Effects of perineal preparation techniques on tissue extensibility and muscle strength: a pilot study

Freitas, Síssi Sisconeto de; Cabral, Alana Leandro; Pinto, Rogério de Melo Costa; Resende, Ana Paula Magalhães; Baldon, Vanessa Santos Pereira

doi:10.1007/s00192-018-3793-1

Cited by 20 publications

(20 citation statements)

References 27 publications

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“…It should be noted that in none of the interventions were pernicious or secondary effects of perineal massage reported. It increases the flexibility of the musculature without reducing its strength and decreases its resistance, which could help perineal stretching to avoid serious tears or episiotomy 35 . It also causes vasodilatation, increased blood supply, 36 and a decrease in the perception of pain 36,37 and the burning sensation during labor 37 .…”

Section: Discussionmentioning

confidence: 99%

“…It increases the flexibility of the musculature without reducing its strength and decreases its resistance, which could help perineal stretching to avoid serious tears or episiotomy. 35 It also causes vasodilatation, increased blood supply, 36 and a decrease in the perception of pain 36,37 and the burning sensation during labor. 37 At the same time, endorphins and enkephalins, hormones related to pain reduction, are released, so that massage could act as a natural analgesic.…”

Section: Discussionmentioning

confidence: 99%

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Efficacy of perineal massage during the second stage of labor for the prevention of perineal injury: A systematic review and meta‐analysis

Marcos‐Rodríguez

Leirós‐Rodríguez

Hernández‐Lucas

2023

Intl J Gynecology & Obste

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BackgroundNumerous interventions to reduce perineal trauma during childbirth have been studied in recent years, including perineal massage.ObjectiveTo determine the efficacy of perineal massage during the second stage of labor to prevent perineal damage.Search StrategySystematic search in PubMed, Pedro, Scopus, Web of Science, ScienceDirect, BioMed, SpringerLink, EBSCOhost, CINAHL, and MEDLINE with the terms Massage, Second labor stage, Obstetric delivery, and Parturition.Selection CriteriaThe articles must have been published in the last 10 years; the perineal massage was administered to the study sample; and the experimental design consisted of randomized controlled trial.Data Collection and AnalysisTables were used to describe both the studies' characteristics and the extracted data. The PEDro and Jadad scales were used to assess the quality of studies.Main ResultsOf the 1172 total results identified, nine were selected. Seven studies were included in the meta‐analysis and indicated a statistically significant decreased number of episiotomies in perineal massage.ConclusionsMassage during the second stage of labor appears to be effective in preventing episiotomies and reducing the duration of the second stage of labor. However, it does not appear to be effective in reducing the incidence and severity of perineal tears.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Efficacy of perineal massage during the second stage of labor for the prevention of perineal injury: A systematic review and meta‐analysis

Marcos‐Rodríguez

Leirós‐Rodríguez

Hernández‐Lucas

2023

Intl J Gynecology & Obste

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“…At the same time, elastography research managed to prove that perineal laceration was more prevalent in women with stiffer perineal body [ 38 ]. Therefore, perineal preparation techniques for birth have been explored to avoid tears; instrument-assisted stretching and perineal massage managed to increase extensibility in pregnant women [ 39 ]. Future studies should focus on ways to assess the strength and distensibility of the perineal structures before and during labor to try to improve the accuracy in predicting lesions [ 14 ].…”

Section: Discussionmentioning

confidence: 99%

Obstetrical Soft Tissue Trauma during Spontaneous Vaginal Birth in the Romanian Adolescent Population—Multicentric Comparative Study with Adult Population

