{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T18:24:50Z","timestamp":1777055090031,"version":"3.51.4"},"reference-count":33,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2024,5,6]],"date-time":"2024-05-06T00:00:00Z","timestamp":1714953600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100006095","name":"Helse S\u00f8r-\u00d8st RHF","doi-asserted-by":"publisher","award":["270926"],"award-info":[{"award-number":["270926"]}],"id":[{"id":"10.13039\/501100006095","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100012446","name":"Akershus Universitetssykehus","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100012446","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2024,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Second\u2010degree perineal tears following vaginal birth are common and presumed to be of little clinical importance. However, the extent of damage to the perineal body varies widely, and there is reason to believe that larger second\u2010degree tears may be associated with more pelvic floor symptoms, compared to lesser form. Therefore, the aim of this study was to assess differences in pelvic floor symptoms according to the severity of second\u2010degree perineal tears up to 12\u2009months post\u2010partum, stratified by parity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and Methods<\/jats:title><jats:p>This was a prospective cohort study conducted at Akershus University Hospital, a tertiary referral hospital in Norway. The study sample consisted of 409 primiparas and 394 multiparas with vaginal births. Perineal tears were classified using the classification system recommended by the Royal College of Obstetricians and Gynecologists. Further, second\u2010degree tears were subclassified as 2A, 2B, or 2C, depending on the percentage of damage to the perineal body. Episiotomies were analyzed as a separate group. Pelvic floor symptoms were assessed using the Karolinska Symptoms After Perineal Tear Inventory (KAPTAIN). A linear mixed model was estimated to assess the trend in pelvic floor symptom scores according to perineal tear category and stratified by parity. The primary and secondary outcome measures were the mean sum scores of the KAPTAIN\u2010Inventory, measured in pregnancy (at 18\u2009weeks of gestation), at 3\u2010\u00a0and 12\u2009months post\u2010partum, and the reported impact of genital discomfort on quality of life measured in pregnancy and at 12\u2009months post\u2010partum.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There were no significant differences in pelvic floor symptom scores over time, or at any timepoint, between no tear, first\u2010degree tear, or second\u2010degree tear subcategories, for primi\u2010, and multiparas. Pelvic floor symptoms increased from pregnancy to 3\u2009months post\u2010partum and remained higher at 12\u2009months post\u2010partum compared to pregnancy in all perineal tear categories. Compared to primiparas, multiparas reported a significantly higher impact of genital discomfort on quality of life in pregnancy and at 12\u2009months post\u2010partum.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>There were no statistically significant differences in pelvic floor symptoms according to the severity of second\u2010degree perineal tears.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aogs.14854","type":"journal-article","created":{"date-parts":[[2024,5,6]],"date-time":"2024-05-06T12:44:13Z","timestamp":1714999453000},"page":"1366-1376","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Pelvic floor symptoms according to the severity of second\u2010degree perineal tears within 12\u2009months post\u2010partum: A\u00a0longitudinal prospective cohort study"],"prefix":"10.1111","volume":"103","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0983-8603","authenticated-orcid":false,"given":"Marthe Dalevoll","family":"Macedo","sequence":"first","affiliation":[{"name":"Division Akershus University Hospital, Faculty of Medicine, University of Oslo  Oslo Norway"},{"name":"Department of Obstetrics and Gynecology Akershus University Hospital  L\u00f8renskog Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-1501-5892","authenticated-orcid":false,"given":"Jeanette","family":"Risl\u00f8kken","sequence":"additional","affiliation":[{"name":"Division Akershus University Hospital, Faculty of Medicine, University of Oslo  Oslo Norway"},{"name":"Department of Obstetrics and Gynecology Akershus University Hospital  L\u00f8renskog Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2529-9390","authenticated-orcid":false,"given":"Emilia","family":"Rotstein","sequence":"additional","affiliation":[{"name":"Department of Clinical Science, Intervention and Technology Karolinska Institutet  Stockholm Sweden"},{"name":"Department of Women's Health Karolinska University Hospital  Stockholm Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J\u016brat\u0117 \u0160altyt\u0117","family":"Benth","sequence":"additional","affiliation":[{"name":"Institute of Clinical Medicine University of Oslo  Oslo Norway"},{"name":"Health Services Research Unit Akershus University Hospital  