Effects of an intervention program for reducing severe perineal trauma during the second stage of labor.
Cast your vote
You can rate an item by clicking the amount of stars they wish to award to this item.
When enough users have cast their vote on this item, the average rating will also be shown.
Your vote was cast
Thank you for your feedback
Thank you for your feedback
Vernhardsdottir, Anna S
Tryggvadottir, Gudny B
Geirsson, Reynir T
MetadataShow full item record
CitationEffects of an intervention program for reducing severe perineal trauma during the second stage of labor. 2019, 46(2):371-378 Birth
AbstractBACKGROUND: Obstetric anal sphincter injuries lead frequently to short- and long-term consequences for the mother, including perineal pain, genital prolapse, and sexual problems. The aim of the study was to evaluate whether the implementation of an intervention program in the second stage of labor involving altered perineal support techniques reduced severe perineal trauma. METHODS: All women reaching the second stage of labor and giving birth vaginally to singleton babies at Landspítali University Hospital (comprising 76% of births in Iceland in 2013) were enrolled in a cohort study. Data were recorded retrospectively for 2008-2010 and prospectively in 2012-2014, for a total of 16 336 births. During 2011, an intervention program was implemented, involving all midwives and obstetricians working in the labor wards. Two professionals assessed and agreed on classification of every perineal tear. RESULTS: The prevalence of obstetric anal sphincter injuries decreased from 5.9% to 3.7% after the implementation (P < 0.001). Third-degree tears decreased by 40%, and fourth-degree tears decreased by 56% (P < 0.001). The prevalence of first-degree tears increased from 25.8% to 33.1%, whereas second-degree tears decreased from 44.7% to 36.6% between the before and after study periods. Severe perineal trauma was linked to birthweight, and this did not change despite the new intervention. CONCLUSIONS: Active intervention to reduce perineal trauma was associated with an overall significant decrease in obstetric anal sphincter injuries. Good perineal visualization, manual perineal support, and controlled delivery of the fetal head were essential components for reducing perineal trauma.
DescriptionTo access publisher's full text version of this article click on the hyperlink below
- Perineal techniques during the second stage of labour for reducing perineal trauma.
- Authors: Aasheim V, Nilsen ABV, Reinar LM, Lukasse M
- Issue date: 2017 Jun 13
- Use of endoanal ultrasound for reducing the risk of complications related to anal sphincter injury after vaginal birth.
- Authors: Walsh KA, Grivell RM
- Issue date: 2015 Oct 29
- Anal sphincter tears: prospective study of obstetric risk factors.
- Authors: Samuelsson E, Ladfors L, Wennerholm UB, Gåreberg B, Nyberg K, Hagberg H
- Issue date: 2000 Jul
- Predicting obstetric anal sphincter injuries in a modern obstetric population.
- Authors: Meister MR, Cahill AG, Conner SN, Woolfolk CL, Lowder JL
- Issue date: 2016 Sep
- Incidence of and risk factors for perineal trauma: a prospective observational study.
- Authors: Smith LA, Price N, Simonite V, Burns EE
- Issue date: 2013 Mar 7