Labor, delivery, postpartum

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Episiotomy, perineal trauma

Australia

• Australian Institute of Health and Welfare
  • Third and fourth degree tears
  • Episiotomy

• Australian Journal of General Practice
  • Perineal tears - A review [2018]

• International Journal of Women's Health
  • The effect of implementing a new guideline and operative pro forma on the detection and management of third- and fourth-degree perineal tears [2016]

• Queensland Health
  • Perineal care

• SA Health
  • Third and Fourth Degree Tear Management
  • Puerperal Genital Haematomas
  • Perineal Care and Repair

Australia, Europe

• American Journal of Obstetrics & Gynecology
  • The incidence of anal incontinence following obstetric anal sphincter injury graded using the Sultan classification: a network meta-analysis [2023]

Australia, New Zealand

• Australian and New Zealand Journal of Obstetrics and Gynaecology
  • Management of obstetric anal sphincter injury: Colorectal surgeons' perspectives in Australia and New Zealand [2021]

Austria, Germany, Switzerland

• Geburtshilfe und Frauenheilkunde
  • Management of Third and Fourth-Degree Perineal Tears After Vaginal Birth. Guideline of the DGGG, OEGGG and SGGG (S2k-Level, AWMF Registry No. 015/079, December 2020) [2022]

Canada

• CMAJ
  • Episiotomy use among vaginal deliveries and the association with anal sphincter injury: a population-based retrospective cohort study [2019]

• Perinatal Services BC
  • Supportive Care of the Perineum During Labour and Birth

• Society of Obstetricians and Gynaecologists of Canada
  • Obstetrical Anal Sphincter Injuries (OASIS) Part I: Prevention, Recognition, and Immediate Management [2024]

Denmark, United Kingdom, United States

• American Journal of Obstetrics & Gynecology
  • The incidence of wound complications following primary repair of obstetric anal sphincter injury: a systematic review and meta-analysis [2022]

Ethiopia

• Women's Health
  • Prevalence of episiotomy practice and factors associated with it in Ethiopia, systematic review and meta-analysis [2022]

Europe

• Euro-Peristat
  • Variations in rates of severe perineal tears and episiotomies in 20 European countries: a study based on routine national data in Euro-Peristat Project [2016]

France

• Archive ouverte HAL
  • Perineal prevention and protection in obstetrics: CNGOF Clinical Practice Guidelines [2019]

• BMC Pregnancy and Childbirth
  • Midterm complications after primary obstetrical anal sphincter injury repair in France [2024]

• PLoS Medicine
  • Episiotomies and obstetric anal sphincter injuries following a restrictive episiotomy policy in France: An analysis of the 2010, 2016, and 2021 National Perinatal Surveys [2025]

• Scientific Reports
  • French guidelines for restrictive episiotomy during instrumental delivery were not followed by an increase in obstetric anal sphincter injury [2022]
  • Episiotomy practices in France: epidemiology and risk factors in non-operative vaginal deliveries [2020]

High-income countries

• European Journal of Obstetrics & Gynecology and Reproductive Biology
  • Clinical practices in the management and follow-up of obstetric anal sphincter injuries: a comprehensive review [2024]

• International Journal of Gynecology & Obstetrics
  • Risk factors for obstetric anal sphincter injury recurrence: A systematic review and meta-analysis [2022]

India

• Federation of Obstetric and Gynecological Societies of India
  • Prevention and Management of Perineal Tear [2024]

International

• American Journal of Obstetrics & Gynecology
  • The prevention of perineal trauma during vaginal birth [2024]

• Cochrane Database of Systematic Reviews
  • Perineal techniques during the second stage of labour for reducing perineal trauma and postpartum complications [2024]
  • Oral non-steroidal anti-inflammatory drugs (single dose) for perineal pain in the early postpartum period [2021]
  • Aspirin (single dose) for perineal pain in the early postpartum period [2020]

• European Review for Medical and Pharmacological Sciences
  • Does episiotomy always equate violence in obstetrics? Routine and selective episiotomy in obstetric practice and legal questions [2019]

• International Urogynecology Journal
  • Review of available national guidelines for obstetric anal sphincter injury [2020]

• Journal of Gynecology Obstetrics and Human Reproduction
  • Antenatal perineal massage - risk of perineal injuries, pain, urinary incontinence and dyspereunia - a systematic review [2023]

• Revista da Escola de Enfermagem da USP
  • Upright positions in childbirth and the prevention of perineal lacerations: a systematic review and meta-analysis [2020]

Ireland

• Ireland's Health Services
  • Perineal wound infection

Israel

• International Journal of Gynecology & Obstetrics
  • Use of antibiotics in women undergoing correction of an obstetric anal sphincter injury: Results from a national Israeli survey [2023]

Jamaica

• Permanente Journal
  • An Audit of Clinician Compliance with Best Practice Recommendations to Repair Severe Obstetric Anal Sphincter Injuries [2014]

Low and middle income countries

• Maternal and Child Health Journal
  • Birth-Related Perineal Trauma in Low- and Middle-Income Countries: A Systematic Review and Meta-analysis [2019]

Netherlands

• International Urogynecology Journal
  • Choice of mode of delivery in a subsequent pregnancy after OASI: a survey among Dutch gynecologists [2017]

Norway

• Tidsskrift for Den norske legeforening
  • Follow-up of postpartum anal sphincter injuries [2020]

Palestine

• BMJ Open
  • Episiotomy practice in six Palestinian hospitals: a population-based cohort study among singleton vaginal births [2018]

Portugal

• BMC Pregnancy and Childbirth
  • Time trends in episiotomy and severe perineal tears in Portugal: a nationwide register-based study [2022]

Romania

• Journal of Evaluation in Clinical Practice
  • A multicenter cross-sectional study of episiotomy practice in Romania [2019]

Saudi Arabia

• Materia Socio-Medica
  • Rates and Indicators for Episiotomy in Modern Obstetrics – a study from Saudi Arabia [2015]

Spain

• Nursing Open
  • Midwives' approach to the prevention and repair of obstetric perineal trauma in Spain [2024]

Sub-Saharan Africa

• Frontiers in Medicine
  • Episiotomy Practice and Its Associated Factors in Africa: A Systematic Review and Meta-Analysis [2022]

Sweden

• American Journal of Obstetrics & Gynecology
  • Symptoms of fecal incontinence two decades after no, one, or two obstetrical anal sphincter injuries [2021]

• International Journal of Gynecology & Obstetrics
  • Maternal origin matters: Country of birth as a risk factor for obstetric anal sphincter injuries [2024]

• Midwifery
  • Regional and clinical guidelines for prevention and care of obstetric anal sphincter injuries - A critical frame analysis [2023]

• Swedish Agency for Health Technology Assessment and Assessment of Social Services
  • Practices to improve detection of perineal tears and women’s views and experiences of healthcare providers following sustained perineal tear [2021]

United Kingdom

• International Urogynecology Journal
  • Diagnosis, management and training in perineal trauma: a UK national survey of obstetricians [2023]

• National Institute for Health and Care Excellence
  • Perineal pain: Postnatal care [2021]
  • Episcissors-60 for mediolateral episiotomy [2020]

• Royal College of Obstetricians and Gynaecologists
  • Third- and Fourth-degree Perineal Tears, Management [2015]

United States

• American Journal of Obstetrics & Gynecology
  • Repair of episiotomy and obstetrical perineal lacerations (first-fourth) [2024]

• Obstetrical & Gynecological Survey
  • Techniques for Repair of Obstetric Anal Sphincter Injuries [2018]

{Related topics}

• Topic
  • Labor, delivery
  • Fecal incontinence