Choose your font:
 Mukta Malar
 Open Sans Condensed
 Source Sans Pro


[Valid RSS] RSS

Database - Alliance francophone pour l'accouchement respecté (AFAR)

Description of this bibliographical database (AFAR website)
Currently 3046 records
YouTube channel (tutorial)

Created on : 30 Sep 2003
Modified on : 02 Dec 2007

 Modify this record
Do not follow this link unless you know an editor’s password!

Share: Facebook logo   Tweeter logo   Hard

Bibliographical entry (without author) :

Preventing perineal trauma during childbirth: a systematic review Obstet Gynecol. 2000 Mar;95(3):464-71.

Author(s) :

Eason E, Labrecque M, Wells G, Feldman P

Year of publication :


URL(s) :…

Résumé (français)  :

Abstract (English)  :

OBJECTIVE: To review systematically techniques proposed to prevent perineal trauma during childbirth and meta-analyze the evidence of their efficacy from randomized controlled trials.

DATA SOURCES: MEDLINE (1966-1999), the Cochrane Library (1999 Issue 1), and the Cochrane Collaboration: Pregnancy and Childbirth Database (1995); and reference lists from articles identified. Search terms included childbirth or pregnancy or delivery, and perineum, episiotomy, perineal massage, obstetric forceps, vacuum extraction, labor stage-second. No language or study-type constraints were imposed.

STUDY SELECTION: Randomized controlled trials (RCTs) of interventions affecting perineal trauma were reviewed. If no RCTs were available, nonrandomized research designs such as cohort studies were included. Studies were selected by examination of titles and abstracts of more than 1,500 articles, followed by analysis of the methods sections of studies that appeared to be RCTs.

INTEGRATION AND RESULTS: Eligible studies used random or quasirandom allocation of an intervention of interest and reported perineal outcomes. Further exclusions were based on failure to report results by intention to treat, or incomplete or internally inconsistent reporting of perineal outcomes. Final selection of studies and data extraction was by consensus of the first two authors. Data from trials that evaluated similar interventions were combined using a random effects model to determine weighted estimate of risk difference and number needed to treat. Effects of sensitivity analysis and quality scoring were examined. Results indicated good evidence that avoiding episiotomy decreased perineal trauma (absolute risk difference -0.23, 95% confidence interval [CI] -0.35, -0.11). In nulliparas, perineal massage during the weeks before giving birth also protected against perineal trauma (risk difference -0.08, CI -0.12, -0.04). Vacuum extraction (risk difference -0.06, CI -0.10, -0.02) and spontaneous birth (-0.11, 95% CI -0.18, -0.04) caused less anal sphincter trauma than forceps delivery. The mother’s position during the second stage has little influence on perineal trauma (supported upright versus recumbent: risk difference 0.02, 95% CI -0.05, 0.09).

CONCLUSION: Factors shown to increase perineal integrity include avoiding episiotomy, spontaneous or vacuum-assisted rather than forceps birth, and in nulliparas, perineal massage during the weeks before childbirth. Second-stage position has little effect. Further information on techniques to protect the perineum during spontaneous delivery is sorely needed.

Sumário (português)  :

Full text (private) :

 ➡ Access requires authorization

Comments :

Acces libre au resume, texte payant.

Argument (français) :

Revue systématique des techniques de prévention des traumatismes périnéaux.

Argument (English):

Argumento (português):

Keywords :

➡ position during labor ; physiology ; perineal/vaginal tears ; episiotomy ; instrumental delivery ; forceps delivery

Author of this record :

Cécile Loup — 30 Sep 2003

Discussion (display only in English)
➡ Only identified users

 I have read the guidelines of discussions and I accept all terms (read guidelines)


New expert query --- New simple query

Creating new record --- Importing records

User management --- Dump database --- Contact


This database is managed by Alliance francophone pour l'accouchement respecté (AFAR,
affiliated with Collectif interassociatif autour de la naissance (CIANE,
It is fed by the voluntary contributions of persons interested in the sharing of scientific data.
If you agree with this project, you can support us in several ways:
(1) contributing to this database if you have a minimum training in documentation
(2) or financially supporting AFAR (see below)
(3) or joining the AFAR (or another society affiliated with CIANE).
Sign in or create an account to follow changes or become an editor.
Contact afar.association(arobase) for more information.

Valid CSS! Valid HTML!
Donating to AFAR (click “Faire un don”) will help us to maintain and develop sites and public
databases towards the support of parents and caregivers’ informed decisions with respect to childbirth