Perineal trauma is a common complication during vaginal childbirth, often resulting in short- and long-term maternal morbidity. Early prediction of women at risk can aid in preventive strategies and improve maternal outcomes. Striae gravidarum, commonly known as stretch marks, are skin changes that occur during pregnancy due to hormonal, mechanical, and genetic factors. Recent studies have suggested that the presence and severity of striae gravidarum may be associated with the integrity of connective tissue and, consequently, may serve as a predictor of perineal tearing during labor. This study aims to evaluate the potential role of the Striae Gravidarum Score (SGS) as a non-invasive clinical tool for predicting perineal trauma during vaginal delivery. A prospective observational study was conducted on pregnant women in their third trimester. The severity of striae was assessed using the Davey scoring system, and perineal outcomes were recorded after delivery. Statistical analysis was performed to determine the correlation between SGS and the incidence as well as severity of perineal lacerations. Preliminary findings indicate a positive correlation between higher striae scores and increased risk of perineal trauma, suggesting that the SGS may reflect underlying connective tissue vulnerability. The study supports the potential use of SGS as a simple, inexpensive, and non-invasive method to identify women at higher risk of perineal injury. Early identification may facilitate preventive strategies, such as controlled delivery techniques, perineal massage, or elective episiotomy in high-risk cases. Further research is recommended to validate these findings across diverse populations and clinical settings..

Keywords: Perineal Trauma, Striae Gravidarum, Childbirth, Risk Prediction, Connective Tissue Integrity

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1. Ofra Halferin,Prediction of perineal trauma during childbirthby assessment of striae gravidarum score”.Journal of obstetric,gynaecologic & Neonatal nursing.may-june2010;39.
2. Halperin O, Anita Noble, Shosh Balachsan, Ester Klug, Michal liebergall- Wischnitzer. Association between severities of striae gravidarum and obstetrics anal sphincter injuries, midwifery. An international journal.2017.
3. Stretch Mark. Encyclopædia Britannica. Retrieved 19 June 2017.
4. Korgavkar K, Wang F "Stretch marks during pregnancy: a review of topical prevention". The British Journal of Dermatology. March 2015; 172 (3): 606–15.
5. Kroumpouzos, Cohen, LM. Specific dermatoses of pregnancy: an evidenced-based systematic review. American Journal Obstet Gynecol. 2003; 188: 1083–92.
6. Stretch Mark. Retrieved 2017-06-10.
7. Atwal G.S.S, Manku L.K, Griffiths C.E.M, Polson D.W. Striae gravidarum in primiparae. British Journal of Dermatology. 2006;155 (5):965–9.
8. Chang AL, Agredano YZ, Kimball AB. Risk factors associated with striae gravidarum. Journal American Acad Dermatol. 2004; 881–5.
9. Atwal G.S.S, Manku L.K, GriffithsC.E.M Polson D.W. Striae gravidarum in primiparae. British Journal of Dermatology. 2006; 155 (5): 965–9.
10. Archived copy. Archived from the original on 2011-10-01. Retrieved 2017-06-12.
11. Fernando RJ, Sultan AH, Radley S, Jones PW, Johanson RB. Management of obstetric anal sphincter injury: systematic review and national practice survey. Biomedical Medical Control Health Services Res 2002; 13: 9.
12. Kettle C, & Tohill S. Perineal care. Clinical evidence. 2008.
13. Roys,Sr., & Andrews, H.A.(1991).T he Roy adaptation model: The definitive statement. Norwalk,CT:Appleton & Lange.
14. Halperin O, Anita Noble, Shosh Balachsan, Ester Klug, Michal liebergall- Wischnitzer. Association between severities of striae gravidarum and obstetrics anal sphincter injuries, midwifery. An international journal.2017.
15. Sultan HA,Kamm A.M.,HudsonN.C. Obstetrics perineal trauma: an audit of training,Journal of obstetrics and gynecology.2009;15:19-23.
16. Janet Wheeler, Deborah Davis, Margaret Fry, Pat Brodie, Caroline S.E.Homer. Is Asian ethinicity an independent risk factor for severe perineal trauma in childbirth? A systematic review of literature. Journal of the Australian college of midwives.2011;10.

