Trial reportInternational urogynecology journal and pelvic floor dysfunction2007
Anal sphincter lacerations and upright delivery postures--a risk analysis from a randomized controlled trial.
Trial report in International urogynecology journal and pelvic floor dysfunction, 2007. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
12 citing papers in PubMed, 2 syntheses or guidelines pooled it, 50 citations in OpenAlex.
- Position in the second stage of labour for women without epidural anaesthesia.The Cochrane database of systematic reviews · 2017Pooled it
- Hyaluronidase for reducing perineal trauma.The Cochrane database of systematic reviews · 2014Pooled it
- A randomized trial of birthing with and without stirrups.American journal of obstetrics and gynecology · 2012Trial
- IUGA International Guidelines on Obstetric Anal Sphincter Injuries.International urogynecology journal · 2026Article
- Aspects of Pelvic Floor Protection in Spontaneous Delivery - a Review.Geburtshilfe und Frauenheilkunde · 2022Article
- The effectiveness of mediolateral episiotomy in preventing obstetric anal sphincter injuries during operative vaginal delivery: a ten-year analysis of a national registry.International urogynecology journal · 2018Article
- A cross-sectional survey of policies guiding second stage labor in urban Japanese hospitals, clinics and midwifery birth centers.BMC pregnancy and childbirth · 2016Article
- Position in the second stage of labour and de novo onset of post-partum urinary incontinence.International urogynecology journal · 2016Article
- Birth position and obstetric anal sphincter injury: a population-based study of 113 000 spontaneous births.BMC pregnancy and childbirth · 2015Article
- Incidence of and risk factors for perineal trauma: a prospective observational study.BMC pregnancy and childbirth · 2013Article
- Fear causes tears - perineal injuries in home birth settings. A Swedish interview study.BMC pregnancy and childbirth · 2011Article
- Risk factors for birth canal lacerations in primiparous women.American journal of perinatology · 2008Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo evaluate obstetric sphincter lacerations after a kneeling or sitting position at second stage of labor in a multivariate risk analysis model. MATERIALS AND
methodsTwo hundred and seventy-one primiparous women with normal pregnancies and spontaneous labor were randomized, 138 to a kneeling position and 133 to a sitting position. Medical data were retrieved from delivery charts and partograms. Risk factors were tested in a multivariate logistic regression model in a stepwise manner.
resultsThe trial was completed by 106 subjects in the kneeling group and 112 subjects in the sitting group. There were no significant differences with regard to duration of second stage of labor or pre-trial maternal characteristics between the two groups. Obstetrical sphincter tears did not differ significantly between the two groups but an intact perineum was more common in the kneeling group (p<0.03) and episiotomy (mediolateral) was more common in the sitting group (p<0.05). Three grade IV sphincter lacerations occurred in the sitting group compared to none in the kneeling group (NS). Multivariate risk analysis indicated that prolonged duration of second stage of labor and episiotomy were associated with an increased risk of third- or fourth-degree sphincter tears (p<0.01 and p<0.05, respectively). Delivery posture, maternal age, fetal weight, use of oxytocin, and use of epidural analgesia did not increase the risk of obstetrical anal sphincter lacerations in the two upright postures.
conclusionObstetrical anal sphincter lacerations did not differ significantly between a kneeling or sitting upright delivery posture. Episiotomy was more common after a sitting delivery posture, which may be associated with an increased risk of anal sphincter lacerations. Upright delivery postures may be encouraged in healthy women with normal, full-term pregnancy.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.