Effects of perineal preparation techniques on tissue extensibility and muscle strength: a pilot study.

Perineal preparation techniques for childbirth have been used to decrease the risk of perineal trauma during labor and delivery. This study aims to assess the effects of stretching the perineum using instruments as compared to perineal massage on the extensibility and strength of Pelvic Floor Muscles as no prior research regarding this has been made.

Women who have not yet given birth were divided into two groups—one group with women who would receive instrument-assisted stretching (IStr) and another group of women who would receive perineal massage (PnM). This was done twice weekly beginning at the 34th week of gestation with both groups participated in eight sessions. The group with IStr used EPI-NO® for 15minutes while the PnM group received 10 minutes of perineal massage. Each woman was evaluated by a physiotherapist who was unaware of the group they belonged to, after the fourth and eighth session. And the results from both groups were compared.

Both groups showed an increase in PFM extensibility and muscle strength, with no difference between groups.

The study found that instrument-assisted stretching and perineal massage both increase PFM extensibility and do not alter the muscle strength of PFMs in pregnant women.

Citation: Int Urogynecol J. 2019 Jun;30(6):951-957 
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Title: Perineal prevention and protection in obstetrics: CNGOF clinical practice guidelines.

These are the guidelines that were developed in accordance with the methods prescribed by the French Health Authority (HAS). The paper analyzed all interventions during pregnancy and childbirth that might stop obstetric anal sphincter injuries (OASIS) and postnatal pelvic floor symptoms. Perineal massage during pregnancy must be encouraged among women who want it. 

Citation: J Gynecol Obstet Hum Reprod. 2019 Sep;48(7):455-460. doi: 10.1016/j.jogoh.2018.12.002.
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July 23, 2021