A study to assess the prediction of perineal trauma during child birth using striae gravidarum among the post natal mothers at selected hospitals, sasaram, rohtas, bihar

Latha K``; Kumar Gaurav; Kumari Soni; Vardhan Harsh; Priya Vishnu; Kumari Anjali; Malik Irfan

doi:10.22376/

Authors

K.Latha Dean Cum Principal, Narayan Nursing College, Gopal Narayan Singh University, Jamuhar, Rohtas, Bihar, India – 821305
Gaurav Kumar Narayan Nursing College, Gopal Narayan Singh University, Jamuhar, Rohtas, Bihar, India – 821305
Soni Kumari Narayan Nursing College, Gopal Narayan Singh University, Jamuhar, Rohtas, Bihar, India – 821305
Harsh Vardhan Narayan Nursing College, Gopal Narayan Singh University, Jamuhar, Rohtas, Bihar, India – 821305
Vishnu Priya Narayan Nursing College, Gopal Narayan Singh University, Jamuhar, Rohtas, Bihar, India – 821305
Anjali Kumari Narayan Nursing College, Gopal Narayan Singh University, Jamuhar, Rohtas, Bihar, India – 821305
Irfan Malik Narayan Nursing College, Gopal Narayan Singh University, Jamuhar, Rohtas, Bihar, India – 821305

Abstract

Perineal trauma during childbirth poses significant maternal health concerns, resulting in both immediate and long-term complications such as pain, infection, incontinence, and psychological distress. This study aimed to evaluate the relationship between the severity of striae gravidarum and perineal trauma during vaginal delivery, as well as to explore associated demographic and obstetric factors. Conducted at Narayan Medical College & Hospital and Sadar Hospital, Sasaram, Bihar, the research employed a quantitative, non-experimental, descriptive correlational design involving 60 postnatal mothers selected through convenience sampling. Data collection tools included a demographic proforma, the Atwal Scale for striae gravidarum, and the Perineal Trauma Grading Scale. Results indicated that 35% of mothers had moderate striae and 45% experienced Grade 1 perineal trauma, with a weak positive correlation (r = 0.621) observed between striae severity and perineal trauma. Religion and socio-economic status showed significant associations with perineal trauma (p < 0.05), while birth weight was significantly associated with striae gravidarum; other demographic variables were not significant. The findings suggest that striae gravidarum could serve as a simple, non-invasive clinical indicator for identifying women at higher risk of perineal trauma, advocating for its inclusion in routine antenatal assessments to facilitate preventive interventions and improve maternal outcomes.

Keywords:

Perineal trauma, Striae gravidarum, Vaginal delivery, Maternal outcomes, Risk prediction, Antenatal care

DOI

https://doi.org/10.22376/

References

1. Abbas, A. M. (2020). Atwal Striae gravidarum score for prediction of perineal tears during vaginal delivery: a cross- sectional study. World Journal of Gynecology&Womens Health 4(3). https://doi.org/10.33552/wjgwh.2020.04.000587

2. ACOG Practice Bulletin No. 198: Prevention and Management of Obstetric Lacerations at Vaginal Delivery. (2018). Obstetrics and Gynecology, 132(3), e87–e102. https://doi.org/10.1097/aog.0000000000002841

3. Andrade, C. (2021). A Student’s Guide to the Classification and Operationalization of Variables in the Conceptualization and Design of a Clinical Study: Part 1. Indian Journal of Psychological Medicine, 43(2), 177–179. https://doi.org/10.1177/0253717621994334

4. Arnold, M., Saddler, K., & Leli, K. (2021). Obstetric lacerations: Prevention and repair. Am Fam Physician, 103, PMID: 34128615. https://pubmed.ncbi.nlm.nih.gov/34128615/

5. Banu, M. A., Nargis, S., Rahman, M. M., Sina, M. M. I., Pervin, M., & Manjari, M. (2019). Prediction of perineal tear during childbirth by the assessment of striae gravidarum score. Medicine Today, 31(2), 64–67. https://doi.org/10.3329/medtoday.v31i2.41945

6. Bhujabal, D., Rath, K., &Baxla, P. (2019). Association of Striae Gravidarum Score with Perineal Trauma among Primi-para Mothers. https://www.semanticscholar.org/paper/Association-of-Striae-Gravidarum-Score-with-Trauma-Bhujabal-Rath/1dbcd13da6aa84ea65f84943138f521b38b3bb6b

7. Bong, A. B., Bonnekoh, B., Schön, M. P., & Gollnick, H. (2005). Treatment of scalp angiosarcoma by controlled perfusion of A. carotis externa with pegylated liposomal doxorubicin and intralesional application of pegylated interferon alfa. Journal of the American Academy of Dermatology, 52(2), S20–S23. https://doi.org/10.1016/j.jaad.2004.06.026

8. Creswell, J. W., & Creswell, J. D. (2022). The Selection of a Research Approach [E-book]. In Research Design (6th ed., pp. 5–6). Sage Publications, Incorporated.

