Konzervativní léčba nebo resutura u žen s dehiscencí perineální rány po vaginálním porodu (HEAL)
Dehisced perineální slza po vaginálním porodu (HEAL) – konzervativní léčba nebo resutura
The goal of this observational study is to make us more aware of the short and long-term outcomes for women having an uncomplicated healing process after a rupture or birth cut in the perineum after giving birth in relation to a healing process with a dehisced wound treated with conservative management or secondary suturing.
Participants will be asked to do
- A gynecological examination at one month after birth and 9-12 months after birth.
- Have a picture taken of the healing process
- Answer a questionnaire at one month, three months, and 9-12 months after birth
Přehled studie
Postavení
Intervence / Léčba
Detailní popis
The best way to manage perineal wound dehiscence after childbirth is unknown. Currently, there is no agreed best practice recommendation for managing perineal wound dehiscence due to a lack of evidence comparing conservative management with secondary suturing. Therefore, studies are urgently needed to compare the benefits and risks of both treatments. This study has the potential to significantly impact women´s health for those suffering from perineal wound dehiscence.
The investigators want to include 100 women who have had a primary repair of a second-degree tear or episiotomy with a normal/uncomplicated healing process, 100 women with a second-degree tear or episiotomy identified with a dehisced wound treated with secondary resuturing, and 100 women with a second-degree tear or episiotomy identified with a dehisced wound treated with conservative management.
All women who meet the inclusion criteria are recommended the same treatment and follow-up as currently present as standard care at the four hospitals that the investigators are recruiting from. The study deviates from the standard of care by offering two extra clinical examinations, one questionnaire evaluation without clinical examination, and a follow-up with pictures of the perineal tear healing process.
Typ studie
Zápis (Aktuální)
Kontakty a umístění
Studijní místa
-
-
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Herlev, Dánsko, DK-2730
- Department of Obstetrics and Gynaecology, Copenhagen University Hospital - Herlev and Gentofte
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Kritéria účasti
Kritéria způsobilosti
Věk způsobilý ke studiu
Přijímá zdravé dobrovolníky
Pohlaví způsobilá ke studiu
Metoda odběru vzorků
Studijní populace
We want to include 100 women who have had a primary repair of a second-degree tear or episiotomy with an uncomplicated healing process. They will only be recruited from the Perineal Care Clinics at the Department of Obstetrics and Gynecology at the Copenhagen University Hospital - Herlev. Furthermore, we want to include 100 women with a second-degree tear or episiotomy identified with a dehisced wound treated with secondary resuturing, and 100 women with a second-degree tear or episiotomy identified with a dehisced wound treated with conservative management. They will be recruited from the Perineal Care Clinics at the Department of Obstetrics and Gynecology at the Copenhagen University Hospitals - Rigshospitalet, Herlev Hospital, North Zealand Hospital, and Hvidovre Hospital. The women will come for a clinical examination to assess wound infection and healing 4 - 14 days post-partum.
Popis
Inclusion Criteria:
- Women with a vaginal delivery who have had a primary repair of a second-degree perineal tear or episiotomy
- At least 18 years old
- Able to understand, read and speak Danish or English
- Able to give informed consent
Exclusion Criteria:
- None, first, third- and fourth-degree tear
- Cesarean Section
Studijní plán
Jak je studie koncipována?
Detaily designu
- Observační modely: COHORT
- Časové perspektivy: PROSPECTIVE
Kohorty a intervence
Skupina / kohorta |
Intervence / Léčba |
|---|---|
|
Normal/uncomplicated healing process
100 women with a second-degree tear or episiotomy primarily sutured after labor: identified with a normal/uncomplicated healing process |
A clinical examination is needed to assess the healing process for the three groups. After assessing the healing process, we will take pictures of the tear for documentation. The participant will answer questions, serving as a baseline questionnaire, when arriving at the clinical examination one month post-partum. At three and 9-12 months post-postpartum, they will receive another questionnaire. The questionnaire will consist of validated questions regarding body image, pain, Urogynecological problems as symptoms of prolapse, urinary and anal incontinence, and questions about sexual problems. |
|
Dehisced wound treated with secondary resuturing
100 women with a second-degree tear or episiotomy: identified with a dehisced wound treated with secondary resuturing |
A clinical examination is needed to assess the healing process for the three groups. After assessing the healing process, we will take pictures of the tear for documentation. The participant will answer questions, serving as a baseline questionnaire, when arriving at the clinical examination one month post-partum. At three and 9-12 months post-postpartum, they will receive another questionnaire. The questionnaire will consist of validated questions regarding body image, pain, Urogynecological problems as symptoms of prolapse, urinary and anal incontinence, and questions about sexual problems. |
|
Dehisced wound treated with conservative management
100 women with a second-degree tear or episiotomy: identified with a dehisced wound treated with conservative management |
A clinical examination is needed to assess the healing process for the three groups. After assessing the healing process, we will take pictures of the tear for documentation. The participant will answer questions, serving as a baseline questionnaire, when arriving at the clinical examination one month post-partum. At three and 9-12 months post-postpartum, they will receive another questionnaire. The questionnaire will consist of validated questions regarding body image, pain, Urogynecological problems as symptoms of prolapse, urinary and anal incontinence, and questions about sexual problems. |
Co je měření studie?
