SpringerLink
Log in

Patient-reported outcomes and outcome measures in childbirth perineal trauma research: a systematic review

  • Review Article
  • Published:
International Urogynecology Journal Aims and scope Submit manuscript

Abstract

Introduction and hypothesis

In evaluating the effectiveness of interventions in perineal trauma research, outcomes reported by patients should have a prominent focus. There is no international consensus regarding the use of either patient-reported outcomes (PROs) or tools used to determine these outcomes (patient-reported outcome measures, PROMs). The objective was to evaluate the selection, reporting and geographical variations of PROs and PROMs in randomised controlled trials (RCTs) on perineal trauma.

Methods

We performed a systematic review of RCTs in perineal trauma research evaluating outcome and outcome measure reporting. We identified PROs and PROMs and grouped PROs into domains and themes, a classification system based on a medical outcome taxonomy.

Results

Of 48 included RCTs, 47 reported PROs. In total, we identified 51 PROs. Outcome reporting consistency was low, with 27 PROs reported only once. Nine PROs were reported more than five times, the most frequent being perineal pain, with no geographical variation in reporting. Four themes encompassing 12 domains were identified. The most frequently reported theme was “Clinical”, with 25 PROs grouped within four domains. “Resource use” and “Adverse events” themes were rarely reported, with only five PROs. PROMs also exhibited variation. Most common were visual analogue scale (VAS; 100 mm), Cleveland Clinic Continence Score, The Faecal Incontinence Quality of Life scale, VAS (0–10) and the McGill Pain Questionnaire.

Conclusions

Significant heterogeneity in PROs and PROMs was observed among RCTs. Despite inconsistency, PROs are the most prevalent outcome in perineal trauma research. Patient-reported adverse events are underreported. Their use in determining the effectiveness and safety of interventions makes their integration important in perineal trauma core outcome sets. Identification and grou** of outcomes will assist future core outcome consensus studies.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price includes VAT (Germany)

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Aguiar M, Farley A, Hope L, Amin A, Shah P, Manaseki-Holland S. Birth-related perineal trauma in low- and middle-income countries: a systematic review and meta-analysis. Matern Child Health J. 2019;23(8):1048–70.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Frohlich J, Kettle C. Perineal care. BMJ Clin Evid. 2015;2015:1401.

    PubMed  PubMed Central  Google Scholar 

  3. Smith LA, Price N, Simonite V, Burns EE. Incidence of and risk factors for perineal trauma: a prospective observational study. BMC Pregnancy Childbirth 2013;13(1):59.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Dudding TC, Vaizey CJ, Kamm MA. Obstetric anal sphincter injury: incidence, risk factors, and management. Ann Surg. 2008;247:224–37.

    Article  PubMed  Google Scholar 

  5. Williams A. Anal sphincter damage after vaginal delivery using three-dimensional endosonography. Obstet Gynecol. 2001;97(5):770–5.

    CAS  PubMed  Google Scholar 

  6. Thiagamoorthy G, Johnson A, Thakar R, Sultan AH. National survey of perineal trauma and its subsequent management in the United Kingdom. Int Urogynecol J Pelvic Floor Dysfunct. 2014;25(12):1621–7.

    Article  CAS  Google Scholar 

  7. Kettle C, Tohill S. Perineal care. BMJ. 2008;2011:1401.

    Google Scholar 

  8. Selo-Ojeme DO, Okonkwo CA, Atuanya C, Ndukwu K. Single-knot versus multiple-knot technique of perineal repair: a randomised controlled trial. Arch Gynecol Obstet. 2016;294(5):945–52.

    Article  CAS  PubMed  Google Scholar 

  9. Fernando R, Sultan A, Freeman R, Williams A, Adams E. The Management of Third- and Fourth-Degree Perineal Tears (Green-Top Guideline No. 29). 2015. https://www.rcog.org.uk/globalassets/documents/guidelines/gtg-29.pdf.

  10. Fernando RJ, Sultan AH, Kettle C, Radley S, Jones P, O’Brien PMS. Repair techniques for obstetric anal sphincter injuries: a randomized controlled trial. Obstet Gynecol. 2006;107(6):1261–8.

    Article  PubMed  Google Scholar 

  11. Fynes MM, Marshall K, Cassidy M, Behan M, Walsh D, O’Connell PR, et al. A prospective, randomized study comparing the effect of augmented biofeedback with sensory biofeedback alone on fecal incontinence after obstetric trauma. Dis Colon Rectum. 1999;42(6):753–8.

