Xiao Cao1, Qiuyu Yang1, Qi Wang2, Shasha Hu3, Liangying Hou2, Mingyao Sun1, Honghao Lai2, Cailiang Wu4, Yu Wu3,5, Lin Xiao6, Xiaofeng Luo7, Jinhui Tian8,9, Long Ge10,11, Chenling Luo12. 1. Evidence-Based Nursing Centre, School of Nursing, Lanzhou University, Lanzhou, China. 2. Department of Social Medicine and Health Management, and Evidence Based Social Science Research Centre, School of Public Health, Lanzhou University, Lanzhou, China. 3. Department of Obstetrics and Gynecology, First Hospital of Lanzhou University, Lanzhou, China. 4. Department of Obstetrics and Gynecology, Shanghai General Hospital, Shanghai, China. 5. Key Laboratory of Gynecologic Oncology of Gansu Province, Lanzhou, China. 6. Evidence-Based Nursing and Midwifery Practice Center, School of Nursing, Southern Medical University, Guangzhou, China. 7. School of Public Health, Lanzhou University, Lanzhou, China. 8. Evidence-Based Medicine Center, School of Basic Medicine Science, Lanzhou University, Lanzhou, China. 9. Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, China. 10. Department of Social Medicine and Health Management, and Evidence Based Social Science Research Centre, School of Public Health, Lanzhou University, Lanzhou, China. gelong2009@163.com. 11. Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, China. gelong2009@163.com. 12. Evidence-Based Nursing and Midwifery Practice Center, School of Nursing, Southern Medical University, Guangzhou, China. 824223178@qq.com.
Abstract
BACKGROUND: Most women suffer from perineal trauma during childbirth, whether it is natural tears or episiotomy. OBJECTIVES: To perform a systematic review and network meta-analysis investigating the effectiveness of different PFMT relevant strategies in the prevention of perineal trauma. SEARCH STRATEGY: PubMed, Embase, the Cochrane Library, CINAHL, CNKI, CBM, WANFANG DATABASE, and ClinicalTrials.gov were searched for citations published in any language from inception to 1 July 2021. SELECTION CRITERIA: Randomized controlled trials (RCTs) of PFMT relevant prevention strategies for preventing perineal trauma during childbirth. DATA COLLECTION AND ANALYSIS: Data were independently extracted by two reviewers. Relative treatment effects were estimated using network meta-analysis (NMA). MAIN RESULTS: Of 12 632 citations searched, 21 RCTs were included. Comparing with usual care, "PFMT combine with perineal massage" and PFMT alone showed more superiority in intact perineum (RR = 5.37, 95% CI: 3.79 to 7.60, moderate certainty; RR = 2.58, 95% CI 1.34-4.97, moderate certainty, respectively), episiotomy (RR = 0.26, 95% CI 0.14-0.49, very low certainty; RR = 0.63, 95% CI 0.45-0.90, very low certainty, respectively), and OASIS (RR = 0.35, 95% CI 0.16-0.78, moderate certainty; RR = 0.49, 95% CI 0.28-0.85, high certainty, respectively). "PFMT combine with perineal massage" showed superiority in reducing perineal tear (RR = 0.41, 95% CI 0.20-0.85, moderate certainty). CONCLUSIONS: In view of the results, antenatal "PFMT combine with perineal massage" and PFMT were effective strategies for the prevention of perineal trauma.
BACKGROUND: Most women suffer from perineal trauma during childbirth, whether it is natural tears or episiotomy. OBJECTIVES: To perform a systematic review and network meta-analysis investigating the effectiveness of different PFMT relevant strategies in the prevention of perineal trauma. SEARCH STRATEGY: PubMed, Embase, the Cochrane Library, CINAHL, CNKI, CBM, WANFANG DATABASE, and ClinicalTrials.gov were searched for citations published in any language from inception to 1 July 2021. SELECTION CRITERIA: Randomized controlled trials (RCTs) of PFMT relevant prevention strategies for preventing perineal trauma during childbirth. DATA COLLECTION AND ANALYSIS: Data were independently extracted by two reviewers. Relative treatment effects were estimated using network meta-analysis (NMA). MAIN RESULTS: Of 12 632 citations searched, 21 RCTs were included. Comparing with usual care, "PFMT combine with perineal massage" and PFMT alone showed more superiority in intact perineum (RR = 5.37, 95% CI: 3.79 to 7.60, moderate certainty; RR = 2.58, 95% CI 1.34-4.97, moderate certainty, respectively), episiotomy (RR = 0.26, 95% CI 0.14-0.49, very low certainty; RR = 0.63, 95% CI 0.45-0.90, very low certainty, respectively), and OASIS (RR = 0.35, 95% CI 0.16-0.78, moderate certainty; RR = 0.49, 95% CI 0.28-0.85, high certainty, respectively). "PFMT combine with perineal massage" showed superiority in reducing perineal tear (RR = 0.41, 95% CI 0.20-0.85, moderate certainty). CONCLUSIONS: In view of the results, antenatal "PFMT combine with perineal massage" and PFMT were effective strategies for the prevention of perineal trauma.
Authors: Ahmed Taher Masoud; Mohammed M AbdelGawad; Norihan Hatem Elshamy; Omar Magdy Mohamed; Zeinab Y Hashem; Ahmed K Abd Eltawab; Ahmed Samy; Ahmed M Abbas Journal: J Gynecol Obstet Hum Reprod Date: 2020-03-29
Authors: G Ducarme; A C Pizzoferrato; R de Tayrac; C Schantz; T Thubert; C Le Ray; D Riethmuller; E Verspyck; B Gachon; F Pierre; F Artzner; B Jacquetin; X Fritel Journal: J Gynecol Obstet Hum Reprod Date: 2018-12-12
Authors: Ahmed Mohamed Abdelhakim; Elsayed Eldesouky; Ibrahim Abo Elmagd; Attia Mohammed; Elsayed Aly Farag; Abd Elhalim Mohammed; Khaled M Hamam; Ahmed Salah Hussein; Ahmed Said Ali; Nawal Hamdy Ahmed Keshta; Mohamed Hamza; Ahmed Samy; Ali Abdelhafeez Abdel-Latif Journal: Int Urogynecol J Date: 2020-05-12 Impact factor: 2.894
Authors: Brian Hutton; Georgia Salanti; Deborah M Caldwell; Anna Chaimani; Christopher H Schmid; Chris Cameron; John P A Ioannidis; Sharon Straus; Kristian Thorlund; Jeroen P Jansen; Cynthia Mulrow; Ferrán Catalá-López; Peter C Gøtzsche; Kay Dickersin; Isabelle Boutron; Douglas G Altman; David Moher Journal: Ann Intern Med Date: 2015-06-02 Impact factor: 25.391