Perineal Lacerations
Conditions
Brief summary
The investigators hypothesize that the rate of perineal lacerations in nulliparous women will be reduced by a simple change in common obstetrical delivery practice, i.e., bed delivery versus conventional delivery in obstetrical stirrups.
Detailed description
This is a randomized controlled trial of bed delivery in the supine position versus conventional delivery in obstetrical stirrups. It will include nulliparous women presenting in active labor to the L&D East (low risk) Unit at Parkland Hospital, \> 370/7 weeks gestation, with singleton fetuses in cephalic presentation. The primary outcome variable is any perineal laceration. Secondary outcomes measures include (1) 3rd or 4th degree lacerations and (2) any lacerations in subgroup comparisons between study arms.
Interventions
OTHERStirrups delivery vs bed delivery
Position of legs at time of vaginal delivery (bed vs stirrups)
Sponsors
University of Texas Southwestern Medical Center
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
NONE
Eligibility
Sex/Gender
FEMALE
Age
16 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* Nulliparous women presenting in active labor to Parkland L&D East Unit * ≥ 370/7 weeks gestation * Singleton fetus in cephalic presentation * ≥ 4 cm but ≤ 8 cm of cervical dilation * No medical or obstetrical complication
Exclusion criteria
* Women with any obstetric or medical complication of pregnancy, such as pregnancy related hypertension, diabetes, labor induction * Prior history of perineal trauma requiring surgical repair or known congenital perineal malformation * Non-English or non-Spanish speaking
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Any perineal laceration (first through fourth degree) | Immediately post delivery |
Secondary
| Measure | Time frame |
|---|---|
| Third and fourth-degree perineal lacerations | Immediately post delivery |
Countries
United States
Outcome results
None listed