ArticleInternational urogynecology journal2014
Modeling manual perineal protection during vaginal delivery.
Article in International urogynecology journal, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers.
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Who cites it
21 citing papers in PubMed, 58 citations in OpenAlex.
- Transfer of Restrictive Episiotomy Practice with Low OASIS Rate from Tertiary to Primary Care Level-Lessons Learned and Future Challenges.Healthcare (Basel, Switzerland) · 2026Article
- IUGA International Guidelines on Obstetric Anal Sphincter Injuries.International urogynecology journal · 2026Article
- Clinical guidance paper VVOG-CRGOLFB prevention and management of obstetrical perineal trauma.European journal of obstetrics & gynecology and reproductive biology: X · 2025Article
- Birth and Regulation of head Extension to Guide Manual perineal Assistance (BREGMA) study: a prospective cohort study.BMC pregnancy and childbirth · 2025Article
- Finite element modeling in obstetrics and gynecology: advances, applications, and challenges.Frontiers in medicine · 2025Review
- Influence of experimental conditions on some in-vitro biomechanical properties of the sow's perineum.Scientific reports · 2024Article
- On the uncertainty quantification of the active uterine contraction during the second stage of labor simulation.Medical & biological engineering & computing · 2024Article
- Perineal stress as a predictor of performing episiotomy in primiparous women: a prospective observational study.BMC pregnancy and childbirth · 2022Observational
- Finite element modeling of maximum stress in pelvic floor structures during the head expulsion (FINESSE) study.International urogynecology journal · 2021Article
- Feasibility and safety of antepartum tactile imaging.International urogynecology journal · 2021Article
- Postpartum perineal pain and dyspareunia related to each superficial perineal muscle injury: a cohort study.International urogynecology journal · 2020Article
- Persistent occiput posterior position and stress distribution in levator ani muscle during vaginal delivery computed by a finite element model.International urogynecology journal · 2020Article
- Metrics of perineal support (MOPS) study.BMC pregnancy and childbirth · 2020Article
- Characterization of Perineum Elasticity and Pubic Bone-Perineal Critical Distance with a Novel Tactile Probe: Results of an Intraobserver Reproducibility Study.Open journal of obstetrics and gynecology · 2020Article
- The effect of the first vaginal birth on pelvic floor anatomy and dysfunction.International urogynecology journal · 2019Observational
- Timing of cesarean and its impact on labor duration and genital tract trauma at the first subsequent vaginal birth: a retrospective cohort study.BMC pregnancy and childbirth · 2019Article
- 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
- Active delivery of the anterior arm and incidence of second-degree perineal tears: a clinical practice evaluation.BMC pregnancy and childbirth · 2017Observational
- Fetal head size and effect of manual perineal protection.PloS one · 2017Article
- Obstetric anal sphincter injuries: review of anatomical factors and modifiable second stage interventions.International urogynecology journal · 2015Review
Corrections and comments
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Authors and funding
6 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introduction and hypothesisWe compared hands-on manual perineal protection (MPP) and hands-off delivery techniques using the basic principles of mechanics and assessed the tension of perineal structures using a novel biomechanical model of the perineum. We also measured the effect of the thumb and index finger of the accoucheur's dominant-posterior hand on perineal tissue tension when a modified Viennese method of MPP is performed.
methodsHands-off and two variations of hands-on manual perineal protection during vaginal delivery were simulated using a biomechanical model, with the main outcome measure being strain/tension throughout the perineal body during vaginal delivery.
resultsStress distribution with the hands-on model shows that when using MPP, the value of highest stress was decreased by 39 % (model B) and by 30 % (model C) compared with the hands-off model A. On the cross section there is a significant decrease in areas of equal tension throughout the perineal body in both hands-on models. Simulation of the modified Viennese MPP significantly reduces the maximum tension on the inner surface of the perineum measured at intervals of 2 mm from the posterior fourchette.
conclusionsIn a biomechanical assessment with a finite element model of vaginal delivery, appropriate application of the thumb and index finger of the accoucheur's dominant-posterior hand to the surface of the perineum during the second stage of delivery significantly reduces tissue tension throughout the entire thickness of the perineum; thus, this intervention might help reduce obstetric perineal trauma.
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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.