Evidence map›Paper›PMID 38441866›Full record

Trial reportMaternal and child health journal2024

First and Second Stage Risk Factors Associated with Perineal Lacerations.

Alexander M Saucedo, Methodius G Tuuli, W Thomas Gregory, Holly E Richter, Jerry L Lowder, Candice Woolfolk, Aaron B Caughey, Sindhu K Srinivas, Alan T N Tita, George A Macones and 1 more

Abstract readMulticenter StudyRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in Maternal and child health journal, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
0.5field-weighted citation impact, top 39% of its field
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

0 citing papers in PubMed, 1 citations in OpenAlex.

No citing paper in PubMed yet.

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

11 authors at 6 institutions in 2 countries.

Alexander M SaucedoDepartment of Women's Health, Dell School of Medicine, University of Texas at Austin, 1301 W 38th St. Suite 705, Austin, TX, 78705, USA. alexander.saucedo@ascension.org.ORCID http://orcid.org/0000-0002-1907-2413
Methodius G TuuliDepartment of Obstetrics and Gynecology, The Warren Alpert School of Medicine of Brown University, Providence, USA.
W Thomas GregoryDepartment of Obstetrics and Gynecology, Oregon Health and Science University, Portland, USA.
Holly E RichterDepartment of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, USA.
Jerry L LowderDepartment of Obstetrics and Gynecology, Washington University School of Medicine in St. Louis, St. Louis, USA.
Candice WoolfolkDepartment of Obstetrics and Gynecology, Washington University School of Medicine in St. Louis, St. Louis, USA.
Aaron B CaugheyDepartment of Obstetrics and Gynecology, Oregon Health and Science University, Portland, USA.
Sindhu K SrinivasDepartment of Obstetrics and Gynecology, Maternal and Child Health Research Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA.
Alan T N TitaDepartment of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, USA.
George A MaconesDepartment of Women's Health, Dell School of Medicine, University of Texas at Austin, 1301 W 38th St. Suite 705, Austin, TX, 78705, USA.
Alison G CahillDepartment of Women's Health, Dell School of Medicine, University of Texas at Austin, 1301 W 38th St. Suite 705, Austin, TX, 78705, USA.
The University of Texas at Austin · USOregon Health & Science University · USUniversity of Alabama at Birmingham · USWashington University in St. Louis · USProvidence College · USUniversity of Pennsylvania · US

Funding

Optimizing Management of the Second Stage of Labor: Multicenter Randomized TrialU01HD077384 · NICHD · WASHINGTON UNIVERSITY · PI CAHILL, ALISON G, TUULI, METHODIUS GAMUO · 2014 to 2019
$7.8M
NICHD NIH HHS U01 HD077384
6 · The paper itself

Abstract

objectiveTo determine intrapartum factors associated with perineal laceration at delivery.

methodsThis was a planned secondary analysis of a multicenter randomized clinical trial of delayed versus immediate pushing among term nulliparous women in labor with neuraxial analgesia conducted in the United States. Intrapartum characteristics were extracted from the medical charts. The primary outcome was perineal laceration, defined as second degree or above, characterized at delivery in women participating in longer term pelvic floor assessments post-delivery. Multivariable logistic regression was used to refine risk estimates while adjusting for randomization group, birth weight, and maternal age.

resultsAmong the 941 women participating in the pelvic floor follow-up, 40.6% experienced a perineal laceration. No first stage labor characteristics were associated with perineal laceration, including type of labor or length of first stage. Receiving an amnioinfusion appeared protective of perineal laceration (adjusted odds ratio, 0.48; 95% confidence interval 0.26-0.91; P = 0.01). Second stage labor characteristics associated with injury were length of stage (2.01 h vs. 1.50 h; adjusted odds ratio, 1.36; 95% confidence interval 1.18-1.57; P < 0.01) and a prolonged second stage (adjusted odds ratio, 1.64; 95% confidence interval 1.06-2.56; P < 0.01). Operative vaginal delivery was strongly associated with perineal laceration (adjusted odds ratio, 3.57; 95% confidence interval 1.85-6.90; P < 0.01).

conclusionOperative vaginal delivery is a modifiable risk factor associated with an increased risk of perineal laceration. Amnioinfusion appeared protective against injury, which could reflect a spurious finding, but may also represent true risk reduction similar to the mechanism of warm perineal compress.

Indexed as

Delivery, ObstetricLabor Stage, SecondLacerationsObstetric Labor ComplicationsPerineumAdultFemaleHumansLogistic ModelsPregnancyRisk FactorsUnited StatesYoung AdultAmnioinfusionDelayed pushingImmediate pushingOperative deliveryPerineal lacerations

Identifiers

PMID38441866
OpenAlexW4392458820

What OpenQuestion holds

Textmetadata
Read underepoch 390

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.