Evidence map›Paper›PMID 32328711›Full record

ArticleArchives of gynecology and obstetrics2020

The association between the number of vaginal examinations during labor and perineal trauma: a retrospective cohort study.

Ohad Gluck, Hadas Ganer Herman, Ori Tal, Ehud Grinstein, Jacob Bar, Michal Kovo, Shimon Ginath, Eran Weiner

Abstract read
PubMed Publisher
In one paragraph

Article in Archives of gynecology and obstetrics, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Berlin survey on obstetric anal sphincter injury (OASI).Archives of gynecology and obstetrics · 2022
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Ohad GluckDepartment of Obstetrics and Gynecology, The Edith Wolfson Medical Center, Holon, and Sackler School of Medicine, Tel Aviv University, P.O. Box 5, 58100, Holon, Israel. ohadgluck@gmail.com.
Hadas Ganer HermanDepartment of Obstetrics and Gynecology, The Edith Wolfson Medical Center, Holon, and Sackler School of Medicine, Tel Aviv University, P.O. Box 5, 58100, Holon, Israel.
Ori TalDepartment of Obstetrics and Gynecology, The Edith Wolfson Medical Center, Holon, and Sackler School of Medicine, Tel Aviv University, P.O. Box 5, 58100, Holon, Israel.
Ehud GrinsteinDepartment of Obstetrics and Gynecology, The Edith Wolfson Medical Center, Holon, and Sackler School of Medicine, Tel Aviv University, P.O. Box 5, 58100, Holon, Israel.
Jacob BarDepartment of Obstetrics and Gynecology, The Edith Wolfson Medical Center, Holon, and Sackler School of Medicine, Tel Aviv University, P.O. Box 5, 58100, Holon, Israel.
Michal KovoDepartment of Obstetrics and Gynecology, The Edith Wolfson Medical Center, Holon, and Sackler School of Medicine, Tel Aviv University, P.O. Box 5, 58100, Holon, Israel.
Shimon GinathDepartment of Obstetrics and Gynecology, The Edith Wolfson Medical Center, Holon, and Sackler School of Medicine, Tel Aviv University, P.O. Box 5, 58100, Holon, Israel.
Eran WeinerDepartment of Obstetrics and Gynecology, The Edith Wolfson Medical Center, Holon, and Sackler School of Medicine, Tel Aviv University, P.O. Box 5, 58100, Holon, Israel.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTo study the association between the number of vaginal examinations (VEs) performed during labor and subsequent severe perineal trauma.

methodsThis is a retrospective cohort study. We included all women admitted to the delivery ward between 2008 and 2017, in active labor. Exclusion criteria included preterm deliveries (< 37 weeks), Cesarean deliveries and episiotomy during delivery. The primary outcome, severe perineal trauma, was defined as perineal tears grades 3-4. The cohort was divided into 4 groups, based on the number of VEs performed during labor: Group 1-up to two VEs (n = 4588), Group 2-three to four VEs (n = 5815), Group 3-five to six VEs (n = 4687), and Group 4-seven or more VEs (n = 7297).

resultsOverall, 22,387 women were included in the study. The rate of severe perineal trauma in groups 1, 2, 3 and 4 was 0.4%, 0.1%, 0.8%, and 0.4%, respectively (p < 0.001). Performing five or more VEs during labor was associated with a higher risk of severe perineal trauma (0.26% vs. 0.53%, p < 0.01), as compared to four VEs or less. Using a logistic regression model, we found that performing five or more VEs during labor (aOR = 1.72 CI 95% (1.21-2.47), p < 0.001) or performing an instrumental delivery (aOR = 2.65 CI 95% (1.72-4.07), p < 0.001) were directly associated with the risk for severe perineal trauma. Applying epidural anesthesia showed an inverse association with severe perineal trauma (aOR = 0.54 CI 95% (0.38-0.77), p < 0.001).

conclusionPerforming five or more VEs during active labor is associated with an increased risk for severe perineal trauma.

Indexed as

AdultCohort StudiesFemaleGynecological ExaminationHumansObstetric Labor ComplicationsPerineumPregnancyRetrospective StudiesObstetric anal sphincter injuryPerineal traumaVaginal examination

Identifiers

PMID32328711

What OpenQuestion holds

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Registered trials

None linked

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.