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Erschienen in: International Urogynecology Journal 3/2020

02.04.2019 | Original Article

Perineal massage and training reduce perineal trauma in pregnant women older than 35 years: a randomized controlled trial

verfasst von: Amira S. Dieb, Amira Y. Shoab, Hala Nabil, Amir Gabr, Ahmed A. Abdallah, Mona M. Shaban, Ahmed H. Attia

Erschienen in: International Urogynecology Journal | Ausgabe 3/2020

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Abstract

Introduction and hypothesis

The aim of this study was to evaluate the effectiveness of perineal massage, pelvic floor muscle training (PFMT) and a pelvic floor dysfunction (PFD) prevention educational program in pregnant women above the age of 35 years to prevent perineal tear and episiotomy.

Methods

A randomized parallel assignment study involved two groups of pregnant women at the obstetrics outpatient clinic 4 weeks prior to their due date. The first group (n = 200) was educated to do digital perineal massage and pelvic floor muscle training and received an educational PFD prevention program. The second group (n = 200) received only the prevention education program. Occurrence of perineal laceration was reported at time of delivery as a primary outcome. Statistical analysis was done using the IBM SPSS computer program (Statistical Package for the Social Sciences; IBM Corp, Armonk, NY, USA), release 22 for Microsoft Windows.

Results

Delivery was significantly less complicated by perineal tear, episiotomy and postnatal pain in the first than in the second group (p < 0.05). Grades of perineal tear were mostly of first and second degree in the first group compared with the second group. We found a significantly lower need for analgesia and fewer ampoules required during the hospital stay in the first group (p < 0.001, 0.002, respectively).

