RESEARCH PAPER
 
KEYWORDS
TOPICS
ABSTRACT
Introduction:
Vaginal delivery can cause genital tract trauma and lacerations of different severity. This study aims to establish if routinary use of Ritgen’s maneuver decreases the prevalence and severity of perineal lacerations compared to the traditional manual perineal protection (MPP).

Methods:
This prospective case-control study was conducted in the labor ward of Fondazione Policlinico A. Gemelli, Rome, Italy. One hundred sixteen women who met inclusion criteria were included. The study group (n=58) consisted of women who were assisted using the Ritgen maneuver, whereas the women who gave birth immediately afterward were selected as the control group (n=58). All information was retrieved through electronic medical records.

Results:
In all, 22% women of the study group reported no perineal lacerations compared with 5% of the control group (p=0.007). Regarding the degree of lacerations, the study group exhibited more first-degree lacerations and fewer second-degree lacerations, while the control group exhibited the opposite trend. Among women who received epidural analgesia, 24% of the study group did not experience perineal lacerations, compared to 4.5% of the control (OR=0.15; 95% CI: 0.03–0.72; p=0.008). Similarly, 23.4% of cases in the study group with oxytocin-enhanced labor, experienced no perineal trauma while none in the control group had no perineal trauma in cases of oxytocin augmentation (p=0.005).

Conclusions:
Our results suggest that using Ritgen’s maneuver in childbirth care may reduce the incidence and severity of perineal lacerations, even in the presence of known risk factors for perineal lacerations such as oxytocin augmentation and epidural analgesia.

ACKNOWLEDGEMENTS
We would like to thank all the women and their babies, who participated in the study. We also would like to thank the Italian Ministry of Health: current research year 2024.
CONFLICTS OF INTEREST
The authors have completed and submitted the ICMJE Form for disclosure of Potential Conflicts of Interest and none was reported.
FUNDING
There was no source of funding for this research.
ETHICAL APPROVAL AND INFORMED CONSENT
Ethical approval was obtained from the Institutional Review Board of the Institute of Obstetrics and Gynecology of the Catholic University of the Sacred Heart, Rome, where the project has been developed (Approval number: IST CICOG-04-03-19/14). Participants provided informed consent.
DATA AVAILABILITY
The data supporting this research are available from the authors on reasonable request.
AUTHORS' CONTRIBUTIONS
SS, MD, AR and JP: conceived the study and conducted data collection. SS conducted the statistical analysis, collaborated on drafting the article, and reviewed the final version. FTA drafted the article, and edited and reviewed the final version. RR, SB and FS assisted with data collection, collaborated on drafting the article, and reviewed the final version. AL, JP, GA and MD supervised data collection, and edited and reviewed the final version. All authors read and agreed on the final version of the manuscript.
PROVENANCE AND PEER REVIEW
Not commissioned; externally peer reviewed.
 
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