Meta-Analysis of 21 studies about Pelvic Floor Muscle Training to prevent perineal trauma

Title: PFMT relevant strategies to prevent perineal trauma: a systematic review and network meta-analysis

The authors of this study performed a review of all the published studies about the effectiveness of pelvic floor muscle training and the potential for perineal trauma. 21 clinical studies were included in the analysis. The combination of doing pelvic floor muscle training with perineal massage—or even pelvic floor muscle training on its own—showed superiority in keeping the perineum intact.

The authors of the study concluded that antenatal perineal massage, combined with pelvic floor exercises, and even pelvic floor muscle training on its own were effective strategies for the prevention of perineal trauma.

Citation: PFMT relevant strategies to prevent perineal trauma: a systematic review and network meta-analysis. Arch Gynecol Obstet. 2022 Sep 15. doi: 10.1007/s00404-022-06769-w.

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Effect of prenatal perineal massage on postpartum perineal injury and postpartum complications: A Meta-Analysis

Title: Effect of Prenatal Perineal Massage on Postpartum Perineal Injury and Postpartum Complications: A Meta-Analysis

The efficacy of perineal massage is controversial. The study aimed at comparing the effects of perineal massage on perineal injury and complications. PubMed, Embase, the Cochrane Library, and ISI Web of Science were searched for literature on the relationship between prenatal perineal massage and postpartum perineal injury and complications. Indicators included postpartum perineal tears, perineotomy, postpartum perineal pain, natural labor, and postpartum incontinence. 

A total of 6,487 subjects in 16 studies were included. This encompassed 3,211 woman who did perineal massage and 3,276 who did not. The analysis showed that there was no significant difference in 1- or 2-degree perineal tearing between the two groups. However, prenatal perineal massage was shown to significantly reduce the incidence of 3- and 4-degree perineal tears. Additionally, prenatal perineal massage reduced the risk of lateral perineal resection and the risk of postpartum pain at 3 months.  

The authors concluded that prenatal perineal massage can reduce the risk of perineal injury, the incidence of lateral perineal resection, and the incidence of long-term pain.

Citation: Effect of Prenatal Perineal Massage on Postpartum Perineal Injury and Postpartum Complications: A Meta-Analysis. Comput Math Methods Med. 2022 Jul 14;2022:3315638.

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Does perineal stretching with instruments increase the elasticity of the pelvic floor muscle?

Title: Are Perineal Massage and Instrument-Assisted Perineal Stretching With Short Protocol Effective for Increasing Pelvic Floor Muscle Extensibility? A Randomized Controlled Trial

The authors in this study, from Brazil, compared the effects of instrument-assisted perineal stretching techniques when combined with perineal massage to the effects of the techniques when done without any devices on the extensibility and strength of the pelvic floor muscles (PFMs). 96 pregnant woman aged 18-40 years participated in the study. The woman were divided into four group each having its own short perineal stretching protocol. The pelvic floor muscle extensibility was assessed at the beginning and the end of the study. In addition, pelvic floor muscle strength was assessed too. The study showed that pregnant woman who received a combination of perineal massage and instrument-assisted perineal stretching had a greater increase in pelvic floor extensibility than either perineal massage or instrument-assisted perineal stretching alone.

The authors concluded that pregnant women could benefit from combining perineal massage and instrument-assisted perineal stretching techniques with a short, repeated protocol.

Citation: Are Perineal Massage and Instrument-Assisted Perineal Stretching With Short Protocol Effective for Increasing Pelvic Floor Muscle Extensibility? A Randomized Controlled Trial. Phys Ther. 2022 Mar 1;102(3):pzab305. doi: 10.1093/ptj/pzab305.

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September 27, 2022