Amira S Dieb1, Amira Y Shoab2, Hala Nabil2, Amir Gabr2, Ahmed A Abdallah2, Mona M Shaban2, Ahmed H Attia2. 1. Department of Obstetrics and Gynecology, Kasr AlAini Hospital, Faculty of Medicine, Cairo University, ElSaraya Street, Manial, Cairo, P.O. Box 11956, Egypt. amirasaied2026@gmail.com. 2. Department of Obstetrics and Gynecology, Kasr AlAini Hospital, Faculty of Medicine, Cairo University, ElSaraya Street, Manial, Cairo, P.O. Box 11956, Egypt.
Abstract
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. METHODS: 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. RESULTS: 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). CONCLUSIONS: Performing antenatal digital perineal massage and PFMT in addition to health education is recommended to reduce perineal complications.
RCT Entities:
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. METHODS: 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. RESULTS: 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). CONCLUSIONS: Performing antenatal digital perineal massage and PFMT in addition to health education is recommended to reduce perineal complications.
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