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Introduction <p>Several nations continue to have high rates of episiotomy in Iran; 97% of primiparous women have this procedure. Perineum rupture and difficult delivery are more common in women with less than 40&#xa0;mm perineum length. This study aimed to determine the perineum length in nulliparous women to predict the need for episiotomy in women with shorter perineum length.</p> Methods <p>The study included nulliparous women in Tabriz, Iran, referred for breast cancer screening and gynecological care. Multigravida women, those with perineum disorders, pelvic prolapse, and underlying diseases were excluded. The length of the perineum was obtained by measuring the area between the posterior fourchette and the anus foramen. To obtain the anal position index (API), the fourchette to anus distance and fourchette to coccyx distance were measured in vertical and curved positions, and the first distance was divided by the second distance (API1 in the vertical distance) and (API2 in curved distance). Moreover, height, weight, shoe size, and API relation were evaluated.</p> Results <p>Among the total of 300 women, the mean size of the perineum was 3.1 ± 0.53&#xa0;cm. The size of the fourchette to coccyx distance was 7.72 ± 1.03 in the vertical position and 8.47 ± 1.04&#xa0;cm in the curved position. A significant correlation between BMI and perineum length was detected (<i>r</i> = 0.128, <i>p</i> = 0.026). In addition, the correlation between weight and API was significant in curved and vertical positions. We detected a significant correlation between height, perineum length, and API in the curved and vertical position measurements.</p> Conclusion <p>This study showed that the mean size of the perineum was short compared to the other races, and was correlated with BMI, as well as shoe size. Higher episiotomy rate would be attributed to short perineum compared to other races. Although, episiotomy has been a topic of debate globally, and efforts should be made to individualize care and consider alternative strategies to reduce perineal trauma while ensuring safe and positive childbirth experiences for Iranian women.</p>

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Determination of the Perineal Body Length in Iranian Nulliparous Women

  • 期刊论文

  • 发表日期：

    2025年10月9日

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  • Shalaleh Mousaei,
  • Parvin Bastani,
  • Hanieh Salehi-Pourmehr

摘要

Introduction

Several nations continue to have high rates of episiotomy in Iran; 97% of primiparous women have this procedure. Perineum rupture and difficult delivery are more common in women with less than 40 mm perineum length. This study aimed to determine the perineum length in nulliparous women to predict the need for episiotomy in women with shorter perineum length.

Methods

The study included nulliparous women in Tabriz, Iran, referred for breast cancer screening and gynecological care. Multigravida women, those with perineum disorders, pelvic prolapse, and underlying diseases were excluded. The length of the perineum was obtained by measuring the area between the posterior fourchette and the anus foramen. To obtain the anal position index (API), the fourchette to anus distance and fourchette to coccyx distance were measured in vertical and curved positions, and the first distance was divided by the second distance (API1 in the vertical distance) and (API2 in curved distance). Moreover, height, weight, shoe size, and API relation were evaluated.

Results

Among the total of 300 women, the mean size of the perineum was 3.1 ± 0.53 cm. The size of the fourchette to coccyx distance was 7.72 ± 1.03 in the vertical position and 8.47 ± 1.04 cm in the curved position. A significant correlation between BMI and perineum length was detected (r = 0.128, p = 0.026). In addition, the correlation between weight and API was significant in curved and vertical positions. We detected a significant correlation between height, perineum length, and API in the curved and vertical position measurements.

Conclusion

This study showed that the mean size of the perineum was short compared to the other races, and was correlated with BMI, as well as shoe size. Higher episiotomy rate would be attributed to short perineum compared to other races. Although, episiotomy has been a topic of debate globally, and efforts should be made to individualize care and consider alternative strategies to reduce perineal trauma while ensuring safe and positive childbirth experiences for Iranian women.