A prospective cohort study of repair and non-repair of second-degree perineal trauma: results and issues for future research

Bick, Debra, Metcalfe, Alison, Tohill, Sue, Williams, Amanda and Haldon, Valerie (2006) A prospective cohort study of repair and non-repair of second-degree perineal trauma: results and issues for future research. Evidence-Based Midwifery, 4 (2). pp. 60-64. ISSN 1479-4489

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Abstract

BACKGROUND:
Perineal trauma is common following vaginal birth. For the most frequently occurring trauma – second-degree tears – there is debate about whether these should be sutured or left to heal by primary intent.

METHOD:
A prospective cohort study was undertaken in five maternity units in Birmingham of women who sustained asutured or unsutured second-degree perineal tear. Recruited women were followed up at 24 hours, ten days, 12 weeks and 12 months to capture data on maternal health outcomes. The main outcome of interest was prevalence of perineal pain.

RESULTS:
A total of 282 women (196 sutured and 86 unsutured) were recruited, 20% of the anticipated eligible sample. Highlevels of morbidity persisted in both groups. Women whose trauma was unsutured had more urinary frequency at ten days(p<0.04), and increased self-referral for perineal problems (p<0.02) and Edinburgh postnatal depression scores >13 (p<0.01)at 12 months. No differences were observed for perineal pain. Clinician compliance with study protocols was poor.

CONCLUSION:
This is the largest cohort study to date to compare outcomes of suturing versus non-suturing of second-degreetears. Results suggest that pain should not be the primary outcome in future studies of long-term morbidity. High levels ofmorbidity highlight the need for studies to establish the most clinically and cost-effective management of this commonlysustained trauma, and to ascertain why compliance with study protocols is poor.

Item Type: Article
Uncontrolled Keywords: Midwifery; Pain; Postpartum; Sexual health; Women's health; Perineal management
Subjects: Medicine and health > Midwifery
Related URLs:
Depositing User: Rod Pow
Date Deposited: 24 Jul 2012 08:25
Last Modified: 10 Aug 2016 12:36
URI: http://repository.uwl.ac.uk/id/eprint/113

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