Effect of perineal massage during pregnancy on perineal trauma: A prospective controlled trial Academic Article uri icon

abstract

  • PROSPECTIVE CONTROLLED TRIAL ELAD MEI-DAN, ASNAT WALFISCH, IRIS RAZ, SHLOMIT HARLEV, AMALYA LEVI, MORDECHAI HALLAK, Soroka University Medical Center, Beer Sheva, Israel, Israel, Soroka University Medical Center, Beer-Sheva, Israel, Israel OBJECTIVE: Massaging of the perineum has been promoted as a means of relaxing the perineum and possibly preventing tearing and the need for episiotomy. We aimed to evaluate the effectiveness of antenatal perineal massage in increasing the rates of vaginal delivery with an intact perineum. STUDY DESIGN: Two hundred thirty four nulliprous women with a singleton fetus participated in this single blinded, prospective, controlled trial. Women allocated to the study group were instructed to practice a 10 minutes perineal massage daily from the 34th week of gestation until delivery. The massage oil consisted of Calendula flower essence and Vitamin E. Primary outcome measures included episiotomy rate, 1st-4th degree perineal tear and intact perineum rates. Secondary outcomes were related to specific tear locations, amount of suture material required for repair and participant satisfaction with the massage and delivery experiences. The number of patients allocated for each group in this study was calculated with a statistical power of 80% for the main primary outcomes. RESULTS: Episiotomy rate, overall spontaneous tears and intact perineum rates were all similar in the study and control groups. Women in the massage group suffered slightly lower second degree tears rates (19.3% vs. 26.7%, P = .39) and slightly higher rates of first degree tears (78.9% vs. 73.3%, P = .39). The rates of anterior perineal tears were lower in massage group (3% vs. 9.5%, P = .058) whereas internal lateral tears were slightly higher (13.1% vs. 11.5%, P= .44). Lastly, women who practiced the perineal massage had higher satisfaction rates with the delivery experience (69% s. 45.5%, P = .29) although this also did not reach statistical significance. CONCLUSION: This study agrees with a growing body of evidence reflecting neither a protective nor a detrimental significant effect of antenatal perineal massage on the occurrence of perineal trauma. However, women’s satisfaction with the delivery experience seems to increase. SMFM Abstracts S189

publication date

  • January 1, 2004