Conclusions

Performing antenatal digital perineal massage and PFMT in addition to health education is recommended to reduce perineal complications.
Literatur
1.
Zurück zum Zitat Larbi KT, Buchmann EJ, Matshidze PR. Pregnancy outcomes in urban black South African women aged 35 years and older. J Obstet Gynaecol. 2000;20(3):259–62.CrossRefPubMed Larbi KT, Buchmann EJ, Matshidze PR. Pregnancy outcomes in urban black South African women aged 35 years and older. J Obstet Gynaecol. 2000;20(3):259–62.CrossRefPubMed
2.
Zurück zum Zitat Andrews V, Thakar R, Sultan AH, Jones PW. Evaluation of postpartum perineal pain and dyspareunia—a prospective study. Eur J Obstet Gynecol Reprod Biol. 2008;137(2):152–6.CrossRefPubMed Andrews V, Thakar R, Sultan AH, Jones PW. Evaluation of postpartum perineal pain and dyspareunia—a prospective study. Eur J Obstet Gynecol Reprod Biol. 2008;137(2):152–6.CrossRefPubMed
3.
Zurück zum Zitat Torrisi G, Minini G, Bernasconi F, Perrone A, Trezza G, Guardabasso V, et al. A prospective study of pelvic floor dysfunctions related to delivery. Eur J Obstet Gynecol Reprod Biol. 2012;160(1):110–5.CrossRefPubMed Torrisi G, Minini G, Bernasconi F, Perrone A, Trezza G, Guardabasso V, et al. A prospective study of pelvic floor dysfunctions related to delivery. Eur J Obstet Gynecol Reprod Biol. 2012;160(1):110–5.CrossRefPubMed
4.
Zurück zum Zitat Masoumi SZ, Kazemi F, Oshvandi K, Jalali M, Esmaeili-Vardanjani A, Rafiei H. Effect of training preparation for childbirth on fear of normal vaginal delivery and choosing the type of delivery among pregnant women in Hamadan, Iran: a randomized controlled trial. J Family Reprod Health. 2016;10(3):115.PubMedPubMedCentral Masoumi SZ, Kazemi F, Oshvandi K, Jalali M, Esmaeili-Vardanjani A, Rafiei H. Effect of training preparation for childbirth on fear of normal vaginal delivery and choosing the type of delivery among pregnant women in Hamadan, Iran: a randomized controlled trial. J Family Reprod Health. 2016;10(3):115.PubMedPubMedCentral
5.
Zurück zum Zitat de Castro Monteiro MV, Pereira GMV, Aguiar RAP, Azevedo RL, Correia-Junior MD, Reis ZSN. Risk factors for severe obstetric perineal lacerations. Int Urogynecol J. 2016;27(1):61–7.CrossRef de Castro Monteiro MV, Pereira GMV, Aguiar RAP, Azevedo RL, Correia-Junior MD, Reis ZSN. Risk factors for severe obstetric perineal lacerations. Int Urogynecol J. 2016;27(1):61–7.CrossRef
6.
Zurück zum Zitat King TL, Pinger W. Evidence-based practice for intrapartum care: the pearls of midwifery. J Midwifery Womens Health. 2014;59(6):572–85.CrossRefPubMed King TL, Pinger W. Evidence-based practice for intrapartum care: the pearls of midwifery. J Midwifery Womens Health. 2014;59(6):572–85.CrossRefPubMed
7.
Zurück zum Zitat Zare O, Pasha H, Faramarzi M. Effect of perineal massage on the incidence of episiotomy and perineal laceration. Health. 2014;6(01):10.CrossRef Zare O, Pasha H, Faramarzi M. Effect of perineal massage on the incidence of episiotomy and perineal laceration. Health. 2014;6(01):10.CrossRef
9.
Zurück zum Zitat Dame J, Neher J, Safranek S. Does antepartum perineal massage reduce intrapartum lacerations? J Fam Pract. 2008;57(7):480–2. Dame J, Neher J, Safranek S. Does antepartum perineal massage reduce intrapartum lacerations? J Fam Pract. 2008;57(7):480–2.
11.
Zurück zum Zitat Dönmez S, Kavlak O. Effects of prenatal perineal massage and Kegel exercises on the integrity of postnatal perine. Health. 2015;7(04):495.CrossRef Dönmez S, Kavlak O. Effects of prenatal perineal massage and Kegel exercises on the integrity of postnatal perine. Health. 2015;7(04):495.CrossRef
12.
Zurück zum Zitat Abd H. Effects of prenatal perineal massage and Kegel exercise on the episiotomy rate. IOSR-JNHS. 2015;4(4):61–70. Abd H. Effects of prenatal perineal massage and Kegel exercise on the episiotomy rate. IOSR-JNHS. 2015;4(4):61–70.
13.
Zurück zum Zitat DeFrances CJ, Hall MJ. 2002 national hospital discharge survey. Adv Data. 2004;342(342):1–29. DeFrances CJ, Hall MJ. 2002 national hospital discharge survey. Adv Data. 2004;342(342):1–29.
14.
Zurück zum Zitat Ye J, Zhang J, Mikolajczyk R, Torloni MR, Gülmezoglu AM, Betran AP. Association between rates of caesarean section and maternal and neonatal mortality in the 21st century: a worldwide population-based ecological study with longitudinal data. BJOG Int J Obstet Gynaecol. 2016;123(5):745–53.CrossRef Ye J, Zhang J, Mikolajczyk R, Torloni MR, Gülmezoglu AM, Betran AP. Association between rates of caesarean section and maternal and neonatal mortality in the 21st century: a worldwide population-based ecological study with longitudinal data. BJOG Int J Obstet Gynaecol. 2016;123(5):745–53.CrossRef
15.
Zurück zum Zitat Betrán AP, Ye J, Moller AB, Zhang J, Gülmezoglu AM, Torloni MR. The increasing trend in caesarean section rates: global, regional and national estimates: 1990-2014. PLoS One. 2016;11(2):e0148343.CrossRefPubMedPubMedCentral Betrán AP, Ye J, Moller AB, Zhang J, Gülmezoglu AM, Torloni MR. The increasing trend in caesarean section rates: global, regional and national estimates: 1990-2014. PLoS One. 2016;11(2):e0148343.CrossRefPubMedPubMedCentral
