perineal assessment and repair longitudinal study (pearls) protocol for a matched pair cluster trial会阴评估和修复(珍珠)协议的纵向研究集群匹配配对试验.pdf

Bick et al. BMC Pregnancy and Childbirth 2010, 10:10 /1471-2393/10/10 STUDY PROTOCOL Open Access PErineal Assessment and Repair Longitudinal Study (PEARLS): protocol for a matched pair cluster trial 1* 2,3 4 5 6 3,7 Debra E Bick , Christine Kettle , Sue Macdonald , Peter W Thomas , Robert K Hills , Khaled MK Ismail Abstract Background: The Perineal Assessment and Repair Longitudinal Study (PEARLS) is a national clinical quality improvement initiative designed to improve the assessment and management of perineal trauma. Perineal trauma affects around 85% of women who have a vaginal birth in the UK each year and millions more world-wide. Continuous suturing techniques compared with traditional interrupted methods are more effective in reducing pain and postnatal morbidity, however they are not widely used by clinicians despite recommendations of evidence based national clinical guidelines. Perineal suturing skills and postnatal management of trauma remain highly variable within and between maternity units in the UK as well as worldwide. Implementation of a standardised training package to support effective perineal management practices could reduce perineal pain and other related postnatal morbidity for a substantial number of women. Methods/Design: PEARLS is a matched pair cluster trial, which is being conducted in maternity units across the UK. Units within a matched pair will be randomised to implement the study intervention either early or late in the study period. The intervention will include the cascading of a multi-professional training package to enhance midwifery and obstetric skills in the assessment, repair and postnatal management of perineal trauma. Women who have had an episiotomy or