9. Goh, R., Goh, D., &Ellepola, H. (2018). Perineal tears – A review. Australian Journal of General Practice, 47(1–2), 35–38. https://doi.org/10.31128/afp-09-17-4333

10. Granovsky-Grisaru, S., & Elstein, D. (2006). Alfa-fetoprotein and albumin levels together are more predictive of severe fetal hydrops. American Journal of Obstetrics and Gynecology, 196(2), e21. https://doi.org/10.1016/j.ajog.2006.07.039

11. Kapadia, S., Kapoor, S., Parmar, K., Patadia, K., & Vyas, M. (2014). Prediction of perineal tear during childbirth by assessment of striae gravidarum score. International Journal of Reproduction Contraception Obstetrics and Gynecology, 208–212. https://doi.org/10.5455/2320-1770.ijrcog20140342

12. Khamseh, F. K., Zagami, S. E., & Ghavami, V. (2022). The Relationship between Perineal Trauma and Striae Gravidarum. Iranian Journal of Nursing and Midwifery Research, 27(5), 363–369. https://doi.org/10.4103/ijnmr.ijnmr_379_20

13. Matyashov, T., Pardo, E., Rotem, R., Lichtman, Y., Katz, M. E., Weintraub, A. Y., & Horev, A. (2022). The association between striae gravidarum and perineal lacerations during labor. PLoS ONE, 17(3), e0265149. https://doi.org/10.1371/journal.pone.0265149

14. Mayanglambam, P., & Negi, R. (2019). Prediction of perineal tear by striae gravidarum score. International Journal of Academic Research and Development, 103–105. https://www.researchgate.net/publication/331327400

15. Mazov, N. A., &Gureev, V. N. (2020). Problematic aspects in identifying priority areas of scientific research Источник: https://www.science-practice.ru/index.php/science/article/view/84. Science Management: Theory and Practice, 2(3), 37–51. https://www.science-practice.ru/index.php/science/article/view/84

16. Oumeish, O. Y., & Parish, J. L. (2006). Impetigo herpetiformis. Clinics in Dermatology, 24(2), 101–104. https://doi.org/10.1016/j.clindermatol.2005.10.009

17. Patel, N., Shah, N., & Desai, G. (2019, June 1). Can perineal tear be predicted by severity of striae gravidarum score? Document - Gale OneFile: Health and Medicine. https://go.gale.com/ps/i.do?id=GALE%7CA593352877&sid=googleScholar&v=2.1&it=r&linkaccess=abs&issn=23201770&p=HRCA&sw=w&userGroupName=anon%7Ed982502c&aty=open-web-entry

18. Priddis, H., Dahlen, H., & Schmied, V. (2012). Women’s experiences following severe perineal trauma: a meta‐ethnographic synthesis. Journal of Advanced Nursing, 69(4), 748–759. https://doi.org/10.1111/jan.12005

19. Ramar, C., Vadakektu, E., & Grimes, W. (2024). Perineal tear [English]. StarPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK559068/

20. Soliman, M., Maged, A., Salama, S., Sharaf, M., Rasheed, M. A., Eltaieb, E., & Lotfy, R. (2024). The relation between development of vaginal and perineal lacerations during delivery and stria gravidarum: a cross sectional study. Evidence Based Women S Health Journal, 14(3), 355–361. https://doi.org/10.21608/ebwhj.2024.295572.1334

21. Thyer, B. (2001). Single System Design [E-Book]. In The Handbook of Social Work Research Methods (1st ed., pp. 239–241). SAGE. http://books.google.ie/books?id=WhD_kwntYOAC&pg=PR4&dq=0-7619-1905-8&hl=&cd=1&source=gbs_api

22. Ugwu, E. O., Iferikigwe, E. S., Obi, S. N., Eleje, G. U., &Ozumba, B. C. (2018). Effectiveness of antenatal perineal massage in reducing perineal trauma and post‐partum morbidities: A randomized controlled trial. Journal of Obstetrics and Gynaecology Research, 44(7), 1252–1258. https://doi.org/10.1111/jog.13640