{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T00:47:27Z","timestamp":1774486047668,"version":"3.50.1"},"reference-count":33,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2011,8,25]],"date-time":"2011-08-25T00:00:00Z","timestamp":1314230400000},"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":["J Midwife Womens Health"],"published-print":{"date-parts":[[2011,9]]},"abstract":"<jats:p><jats:bold>Introduction:<\/jats:bold> The purpose of this study was to compare the frequency and severity of perineal trauma during spontaneous birth with or without perineal injections of hyaluronidase (HAase).<\/jats:p><jats:p><jats:bold>Methods:<\/jats:bold> A randomized, placebo\u2010controlled, double\u2010blind clinical trial was conducted in a midwife\u2010led, in\u2010hospital birth center in S\u00e3o Paulo, Brazil. Primiparous women (N = 160) were randomly assigned to an experimental (n = 80) or control (n = 80) group. During the second stage of labor, women in the experimental group received an injection of 20.000 turbidity\u2010reducing units of HAase in the posterior region of the perineum, and those in the control group received a placebo injection. The assessment of perineal outcome was performed by 2 independent nurse\u2010midwives. A 1\u2010tailed Fisher exact test was performed, and a <jats:italic>P<\/jats:italic> value &lt; .025 was considered statistically significant.<\/jats:p><jats:p><jats:bold>Results:<\/jats:bold> Perineal integrity occurred in 34.2% of the experimental group and in 32.5% of the control group, which was not a statistically significant difference (<jats:italic>P<\/jats:italic>= .477). First\u2010degree laceration was the most common trauma in the posterior region of the perineum in women in both groups (experimental = 56%, control = 42.6%). Severe perineal trauma occurred in 28.9% of the experimental group and 38.8% of the control group, which also was not a statistically significant difference (<jats:italic>P<\/jats:italic>= .131). The depth of second\u2010degree perineal lacerations in the experimental and control groups, measured by the Peri\u2010Rule, was 1.9 cm and 2.3 cm, respectively. An episiotomy was performed in 11 women (experimental group = 3, control group = 8), and 4 (all in control group) had third\u2010degree lacerations.<\/jats:p><jats:p><jats:bold>Discussion:<\/jats:bold> The use of injectable HAase did not increase the proportion of intact perineum and did not reduce the proportion of severe perineal trauma in our sample.<\/jats:p>","DOI":"10.1111\/j.1542-2011.2011.00056.x","type":"journal-article","created":{"date-parts":[[2011,11,10]],"date-time":"2011-11-10T12:58:21Z","timestamp":1320929901000},"page":"436-445","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Use of Hyaluronidase to Prevent Perineal Trauma During Spontaneous Births: A Randomized, Placebo\u2010Controlled, Double\u2010blind, Clinical Trial"],"prefix":"10.1111","volume":"56","author":[{"given":"Priscila Maria","family":"Colacioppo","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria Luiza","family":"Gonzalez Riesco","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marcia Duarte","family":"Koiffman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2011,8,25]]},"reference":[{"key":"e_1_2_8_2_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.0730-7659.2006.00085.x"},{"key":"e_1_2_8_3_2","article-title":"Advanced age is a risk factor for higher grade perineal lacerations during delivery in nulliparous women","author":"Hornemann A","journal-title":"Arch Gynecol 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