    Article  CAS  PubMed  Google Scholar 

  12. Oakley SH, Ghodsi VC, Crisp CC, Estanol MV, Westermann LB, Novicki KM, et al. Impact of pelvic floor physical therapy on quality of life and function after obstetric anal sphincter injury: a randomized controlled trial. Female Pelvic Med Reconstr Surg. 2016;22(4):205–13.

    Article  PubMed  Google Scholar 

  13. Leroux N, Bujold E. Impact of chromic catgut versus polyglactin 910 versus fast-absorbing polyglactin 910 sutures for perineal repair: a randomized, controlled trial. Am J Obstet Gynecol. 2006;194(6):1585–90.

    Article  CAS  PubMed  Google Scholar 

  14. Rydningen M, Dehli T, Wilsgaard T, Rydning A, Kumle M, Lindsetmo RO, et al. Sacral neuromodulation compared with injection of bulking agents for faecal incontinence following obstetric anal sphincter injury—a randomized controlled trial. Colorectal Dis. 2017;19(5):O134–44.

    Article  CAS  PubMed  Google Scholar 

  15. Yildizhan R, Yildizhan B, Sahin S, Suer N. Comparison of the efficacy of diclofenac and indomethacin suppositories in treating perineal pain after episiotomy or laceration: a prospective, randomized, double-blind clinical trial. Arch Gynecol Obstet. 2009;280(5):735–8.

    Article  CAS  PubMed  Google Scholar 

  16. Zhou F, Wang XD, Li J, Huang GQ, Gao BX. Hyaluronidase for reducing perineal trauma. Cochrane Database of Systematic Reviews. (2):CD010441.

  17. Jiang H, Qian X, Carroli G, Garner P. Selective versus routine use of episiotomy for vaginal birth. Cochrane Database Syst Rev. 2017;2(2):CD000081.

    PubMed  Google Scholar 

  18. Aasheim V, Nilsen ABV, Reinar LM, Lukasse M. Perineal techniques during the second stage of labour for reducing perineal trauma. Cochrane Database Syst Rev. 2017;6(6):CD006672.

    PubMed  Google Scholar 

  19. Pergialiotis V, Durnea C, Elfituri A, Duffy J, Doumouchtsis S. Do we need a core outcome set for childbirth perineal trauma research? A systematic review of outcome reporting in randomised trials evaluating the management of childbirth trauma. BJOG. 2018;125(12):1522–31.

    Article  CAS  PubMed  Google Scholar 

  20. Harman NL, Bruce IA, Callery P, Tierney S, Sharif MO, O’Brien K, et al. MOMENT—Management of Otitis Media with Effusion in Cleft Palate: Protocol for a systematic review of the literature and identification of a core outcome set using a Delphi survey. Trials. 2013;14(1):70.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Williamson PR, Altman DG, Bagley H, Barnes KL, Blazeby JM, Brookes ST, et al. The COMET handbook: version 1.0. Trials. 2017;18(Suppl 3):280.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Ghai V, Subramanian V, Jan H, Pergialiotis V, Thakar R, Doumouchtsis SK. A systematic review on reported outcomes and outcome measures in female idiopathic chronic pelvic pain for the development of a core outcome set. BJOG. 2020;128(4):628–34.

    Article  PubMed  Google Scholar 

  23. Durnea CM, Pergialiotis V, Duffy JMN, Bergstrom L, Elfituri A, Doumouchtsis SK. A systematic review of outcome and outcome-measure reporting in randomised trials evaluating surgical interventions for anterior-compartment vaginal prolapse: a call to action to develop a core outcome set. Int Urogynecol J. 2018;29(12):1727–45.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Rada MP, Jones S, Falconi G, Milhem Haddad J, Betschart C, Pergialiotis V, et al. A systematic review and meta-synthesis of qualitative studies on pelvic organ prolapse for the development of core outcome sets. Neurourol Urodyn. 2020;39(3):880–9.

    Article  PubMed  Google Scholar 

  25. Doumouchtsis SK, Pookarnjanamorakot P, Durnea C, Zini M, Elfituri A, Haddad JM, et al. A systematic review on outcome reporting in randomised controlled trials on surgical interventions for female stress urinary incontinence: a call to develop a core outcome set. BJOG. 2019;126(12):1417–22.

