Observational studyBMC pregnancy and childbirth2017
Active delivery of the anterior arm and incidence of second-degree perineal tears: a clinical practice evaluation.
Observational study in BMC pregnancy and childbirth, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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.
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Who cites it
3 citing papers in PubMed, 20 citations in OpenAlex.
- Influence of in utero fetal death on perineal tears in vaginal deliveries.Scientific reports · 2023Article
- Ultrasonographic study of female perineal body and its supportive function on pelvic floor.Frontiers in medicine · 2023Article
- Shoulder dystocia: incidence, mechanisms, and management strategies.International journal of women's health · 2018Review
Corrections and comments
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundEvaluate the feasibility of active delivery of the anterior arm during spontaneous delivery. This maneuver could decrease incidence of second-degree perineal tears because it reduces fetal biacromial diameter.
methodsAn observational comparative prospective study was conducted at our teaching maternity from July 2012 to March 2013. The study included 199 nulliparous women ≥18 years, who met the following criteria: singleton pregnancy, vaginal delivery with occiput anterior presentation, on epidural analgesia, from 37 weeks of gestation onward. The distribution of rate and type of perineal tears were compared between two groups: a non-exposed group and a group exposed to the maneuver.
resultsA total of 101 patients were exposed to Couder's maneuver (CM) and 98 patients were not exposed. In the intervention group, 3 failures of the maneuver were reported. The maneuver was considered easy in 80% of cases, moderately easy in 12% and difficult in 8% of cases. There was a significant difference (p = 0.03) in the distribution of perineal tears between the two groups. There was a significant reduction (p < 0.001) in the number of second-degree perineal tears in the patients exposed to CM. There was no significant difference in the rate of anterior perineal trauma between the exposed and non-exposed arms.
conclusionsCM in primiparous women at term is feasible with a low failure rate and influences the distribution of perineal tears by lowering second-degree perineal tears in a highly significant manner (p <0.01).
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