SynthesisInternational urogynecology journal2015
Antepartum use of Epi-No birth trainer for preventing perineal trauma: systematic review.
Synthesis in International urogynecology journal, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02582580 (Effects of Perineal Massage, Vaginal Dilator and Pelvic Floor Muscles Training on the Perineal Integrity Primiparous), which is not on this map. Cited by 14 papers, 4 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
Who cites it
14 citing papers in PubMed, 4 syntheses or guidelines pooled it, 42 citations in OpenAlex.
- The effect of antenatal vaginal dilators on perineal trauma: A systematic review and meta-analysis.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2025Pooled it
- Effectiveness of education and training programmes to help clinicians assess and classify perineal tears: a systematic review.BMJ open · 2025Pooled it
- Effects of perineal massage at different stages on perineal and postpartum pelvic floor function in primiparous women: a systematic review and meta-analysis.BMC pregnancy and childbirth · 2024Pooled it
- PFMT relevant strategies to prevent perineal trauma: a systematic review and network meta-analysis.Archives of gynecology and obstetrics · 2023Pooled it
- The Effect of Perineum Massage Applied With and Without an Instrument in the Active Phase of Labor Birth Outcomes: A Randomized Clinical Trial.International urogynecology journal · 2024Trial
- Effects of perineal preparation techniques on tissue extensibility and muscle strength: a pilot study.International urogynecology journal · 2019Trial
- Birth plans: Developing a shared medical decision aid tool.BMC pregnancy and childbirth · 2025Article
- Antenatal Perineal Training for Injuries Prevention: Follow Up after Puerperium.Medicina (Kaunas, Lithuania) · 2024Article
- Management of Third and Fourth-Degree Perineal Tears After Vaginal Birth. Guideline of the DGGG, OEGGG and SGGG (S2k-Level, AWMF Registry No. 015/079, December 2020).Geburtshilfe und Frauenheilkunde · 2023Article
- The Efficacy of Divabirth Vaginal Dilator to Prevent Pelvic Floor Trauma During Labor: A Protocol Study.International journal of surgery protocols · 2022Article
- INCREASED OASIS INCIDENCE - INDICATOR OF THE QUALITY OF OBSTETRIC CARE?Acta clinica Croatica · 2019Review
- Prevention of pelvic floor disorders: international urogynecological association research and development committee opinion.International urogynecology journal · 2016Article
- Epi-No should be tested in different obstetric settings until an evidence-based clinical decision can be made.International urogynecology journal · 2015Article
- Testing the Epi-No birth trainer where episiotomy is not practiced.International urogynecology journal · 2015Article
Corrections and comments
- Commented on by
- Commented on by
Authors and funding
5 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introduction and hypothesisIn this systematic review we aimed to assess if the Epi-No birth trainer used during antepartum could prevent perineal trauma in nulliparous women.
methodsWe searched CENTRAL, MEDLINE, EMBASE, Scielo, and Conference abstracts, looking for randomized controlled studies (RCT). High heterogeneity (i(2) > 50 %) was corrected with random models. All studies were analyzed according to their quality and risk of bias. Nulliparous women or women whose previous pregnancy ended before 21 weeks' gestation were included and the main outcome measures were: episiotomy rates, perineal tears, severe (3rd/4th) perineal tears, and intact perineum.
resultsFive studies were included (1,369 participants) for systematic review and two of them (932 participants) were eligible for meta-analysis. Epi-No did not reduce episiotomy rates (RR 0.92 [95%CI 0.75-1.13], n = 710, p =0.44; two studies; fixed model) and second stage of labor (MD -12.50 [95%CI -29.62, -4.62], n = 162, p = 0.54; one study; fixed model), and did not increase intact perineum (RR 1.15 [95 % CI 0.81-1.64], n = 705, p = 0.43; two studies; random model). No influence of Epi-No on reducing all perineal tears (RR 0.99 [95%CI 0.84-1.17], n = 705, p = 0.93, two studies; fixed model) or severe (3rd/4th) perineal tears (RR 1.31 [95%CI 0.72-2.37], n = 705, p = 0.38, two studies; fixed model). Mean birthweight of the Epi-No group was higher than that of the control group in both studies, with no statistical significance.
conclusionEpi-No birth trainer is a device that did not reduce episiotomy rates and had no influence on reducing perineal tears.
Indexed as
Identifiers
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.