Influence of a pelvic floor training programme to prevent perineal trauma: A quasi-randomised controlled trial.
Study Goal
The researchers aimed to investigate the effects of a pelvic floor training program, including perineal massage and exercises, on reducing perineal trauma during childbirth in primiparous women.
Results Summary
The study found that the intervention significantly reduced episiotomy rates (31.63% reduction), increased the likelihood of an intact perineum, and decreased severe perineal tears and postpartum pain compared to standard care.
Population
Primiparous women at 32 weeks of pregnancy with singleton pregnancies anticipating normal birth.
Effective Dosage
Daily perineal massage and pelvic floor exercises.
Duration
From 32 weeks of pregnancy until birth.
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
pelvic floor training programme that included: daily perineal massage and pelvic floor exercises | decrease | episiotomy | women (n=466) who were 32 weeks pregnant, having a singleton pregnancy and anticipating a normal birth | 31.63% | showed a 31.63% reduction in | #1 |
pelvic floor training programme that included: daily perineal massage and pelvic floor exercises | increase | an intact perineum | women (n=466) who were 32 weeks pregnant, having a singleton pregnancy and anticipating a normal birth | - | a higher likelihood of having | #2 |
pelvic floor training programme that included: daily perineal massage and pelvic floor exercises | decrease | third degree-tears | women (n=466) who were 32 weeks pregnant, having a singleton pregnancy and anticipating a normal birth | - | fewer | #3 |
pelvic floor training programme that included: daily perineal massage and pelvic floor exercises | decrease | fourth degree-tears | women (n=466) who were 32 weeks pregnant, having a singleton pregnancy and anticipating a normal birth | - | fewer | #4 |
pelvic floor training programme that included: daily perineal massage and pelvic floor exercises | decrease | postpartum perineal pain | women (n=466) who were 32 weeks pregnant, having a singleton pregnancy and anticipating a normal birth | - | less | #5 |
pelvic floor training programme that included: daily perineal massage and pelvic floor exercises | decrease | analgesia in the postnatal period | women (n=466) who were 32 weeks pregnant, having a singleton pregnancy and anticipating a normal birth | - | required less | #6 |
BACKGROUND: perineal injury is common after birth and may be caused by tears or episiotomy or both. Perineal massage has been shown to prevent episiotomies in primiparous women. On the other hand, pelvic floor exercises might have an influence by shortening the first and second stages of labour in the primigravida. AIM: the aim of this study was to investigate the effects of a pelvic floor training following a birth programme on perineal trauma. DESIGN: a single-blind quasi-randomized controlled trial with two groups: standard care and intervention. SETTING: a tertiary, metropolitan hospital in Seville, Spain. PARTICIPANTS: women (n=466) who were 32 weeks pregnant, having a singleton pregnancy and anticipating a normal birth were randomised. Women in the experimental groups were asked to perform a pelvic floor training programme that included: daily perineal massage and pelvic floor exercises from 32 weeks of pregnancy until birth. They were allocated to an intervention group by clusters (antenatal education groups) randomized 1:1. The control group had standard care that did not involve a perineal/pelvic floor intervention. These women were collected in a labour ward at admission 1:3 by midwives. RESULTS: outcomes were analysed by intention-to-treat. Women assigned to the perineal/pelvic floor intervention showed a 31.63% reduction in episiotomy (50.56% versus 82.19%, p<0.001) and a higher likelihood of having an intact perineum (17.61% versus 6.85%, p<0.003). There were also fewer third (5.18% versus 13.12%, p<0.001) and fourth degree-tears (0.52% versus 2.5%, p<0.001). Women allocated to the intervention group also had less postpartum perineal pain (24.57% versus 36.30%, p<0.001) and required less analgesia in the postnatal period (21.14% versus 30.82%, p<0.001). CONCLUSIONS: a training programme composed of pelvic floor exercises and perineal massage may prevent episiotomies and tears in primiparous women. This programme can be recommended to primiparous women in order to prevent perineal trauma. KEY CONCLUSION: the pelvic floor programme was associated with significantly lower rates of episiotomies and severe perineal trauma; and higher intact perineum when compared with women who received standard care only. IMPLICATIONS FOR PRACTICE: the programme is an effective intervention that we recommend to all women at 32nd week of pregnancy to prevent perineal trauma.