Systematic review of pelvic floor interventions during pregnancy.
Study Goal
The researchers aimed to determine the effects of perineal massage during pregnancy on childbirth-related parameters and pelvic floor symptoms.
Results Summary
Two of six trials investigating perineal massage reported a lower rate of perineal pain associated with the intervention, suggesting some benefit. However, the results were not consistent across all studies.
Population
Healthy pregnant women
Effective Dosage
Not specified
Duration
Not specified
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
EPI-NO perineal dilator | no change | - | healthy pregnant women | - | showed no benefit | #1 |
pelvic floor muscle training | decrease | duration of the second stage of labor | healthy pregnant women | - | significant reduction | #2 |
pelvic floor muscle training | decrease | incidence of urinary incontinence | healthy pregnant women | - | reduced | #3 |
perineal massage | decrease | perineal pain | healthy pregnant women | - | lower rate | #4 |
pelvic floor muscle training | increase | childbirth-related parameters and pelvic floor symptoms | healthy pregnant women | - | improved | #5 |
perineal massage | increase | childbirth-related parameters and pelvic floor symptoms | healthy pregnant women | - | improved | #6 |
EPI-NO | no change | - | healthy pregnant women | - | showed no benefit | #7 |
BACKGROUND: Pelvic floor interventions during pregnancy could reduce the impact of pregnancy and delivery on the pelvic floor. OBJECTIVE: To determine the effects of pelvic floor interventions during pregnancy on childbirth-related and pelvic floor parameters. SEARCH STRATEGY: PubMed, Embase, and LILACS were searched for reports published during between 1990 and 2016 in English, Spanish, or Portuguese. The search terms were "pregnancy," "pelvic floor muscle training," and related terms. SELECTION CRITERIA: Randomized controlled trials with healthy pregnant women were included. DATA COLLECTION AND ANALYSIS: Baseline and outcome data (childbirth-related parameters, pelvic floor symptoms) were compared for three interventions: EPI-NO (Tecsana, Munich, Germany) perineal dilator, pelvic floor muscle training, and perineal massage. MAIN RESULTS: A total of 22 trials were included. Two of three papers assessing EPI-NO showed no benefit. The largest study investigating pelvic floor muscle training reported a significant reduction in the duration of the second stage of labor (P<0.01), and this intervention also reduced the incidence of urinary incontinence (evaluated in 10 trials). Two of six trials investigating perineal massage reported that a lower rate of perineal pain was associated with this intervention. CONCLUSION: Pelvic floor muscle training and perineal massage improved childbirth-related parameters and pelvic floor symptoms, whereas EPI-NO showed no benefit.