    Article  CAS  PubMed  Google Scholar 

  26. De Mattos Lourenço TR, Pergialiotis V, Durnea C, Elfituri A, Haddad JM, Betschart C, et al. A systematic review of reported outcomes and outcome measures in randomized controlled trials on apical prolapse surgery. Int J Gynecol Obstet. 2019;145:4–11.

    Article  Google Scholar 

  27. Lourenço TRM, Pergialiotis V, Durnea CM, Elfituri A, Haddad JM, Betschart C, et al. A systematic review of reported outcomes and outcome measures in randomized trials evaluating surgical interventions for posterior vaginal prolapse to aid development of a core outcome set. Int J Gynecol Obstet. 2020;148(3):271–81.

    Article  Google Scholar 

  28. Doumouchtsis SK, Rada MP, Pergialiotis V, Falconi G, Haddad JM, Betschart C, et al. A protocol for develo**, disseminating, and implementing a core outcome set (COS) for childbirth pelvic floor trauma research. BMC Pregnancy Childbirth. 2020;20(1):376.

    Article  PubMed  PubMed Central  Google Scholar 

  29. Dodd S, Clarke M, Becker L, Mavergames C, Fish R, Williamson PR. A taxonomy has been developed for outcomes in medical research to help improve knowledge discovery. J Clin Epidemiol. 2018;96:84–92.

    Article  PubMed  PubMed Central  Google Scholar 

  30. Akil A, Api O, Bektas Y, Yilmaz AO, Yalti S, Unal O. Paracetamol vs dexketoprofen for perineal pain relief after episiotomy or perineal tear. J Obstet Gynaecol. 2014;34(1):25–8.

    Article  CAS  PubMed  Google Scholar 

  31. Alvarenga MB, de Oliveira SMJV, Francisco AA, da Silva FMB, Sousa M, Nobre MR. Effect of low-level laser therapy on pain and perineal healing after episiotomy: a triple-blind randomized controlled trial. Lasers Surg Med. 2017;49(2):181–8.

    Article  PubMed  Google Scholar 

  32. Aslam R, Khan SA, ul Amir Z, Amir F. Interrupted versus continuous sutures for repair of episiotomy or 2n degree perineal tears. J Ayub Med College Abbottabad. 2015;27(3):680–3.

    Google Scholar 

  33. Berlit S, Tuschy B, Brade J, Mayer J, Kehl S, Sütterlin M. Effectiveness of nitrous oxide for postpartum perineal repair: a randomised controlled trial. Eur J Obstet Gynecol Reprod Biol. 2013;170(2):329–32.

    Article  CAS  PubMed  Google Scholar 

  34. Colacioppo PM, Gonzalez Riesco ML. Effectiveness of local anaesthetics with and without vasoconstrictors for perineal repair during spontaneous delivery: double-blind randomised controlled trial. Midwifery. 2009;25(1):88–95.

    Article  PubMed  Google Scholar 

  35. Dencker A, Lundgren I, Sporrong T. Short communication: suturing after childbirth—a randomised controlled study testing a new monofilament material. BJOG. 2005;113(1):114–6.

    Article  Google Scholar 

  36. Dudley L, Kettle C, Thomas PW, Ismail KMK. Perineal resuturing versus expectant management following vaginal delivery complicated by a dehisced wound (PREVIEW): a pilot and feasibility randomised controlled trial. BMJ Open. 2017;7: e012766.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  37. Duggal N, Mercado C, Daniels K, Bujor A, Caughey AB, El-Sayed YY. Antibiotic prophylaxis for prevention of postpartum perineal wound complications: a randomized controlled trial. Obstet Gynecol. 2008;111(6):1268–73.

    Article  PubMed  Google Scholar 

  38. Eogan M, Daly L, Behan M, O’Connell P, O’Herlihy C. Randomised clinical trial of a laxative alone versus a laxative and a bulking agent after primary repair of obstetric anal sphincter injury. BJOG. 2007;114(6):736–40.

    Article  CAS  PubMed  Google Scholar 

  39. Farrell SA, Gilmour D, Turnbull GK, Schmidt MH, Baskett TF, Flowerdew G, et al. Overlap** compared with end-to-end repair of third- and fourth-degree obstetric anal sphincter tears: a randomized controlled trial. Obstet Gynecol. 2010;116(1):16–24.

    Article  PubMed  Google Scholar 

  40. Feigenberg T, Maor-Sagie E, Zivi E, Abu-Dia M, Ben-Meir A, Sela HY, et al. Using adhesive glue to repair first degree perineal tears: a prospective randomized controlled trial. BioMed Res Intl. 2014;2014:526590.

