Ritgen Maneuver and Birth-Related Perineal Trauma: RCT

Medipol University122 enrolled

Overview

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

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

PREVENTION

Masking

NONE

Enrollment

122

Conditions

Perineal Trauma Ritgen Maneuver

Ritgen maneuverOTHER

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

Routine Care GroupOTHER

Standard management of the second stage of labor according to institutional practice without application of the Ritgen maneuver.

Eligibility

Sex: FEMALEMin age: 20 YearsHealthy volunteers:

Medical Language ↔ Plain English

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)

Outcomes

Primary Outcomes

Incidence of Perineal Trauma

The occurrence of any perineal trauma following vaginal birth, including spontaneous perineal lacerations and episiotomy-related perineal injury.

Time frame: Immediately after birth

Secondary Outcomes

Postpartum Pain Score

Maternal postpartum pain assessed using the Visual Analog Scale (VAS), ranging from 0 (no pain) to 10 (worst imaginable pain)

Time frame: Within 2 hours after birth