Perineal massage and training reduce perineal trauma in pregnant women older than 35 years: a randomized controlled trial
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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.
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.
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).
Performing antenatal digital perineal massage and PFMT in addition to health education is recommended to reduce perineal complications.
KeywordsPregnancy above 35 Episiotomy Health education Pelvic floor muscle training Perineal massage Perineal tear
Compliance with ethical standards
Conflicts of interest
- 4.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.Google Scholar
- 9.Dame J, Neher J, Safranek S. Does antepartum perineal massage reduce intrapartum lacerations? J Fam Pract. 2008;57(7):480–2.Google Scholar
- 12.Abd H. Effects of prenatal perineal massage and Kegel exercise on the episiotomy rate. IOSR-JNHS. 2015;4(4):61–70.Google Scholar
- 13.DeFrances CJ, Hall MJ. 2002 national hospital discharge survey. Adv Data. 2004;342(342):1–29.Google Scholar
- 14.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.CrossRefGoogle Scholar
- 25.WHO Reproductive Health Library. WHO recommendation on episiotomy policy (February 2018). The WHO Reproductive Health Library. World Health Organization, Geneva.Google Scholar
- 28.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.Google Scholar