Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden.
Department of Women's Health and Allied Health Professionals, Karolinska University Hospital, Stockholm, Sweden.
Acta Obstet Gynecol Scand. 2024 Nov;103(11):2314-2323. doi: 10.1111/aogs.14938. Epub 2024 Aug 16.
Postnatal perineal pain is prevalent following childbirth and can impact women both physically and emotionally. The aim of the study was to study the effect of collegial midwifery assistance on perineal pain and pain medication 1 month after birth and to investigate the associations between the type of tear and perineal pain, satisfaction with healing, and resumption of intercourse.
A follow-up questionnaire was sent 1 month postpartum to women with a first spontaneous vaginal birth participating in a randomized controlled trial (Oneplus trial). Data were collected from December 2019 to May 2020. Differences in perineal pain between women attended by one or two midwives were analyzed according to intention-to-treat using bivariate analyses. Associations between the type of tear and perineal pain, satisfaction with healing, and resumption of sexual intercourse were investigated using univariable and multivariable logistic regression. The category no tear/first-degree tear was compared separately to each of the other tear categories.
ClinicalTrials.gov, NCT03770962.
Out of 2233 women, 1762 responded within 30-60 days postpartum. Of women in the no tear/first-degree tear category, 27.7% reported perineal pain during the past week, in contrast to women with OASI, where 64.2% reported perineal pain. Women with OASI experienced the highest odds of perineal pain (aOR 4.51, 95% CI 2.72-7.47) compared to those with no tear/first-degree tear, followed by women with major second-degree tears (aOR 1.87, 95% CI 1.45-2.41), women with an episiotomy (aOR 1.78, 95% CI 1.11-2.87), and those with minor second-degree tears (aOR 1.43, 95% CI 1.06-1.94). Women with episiotomy reported the highest odds ratios for dissatisfaction with tear healing (aOR 3.48, 95% CI 1.92-6.31). No significant differences in perineal pain and pain medication were observed between women allocated to collegial midwifery assistance and those allocated to standard care.
Women with OASI reported the highest odds of perineal pain 30-60 days after birth compared to women with no tear or first-degree tear, followed by women with major second-degree tears. Women subjected to an episiotomy reported highest odds ratios of dissatisfaction with tear healing.
产后会阴疼痛在分娩后很常见，会对女性的身体和情绪产生影响。本研究的目的是研究助产士团队协助对产后 1 个月会阴疼痛和疼痛药物使用的影响，并调查会阴撕裂类型与会阴疼痛、愈合满意度和恢复性生活之间的关系。
对参加随机对照试验（Oneplus 试验）的初产妇在产后 1 个月进行随访问卷调查。数据收集于 2019 年 12 月至 2020 年 5 月。根据意向治疗原则，采用双变量分析比较由一名或两名助产士护理的产妇之间的会阴疼痛差异。使用单变量和多变量逻辑回归分析会阴撕裂类型与会阴疼痛、愈合满意度和恢复性生活之间的关系。无撕裂/一度撕裂与其他撕裂类型分别进行比较。
ClinicalTrials.gov，NCT03770962。
在 2233 名妇女中，1762 名在产后 30-60 天内回复。无撕裂/一度撕裂组中，27.7%的妇女在过去一周有会阴疼痛，而 OASI 组中，64.2%的妇女有会阴疼痛。与无撕裂/一度撕裂组相比，OASI 组的会阴疼痛发生率最高（优势比 4.51，95%置信区间 2.72-7.47），其次是重度二度撕裂组（优势比 1.87，95%置信区间 1.45-2.41）、会阴侧切组（优势比 1.78，95%置信区间 1.11-2.87）和轻度二度撕裂组（优势比 1.43，95%置信区间 1.06-1.94）。会阴侧切组对撕裂愈合不满意的比值比最高（优势比 3.48，95%置信区间 1.92-6.31）。接受助产士团队协助和标准护理的产妇在会阴疼痛和疼痛药物使用方面无显著差异。
与无撕裂或一度撕裂的产妇相比，OASI 产妇产后 30-60 天内会阴疼痛的发生率最高，其次是重度二度撕裂的产妇。会阴侧切的产妇对撕裂愈合不满意的比值比最高。