Matei

Poenaru

Dimitriu

et al. 2021

IJERPH

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Romania is a country with high rates of adolescent births, associating scarce comprehensive obstetrical management with this specific population. This research aims to assess soft tissue trauma after vaginal birth in teenage mothers compared to their adult counterparts. A retrospective case-control study was conducted for one year in two hospitals. All vaginal deliveries were considered; the age cut-off value was considered at 20 years old for case and control groups. Lacerations were divided into three subgroups, considering the involved anatomical region; group I: labial and periurethral lacerations, group II: vaginal and perineal lacerations, and group III: cervical lacerations. There were 1498 women included in the study: 298 young mothers and 1200 adults. Teenagers were more likely to have an episiotomy during vaginal delivery compared to adult women: 56% versus 26.7% (p = 0.00, Pearson Chi-square) and a 1.89 times increased risk for developing additional group II lacerations: p = 0.01, Pearson Chi-square test with Bonferroni correction: OR = 1.89, 95% CI: 1.18–3.02. Group II lacerations were the most frequent type of birth trauma in both study groups. Fetal weight ≥4000 g was associated with a two times higher risk for vaginal and perineal lacerations when age criterion was not considered (OR = 1.98, 95% CI: 1.13–3.47, p = 0.01). The incidence of group I and II lacerations increased with age: from 0% and 9.1% between 10 and 14 years old to 6% and 26.2% between 18 and 19 years old. All groups of lacerations were more often identified in the case group, compared to the adult group. Fetal macrosomia and spontaneously ruptured membranes at admission could not be documented as risk factors for obstetrical injury in young mothers. Episiotomy performed in teenagers was not a protective procedure for group II lacerations.

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“…de Freitas et al conducted a pilot study to explore the effects of perineal preparation techniques on tissue extensibility and muscle strength. 48 They concluded that the techniques increased extensibility without altering the strength of the pelvic floor muscle, which may provide us with a new idea to facilitate perineum stretching. A third of midwives reported that women were expecting an episiotomy.…”

Section: Obstacles To Reducing the Rate Of Episiotomymentioning

confidence: 99%

Knowledge, attitude and experience of episiotomy practice among obstetricians and midwives: a cross-sectional study from China

Yang

Bai

2021

BMJ Open

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ObjectiveEpisiotomy is still performed widely by obstetricians and midwives in some Chinese maternity units, but the reasons are unknown. This study aims to determine the knowledge, attitude and experience towards the practice of episiotomy among obstetricians and midwives in China’s public hospitals and consider strategies to reduce its practice.MethodsA cross-sectional web survey using a self-administered questionnaire was conducted among obstetricians and midwives in 90 public hospitals in Henan Province, China.Results900 (82.21%) participants completed the questionnaire. Average knowledge level (4.15, SD=1.10) on complications and overuse was identified among participants. Episiotomy was performed more frequently in secondary hospitals than in tertiary hospitals (p<0.05). Senior clinicians were more likely to perform episiotomy than younger ones (p<0.05). Almost half of the clinicians (42.11%) considered the current rate of episiotomy (45%) to be right or too low. The most common reason for performing episiotomy identified by obstetricians (83.94%) and midwives (79.69%) was to reduce third-degree or fourth-degree perineal laceration. Both obstetricians (80.29%) and midwives (82.57%) agreed that the most significant obstacle to reducing the rate of episiotomy was lack of training on reducing perineal tears.ConclusionIn sum, episiotomy was driven by previous training, practitioners’ experience and local norms rather than the latest medical evidence. Clinicians in secondary hospitals and senior clinicians are key training targets. It is urgent to improve current clinical policies and surgical procedure guidelines for obstetricians and midwives regarding episiotomy.

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Effects of perineal preparation techniques on tissue extensibility and muscle strength: a pilot study

Cited by 20 publications

References 27 publications

Efficacy of perineal massage during the second stage of labor for the prevention of perineal injury: A systematic review and meta‐analysis

Efficacy of perineal massage during the second stage of labor for the prevention of perineal injury: A systematic review and meta‐analysis

Obstetrical Soft Tissue Trauma during Spontaneous Vaginal Birth in the Romanian Adolescent Population—Multicentric Comparative Study with Adult Population

Knowledge, attitude and experience of episiotomy practice among obstetricians and midwives: a cross-sectional study from China

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