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

  • Amira S. DiebEmail author
  • Amira Y. Shoab
  • Hala Nabil
  • Amir Gabr
  • Ahmed A. Abdallah
  • Mona M. Shaban
  • Ahmed H. Attia
Original Article


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.


Pregnancy above 35 Episiotomy Health education Pelvic floor muscle training Perineal massage Perineal tear 


Compliance with ethical standards

Conflicts of interest



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Copyright information

© The International Urogynecological Association 2019

Authors and Affiliations

  1. 1.Department of Obstetrics and Gynecology, Kasr AlAini Hospital, Faculty of MedicineCairo UniversityCairoEgypt

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