    Google Scholar 

  41. Fleming VEM, Hagen S, Niven C. Does perineal suturing make a difference? The SUNS trial. BJOG. 2003;110(7):684–9.

    Article  PubMed  Google Scholar 

  42. Franchi M, Cromi A, Scarperi S, Gaudino F, Siesto G, Ghezzi F. Comparison between lidocaine-prilocaine cream (EMLA) and mepivacaine infiltration for pain relief during perineal repair after childbirth: a randomized trial. Am J Obstet Gynecol. 2009;201(2):186.e1–5.

    Article  CAS  Google Scholar 

  43. Fyneface-Ogan S, Mato CN, Enyindah CE. Postpartum perineal pain in primiparous women: a comparison of two local anaesthetic agents. Niger J Med. 2006;15(1):77–80.

    CAS  PubMed  Google Scholar 

  44. Gamble J, Creedy D, Moyle W, Webster J, McAllister M, Dickson P. Effectiveness of a counseling intervention after a traumatic childbirth: a randomized controlled trial. Birth. 2005;32(1):11–9.

    Article  PubMed  Google Scholar 

  45. Garcia V, Rogers RG, Kim SS, Hall RJ, Kammerer-Doak DN. Primary repair of obstetric anal sphincter laceration: a randomized trial of two surgical techniques. Am J Obstet Gynecol. 2005;192(5):1697–701.

    Article  PubMed  Google Scholar 

  46. Ghahramani L, Mohammadipour M, Roshanravan R, Hajihosseini F, Bananzadeh A, Izadpanah A, et al. Efficacy of biofeedback therapy before and after sphincteroplasty for fecal incontinence because of obstetric injury: a randomized controlled trial. Iranian J Med Sci. 2016;41(2):126–31.

    Google Scholar 

  47. Gordon B, Mackrodt C, Fern E, Truesdale A, Ayers S, Grant A. The Ipswich childbirth study: 1. A randomised evaluation of two stage postpartum perineal repair leaving the skin unsutured. BJOG. 1998;105(4):435–40.

    Article  CAS  Google Scholar 

  48. Grant A, Ashurst H, Sleep J, Mcintosh J. Ultrasound and pulsed electromagnetic energy treatment for perineal trauma. A randomized placebo-controlled trial. BJOG. 1989;96(4):434–9.

    Article  CAS  Google Scholar 

  49. Grant A, Gordon B, Mackrodat C, Fern E, Truesdale A, Ayers S. The Ipswich childbirth study: one year follow up of alternative methods used in perineal repair. BJOG. 2001;108(1):34–40.

    CAS  PubMed  Google Scholar 

  50. Greenberg JA, Lieberman E, Cohen AP, Ecker JL. Randomized comparison of chromic versus fast-absorbing polyglactin 910 for postpartum perineal repair. Obstet Gynecol. 2004;103(6):1308–13.

    Article  PubMed  Google Scholar 

  51. Ismail KMK, Kettle C, Macdonald SE, Tohill S, Thomas PW, Bick D. Perineal Assessment and Repair Longitudinal Study (PEARLS): a matched-pair cluster randomized trial. BMC Med. 2013;11(1):209.

    Article  PubMed  PubMed Central  Google Scholar 

  52. Kettle C, Hills RK, Jones P, Darby L, Gray R, Johanson R. Continuous versus interrupted perineal repair with standard or rapidly absorbed sutures after spontaneous vaginal birth: a randomised controlled trial. Lancet. 2002;359(9325):2217–23.

    Article  PubMed  Google Scholar 

  53. Kindberg S, Stehouwer M, Hvidman L, Henriksen TB. Postpartum perineal repair performed by midwives: a randomised trial comparing two suture techniques leaving the skin unsutured. BJOG. 2008;115(4):472–9.

    Article  CAS  PubMed  Google Scholar 

  54. Lundquist M, Olsson A, Nissen E, Norman M. Is it necessary to suture all lacerations after a vaginal delivery? Birth. 2000;27(2):79–85.

    Article  CAS  PubMed  Google Scholar 

  55. Mahomed K, James D, Grant A, Ashurst H. The Southmead Perineal Suture study. A randomized comparison of suture materials and suturing techniques for repair of perineal trauma. BJOG. 1989;96(11):1272–80.

