Evidence map›Paper›PMID 40119314›Full record

ArticleBMC pregnancy and childbirth2025

Birth and Regulation of head Extension to Guide Manual perineal Assistance (BREGMA) study: a prospective cohort study.

Abdelrahman Abouelhassan, Vladimir Kalis, Marc Schüssler, Hassan Awwad, Rania H M Ahmed, Khaled M Ismail

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC pregnancy and childbirth, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–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

1 citing paper in PubMed.

  1. 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

6 authors.

Abdelrahman AbouelhassanDepartment of Obstetrics and Gynecology, Faculty of Medicine, Ain Shams University, 38 Abbassia, Next to the Al-Nour Mosque, Cairo, 1181, Egypt.
Vladimir KalisDepartment of Obstetrics and Gynecology, Faculty of Medicine in Pilsen, Charles University, Alej Svobody 76, Pilsen, 304 60, Czech Republic.
Marc SchüsslerDepartment of Obstetrics & Gynecology, Agaplesion General Hospital Hagen (Allgemeines Krankenhaus Hagen), Hagen, Germany.
Hassan AwwadDepartment of Obstetrics and Gynecology, Faculty of Medicine, Ain Shams University, 38 Abbassia, Next to the Al-Nour Mosque, Cairo, 1181, Egypt.
Rania H M AhmedDepartment of Obstetrics and Gynecology, Faculty of Medicine, Ain Shams University, 38 Abbassia, Next to the Al-Nour Mosque, Cairo, 1181, Egypt.
Khaled M IsmailDepartment of Obstetrics and Gynecology, Faculty of Medicine in Pilsen, Charles University, Alej Svobody 76, Pilsen, 304 60, Czech Republic. khaled.ismail@lfp.cuni.cz.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe exact positioning of the dominant hand at the time of manual perineal protection (MPP) is not clearly specified. The main aim of this work was to identify the place on the perineum where pressure needs to be applied to achieve optimal forward fetal head displacement away from the anal sphincters using the bregma to posterior fourchette distance (BFD) and the perineal body length (PBL).

methodsThis was a two-center prospective cohort study. Term cephalic singleton nulliparous women having spontaneous vaginal delivery were considered eligible for recruitment into the study. Once crowning was diagnosed and just prior the initiation of manual perineal protection (MPP) or cutting an episiotomy, the BFD and PBL were measured using a standardized measurement protocol. RESULTS AND DISCUSSION: A total of 100 women (50 women in each center) were recruited into the study. The overall mean BFD was 2.8 ± 0.5 cm. The overall mean PBL was 4.4 ± 0.8 cm. There were no statistically significant differences between the measurements taken in both units regarding BFD or PBL (p = 0.81 and 0.10 respectively). There was a weak correlation between both measurements. Based on our measured parameters, it seems that the most effective point to apply perineal pressure to displace the head away from the anus is approximately 1 - 1.5 cm anterior to the anal margin.

conclusionMeasurements generated by this study will form the bases of future biomechanical studies to confirm their validity.

Indexed as

Delivery, ObstetricHeadPerineumVersion, FetalAdultAnal CanalEpisiotomyFemaleHumansPregnancyPressureProspective StudiesYoung AdultManual perineal protectionPerineal bodyPerineal mappingPerineal tension

Identifiers

PMID40119314
PMCPMC11929361

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Registered trials

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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.