Antenatal perineal massage benefits in reducing perineal trauma and postpartum morbidities: a systematic review and meta-analysis of randomized controlled trials
Introduction and hypothesis Most vaginal births are associated with trauma to the perineum. The morbidity associated with perineal trauma can be significant, especially when it leads to third- and fourth-degree perineal tears. We hypothesized that antenatal perineal massage could decrease the incide...
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| Veröffentlicht in: | International Urogynecology Journal 2020-09, Vol.31 (9), p.1735-1745 |
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| creator | Abdelhakim, Ahmed Mohamed Eldesouky, Elsayed Elmagd, Ibrahim Abo Mohammed, Attia Farag, Elsayed Aly Mohammed, Abd Elhalim Hamam, Khaled M. Hussein, Ahmed Salah Ali, Ahmed Said Keshta, Nawal Hamdy Ahmed Hamza, Mohamed Samy, Ahmed Abdel-Latif, Ali Abdelhafeez |
| description | Introduction and hypothesis
Most vaginal births are associated with trauma to the perineum. The morbidity associated with perineal trauma can be significant, especially when it leads to third- and fourth-degree perineal tears. We hypothesized that antenatal perineal massage could decrease the incidence of perineal trauma, particularly severe perineal tears and other postpartum complications.
Methods
We searched four different databases from inception until August 2019 for the available trials. We included randomized controlled trials (RCTs) which assessed the effect of antenatal perineal massage (intervention group) versus control group (no antenatal perineal massage) in perineal trauma patients. Data were extracted from eligible studies and meta-analyzed using RevMan software. Primary outcomes were the risk of episiotomies and perineal tears. Secondary outcomes were perineal pain, second stage of labor duration, wound healing, anal incontinence, and Apgar scores at 1 and 5 min.
Results
Eleven RCTs with 3467 patients were analyzed. Women who received antenatal perineal massage had significantly lower incidence of episiotomies (RR = 0.79, 95% CI [0.72, 0.87],
p
|
| doi_str_mv | 10.1007/s00192-020-04302-8 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2402422383</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2402422383</sourcerecordid><originalsourceid>FETCH-LOGICAL-c375t-c11babd9abb0827fe9145bb6d4b476aa1d6448bd47ab8b5aa0b4843fae2065653</originalsourceid><addsrcrecordid>eNp9kctu1TAQhi0EooeWF2CBLLFhEzq-5MauqrhJlbqh62icTI5cxXawHdDhbXhT3J5CJRasZmx_84-sj7FXAt4JgPY8AYheViChAq1AVt0TthNaqaoc1FO2g161ldKNPGEvUroFAA01PGcnSqq-76HesV8XPpPHjAtfKVpPpXGYEu6JG_I025y49TzStI3W7x-pHHFzyNFPfA0prxjz5rgL0djJZkvpPUeeDimTw2zHkvDd0o973lHGCj0uh2QTDzOP5TY4-5MmPgafY1iW0uZocUln7NlcCr18qKfs5uOHr5efq6vrT18uL66qUbV1rkYhDJqpR2Ogk-1MvdC1Mc2kjW4bRDE1Wndm0i2aztSIYHSn1YwkoambWp2yt8fcNYZvG6U8OJtGWhb0FLY0SA1SS6k6VdA3_6C3YYvlP3eU0kK3dasLJY_UGENKkeZhjdZhPAwChjuBw1HgUAQO9wKHrgy9fojejKPp78gfYwVQRyCVJ7-n-Lj7P7G_Ac7uqjc</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2434147574</pqid></control><display><type>article</type><title>Antenatal perineal massage benefits in reducing perineal trauma and postpartum morbidities: a systematic review and meta-analysis of randomized controlled trials</title><source>SpringerLink Journals</source><creator>Abdelhakim, Ahmed Mohamed ; Eldesouky, Elsayed ; Elmagd, Ibrahim Abo ; Mohammed, Attia ; Farag, Elsayed Aly ; Mohammed, Abd Elhalim ; Hamam, Khaled M. ; Hussein, Ahmed Salah ; Ali, Ahmed Said ; Keshta, Nawal Hamdy Ahmed ; Hamza, Mohamed ; Samy, Ahmed ; Abdel-Latif, Ali Abdelhafeez</creator><creatorcontrib>Abdelhakim, Ahmed Mohamed ; Eldesouky, Elsayed ; Elmagd, Ibrahim Abo ; Mohammed, Attia ; Farag, Elsayed Aly ; Mohammed, Abd Elhalim ; Hamam, Khaled M. ; Hussein, Ahmed Salah ; Ali, Ahmed Said ; Keshta, Nawal Hamdy Ahmed ; Hamza, Mohamed ; Samy, Ahmed ; Abdel-Latif, Ali Abdelhafeez</creatorcontrib><description>Introduction and hypothesis
Most vaginal births are associated with trauma to the perineum. The morbidity associated with perineal trauma can be significant, especially when it leads to third- and fourth-degree perineal tears. We hypothesized that antenatal perineal massage could decrease the incidence of perineal trauma, particularly severe perineal tears and other postpartum complications.
