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Effect of Perineal Massage and Warm Compresses Technique in Postpartum Pelvic Floor Dysfunction. A Secondary Analysis from a Randomised Controlled Trial

  • Maternal Fetal Medicine/Biology: Original Article
  • Published:
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Abstract

Pelvic floor dysfunction (PFD) is common to be associated with pregnancy and birth. To date, no research has been done to understand whether the perineal massage and warm compresses technique has an impact on pelvic floor dysfunction. To assess the impact of perineal massage and warm compresses technique during the second stage of labor in pelvic floor dysfunction at 3 and 6 months postpartum. Of the 800 women recruited to randomised controlled trial to prevent perineal trauma, 496 were included in the study, with 242 (48.8%) assigned to the Perineal Massage and Warm Compresses (PeMWaC) group and 254 (51.2%) to the control group (hands-on). Used the Pelvic Floor Distress Inventory-20 (PFDI-20). The questionnaire is divided into three subscales: Urinary (UDI), Colorectal-Anal (CRADI), and Pelvic Organ Prolapse Distress Inventory (POPDI). The PeMWaC group had a significantly higher frequency of intact perineum (p < 0.001) and low-severity vaginal tears (tears without any other degree of perineal trauma) (p = 0.031) compared to the control group, while the control group had significantly more patients who suffered high-severity vaginal/perineal trauma (second degree perineal tears) (p = 0.031) and patients without spontaneous perineal trauma or vaginal tears who underwent episiotomy (p < 0.001). In addition, at 3 months postpartum, women in the control group had a higher Urinary Distress Inventory (UDI) score and global score, compared to the PeMWaC group, and after controlling for confounding variables, the perineal massage and warm compresses technique was associated with lower UDI scores at 3 months postpartum compared to control group. At 6 months postpartum, there were no differences in the UDI or global scores, indicating general recovery from perineal trauma. In addition to reducing perineal trauma during birth, the perineal massage and warm compresses technique was associated with a lower prevalence of early PFD symptoms, mainly urinary distress, at 3 months.

Trial registration http://www.ClinicalTrials.gov NCT05854888, retrospectively registered.

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Acknowledgements

We gratefully acknowledge all staff in the labor ward of Hospital of Braga for their support and cooperation.

Funding

The authors declare that no funds, grants, or other support were received during the preparation of this manuscript.

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Authors and Affiliations

  1. Biomedical Sciences Institute Abel Salazar, Portugal and Hospital of Braga, Sete Fontes - São Victor, 4710-243, Braga, Portugal

    Silvia Rodrigues

  2. Hospital of Braga, Sete Fontes - São Victor, 4710-243, Braga, Portugal

    Paulo Silva

  3. Department of Obstetrics and Gynecology, Hospital de Braga, Sete Fontes - São Victor, 4710-243, Braga, Portugal

    Ana Catarina Borges & Natacha Quintal de Sousa

  4. ISAVE – Instituto Superior de Saúde, CICS – Centro Interdisciplinar em Ciências da Saúde, Braga, Portugal

    João Neves Silva

  5. Health and Integrated Care Division, Catalan Health Service, Barcelona, Spain

    Ramon Escuriet

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Contributions

SR: Protocol/project development; Data collection or management; Data analysis; Manuscript writing/editing, PS: Manuscript writing/editing, ACB: Data analysis, NQS: Data analysis; Manuscript writing/editing, JNS: Data analysis; Manuscript writing/editing, RE: Protocol/project development; Data collection or management; Data analysis; Manuscript writing/editing. And all authors have approved the submitted version.

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Correspondence to Silvia Rodrigues.

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Approval was granted by the Ethics Committee of Hospital of Braga (Reference nº 1; approved February 2019).

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Rodrigues, S., Silva, P., Borges, A.C. et al. Effect of Perineal Massage and Warm Compresses Technique in Postpartum Pelvic Floor Dysfunction. A Secondary Analysis from a Randomised Controlled Trial. Reprod. Sci. 31, 1006–1016 (2024). https://doi.org/10.1007/s43032-023-01424-4

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