{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,12]],"date-time":"2026-11-12T08:43:44Z","timestamp":1794473024879,"version":"4.9.1"},"reference-count":10,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2022,8,12]],"date-time":"2022-08-12T00:00:00Z","timestamp":1660262400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Birth"],"published-print":{"date-parts":[[2023,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The objective of this study was to assess the preliminary efficacy and safety of conservative management compared with systematic suture in isolated vaginal or first\u2010degree perineal tears after birth.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a preliminary efficacy, open\u2010label, randomized, controlled, and prospective trial. This study implemented Simon's 2\u2010step plan (interim analysis and final analysis) to test the success rate of the digital compression strategy group. Primiparous women aged \u226518\u2009years with isolated vaginal or first\u2010degree perineal tears after spontaneous vaginal birth of a cephalic presenting term (\u226537\u2009weeks) neonate were randomly allocated to the conservative management (CM) group (digital compression if bleeding followed by suture if persistent bleeding) or a systematic suture (SS) group. The primary outcome was the success of the intervention 10\u2009days after delivery, defined by pain as evaluated using a visual analog scale\u00a0&lt;\u20093, satisfactory healing defined by a REEDA score\u2009\u2264\u20092, and no bleeding or infection. Sexual well\u2010being was assessed at 2 and 6\u2009months postpartum.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 861\/2209 eligible women, 143 consenting women with a superficial perineal tear were randomized: 72 in the systematic suture group and 71 in the conservative management group. Success rate was 87.8% (90% CI [70.5\u201093.54]) (42\/55) in the systematic suture group vs 90% (90% CI [78.3\u201093.8]) (53\/61) in the conservative management group. The REEDA score was significantly higher in the systematic suture group (1.4 vs 0.9; <jats:italic>P<\/jats:italic>\u00a0=\u20090.036). Perineal pain was significantly higher at day 1 in the systematic suture group (2.38 vs 1.69; <jats:italic>P<\/jats:italic>\u00a0=\u20090.034). For the Female Sexual Functional Index score, no significant difference was found between the two groups at inclusion or at 2 and 6\u00a0months postpartum.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Conservative management of superficial perineal tears shows an efficacy rate \u226590%. Women in the conservative management group had less pain at the 1st day follow\u2010up and lower REEDA scores at the 10th day follow\u2010up.<\/jats:p><\/jats:sec>","DOI":"10.1111\/birt.12671","type":"journal-article","created":{"date-parts":[[2022,8,12]],"date-time":"2022-08-12T16:14:22Z","timestamp":1660320862000},"page":"513-524","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Conservative management versus systematic suture of isolated vaginal or first\u2010degree perineal tears after delivery: A preliminary randomized efficacy trial"],"prefix":"10.1111","volume":"50","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3341-5267","authenticated-orcid":false,"given":"Marine","family":"Lallemant","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology University Medical Center of Besancon, University of Franche\u2010Comte  Besan\u00e7on France"},{"name":"Applied Mechanics Department, FEMTO\u2010ST Institute University Bourgogne Franche\u2010Comt\u00e9, CNRS (UMR 6174)  Besan\u00e7on France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aur\u00e9lie","family":"D'Antona","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University Medical Center of Besancon, University of Franche\u2010Comte  Besan\u00e7on France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chrystelle","family":"Vidal","sequence":"additional","affiliation":[{"name":"Centre d'investigation Clinique, INSERM CI 1431 University Medical Center of Besancon  Besan\u00e7on France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aude","family":"Bourtembourg","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University Medical Center of Besancon, University of Franche\u2010Comte  Besan\u00e7on France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claire","family":"Toubin","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University Medical Center of Besancon, University of Franche\u2010Comte  Besan\u00e7on France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Malek","family":"Chehab","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University Medical Center of Besancon, University of Franche\u2010Comte  Besan\u00e7on France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie","family":"Vilchez","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University Medical Center of Besancon, University of Franche\u2010Comte  Besan\u00e7on France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guillaume","family":"Boiteux","sequence":"additional","affiliation":[{"name":"Centre d'investigation Clinique, INSERM CI 1431 University Medical Center of Besancon  Besan\u00e7on France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajeev","family":"Ramanah","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University Medical Center of Besancon, University of Franche\u2010Comte  Besan\u00e7on France"},{"name":"Nanomedecine Laboratory, INSERM EA4662 University of Franche\u2010Comte  Besan\u00e7on France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lionel","family":"Pazart","sequence":"additional","affiliation":[{"name":"Centre d'investigation Clinique, INSERM CI 1431 University Medical Center of Besancon  Besan\u00e7on France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Didier","family":"Riethmuller","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University Medical Center of Grenoble  Grenoble France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolas","family":"Mottet","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University Medical Center of Besancon, University of Franche\u2010Comte  Besan\u00e7on France"},{"name":"Nanomedecine Laboratory, INSERM EA4662 University of Franche\u2010Comte  Besan\u00e7on France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,8,12]]},"reference":[{"key":"e_1_2_12_2_1","unstructured":"NHS Maternity Statistics England 2017\u201018.https:\/\/digital.nhs.uk\/data\u2010and\u2010information\/publications\/statistical\/nhs\u2010maternity\u2010statistics\/2017\u201018. 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