Methods
We searched four different databases from inception until August 2019 for the available trials. We included randomized controlled trials (RCTs) which assessed the effect of antenatal perineal massage (intervention group) versus control group (no antenatal perineal massage) in perineal trauma patients. Data were extracted from eligible studies and meta-analyzed using RevMan software. Primary outcomes were the risk of episiotomies and perineal tears. Secondary outcomes were perineal pain, second stage of labor duration, wound healing, anal incontinence, and Apgar scores at 1 and 5 min.
Results
Eleven RCTs with 3467 patients were analyzed. Women who received antenatal perineal massage had significantly lower incidence of episiotomies (RR = 0.79, 95% CI [0.72, 0.87],
p
< 0.001) and perineal tears (RR = 0.79, 95% CI [0.67, 0.94],
p
= 0.007), particularly the risk of third- and fourth-degree perineal tears (
p
= 0.03). Better wound healing and less perineal pain were evident in the antenatal perineal massage group. Antenatal perineal massage reduced the second stage of labor duration (
p
= 0.005) and anal incontinence (
p
= 0.003) with significant improvement in Apgar scores at 1 and 5 min (
p
= 0.01 and
p
= 0.02).
Conclusions
Antenatal perineal massage is associated with a lower risk of severe perineal trauma and postpartum complications.</description><identifier>ISSN: 0937-3462</identifier><identifier>EISSN: 1433-3023</identifier><identifier>DOI: 10.1007/s00192-020-04302-8</identifier><identifier>PMID: 32399905</identifier><language>eng</language><publisher>Cham: Springer International Publishing</publisher><subject>Apgar score ; Clinical trials ; Episiotomy ; Gynecology ; Medicine ; Medicine & Public Health ; Meta-analysis ; Review Article ; Urology ; Wound healing</subject><ispartof>International Urogynecology Journal, 2020-09, Vol.31 (9), p.1735-1745</ispartof><rights>The International Urogynecological Association 2020</rights><rights>The International Urogynecological Association 2020.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c375t-c11babd9abb0827fe9145bb6d4b476aa1d6448bd47ab8b5aa0b4843fae2065653</citedby><cites>FETCH-LOGICAL-c375t-c11babd9abb0827fe9145bb6d4b476aa1d6448bd47ab8b5aa0b4843fae2065653</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00192-020-04302-8$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00192-020-04302-8$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32399905$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Abdelhakim, Ahmed Mohamed</creatorcontrib><creatorcontrib>Eldesouky, Elsayed</creatorcontrib><creatorcontrib>Elmagd, Ibrahim Abo</creatorcontrib><creatorcontrib>Mohammed, Attia</creatorcontrib><creatorcontrib>Farag, Elsayed Aly</creatorcontrib><creatorcontrib>Mohammed, Abd Elhalim</creatorcontrib><creatorcontrib>Hamam, Khaled M.</creatorcontrib><creatorcontrib>Hussein, Ahmed Salah</creatorcontrib><creatorcontrib>Ali, Ahmed Said</creatorcontrib><creatorcontrib>Keshta, Nawal Hamdy Ahmed</creatorcontrib><creatorcontrib>Hamza, Mohamed</creatorcontrib><creatorcontrib>Samy, Ahmed</creatorcontrib><creatorcontrib>Abdel-Latif, Ali Abdelhafeez</creatorcontrib><title>Antenatal perineal massage benefits in reducing perineal trauma and postpartum morbidities: a systematic review and meta-analysis of randomized controlled trials</title><title>International Urogynecology Journal</title><addtitle>Int Urogynecol J</addtitle><addtitle>Int Urogynecol J</addtitle><description>Introduction and hypothesis
Most vaginal births are associated with trauma to the perineum. The morbidity associated with perineal trauma can be significant, especially when it leads to third- and fourth-degree perineal tears. We hypothesized that antenatal perineal massage could decrease the incidence of perineal trauma, particularly severe perineal tears and other postpartum complications.
