A Protocol for Developing a Clinical Practice Guideline for Prevention and Management of Perineal Tears at Vaginal Delivery

Introduction: Perineal tear is a distressing obstetric complication affecting females globally. More than 85% of women sustain some degree of perineal tears during childbirth, resulting in potential effects on women’s well-being and quality of life. Although different institutions around the world have developed some related clinical practice guidelines (CPGs), a few recommendations are inconsistent, unspecific, and some CPGs are silent on certain matters, which might confuse guideline users. Nowadays, there is still no domestic CPG for prevention and management of perineal tears in China to guide clinical practice. Methods: : This CPG will be developed in line with the latest guideline definition from Institute of Medicine (IOM) and comply with the World Health Organization handbook for guideline. We will adhere closely to the six domains of the Appraisal of Guidelines for Research & Evaluation II (AGREE II) and apply the Grade of Recommendations Assessment, Development and Evaluation (GRADE) system to appraise the quality of evidence and develop recommendations. We have established a guideline working group (including a guideline steering group, a guideline development group, a guideline secretary group, and a system evaluation group), formulated 21 questions in the form of Population, Intervention, Comparison, Outcome (PICO) and completed a literature search. The recommendations will be formed via evidence search, syntheses, and 2 to 3 rounds of Delphi process to reach consensus. We will also consider patients’ values or preferences, peer review results in this CPG. Ethics and dissemination: The CPG has been registered on the International Practice Guidelines Registry Platform. The need for ethics approval has been exempted by the Institutional Review Boards of the Southern Medical University. The CPG is to be published in peer-reviewed journals and will form the care standard for perineal care for Chinese women with vaginal delivery.