L\u00f8renskog Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marie","family":"Ellstr\u00f6m\u00a0Engh","sequence":"additional","affiliation":[{"name":"Division Akershus University Hospital, Faculty of Medicine, University of Oslo  Oslo Norway"},{"name":"Department of Obstetrics and Gynecology Akershus University Hospital  L\u00f8renskog Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Franziska","family":"Siafarikas","sequence":"additional","affiliation":[{"name":"Division Akershus University Hospital, Faculty of Medicine, University of Oslo  Oslo Norway"},{"name":"Department of Obstetrics and Gynecology Akershus University Hospital  L\u00f8renskog Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,5,6]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2393-13-59"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2013.09.011"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bpobgyn.2018.05.004"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.midw.2020.102748"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/birt.12267"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.0001-6349.2001.10182.x"},{"key":"e_1_2_12_8_1","first-page":"560","article-title":"Obstetric vulvar lacerations and postpartum dyspareunia","volume":"59","author":"Ventolini G","year":"2014","journal-title":"J Reprod Med"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00192-014-2406-x"},{"key":"e_1_2_12_10_1","unstructured":"RCOG NICE.The Management of Third\u2010 and Fourth\u2010 Degree Perineal Tears Green\u2010Top Guideline No. 29.2015."},{"key":"e_1_2_12_11_1","volume-title":"Veileder i F\u00f8dselshjelp: Perinealskade og anal sfinkterskade ved f\u00f8dsel [Supervisor in Childbirth: Perineal Injury and Anal Sphincter Injury During Childbirth","author":"Laine K","year":"2020"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00192-021-04700-6"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.midw.2019.08.004"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00192-020-04317-1"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/birt.12258"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00404-019-05404-5"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/aogs.14369"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2006.00938.x"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.2147\/IJWH.S164266"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.13432"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-021-91799-8"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-022-04964-w"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2017.11.569"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.15408"},{"key":"e_1_2_12_25_1","unstructured":"StergiosK.Developing a core outcome set for female pelvic floor disorders (urinary incontinence pelvic organ prolapse childbirth perineal trauma and pelvic pain syndromes). COMET Database;2017. Accessed October 7 2023.https:\/\/www.comet\u2010initiative.org\/Studies\/Details\/981"},{"key":"e_1_2_12_26_1","unstructured":"LFK.Landsforeningen for kvinner med plager etter f\u00f8dsel [The national association for women with problems after childbirth].2022. Internet. Accessed September 25 2023.https:\/\/www.fodselsplager.no\/vre\u2010saker"},{"key":"e_1_2_12_27_1","doi-asserted-by":"publisher","DOI":"10.1111\/aogs.14614"},{"key":"e_1_2_12_28_1","volume-title":"Clinical Guideline: Intrapartum Care for Healthy Women and Babies \u2013 Recommendations for Second Stage of Labour","author":"NICE","year":"2014"},{"key":"e_1_2_12_29_1","doi-asserted-by":"publisher","DOI":"10.3109\/14767058.2016.1169527"},{"key":"e_1_2_12_30_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e318240df4f"},{"key":"e_1_2_12_31_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00192-018-3616-4"},{"key":"e_1_2_12_32_1","volume-title":"Pelvic Floor Dysfunction after Childbirth \u2013 Symptoms, Diagnosis, Treatment","author":"Rotstein E","year":"2022"},{"key":"e_1_2_12_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2014.06.021"},{"key":"e_1_2_12_34_1","volume-title":"Den store forskjellen: Om kvinners helse og betydningen av kj\u00f8nn for helse [The Big Difference: About Women's Health and the Importance of Gender for Health","author":"Norges offentlige utredninger (NOU","year":"2023"}],"container-title":["Acta Obstetricia et Gynecologica Scandinavica"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/aogs.14854","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,6]],"date-time":"2025-04-06T10:52:17Z","timestamp":1743936737000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1111\/aogs.14854"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,5,6]]},"references-count":33,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2024,7]]}},"alternative-id":["10.1111\/aogs.14854"],"URL":"https:\/\/doi.org\/10.1111\/aogs.14854","archive":["Portico"],"relation":{},"ISSN":["0001-6349","1600-0412"],"issn-type":[{"value":"0001-6349","type":"print"},{"value":"1600-0412","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,5,6]]},"assertion":[{"value":"2024-01-29","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-04-14","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-05-06","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}