Diagnosing Perineal Tears, Does Different Assessment Methods Affect the Midwife's Clinical Judgement of Perineal Tears?

Diagnosing Perineal Tears. Consistency in Midwifes Clinical Judgement When Assessing Perineal Tears Using Two Different Assessment Methods.

Status

Completed

Phases

Study type

Interventional

Source

ClinicalTrials.gov

Registry ID

NCT01278979

Enrollment

400

Registered

2011-01-19

Start date

2011-01-31

Completion date

2013-02-28

Last updated

2013-05-21

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Obstetric Perineal Rupture

Keywords

obstetric, perineal tear, perineal injury, diagnosis

Brief summary

This study aims to compare different midwife practitioners assessments of perineal tears.

Detailed description

Perineal injuries are one of the traumas most frequently suffered by women during delivery.Countries report wide variations in trauma rates, and within countries further variations exists among institutions and also among professional groups of caregivers.Visual and digital examination of the wound has been and is the most common way to assess and classify a perineal tear. However resent studies indicate that many tears diagnosed with this method are misclassified.The suggested reasons for this, apart from the fact that bleeding and tissue oedema make the diagnose difficult, is that many healthcare providers have too little training in perineal assessment and basic anatomy. In this prospective randomised trial consenting women will be randomised in to the common visual and digital assessment of the perineal tear by to different midwives, blinded to each others assessment or visual and digital assessment and measuring of the tear with a small soft ruler, Peri-Rule also by two different midwives.

Interventions

DEVICEObjective measurements of perineal tears with Peri-Rule

Four measurements will be used in this study. 1. Depth of tear, from the fourchette into the greatest depth of the perineal body. 2. Length of tear, from the fourchette to the apex of the vaginal tear. 3. Length of tear, from the fourchette along perineal skin towards the anus. 4. Length of the perineal body, from the fourchette to outer margin of anus.

OTHERVisual and digital assessment

Midwifes assessing perineal tears as standard procedure with visual and digital examination of the perineal tear.

Study design

Allocation

RANDOMIZED

Intervention model

PARALLEL

Primary purpose

DIAGNOSTIC

Masking

NONE

Eligibility

Sex/Gender

FEMALE

Age

18 Years to 55 Years

Healthy volunteers

Yes

Inclusion criteria

* Spontaneous vaginal birth * Women over 18 years of age * Healthy Child * Written consent signed by participant * Spontaneous tear in perineum that involves the perineal skin

Exclusion criteria

* Bleeding from tears that demand suturing immediately. * Bleeding that affected the general condition negatively * Complex tears that branched out in two or more different directions * Women delivered instrumentally forceps or ventouse * Women delivered with Cesarian section * Women who sustain episiotomy

Design outcomes

Primary

Measure	Time frame	Description
To investigate how different assessment methods affected the midwives´ clinical judgement between different midwife practitioners when they classify and evaluate perineal tears.	One and a half years	Assessment of perineal tears using different two different assessment methods

Secondary

Measure	Time frame	Description
Consistency between different midwife practitioners when the classify and evaluate perineal tears.	One and a half years	Two different midwife practitioners' assess the same perineal tear and fill out an assessment protocol independently.

Countries

Norway

Outcome results

None listed

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026