
<kwd lng="es"><![CDATA[parto instrumentado]]></kwd>
<kwd lng="es"><![CDATA[prevalencia]]></kwd>
<kwd lng="en"><![CDATA[Perineal tears]]></kwd>
<kwd lng="en"><![CDATA[Vacuum]]></kwd>
<kwd lng="en"><![CDATA[Risk factors]]></kwd>
<kwd lng="en"><![CDATA[Anal sphincter: Vacuum deliveries]]></kwd>
<kwd lng="en"><![CDATA[Instrumental deliveries]]></kwd>
<kwd lng="en"><![CDATA[Prevalence]]></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[Peaceman]]></surname>
<given-names><![CDATA[AM]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Operative vaginal delivery. Clinical management guidelines for obstetrician-gynecologists]]></article-title>
<source><![CDATA[Practice Bulletin. ACOG]]></source>
<year>2015</year>
<volume>154</volume>
</nlm-citation>
</ref>
<ref id="B2">
<label>2</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Baskett]]></surname>
<given-names><![CDATA[TF]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Operative vaginal delivery: An historical perspective]]></article-title>
<source><![CDATA[Best Pract Res Clin Obstet Gynaecol]]></source>
<year>2019</year>
<volume>56</volume>
<numero>3-10</numero>
<issue>3-10</issue>
</nlm-citation>
</ref>
<ref id="B3">
<label>3</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Caughey]]></surname>
<given-names><![CDATA[AB]]></given-names>
</name>
<name>
<surname><![CDATA[Sandberg]]></surname>
<given-names><![CDATA[PL]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Forceps compared with vacuum rates of neonatal and maternal morbidity]]></article-title>
<source><![CDATA[Obstetrics &amp; Gynecology]]></source>
<year>2005</year>
<volume>106</volume>
<numero>5</numero>
<issue>5</issue>
<page-range>908-12</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[Ryman]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Ahlberg]]></surname>
<given-names><![CDATA[MB]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Risk factors for anal sphincter tears in vacuum-assisted delivery]]></article-title>
<source><![CDATA[Sexual &amp; Reproductive Healthcare]]></source>
<year>2015</year>
<volume>6</volume>
<page-range>151-6</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[Andrews]]></surname>
<given-names><![CDATA[SE]]></given-names>
</name>
<name>
<surname><![CDATA[Alston]]></surname>
<given-names><![CDATA[MJ]]></given-names>
</name>
<name>
<surname><![CDATA[Allshouse]]></surname>
<given-names><![CDATA[AA]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Does the number of forceps deliveries performed in residency predict use in practice?]]></article-title>
<source><![CDATA[Am J ObstetGynecol]]></source>
<year>2015</year>
<volume>213</volume>
<numero>93</numero>
<issue>93</issue>
</nlm-citation>
</ref>
<ref id="B6">
<label>6</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Merriam]]></surname>
<given-names><![CDATA[AA]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Trends in operative vaginal delivery, 2005-2013: a population-based study]]></article-title>
<source><![CDATA[BJOG]]></source>
<year>2017</year>
</nlm-citation>
</ref>
<ref id="B7">
<label>7</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Thiagamoorthy]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[National survey of perineal trauma and its subsequent management in the United Kingdom]]></article-title>
<source><![CDATA[Int Urogynecol J]]></source>
<year>2014</year>
<volume>25</volume>
<numero>12</numero>
<issue>12</issue>
<page-range>1621-7</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[Martínez]]></surname>
<given-names><![CDATA[PJ]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Consideraciones sobre 113 casos de aplicación de fórceps medio]]></article-title>
<source><![CDATA[Ginecol Obstet Mex]]></source>
<year>2011</year>
<volume>79</volume>
<numero>8</numero>
<issue>8</issue>
<page-range>516-24</page-range></nlm-citation>
</ref>
<ref id="B9">
<label>9</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Althabe]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
</person-group>
<source><![CDATA[Elección de instrumentos para parto vaginal asistido: Comentario de la BSR. La Biblioteca de Salud Reproductiva de la OMS]]></source>
<year></year>
<publisher-loc><![CDATA[Ginebra ]]></publisher-loc>
<publisher-name><![CDATA[Organización Mundial de la Salud]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B10">
<label>10</label><nlm-citation citation-type="book">
<collab>Encuesta Perinatal</collab>
<source><![CDATA[Resultados en Hospitales Públicos de la Provincia de Buenos Aires y Ciudad Autónoma de Buenos Aires 2009]]></source>
<year>2008</year>
<publisher-loc><![CDATA[Buenos Aires ]]></publisher-loc>
<publisher-name><![CDATA[Ministerio de salud]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B11">
<label>11</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Cargill]]></surname>
<given-names><![CDATA[YM]]></given-names>
</name>
<name>
<surname><![CDATA[MacKinnon]]></surname>
<given-names><![CDATA[CJ]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[No. 148-Guidelines for Operative Vaginal Birth]]></article-title>
<source><![CDATA[J Obstet Gynaecol Can]]></source>
<year>2018</year>
<volume>40</volume>
<numero>2</numero>
<issue>2</issue>
</nlm-citation>
</ref>
<ref id="B12">
<label>12</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Martin]]></surname>
<given-names><![CDATA[JA]]></given-names>
</name>
<name>
<surname><![CDATA[Hamilton]]></surname>
<given-names><![CDATA[BE]]></given-names>
</name>
<name>
<surname><![CDATA[Sutton]]></surname>
<given-names><![CDATA[PD]]></given-names>
</name>
<name>
<surname><![CDATA[Ventura]]></surname>
<given-names><![CDATA[SJ]]></given-names>
</name>
<name>
<surname><![CDATA[Menacker]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[Kirmeyer]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Births: Final data for 2006]]></article-title>
<source><![CDATA[National Vital Statistics Reports]]></source>
<year>2016</year>
<volume>67</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>11-20</page-range></nlm-citation>
</ref>
<ref id="B13">
<label>13</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[O&#8217;Mahony]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Choice of instruments for assisted vaginal delivery]]></article-title>
<source><![CDATA[Cochrane Database of Systematic Reviews]]></source>
<year>2010</year>
<volume>11</volume>
</nlm-citation>
</ref>
<ref id="B14">
<label>14</label><nlm-citation citation-type="book">
<source><![CDATA[The management of third- and fourth-degree perineal tears. Green-top guideline]]></source>
<year>2015</year>
<publisher-name><![CDATA[RCOG]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B15">
<label>15</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Lewicky-Gaupp]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Leader-Cramer]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Wound complications after obstetric anal sphincter injuries]]></article-title>
<source><![CDATA[ACOG]]></source>
<year>2015</year>
<volume>125</volume>
<numero>5</numero>
<issue>5</issue>
<page-range>1088-93</page-range></nlm-citation>
</ref>
<ref id="B16">
<label>16</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Ramírez]]></surname>
<given-names><![CDATA[GC]]></given-names>
</name>
<name>
<surname><![CDATA[Ramírez]]></surname>
<given-names><![CDATA[GB]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Uso actual del extractor de vacío]]></article-title>
<source><![CDATA[Ginecol Obstet Mex]]></source>
<year>2008</year>
<volume>76</volume>
<numero>10</numero>
<issue>10</issue>
<page-range>629-3</page-range></nlm-citation>
</ref>
</ref-list>
</back>
</article>