Methods
We searched four different databases from inception until August 2019 for the available trials. We included randomized controlled trials (RCTs) which assessed the effect of antenatal perineal massage (intervention group) versus control group (no antenatal perineal massage) in perineal trauma patients. Data were extracted from eligible studies and meta-analyzed using RevMan software. Primary outcomes were the risk of episiotomies and perineal tears. Secondary outcomes were perineal pain, second stage of labor duration, wound healing, anal incontinence, and Apgar scores at 1 and 5 min.
Results
Eleven RCTs with 3467 patients were analyzed. Women who received antenatal perineal massage had significantly lower incidence of episiotomies (RR = 0.79, 95% CI [0.72, 0.87],
p
< 0.001) and perineal tears (RR = 0.79, 95% CI [0.67, 0.94],
p
= 0.007), particularly the risk of third- and fourth-degree perineal tears (
p
= 0.03). Better wound healing and less perineal pain were evident in the antenatal perineal massage group. Antenatal perineal massage reduced the second stage of labor duration (
p
= 0.005) and anal incontinence (
p
= 0.003) with significant improvement in Apgar scores at 1 and 5 min (
p
= 0.01 and
p
= 0.02).
Conclusions
Antenatal perineal massage is associated with a lower risk of severe perineal trauma and postpartum complications.</description><subject>Apgar score</subject><subject>Clinical trials</subject><subject>Episiotomy</subject><subject>Gynecology</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Meta-analysis</subject><subject>Review Article</subject><subject>Urology</subject><subject>Wound healing</subject><issn>0937-3462</issn><issn>1433-3023</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>BENPR</sourceid><recordid>eNp9kctu1TAQhi0EooeWF2CBLLFhEzq-5MauqrhJlbqh62icTI5cxXawHdDhbXhT3J5CJRasZmx_84-sj7FXAt4JgPY8AYheViChAq1AVt0TthNaqaoc1FO2g161ldKNPGEvUroFAA01PGcnSqq-76HesV8XPpPHjAtfKVpPpXGYEu6JG_I025y49TzStI3W7x-pHHFzyNFPfA0prxjz5rgL0djJZkvpPUeeDimTw2zHkvDd0o973lHGCj0uh2QTDzOP5TY4-5MmPgafY1iW0uZocUln7NlcCr18qKfs5uOHr5efq6vrT18uL66qUbV1rkYhDJqpR2Ogk-1MvdC1Mc2kjW4bRDE1Wndm0i2aztSIYHSn1YwkoambWp2yt8fcNYZvG6U8OJtGWhb0FLY0SA1SS6k6VdA3_6C3YYvlP3eU0kK3dasLJY_UGENKkeZhjdZhPAwChjuBw1HgUAQO9wKHrgy9fojejKPp78gfYwVQRyCVJ7-n-Lj7P7G_Ac7uqjc</recordid><startdate>20200901</startdate><enddate>20200901</enddate><creator>Abdelhakim, Ahmed Mohamed</creator><creator>Eldesouky, Elsayed</creator><creator>Elmagd, Ibrahim Abo</creator><creator>Mohammed, Attia</creator><creator>Farag, Elsayed Aly</creator><creator>Mohammed, Abd Elhalim</creator><creator>Hamam, Khaled M.</creator><creator>Hussein, Ahmed Salah</creator><creator>Ali, Ahmed Said</creator><creator>Keshta, Nawal Hamdy Ahmed</creator><creator>Hamza, Mohamed</creator><creator>Samy, Ahmed</creator><creator>Abdel-Latif, Ali Abdelhafeez</creator><general>Springer International Publishing</general><general>Springer Nature B.V</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20200901</creationdate><title>Antenatal perineal massage benefits in reducing perineal trauma and postpartum morbidities: a systematic review and meta-analysis of randomized controlled trials</title><author>Abdelhakim, Ahmed Mohamed ; Eldesouky, Elsayed ; Elmagd, Ibrahim Abo ; Mohammed, Attia ; Farag, Elsayed Aly ; Mohammed, Abd Elhalim ; Hamam, Khaled M. ; Hussein, Ahmed Salah ; Ali, Ahmed Said ; Keshta, Nawal Hamdy Ahmed ; Hamza, Mohamed ; Samy, Ahmed ; Abdel-Latif, Ali Abdelhafeez</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c375t-c11babd9abb0827fe9145bb6d4b476aa1d6448bd47ab8b5aa0b4843fae2065653</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Apgar score</topic><topic>Clinical trials</topic><topic>Episiotomy</topic><topic>Gynecology</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Meta-analysis</topic><topic>Review Article</topic><topic>Urology</topic><topic>Wound healing</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Abdelhakim, Ahmed Mohamed</creatorcontrib><creatorcontrib>Eldesouky, Elsayed</creatorcontrib><creatorcontrib>Elmagd, Ibrahim Abo</creatorcontrib><creatorcontrib>Mohammed, Attia</creatorcontrib><creatorcontrib>Farag, Elsayed Aly</creatorcontrib><creatorcontrib>Mohammed, Abd Elhalim</creatorcontrib><creatorcontrib>Hamam, Khaled M.