Primární výstupní opatření
Měření výsledku |
Popis opatření |
Časové okno |
|---|---|---|
|
Body image
Časové okno: 9-12 months
|
Measured by the Body-Image questionnaire FGSIS - Female Genital Self-Image Scale |
9-12 months
|
Sekundární výstupní opatření
Měření výsledku |
Popis opatření |
Časové okno |
|---|---|---|
|
Wound healing
Časové okno: One month
|
The proportion of women with healed wounds at one month post-partum assessed by clinical examination and REEDA scale (Redness, Oedema, Ecchymosis, Discharge, Approximation of the wound edges). The REEDA scale contains five criteria each receiving a score between 0 and 3. The total score range from 0 - 15 with lower scores representing better-wound healing |
One month
|
|
Infection rate
Časové okno: One month
|
The proportion of women with an infected wound until one month post-partum assessed by clinical examination and measured by REEDA scale |
One month
|
|
Resuming sexual intercourse
Časové okno: One month, three months, and 9-12 months
|
Measured by the PISQ-12 questionnaire which is a short form of the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12) |
One month, three months, and 9-12 months
|
|
Dyspareunia
Časové okno: One month, three months, and 9-12months
|
Measured by the PISQ-12 questionnaire which is a short form of the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12) |
One month, three months, and 9-12months
|
|
Woman´s satisfaction with the aesthetic results of the perineal wound
Časové okno: One month, three months, and 9-12 months
|
Self-reported. The woman will be asked if she is satisfied with the aesthetic results of the perineal wound |
One month, three months, and 9-12 months
|
|
Affected breastfeeding
Časové okno: One month, three months, and 9-12 months
|
The woman will be asked whether she is breastfeeding or not |
One month, three months, and 9-12 months
|
|
Re-admission
Časové okno: Within one month
|
The women will be asked whether they have been readmitted to the hospital and why within four weeks p.p. |
Within one month
|
|
Prolapse
Časové okno: One month, three months, and 9-12 months
|
Measured by ICIQ-VS questionnaire which is a short form of the International Consultation on Incontinence Questionnaire - Vaginal Symptoms (ICIQ-VS) |
One month, three months, and 9-12 months
|
|
Urinary incontinence
Časové okno: One month, three months, and 9-12 months
|
Measured by the ICIQ-UI SF questionnaire which is a short form of the International Consultation on Incontinence Questionnaire - Urinary Incontinence Short Form (ICIQ-UI SF) |
One month, three months, and 9-12 months
|
|
Fecal incontinence
Časové okno: One month, three months, and 9-12 months
|
Measured by ICIQ-B questionnaire which is a short form of the International Consultation on Incontinence Questionnaire - Bowel (ICIQ-B) |
One month, three months, and 9-12 months
|
|
Psychological well-being (maternal anxiety or depression)
Časové okno: Three months, and 9-12 months
|
Measured by Edinburgh Postnatal Depression Scale (EPDS). EPDS is a self-assessment questionnaire consisting of ten statements and the respondent is asked about their feelings over the last seven days. The answers are scored from 0-3 which gives an endpoint from 0-30. In Denmark, women are said to have depressive symptoms after delivery if they score 11 or higher |
Three months, and 9-12 months
|
|
Pain intensity
Časové okno: One month, three months, and 9-12 months
|
Self-reported pain intensity measured by Visual Analog Scale (VAS-score). Numeric rating scale from 0-10 (0 = no pain - 10 = pain as bad as can be) |
One month, three months, and 9-12 months
|
|
Consuming painkillers because of pain due to perineal tear
Časové okno: One month, three months, and 9-12 months
|
The participant will be asked whether she is consuming painkillers because of pain due to a perineal tear (Yes/No) |
One month, three months, and 9-12 months
|
|
Pelvic floor muscle contraction
Časové okno: One month and 9-12 months
|
Measured by Modified Oxford scale |
One month and 9-12 months
|
Spolupracovníci a vyšetřovatelé
Sponzor
Vyšetřovatelé
- Vrchní vyšetřovatel: Hanna M. Jangö, MD, PhD, Copenhagen University Hospital - Herlev and Gentofte
Termíny studijních záznamů
Hlavní termíny studia
Začátek studia (Aktuální)
Primární dokončení (Aktuální)
Dokončení studie (Aktuální)
Termíny zápisu do studia
První předloženo
První předloženo, které splnilo kritéria kontroly kvality
První zveřejněno (Aktuální)
Aktualizace studijních záznamů
Poslední zveřejněná aktualizace (Aktuální)
Odeslaná poslední aktualizace, která splnila kritéria kontroly kvality
Naposledy ověřeno
Více informací
Termíny související s touto studií
Klíčová slova
Další relevantní podmínky MeSH
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