16.
Zurück zum Zitat Altman D, Falconer C, Rossner S, Melin I. The risk of anal incontinence in obese women. Int Urogynecol J. 2007;18(11):1283–9.CrossRef Altman D, Falconer C, Rossner S, Melin I. The risk of anal incontinence in obese women. Int Urogynecol J. 2007;18(11):1283–9.CrossRef
17.
Zurück zum Zitat Voldner N, Frøslie KF, Haakstad LAH, Bø K, Henriksen T. Birth complications, overweight, and physical inactivity. Acta Obstet Gynecol Scand. 2009;88(5):550–5.CrossRefPubMed Voldner N, Frøslie KF, Haakstad LAH, Bø K, Henriksen T. Birth complications, overweight, and physical inactivity. Acta Obstet Gynecol Scand. 2009;88(5):550–5.CrossRefPubMed
18.
Zurück zum Zitat Lindholm ES, Altman D. Risk of obstetric anal sphincter lacerations among obese women. BJOG Int J Obstet Gynaecol. 2013;120(9):1110–5.CrossRef Lindholm ES, Altman D. Risk of obstetric anal sphincter lacerations among obese women. BJOG Int J Obstet Gynaecol. 2013;120(9):1110–5.CrossRef
19.
Zurück zum Zitat Eogan M, Daly L, O’Herlihy C. The effect of regular antenatal perineal massage on postnatal pain and anal sphincter injury: a prospective observational study. J Matern Fetal Neonatal Med. 2006;19(4):225–9.CrossRefPubMed Eogan M, Daly L, O’Herlihy C. The effect of regular antenatal perineal massage on postnatal pain and anal sphincter injury: a prospective observational study. J Matern Fetal Neonatal Med. 2006;19(4):225–9.CrossRefPubMed
20.
Zurück zum Zitat Karaçam Z, Ekmen H, Çalişir H. The use of perineal massage in the second stage of labor and follow-up of postpartum perineal outcomes. Health care for women international. 2012;33(8):697–718.CrossRefPubMed Karaçam Z, Ekmen H, Çalişir H. The use of perineal massage in the second stage of labor and follow-up of postpartum perineal outcomes. Health care for women international. 2012;33(8):697–718.CrossRefPubMed
21.
Zurück zum Zitat Dias LA, Driusso P, Aita DL, Quintana SM, Bø K, Ferreira CH. Effect of pelvic floor muscle training on labor and newborn outcomes: a randomized controlled trial. Brazilian Journal of Physical Therapy. 2011;15(6):487–93.CrossRefPubMed Dias LA, Driusso P, Aita DL, Quintana SM, Bø K, Ferreira CH. Effect of pelvic floor muscle training on labor and newborn outcomes: a randomized controlled trial. Brazilian Journal of Physical Therapy. 2011;15(6):487–93.CrossRefPubMed
22.
Zurück zum Zitat Johanson R. Perineal massage for prevention of perineal trauma in childbirth. Lancet. 2000;355(9200):250–1.CrossRefPubMed Johanson R. Perineal massage for prevention of perineal trauma in childbirth. Lancet. 2000;355(9200):250–1.CrossRefPubMed
23.
Zurück zum Zitat Geranmayeh M, Habibabadi ZR, Fallahkish B, Farahani MA, Khakbazan Z, Mehran A. Reducing perineal trauma through perineal massage with Vaseline in second stage of labor. Arch Gynecol Obstet. 2012;285(1):77–81.CrossRefPubMed Geranmayeh M, Habibabadi ZR, Fallahkish B, Farahani MA, Khakbazan Z, Mehran A. Reducing perineal trauma through perineal massage with Vaseline in second stage of labor. Arch Gynecol Obstet. 2012;285(1):77–81.CrossRefPubMed
24.
Zurück zum Zitat Bodner-Adler B, Bodner K, Mayerhofer K. Perineal massage during pregnancy in primiparous women. Int J Gynecol Obstet. 2002;78(1):51–3.CrossRef Bodner-Adler B, Bodner K, Mayerhofer K. Perineal massage during pregnancy in primiparous women. Int J Gynecol Obstet. 2002;78(1):51–3.CrossRef
25.
Zurück zum Zitat WHO Reproductive Health Library. WHO recommendation on episiotomy policy (February 2018). The WHO Reproductive Health Library. World Health Organization, Geneva. WHO Reproductive Health Library. WHO recommendation on episiotomy policy (February 2018). The WHO Reproductive Health Library. World Health Organization, Geneva.
27.
Zurück zum Zitat Labrecque M, Eason E, Marcoux S. Randomized trial of perineal massage during pregnancy: perineal symptoms three months after delivery. Am J Obstet Gynecol. 2000;182(1):76–80.CrossRefPubMed Labrecque M, Eason E, Marcoux S. Randomized trial of perineal massage during pregnancy: perineal symptoms three months after delivery. Am J Obstet Gynecol. 2000;182(1):76–80.CrossRefPubMed
28.
Zurück zum Zitat Mei-dan E, Walfisch A, Raz I, Levy A, Hallak M. Perineal massage during pregnancy: a prospective controlled trial. Isr Med Assoc J. 2008;10(7):499.PubMed Mei-dan E, Walfisch A, Raz I, Levy A, Hallak M. Perineal massage during pregnancy: a prospective controlled trial. Isr Med Assoc J. 2008;10(7):499.PubMed
Metadaten
Titel
Perineal massage and training reduce perineal trauma in pregnant women older than 35 years: a randomized controlled trial
verfasst von
Amira S. Dieb
Amira Y. Shoab
Hala Nabil
Amir Gabr
Ahmed A. Abdallah
Mona M. Shaban
Ahmed H. Attia
Publikationsdatum
02.04.2019
Verlag
Springer International Publishing
Erschienen in
International Urogynecology Journal / Ausgabe 3/2020
Print ISSN: 0937-3462
Elektronische ISSN: 1433-3023
DOI
https://doi.org/10.1007/s00192-019-03937-6

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