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88], 'can': [23], 'severely': [24], 'affect': [25], 'a': [26, 35, 56, 172], 'woman’s': [27], 'quality': [28], 'of': [29, 43, 55, 84, 110, 171, 198], 'life.': [30], 'The': [31, 195], 'study': [32, 138, 204], 'design': [33], 'was': [34, 184], 'retrospective': [36], 'case': [37], 'control': [38, 79], 'study.': [39, 194], '<strong>Method</strong>.': [40], 'Ninety-three': [41], 'cases': [42, 95], 'third-': [44, 188], 'tears': [48, 147, 191], 'were': [49, 76, 90, 119], 'identified': [50], 'from': [51], 'the': [52, 72, 85, 137, 160, 165, 169, 203], 'birth': [53, 115], 'register': [54], 'tertiary': [57], 'referral': [58], 'hospital': [59], '(Tygerberg': [60], 'Hospital).': [61], 'One': [62], 'hundred': [63], 'nine': [65], 'patients': [66, 132, 201], 'with': [67, 98, 187], 'normal': [68], 'vaginal': [69], 'deliveries': [70, 124], 'same': [73], 'time': [74], 'period': [75], 'used': [77], 'group.': [80, 139], '<strong>Results</strong>.': [81], 'An': [82], 'analysis': [83], 'results': [86], 'revealed': [87], 'there': [89, 118], 'no': [91], 'significant': [92], 'differences': [93], 'between': [94], 'controls': [97], 'regards': [99], 'age,': [101], 'body': [102], 'mass': [103], 'index': [104], '(BMI),': [105], 'gestation': [106], 'at': [107], 'delivery,': [108], 'duration': [109], 'second': [111], 'stage,': [112], 'episiotomy': [113, 177], 'weight.': [116], 'However,': [117, 152], 'significantly': [120], 'more': [121], 'primigravidas,': [122], 'assisted': [123, 156], '(forceps': [125], 'vacuum),': [127], 'occipitoposterior': [128, 154], 'positions,': [129], 'HIV': [130, 199], 'negative': [131, 200], 'shoulder': [134], 'dystocia': [135, 183], '<strong>Conclusions</strong>.': [140], 'Antenatal': [141], 'are': [148], 'difficult': [149], 'identify.': [151], 'intrapartum': [153], 'deliveries,': [157], 'especially': [158], 'primigravid': [161], 'patient,': [162], 'should': [163, 179], 'warn': [164], 'obstetrician/': [166], 'midwife': [167], 'about': [168], 'severe': [173], 'tear.': [174], 'A': [175], 'restrictive': [176], 'policy': [178], 'be': [180], 'practiced.': [181], 'Shoulder': [182], 'invariably': [185], 'associated': [186], 'higher': [196], 'incidence': [197], 'group': [205], 'requires': [206], 'further': [207], 'research.': [208]}, 'cited_by_api_url': 'https://api.openalex.org/works?filter=cites:W2160754263', 'counts_by_year': [{'year': 2024, 'cited_by_count': 1}, {'year': 2022, 'cited_by_count': 1}, {'year': 2020, 'cited_by_count': 1}, {'year': 2018, 'cited_by_count': 1}, {'year': 2016, 'cited_by_count': 1}], 'updated_date': '2024-12-10T02:49:21.718748', 'created_date': '2016-06-24'}