Perineal Massage and Warm Compresses - RCT for Reduce Perineal Trauma During Labor

Universidade do Porto800 enrolled

Overview

The aim of this study is to evaluate the effect of a combined perineal massage and warm compresses intervention on the perineum integrity during second stage of labor.

A single-centre, prospective, randomized controlled trial was conducted. Eligibility and informed consent to participate were checked once the woman was in established labor. Eligible participants were randomized at the second stage of labor. The trial intervention took place during the second stage of the spontaneous vaginal birth. Participants were randomized to one of the two groups, perineal massage and warm compresses on second stage of labor or control group (hands-on).

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

PREVENTION

Masking

TRIPLE

Enrollment

800

Conditions

Perineal Tear Resulting From Childbirth

Interventions

Perineal Massage and Warm Compresses (PeMWaC)PROCEDURE

Perineal Massage was performed in the II Hodge Plan, between maternal contractions and regardless of maternal position. Warm Compresses were applied by the midwife between Hodge plans III and IV, during pushing and regardless of maternal position.

Control Group (Hands-on)PROCEDURE

The midwife placed the index, middle, and little fingers of the non-dominant hand together on the child's occiput, with the palm facing the anterior region of the perineum, when the child's head was crowning. In this way, the expulsion was controlled, maintaining the flexion of the head. Simultaneously, the dominant hand was flattened and placed on the posterior region of the perineum, with the index finger and thumb, forming a "U", exerting pressure on the posterior region of the perineum during the crowning process. During the birth of the shoulders and the rest of the body, the dominant hand was kept in place, protecting the posterior region of the perineum.

Eligibility

Sex: FEMALEMin age: 18 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria: * Women with 18 years or older * Between 37 and 41 weeks of pregnancy * Expected spontaneous vaginal birth * Fetus in the cephalic presentation * Able to provide informed written consent Exclusion Criteria: * Multiple pregnancy * Meconial amniotic fluid * Fetal distress * Suspicion of fetal growth restriction * Gestational hypertensive disorders

Locations (1)

Sílvia Rodrigues

Braga, Portugal

Outcomes

Primary Outcomes

Intact Perineum

Absence of tissue separation at any site, without vaginal tears or any other degree of perineal trauma)