Clinical Research Directory

Comparison of Finnish and Viennese Techniques for Perineal Protection in Women During the Second Stage of Labor

The goal of this clinical trial is to find out which method of protecting the perineum during childbirth works better in reducing tears in first-time mothers. The study will compare two commonly used techniques-Finnish and Viennese manual perineal protection-during the second stage of labor. It will also assess whether these techniques are safe and practical to use. The main questions it aims to answer are: 1. Does the Finnish technique reduce the number of perineal tears compared to the Viennese technique? 2. Are there any differences in labor outcomes or complications between the two techniques? Researchers will randomly assign 60 pregnant women (first-time mothers with full-term, single pregnancies) into two groups. One group will receive the Finnish technique, while the other group will receive the Viennese technique during the second stage of labor. Participants will: * Be enrolled when they are in active labor and planning a normal vaginal delivery * Be randomly assigned to one of the two perineal protection techniques * Have their labor monitored, including the duration of different stages of labor * Undergo a clinical examination after delivery to check for any perineal tears A trained obstetrician who is not aware of which technique was used will examine the mother after delivery to ensure unbiased assessment. Any tears identified will be treated according to standard hospital guidelines. By comparing these two techniques, this study aims to identify the safer and more effective method to reduce perineal injury during childbirth, which may help improve maternal outcomes and quality of care.

Physiotherapeutic Protocol Compared to Usual Care in the Treatment of Primiparas After Perineal Trauma

The aim of this study is to assess the effectiveness of a pelvic floor muscle training (PFMT) protocol associated with cryotherapy initiated in the immediate postpartum period in relieving pain in primiparous women who suffered perineal trauma during vaginal delivery. This is a hybrid effectiveness-implementation type 1 randomized controlled trial with economic evaluation, which will include 82 primiparous women who suffered a perineal tear of grade 2 or above or episiotomy during vaginal delivery. The study participants will be selected from among the women who gave birth at the Hospital das Clínicas in Ribeirão Preto and will be randomly assigned to participate in one of two study groups: the Control Group will receive the usual maternity care, that includes suturing the injury and analgesic medication, and the Intervention Group will receive the usual care combined with a physiotherapy protocol of PFMT and cryotherapy, starting in the immediate postpartum period and lasting 3 months. The primary outcome of the study will be the change in perineal pain intensity assessed using an 11-point Numerical Rating Scale; and the secondary outcomes will be self-reported pelvic floor dysfunction, recovery from injury, functionality, health-related quality of life, use of pain medication, genital self-image and implementation outcomes (satisfaction, acceptability, adequacy, feasibility, equity and adherence to the protocol). Assessments will be carried out by a group of health professionals, including physiotherapists and physicians, at 11 points up to 6 months after delivery. Two doctors from the service will be responsible for carrying out the transperineal ultrasound examination to assess the injury, which will be sent to a third international collaborating physician (SD) to assess the results blindly. The other assessments will be carried out by two physiotherapists.Descriptive statistics will be used, including the ANOVA test to confirm homogeneity between the groups, the chi-square test or Fisher's test for categorical variables and Student's t-test or Wilcoxon's non-parametric test for independent samples for quantitative variables.