During my short experience as a practitioner of medicine few things have impressed me more than the great number of perineal lacerations in women, and no impression has been more profound than that made by the untold suffering endured and the physical and nervous wrecks found as a direct result of perineal lacerations, or of some of the numerous pathologic conditions attendant on or resulting from these conditions. Schroeder has shown that in primiparæ the fourchette is torn through in 61 per cent. of all cases; while in 34 per cent. of primiparæ and 9 per cent. of multiparæ the perineum is lacerated to a greater or less degree. The causes of these lacerations are variable, and the percentage of injuries may be somewhat decreased by judicious care in the management of labor, but with all possible care there will still occur a large percentage of injuries. Since we can
HOLLAND CL. DUTY OF PHYSICIAN TO PATIENTS WITH PERINEAL LACERATIONS. JAMA. 1905;XLV(5):326–327. doi:10.1001/jama.1905.52510050030001c
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