    Article  CAS  Google Scholar 

  56. Mahony R, Behan M, O’Herlihy C, O’Connell PR. Randomized, clinical trial of bowel confinement vs. laxative use after primary repair of a third-degree obstetric anal sphincter tear. Dis Colon Rectum. 2004;47(1):12–7.

    Article  PubMed  Google Scholar 

  57. Morano S, Mistrangelo E, Pastorino D, Lijoi D, Costantini S, Ragni N. A randomized comparison of suturing techniques for episiotomy and laceration repair after spontaneous vaginal birth. J Minim Invasive Gynecol. 2006;13(5):457–62.

    Article  PubMed  Google Scholar 

  58. Mota R, Costa F, Amaral A, Oliveira F, Santos CC, Ayres-De-Campos D. Skin adhesive versus subcuticular suture for perineal skin repair after episiotomy—a randomized controlled trial. Acta Obstet Gynecol Scand. 2009;88(6):660–6.

    Article  PubMed  Google Scholar 

  59. Nordenstam J, Mellgren A, Altman D, López A, Johansson C, Anzén B, et al. Immediate or delayed repair of obstetric anal sphincter tears—a randomised controlled trial. BJOG. 2008;115(7):857–65.

    Article  CAS  PubMed  Google Scholar 

  60. Oboro VO, Tabowei TO, Loto OM, Bosah JO. A multicentre evaluation of the two-layered repair of postpartum perineal trauma. J Obstet Gynaecol. 2003;23(1):5–8.

    Article  CAS  PubMed  Google Scholar 

  61. Peirce C, Murphy C, Fitzpatrick M, Cassidy M, Daly L, O’Connell PR, et al. Randomised controlled trial comparing early home biofeedback physiotherapy with pelvic floor exercises for the treatment of third-degree tears (EBAPT Trial). BJOG. 2013;120(10):1240–7.

    Article  CAS  PubMed  Google Scholar 

  62. Rygh AB, Körner H. The overlap technique versus end-to-end approximation technique for primary repair of obstetric anal sphincter rupture: a randomized controlled study. Acta Obstet Gynecol Scand. 2010;89(10):1256–62.

    Article  PubMed  Google Scholar 

  63. Sadif-Un-Nisa, Shamas-Un-Nisa, Sadif-Un-Nisa. Comparison of efficacy of continuous versus interrupted suturing technique in episiotomy. 2013. Accessed 11 November 2020. Available from: https://www.pjmhsonline.com/2013/oct_dec/pdf/1143

  64. Spencer JAD, Grant A, Elbourne D, Garcia J, Sleep J. A randomized comparison of glycerol-impregnated chromic catgut with untreated chromic catgut for the repair of perineal trauma. BJOG. 1986;93(4):426–30.

    Article  CAS  Google Scholar 

  65. Sultan AH, Johanson RB, Carter JE. Occult anal sphincter trauma following randomized forceps and vacuum delivery. Int J Gynecol Obstet. 1998;61(2):113–9.

    Article  CAS  Google Scholar 

  66. Tjandra JJ, Han WR, Goh J, Carey M, Dwyer P, Saclarides TJ. Direct repair vs. overlap** sphincter repair a randomized, controlled trial. Dis Colon Rectum. 2003;46(7):937–42.

    Article  CAS  PubMed  Google Scholar 

  67. Upton A, Roberts CL, Ryan M, Faulkner M, Reynolds M, Raynes-Greenow C. A randomised trial, conducted by midwives, of perineal repairs comparing a polyglycolic suture material and chromic catgut. Midwifery. 2002;18(3):223–9.

    Article  PubMed  Google Scholar 

  68. Williams A, Adams EJ, Tincello DG, Alfirevic Z, Walkinshaw SA, Richmond DH. How to repair an anal sphincter injury after vaginal delivery: results of a randomised controlled trial. BJOG: An International Journal of Obstetrics and Gynaecology. 2016;113(2):201–7.

  69. Valenzuela P, Saiz Puente M, Valero J, Azorín R, Ortega R, Guijarro R. Continuous versus interrupted sutures for repair of episiotomy or second-degree perineal tears: a randomised controlled trial. BJOG. 2009;116(3):436–41.

    Article  CAS  PubMed  Google Scholar 

  70. Zafar S. Comparison of a single-knot versus three layered technique of perineal repair after vaginal delivery in women requiring episiotomy: a double blind randomized controlled trial. J Turkish German Gynaecol Assoc. 2008;9(3):127–31.

