SynthesisThe Cochrane database of systematic reviews2011
Perineal techniques during the second stage of labour for reducing perineal trauma.
Synthesis in The Cochrane database of systematic reviews, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 37 papers, 5 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Effects of Perineal Massage, Vaginal Dilator and Pelvic Floor Muscles Training on the Perineal Integrity Primiparous: A Randomized Controlled Trial Protocol
Effectiveness of Warm Packs, Perineal Massage and Hands Off During Labour in the Perineal Outcomes.
Who cites it
37 citing papers in PubMed, 5 syntheses or guidelines pooled it, 172 citations in OpenAlex.
- Paracetamol/acetaminophen (single administration) for perineal pain in the early postpartum period.The Cochrane database of systematic reviews · 2021Pooled it
- Local cooling for relieving pain from perineal trauma sustained during childbirth.The Cochrane database of systematic reviews · 2020Pooled it
- How do midwives facilitate women to give birth during physiological second stage of labour? A systematic review.PloS one · 2020Pooled it
- Antepartum use of Epi-No birth trainer for preventing perineal trauma: systematic review.International urogynecology journal · 2015Pooled it
- Does the Finnish intervention prevent obstetric anal sphincter injuries? A systematic review of the literature.BMJ open · 2015Pooled it
- Trial
- Article
- Does transperineal ultrasound predict the risk of perineal trauma in women with term pregnancy? A prospective observational study.Ultrasonography (Seoul, Korea) · 2024Article
- Article
- FIGO good clinical practice paper: management of the second stage of labor.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2021Article
- Review of available national guidelines for obstetric anal sphincter injury.International urogynecology journal · 2020Review
- Factors Associated with Episiotomy Practices in Bahirdar City, Ethiopia: A Cross-Sectional Study.Risk management and healthcare policy · 2020Article
- The impact of third- or fourth-degree perineal tears on the second pregnancy: A cohort study of 182,445 Scottish women.PloS one · 2019Observational
- SemNet: Using Local Features to Navigate the Biomedical Concept Graph.Frontiers in bioengineering and biotechnology · 2019Article
- First do no harm - interventions during labor and maternal satisfaction: a descriptive cross-sectional study.BMC pregnancy and childbirth · 2018Article
- Prospective evaluation of the safety and feasibility of a pelvic floor dilator during active labor.International urogynecology journal · 2018Article
- Risk of obstetric anal sphincter injury increases with maternal age irrespective of parity: a population-based register study.BMC pregnancy and childbirth · 2017Article
- Active delivery of the anterior arm and incidence of second-degree perineal tears: a clinical practice evaluation.BMC pregnancy and childbirth · 2017Observational
- An obstetric sphincter injury risk identification system (OSIRIS): is this a clinically useful tool?International urogynecology journal · 2017Article
- Reducing obstetric anal sphincter injuries using perineal support: our preliminary experience.International urogynecology journal · 2017Article
Corrections and comments
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Authors and funding
4 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundMost vaginal births are associated with some form of trauma to the genital tract. The morbidity associated with perineal trauma is significant, especially when it comes to third- and fourth-degree tears. Different perineal techniques and interventions are being used to prevent perineal trauma. These interventions include perineal massage, warm compresses and perineal management techniques.
objectivesThe objective of this review was to assess the effect of perineal techniques during the second stage of labour on the incidence of perineal trauma. SEARCH
methodsWe searched the Cochrane Pregnancy and Childbirth Group's Trials Register (20 May 2011), the Cochrane Central Register of ControlledTrials (The Cochrane Library 2011, Issue 2 of 4), MEDLINE (January 1966 to 20 May 2011) and CINAHL (January 1983 to 20 May 2011). SELECTION CRITERIA: Published and unpublished randomised and quasi-randomised controlled trials evaluating any described perineal techniques during the second stage. DATA COLLECTION AND ANALYSIS: Three review authors independently assessed trails for inclusion, extracted data and evaluated methodological quality. Data were checked for accuracy. MAIN
resultsWe included eight trials involving 11,651 randomised women. There was a significant effect of warm compresses on reduction of third- and fourth-degree tears (risk ratio (RR) 0.48, 95% confidence interval (CI) 0.28 to 0.84 (two studies, 1525 women)). There was also a significant effect towards favouring massage versus hands off to reduce third- and fourth-degree tears (RR 0.52, 95% CI 0.29 to 0.94 (two studies, 2147 women)). Hands off (or poised) versus hand on showed no effect on third- and fourth-degree tears, but we observed a significant effect of hands off on reduced rate of episiotomy (RR 0.69, 95% CI 0.50 to 0.96 (two studies, 6547 women)). AUTHORS'
conclusionsThe use of warm compresses on the perineum is associated with a decreased occurrence of perineal trauma. The procedure has shown to be acceptable to women and midwives. This procedure may therefore be offered to women.
Indexed as
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.