Effectiveness of antenatal perineal massage in reducing perineal trauma and post‐partum morbidities: A randomized controlled trial

Aim The study aimed to evaluate the effectiveness of antenatal perineal massage (APM) in reducing perineal trauma and post‐partum morbidities. Methods A randomized controlled trial of 108 primigravidae at the University of Nigeria Teaching Hospital, Enugu, Nigeria, was conducted from January 2013 to...

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Bibliographic Details
Published in:The journal of obstetrics and gynaecology research 2018-07, Vol.44 (7), p.1252-1258
Main Authors: Ugwu, Emmanuel Onyebuchi, Iferikigwe, Eric Sunday, Obi, Samuel Nnamdi, Eleje, George Uchenna, Ozumba, Benjamin Chukwuma
Format: Article
Language:English
Subjects:
Adult
antenatal perineal massage
Asphyxia
Birth
Childbirth & labor
Clinical trials
Episiotomy - statistics & numerical data
episiotomy, flatus incontinence, perineal trauma
Fecal Incontinence - prevention & control
Female
Health risk assessment
Humans
Lacerations - prevention & control
Massage - methods
Neonates
Nigeria
Obstetric Labor Complications - prevention & control
Perineum
Perineum - injuries
post‐partum morbidities
Pregnancy
Pregnancy Outcome
Prenatal Care - methods
Trauma
Vagina
Womens health
Young Adult
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Summary:Aim The study aimed to evaluate the effectiveness of antenatal perineal massage (APM) in reducing perineal trauma and post‐partum morbidities. Methods A randomized controlled trial of 108 primigravidae at the University of Nigeria Teaching Hospital, Enugu, Nigeria, was conducted from January 2013 to May 2014. The intervention group received APM, while the control group did not receive APM. Results Women who received APM were significantly more likely to have an intact perineum after childbirth [27/53 (50.9%) vs 16/55 (29.1%); RR: 1.75; 95% CI: 1.07–2.86; P = 0.02]. The incidence of episiotomy was lower in the intervention group [20/53 (37.7%) vs 32/55 (58.2%); RR: 0.65; 95% CI: 0.43–0.98; P = 0.03; NNT = 5]. Women who received APM were significantly less likely to develop flatus incontinence [4/53 (8.3%) vs 13/55 (26.0%); RR: 0.32; 95% CI: 0.11–0.91; P = 0.03]. However, the incidences of premature rupture of membranes, preterm labor and birth asphyxia were similar between the two groups (P > 0.05). Conclusion APM reduces the incidence of episiotomy and increases the incidence of women with an intact perineum after vaginal delivery. It also reduces the risk of flatus incontinence after childbirth without increased maternal or neonatal complications. Women should therefore be counseled on the likely benefits of APM and the information provided during antenatal care. Obstetricians should consider the technique as routine prenatal care for nulliparous women so as to reduce the incidence of perineal trauma during vaginal birth.
ISSN:1341-8076
1447-0756
DOI:10.1111/jog.13640