A randomised controlled trial of care of the perineum during second stage of normal labour

@article{McCandlish1998ARC,
  title={A randomised controlled trial of care of the perineum during second stage of normal labour},
  author={Rona McCandlish and Ursula Bowler and Hedwig Asten and Georgina Berridge and C Winter and Lesley Sames and Jo Garcia and Mary J. Renfrew and Diana Elbourne},
  journal={BJOG: An International Journal of Obstetrics \& Gynaecology},
  year={1998},
  volume={105}
}
Objective To compare the effect of two methods of perineal management used during spontaneous vaginal delivery on the prevalence of perineal pain reported at 10 days after birth. 

Paper Mentions

Observational Clinical Trial
Perineal injury following childbirth can result in complications such as wound infection. The perineum has closely related anatomical structures including the external genital organs… Expand
ConditionsAnal Sphincter Injury, Obstetric Trauma, Perineal Infection, (+1 more)
InterventionDevice, Diagnostic Test
Interventional Clinical Trial
INTRODUCTION It is estimated that over 80% of women who give vaginal birth will sustain some form of perineal tear and of these 60-70% will require suturing. It is of great importance… Expand
ConditionsSkin Structures and Soft Tissue Infections, Wound Infection
InterventionDevice
Multidisciplinary training in perineal care during labor and delivery for the reduction of anal sphincter injuries
  • J. Frost, R. Gundry, H. Young, Adel Naguib
  • Medicine
  • International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics
  • 2016
TLDR
To determine whether the introduction of a multidisciplinary intrapartum perineal‐care training program reduced the rate of obstetric anal sphincter injuries in patients undergoing vaginal deliveries, a large number of patients underwent vaginal deliveries. Expand
Manual perineal support at the time of childbirth: a systematic review and meta‐analysis
TLDR
Debate continues regarding the effectiveness of perineal support during childbirth in reducing the risk of trauma. Expand
Non-surgical intrapartum practices for the prevention of severe perineal trauma: a systematic review protocol.
TLDR
The objective of this review is to determine the effectiveness of non-surgical intrapartum practices in reducing the incidence of severe perineal trauma during childbirth. Expand
Perineal warm compress reduces risk of third- and fourth- degree tears and should be part of second stage care
TLDR
Perineal techniques during the second stage of labour for reducing perineal trauma and its applications in women with high-risk pregnancies are described. Expand
Perineal trauma: prevention and treatment.
TLDR
Two aspects of routine midwifery practice are examined: management of the perineum at the end of the second stage of labor and management and repair of perineal injury. Expand
Is it possible to predict or prevent third degree tears?
  • L. Byrd, J. Hobbiss, M. Tasker
  • Medicine
  • Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland
  • 2005
TLDR
The causes of anal sphincter injury during vaginal delivery are reviewed to emphasise that they are not usually the result of poor obstetric care and the role of the colorectal surgeon in their management is discussed. Expand
Nordic influence on British obstetrics
TLDR
It is concluded that, with the possible exception of warm compresses, no treatment reduces perineal injury and there was no evidence that controlled delivery of the head made a difference. Expand
Perineal re-suturing versus expectant management following vaginal delivery complicated by a dehisced wound : 'The PREVIEW Study'
TLDR
Perineal re-suturing versus expectant management following vaginal delivery complicated by a dehisced wound is evaluated in a mixed methods study incorporating a pilot and feasibility randomised controlled trial. Expand
Promoting normality in the management of the perineum during the second stage of labour
TLDR
The conclusions drawn show that the updating of practice and antenatal education may be required so that woman are given the information they need to make an informed choice as to what they want for their own body, child and experience. Expand
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References

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TLDR
To evaluate a policy of two stage postpartum perineal repair leaving the skin unsutured, a large number of women thought to be suitable for vaginal or laparoscopic mesh placement underwent surgery. Expand
Protecting the perineum in childbirth 3: perineal care today
Recent evidence that a slow physiological birth does not negatively affect maternal or fetal wellbeing, and that the routine use of episiotomy is not justified, has led to a revival of traditionalExpand
A RANDOMISED TRIAL TO EVALUATE THE USE OF A BIRTH CHAIR FOR DELIVERY
TLDR
There was no significant difference in the length of the second stage of labour, the time spent bearing down, or the need for operative delivery in the conventional dorsal position with that in a birth chair. Expand
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The sexual behaviour of postnatal women, including time of restarting intercourse, problems encountered, use of contraception and related use of available services are described. Expand
West Berkshire perineal management trial.
TLDR
Findings provide little support either for liberal use of episiotomy or for claims that reduced use of the operation decreases postpartum morbidity. Expand
West Berkshire perineal management trial: three year follow up.
TLDR
Women who had participated in a randomised controlled trial of policies of restricted (10%) versus liberal (51%) episiotomy during spontaneous vaginal delivery were recontacted by postal questionnaire three years after delivery, and there was no evidence of a differential response rate between the two trial groups. Expand
Care of the perineum in the second stage of labour: a study of views and practices of Australian midwives.
TLDR
There is little evidence from randomised trials to support many of the second stage practices, and further research will clarify those which are most effective. Expand
Practices that minimize trauma to the genital tract in childbirth: a systematic review of the literature.
TLDR
The case for restricting the use of episiotomy is conclusive, and several other clinical factors warrant investigation, including the role of hand maneuvers by the birth attendant in preventing birth trauma. Expand
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TLDR
Univariate and multivariate analyses showed that episiotomy was strongly related to fetal bradycardia, prolonged second stage, ethnic status, and maternal education level, and spontaneous lacerations were influenced by these factors. Expand
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Trends in management and outcome of pregnancy in Cardiff residents from 1965 to 1973 were reviewed and hospital delivery became almost universal, monitoring the fetus during pregnancy was introduced, and induction and acceleration of labour became commonplace. Expand
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