    Google Scholar 

  71. Williamson PR, Gamble C, Altman DG, Hutton JL. Outcome selection bias in meta-analysis. Stat Methods Med Res. 2005;14:515–24.

    Article  CAS  PubMed  Google Scholar 

  72. Clarke M. Standardising outcomes for clinical trials and systematic reviews. Trials. 2007;8:39.

    Article  PubMed  PubMed Central  Google Scholar 

  73. Marshall M, Lockwood A, Bradley C, Adams C, Joy C, Fenton M. Unpublished rating scales: a major source of bias in randomised controlled trials of treatments for schizophrenia. Br J Psychiatr. 2000;176:249–52

    Article  CAS  Google Scholar 

  74. Prinsen CAC, Mokkink LB, Bouter LM, Alonso J, Patrick DL, de Vet HCW, et al. COSMIN guideline for systematic reviews of patient-reported outcome measures. Qual Life Res. 2018;27(5):1147–57.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  75. Signorello LB, Harlow BL, Chekos AK, Repke JT. Postpartum sexual functioning and its relationship to perineal trauma: a retrospective cohort study of primiparous women. Am J Obstet Gynecol. 2001;184:881–90.

    Article  CAS  PubMed  Google Scholar 

Download references

Funding

S. Doumouchtsis has previously had expenses paid by Contura (please see disclosure form). There are no funding disclosures for this review article.

Author information

Authors and Affiliations

  1. Department of Obstetrics and Gynaecology, Epsom and St Helier University Hospitals NHS Trust, Dorking Road, London, UK

    Stergios K. Doumouchtsis, Jemina Loganathan & Abdullatif Elfituri

  2. St George’s University of London, London, UK

    Stergios K. Doumouchtsis & John Fahmy

  3. Laboratory of Experimental Surgery and Surgical Research “N.S. Christeas”, National and Kapodistrian University of Athens, Medical School, Athens, Greece

    Stergios K. Doumouchtsis

  4. School of Medicine, American University of the Caribbean, Cupecoy, Sint Maarten

    Stergios K. Doumouchtsis

  5. School of Medicine, Ross University, Miramar, Florida, United States

    Stergios K. Doumouchtsis

  6. Department of Obstetrics and Gynaecology, San Bortolo Hospital, Vicenza, Italy

    Gabriele Falconi

  7. 2nd Department of Obstetrics and Gynaecology, “Iuliu Hatieganu”, University of Medicine and Pharmacy, Cluj-Napoca, Romania

    Maria Rada

  8. Department of Obstetrics and Gynecology, School of Medicine, University of São Paulo, Butanta, Brazil

    Jorge Milhem Haddad

  9. First Department of Obstetrics and Gynecology, Alexandra Hospital, Athens University Medical School, Athens, Greece

    Vasilios Pergialiotis

  10. Department of Gynecology, University Hospital of Zurich, Frauenklinikstrasse 10, 8091, Zurich, Switzerland

    Cornelia Betschart

Authors
  1. Stergios K. Doumouchtsis
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jemina Loganathan
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. John Fahmy
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Gabriele Falconi
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Maria Rada
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Abdullatif Elfituri
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Jorge Milhem Haddad
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Vasilios Pergialiotis
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Cornelia Betschart
    View author publications

    You can also search for this author in PubMed Google Scholar

Consortia

CHORUS: An International Collaboration for Harmonising Outcomes, Research and Standards in Urogynaecology and Women’s Health

Contributions

S. Doumouchtsis: conceived the idea, project development, data analysis, manuscript writing and editing; J. Loganathan: data analysis, manuscript writing and editing; J. Fahmy: data collection, data analysis and manuscript writing; G. Falconi: data analysis, manuscript editing; M. Rada: data analysis, manuscript editing; A. Elfituri: data analysis, manuscript editing; J.M. Haddad: manuscript writing and editing; V. Pergialiotis: data analysis, manuscript editing; C. Betschart: manuscript writing and editing.

Corresponding author

Correspondence to Jemina Loganathan.

Ethics declarations

Conflicts of interest

All authors declare that they have no conflicts of interest.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary Information

ESM 1

(DOCX 66 kb)

ESM 2

(DOCX 15 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Doumouchtsis, S.K., Loganathan, J., Fahmy, J. et al. Patient-reported outcomes and outcome measures in childbirth perineal trauma research: a systematic review. Int Urogynecol J 32, 1695–1706 (2021). https://doi.org/10.1007/s00192-021-04820-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00192-021-04820-z

Keywords

Search

Navigation