</creatorcontrib><creatorcontrib>Hussein, Ahmed Salah</creatorcontrib><creatorcontrib>Ali, Ahmed Said</creatorcontrib><creatorcontrib>Keshta, Nawal Hamdy Ahmed</creatorcontrib><creatorcontrib>Hamza, Mohamed</creatorcontrib><creatorcontrib>Samy, Ahmed</creatorcontrib><creatorcontrib>Abdel-Latif, Ali Abdelhafeez</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>International Urogynecology Journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Abdelhakim, Ahmed Mohamed</au><au>Eldesouky, Elsayed</au><au>Elmagd, Ibrahim Abo</au><au>Mohammed, Attia</au><au>Farag, Elsayed Aly</au><au>Mohammed, Abd Elhalim</au><au>Hamam, Khaled M.</au><au>Hussein, Ahmed Salah</au><au>Ali, Ahmed Said</au><au>Keshta, Nawal Hamdy Ahmed</au><au>Hamza, Mohamed</au><au>Samy, Ahmed</au><au>Abdel-Latif, Ali Abdelhafeez</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Antenatal perineal massage benefits in reducing perineal trauma and postpartum morbidities: a systematic review and meta-analysis of randomized controlled trials</atitle><jtitle>International Urogynecology Journal</jtitle><stitle>Int Urogynecol J</stitle><addtitle>Int Urogynecol J</addtitle><date>2020-09-01</date><risdate>2020</risdate><volume>31</volume><issue>9</issue><spage>1735</spage><epage>1745</epage><pages>1735-1745</pages><issn>0937-3462</issn><eissn>1433-3023</eissn><abstract>Introduction and hypothesis
Most vaginal births are associated with trauma to the perineum. The morbidity associated with perineal trauma can be significant, especially when it leads to third- and fourth-degree perineal tears. We hypothesized that antenatal perineal massage could decrease the incidence of perineal trauma, particularly severe perineal tears and other postpartum complications.
Methods
We searched four different databases from inception until August 2019 for the available trials. We included randomized controlled trials (RCTs) which assessed the effect of antenatal perineal massage (intervention group) versus control group (no antenatal perineal massage) in perineal trauma patients. Data were extracted from eligible studies and meta-analyzed using RevMan software. Primary outcomes were the risk of episiotomies and perineal tears. Secondary outcomes were perineal pain, second stage of labor duration, wound healing, anal incontinence, and Apgar scores at 1 and 5 min.
Results
Eleven RCTs with 3467 patients were analyzed. Women who received antenatal perineal massage had significantly lower incidence of episiotomies (RR = 0.79, 95% CI [0.72, 0.87],
p
< 0.001) and perineal tears (RR = 0.79, 95% CI [0.67, 0.94],
p
= 0.007), particularly the risk of third- and fourth-degree perineal tears (
p
= 0.03). Better wound healing and less perineal pain were evident in the antenatal perineal massage group. Antenatal perineal massage reduced the second stage of labor duration (
p
= 0.005) and anal incontinence (
p
= 0.003) with significant improvement in Apgar scores at 1 and 5 min (
p
= 0.01 and
p
= 0.02).
Conclusions
Antenatal perineal massage is associated with a lower risk of severe perineal trauma and postpartum complications.</abstract><cop>Cham</cop><pub>Springer International Publishing</pub><pmid>32399905</pmid><doi>10.1007/s00192-020-04302-8</doi><tpages>11</tpages></addata></record> |
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| ispartof | International Urogynecology Journal, 2020-09, Vol.31 (9), p.1735-1745 |
| issn | 0937-3462 1433-3023 |
| language | eng |
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| source | SpringerLink Journals |
| subjects | Apgar score Clinical trials Episiotomy Gynecology Medicine Medicine & Public Health Meta-analysis Review Article Urology Wound healing |
| title | Antenatal perineal massage benefits in reducing perineal trauma and postpartum morbidities: a systematic review and meta-analysis of randomized controlled trials |
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