Perineal Tear Clinical Trial
Official title:
Continuous Versus Discontinuous Suture in the Perineals Lesions Produced During Delivery in Primiparous: Maternal Results: A Randomized Controlled Trial
The hypothesis: Women who have a continuous suture have better health outcomes Two types of sutures were placed in the perineal lesion, using different techniques. Group A received continuous sutures and Group B had interrupted sutures placed. The women were followed-up as follows: Day of childbirth and in the postpartum period.
The hypothesis: Women who have a continuous suture have better health outcomes Two types of
sutures were placed in the perineal lesion, using different techniques. Group A received
continuous sutures and Group B had interrupted sutures placed. The women were allocated to a
treatment group using a computer-generated random numbers table. The sequence was placed in
individual opaque envelopes that were opened when a woman met the inclusion criteria.
The health personnel that carry out the sutures had taken a training course on continuous
suture technique and had at least one year experience in this technique. Additionally, this
person had a minimum of five years of experience in attending deliveries and therefore also
in the suturing of perineal lesions. The sutures were placed by ten trained midwives. Around
5% of the midwives in Torrecardenas, 10% in the Hospital Complex of Jaen, 12% in Granada, and
20% of the midwives in Ubeda and Linares participated.
Data collection Data was collected on sociodemographic variables, type of perineal trauma
(tear of second-degree or episiotomy), type of suture used, time spent placing suture, number
of suture packets used, complications, analogical scale of pain, type of pain, need for
analgesia, wound condition, care performed, urinary and/or fecal incontinence, start of
sexual relations, start of physical activity and type of newborn feeding. It was also
collected the start and type of delivery, medication during dilation, type of analgesia used,
gestational week, duration of dilation, second stage labor and delivery, and data on the
newborn.
Information was gathered by midwives which interviewed the women in the labor room, providing
them with an informed consent form, and hiding the suture technique that was going to be
used. The rest of the data were obtained from the clinical history, maternal record book and
phone calls made for the follow-up. The women did not know at any point which suture
technique had been used.
Follow-up
The women were followed-up as follows:
Day of childbirth: in the postpartum period, the midwife collected data on the type of
delivery, need for epidural analgesia, duration of dilation, stage two of labor, delivery,
type of perineal trauma, time used to place suture, number of suture packets, wound
complications, newborn weight and the Apgar score at one minute and at five minutes. After
the suture was placed, they assessed pain on the pain scale and assessed the wound.
Follow-up after delivery was done at two hours, 24 hours, 15 days and three months. Pain,
need for analgesia, wound condition, sphincter incontinence and the start of sexual relations
were assessed (15 days and three months).
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