ArticleActa obstetricia et gynecologica Scandinavica2022
Detailed classification of second-degree perineal tears in the delivery ward: an inter-rater agreement study.
Article in Acta obstetricia et gynecologica Scandinavica, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07124676 (Prospective Observational Study Comparing Two Classifications of Second-degree Perineal Tears in Spontaneous Vaginal Births, to Evaluate Their Correlation With Postpartum Clinical Outcomes.), which is not on this map. Cited by 14 papers.
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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.
Prospective Observational Study Comparing Two Classifications of Second-degree Perineal Tears in Spontaneous Vaginal Births, to Evaluate Their Correlation With Postpartum Clinical Outcomes.
Who cites it
14 citing papers in PubMed, 19 citations in OpenAlex.
- A clinical trial on pelvic floor sensory testing in women with and without stress urinary incontinence.Zhong nan da xue xue bao. Yi xue ban = Journal of Central South University. Medical sciences · 2024Trial
- Postpartum perineal pain and its association with sub-classified second-degree tears and perineal trauma-A follow-up of a randomized controlled trial.Acta obstetricia et gynecologica Scandinavica · 2024Trial
- Lack of association between second-degree tears and pelvic floor symptoms one year postpartum.Acta obstetricia et gynecologica Scandinavica · 2026Article
- Severity of perineal tears and deviations in perineal body anatomy: A three-dimensional ultrasound study.Acta obstetricia et gynecologica Scandinavica · 2026Article
- Evaluating the prognostic association between race and perineal trauma: a systematic review protocol.BMJ open · 2025Article
- Perspective on Perinatal Birth Canal Injuries: An Analysis of Risk Factors, Injury Mechanisms, Treatment Methods, and Patients' Quality of Life: A Literature Review.Journal of clinical medicine · 2025Review
- The severity of second-degree perineal tears and dyspareunia during one year postpartum: A prospective cohort study.Acta obstetricia et gynecologica Scandinavica · 2025Observational
- Subclassification of second-degree tears at delivery: creation and reported outcomes.BMC pregnancy and childbirth · 2025Article
- Maternal and neonatal outcomes of childbirth care in a Freestanding Birth Centre.Revista latino-americana de enfermagem · 2025Observational
- Pelvic floor symptoms according to the severity of second-degree perineal tears within 12 months post-partum: A longitudinal prospective cohort study.Acta obstetricia et gynecologica Scandinavica · 2024Article
- Article
- Does transperineal ultrasound predict the risk of perineal trauma in women with term pregnancy? A prospective observational study.Ultrasonography (Seoul, Korea) · 2024Article
- Sonographic postpartum anal sphincter defects and the association with pelvic floor pain and dyspareunia.Acta obstetricia et gynecologica Scandinavica · 2023Article
- Detailed classification of second-degree perineal tears in the delivery ward: an inter-rater agreement study.Acta obstetricia et gynecologica Scandinavica · 2022Article
Corrections and comments
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Authors and funding
3 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionSecond-degree perineal tears can vary widely as to the extent of trauma, which may be relevant for women's pelvic floor health postpartum. However, the short- and long-term consequences of second-degree perineal tears are poorly understood, likely due to the lack of a detailed classification system. Such a classification system for second-degree tears has been suggested but the inter-rater agreement has not yet been assessed. The aim of this study was to assess the inter-rater agreement of the already established classification system for perineal tears recommended by the Royal College of Obstetricians and Gynaecologists (RCOG classification) among midwives. Further, we aimed to assess the inter-rater agreement of a classification system that provides three sub-categories for second-degree perineal tears. MATERIAL AND
methodsThis was an inter-rater agreement study, conducted at Akershus University Hospital in Norway from 31 August to 29 November 2020. All midwives working in the delivery ward participated in the study. Midwives classified the integrity of the perineum of all women delivering vaginally within the study period. During the first month of the study, tears were classified by two midwives who were blinded to each other's findings, and the agreement of the RCOG classification was assessed. The following month, the detailed classification system was introduced to the midwifery staff. The last month, perineal tears were classified by two midwives using the detailed classification system, and the agreement was assessed. Inter-rater agreement was measured using Fleiss multirater kappa (k) and Kendall's coefficient of concordance (KCC
resultsThe inter-rater agreement for the RCOG classification was good to very good, with k = 0.705 (95% confidence interval [CI] 0.62-0.79, P < 0.001), KCC
conclusionsThe inter-rater agreement among midwives using both the RCOG classification and the detailed classification system among midwives was good to very good. The detailed classification system provides additional information about the extent of tissue trauma in second-degree tears, warranted for future research on women's pelvic floor health postpartum.
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