Perineal Trauma, Ritgen Maneuver
Conditions
Keywords
ritgen maneuver, perineal trauma
Brief summary
Perineal trauma is one of the common complications that may occur during the second stage of labor and can negatively affect women's postpartum recovery and quality of life. The Ritgen maneuver is a hands-on perineal protection technique performed during fetal head delivery to control the birth of the fetal head and potentially reduce perineal injury. However, evidence regarding its effectiveness remains inconsistent. This randomized controlled trial aims to evaluate the effect of the Ritgen maneuver on perineal trauma during the second stage of labor. Pregnant women admitted for vaginal birth will be randomly assigned to either the Ritgen maneuver group or the standard care group. The incidence and degree of perineal trauma, episiotomy, and related maternal outcomes will be compared between groups. The findings of this study are expected to contribute to the evidence base regarding perineal protection techniques during vaginal birth and support the development of clinical practices aimed at reducing birth-related perineal trauma
Interventions
OTHERRitgen maneuver
The Ritgen maneuver was performed during crowning and delivery of the fetal head. One hand was used to control the fetal head while the other supported the perineum to facilitate controlled birth and potentially reduce perineal injury
OTHERRoutine Care Group
Standard management of the second stage of labor according to institutional practice without application of the Ritgen maneuver.
Sponsors
Medipol University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
NONE
Intervention model description
Participants were randomly assigned to either a Ritgen maneuver group or a control group receiving routine care during the second stage of labor. Perineal trauma outcomes were compared between groups.
Eligibility
Sex/Gender
FEMALE
Age
20 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* Pregnant women aged 20 years or older. * Gestational age ≥37 weeks. * Singleton pregnancy. * Cephalic (vertex) presentation. * Planned vaginal birth. * No perineal massage during the last 4 weeks of pregnancy. * Not regularly engaged in active sports activity. * Willing to participate and provide informed consent
Exclusion criteria
* Fetal anomaly. * Human papillomavirus (HPV) infection. * Herpes simplex virus (HSV) infection. * Presence of perineal edema. * Vulvar varicosities. * Opioid administration during labor. * Prolonged labor. * Labor dystocia. * Development of fetal distress during labor. * Instrumental vaginal delivery (vacuum, Kiwi, or forceps-assisted delivery)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Incidence of Perineal Trauma | Immediately after birth | The occurrence of any perineal trauma following vaginal birth, including spontaneous perineal lacerations and episiotomy-related perineal injury. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Postpartum Pain Score | Within 2 hours after birth | Maternal postpartum pain assessed using the Visual Analog Scale (VAS), ranging from 0 (no pain) to 10 (worst imaginable pain) |
Countries
Turkey (Türkiye)
Contacts
STUDY_DIRECTORGozde Kugcumen
Medipol University
Outcome results
None listed