Perineal trauma is a common complication during vaginal childbirth, often resulting in short- and long-term maternal morbidity. Early prediction of women at risk can aid in preventive strategies and improve maternal outcomes. Striae gravidarum, commonly known as stretch marks, are skin changes that occur during pregnancy due to hormonal, mechanical, and genetic factors. Recent studies have suggested that the presence and severity of striae gravidarum may be associated with the integrity of connective tissue and, consequently, may serve as a predictor of perineal tearing during labor. This study aims to evaluate the potential role of the Striae Gravidarum Score (SGS) as a non-invasive clinical tool for predicting perineal trauma during vaginal delivery. A prospective observational study was conducted on pregnant women in their third trimester. The severity of striae was assessed using the Davey scoring system, and perineal outcomes were recorded after delivery. Statistical analysis was performed to determine the correlation between SGS and the incidence as well as severity of perineal lacerations. Preliminary findings indicate a positive correlation between higher striae scores and increased risk of perineal trauma, suggesting that the SGS may reflect underlying connective tissue vulnerability. The study supports the potential use of SGS as a simple, inexpensive, and non-invasive method to identify women at higher risk of perineal injury. Early identification may facilitate preventive strategies, such as controlled delivery techniques, perineal massage, or elective episiotomy in high-risk cases. Further research is recommended to validate these findings across diverse populations and clinical settings..

Keywords: Perineal Trauma, Striae Gravidarum, Childbirth, Risk Prediction, Connective Tissue Integrity

🔒 This is a subscription article

Full text is available to subscribers and institutional members. Please choose an option below to access it.

1. Ofra Halferin,Prediction of perineal trauma during childbirthby assessment of striae gravidarum score”.Journal of obstetric,gynaecologic & Neonatal nursing.may-june2010;39.
2. Halperin O, Anita Noble, Shosh Balachsan, Ester Klug, Michal liebergall- Wischnitzer. Association between severities of striae gravidarum and obstetrics anal sphincter injuries, midwifery. An international journal.2017.
3. Stretch Mark. Encyclopædia Britannica. Retrieved 19 June 2017.
4. Korgavkar K, Wang F "Stretch marks during pregnancy: a review of topical prevention". The British Journal of Dermatology. March 2015; 172 (3): 606–15.
5. Kroumpouzos, Cohen, LM. Specific dermatoses of pregnancy: an evidenced-based systematic review. American Journal Obstet Gynecol. 2003; 188: 1083–92.
6. Stretch Mark. Retrieved 2017-06-10.
7. Atwal G.S.S, Manku L.K, Griffiths C.E.M, Polson D.W. Striae gravidarum in primiparae. British Journal of Dermatology. 2006;155 (5):965–9.
8. Chang AL, Agredano YZ, Kimball AB. Risk factors associated with striae gravidarum. Journal American Acad Dermatol. 2004; 881–5.
9. Atwal G.S.S, Manku L.K, GriffithsC.E.M Polson D.W. Striae gravidarum in primiparae. British Journal of Dermatology. 2006; 155 (5): 965–9.
10. Archived copy. Archived from the original on 2011-10-01. Retrieved 2017-06-12.
11. Fernando RJ, Sultan AH, Radley S, Jones PW, Johanson RB. Management of obstetric anal sphincter injury: systematic review and national practice survey. Biomedical Medical Control Health Services Res 2002; 13: 9.
12. Kettle C, & Tohill S. Perineal care. Clinical evidence. 2008.
13. Roys,Sr., & Andrews, H.A.(1991).T he Roy adaptation model: The definitive statement. Norwalk,CT:Appleton & Lange.
14. Halperin O, Anita Noble, Shosh Balachsan, Ester Klug, Michal liebergall- Wischnitzer. Association between severities of striae gravidarum and obstetrics anal sphincter injuries, midwifery. An international journal.2017.
15. Sultan HA,Kamm A.M.,HudsonN.C. Obstetrics perineal trauma: an audit of training,Journal of obstetrics and gynecology.2009;15:19-23.
16. Janet Wheeler, Deborah Davis, Margaret Fry, Pat Brodie, Caroline S.E.Homer. Is Asian ethinicity an independent risk factor for severe perineal trauma in childbirth? A systematic review of literature. Journal of the Australian college of midwives.2011;10.