Effect of perineum massage with olive oil on perineum integrity and duration of second period of delivery

Abstract

Background: Perineal trauma that may occur during labor may pose a critical risk both for mother’s health and her quality of life. Childbirth and puerperium are of the most important periods in women’s lives and can affect different aspects of their lives. Aims and objectives: To determine the effect of perineal massage in the second stage of labor with olive oil on perineal lacerations, episiotomy, and perineum tears in multiparous women. Design: A randomized controlled trial. Method: Among women who applied to Maternity Hospital in Turkey 350 pregnant women were assigned to massage group while other 350 were to control group. The participants were selected through convenience sampling, and randomly assigned to two groups: intervention and control groups. The intervention group received perineal massage with olive oil during second stage of labor. Subsequently, we analyzed perineal laceration, episiotomy, and perineal tear among the two groups. All of them were taught about postpartum perineal tear and its severity, and the researcher followed them up 4 hours, and 1 days after childbirth. The data were analyzed using SPSS version 18. We used descriptive statistics and analytical statistics, including t test, Chi-square test, One-Simple Kolmogorov Smirnov test. Findings: Frequency of episiotomy was 34.3% in the intervention group and 48.6% in the control group, and the difference was statistically significant (p<0.05) Tear appeared in 17.7% of the massage group while in 38.0% of the controls. Percentage of tear formation in the massage group significantly decreased (p<0.05) No statistically significant difference was found between the second period of the delivery of massage and control group Conclusion: Regarding the results of this study and those of other studies, perineal massage during the second stage of labor can reduce the need for episiotomy, and avoid perineal injuries, and perineal pain.

Perineal Massage for Prevention of Perineal Trauma and Episiotomy During Labor: A Systematic Review and Meta-analysis

“…The largest sample size was 1,340 and smallest was 77. Among ten studies, six studies included only nulliparous women (14-18, 23) and remaining four studies included both nulliparous and multiparous women (19)(20)(21)(22). The inclusion criteria for maternal age were 18 to 35 years in three studies (16,18), and 18 to 30 years in one study (14).…”

“…Their characteristics are shown in Table 1 . Of the ten studies, four were from Iran ( 14 - 17 ) three from Turkey ( 18 - 20 ) and remaining three from USA ( 21 ), Australia ( 22 ) and India ( 23 ). The largest sample size was 1,340 and smallest was 77.…”

“…Of the ten trials, three trials ( 16 , 21 , 23 ) stated the methods of sequence generation of computerized randomization, one trail stated random number table ( 19 ), and two trial used simple lottery method ( 18 , 20 ), and one trail used block randomization technique ( 17 ) for the selection of participants. Among the ten trials, three trails ( 16 , 21 , 22 ) reported allocation concealment and one trail ( 16 ) reported double-blind for the intervention and outcome assessment.…”

“…Result presented as forest plot shown in figure 7, it maintains the intact perineum significantly (RR: 1.02, 95% CI 0.84-1.24, p= 0.15) compared to control group, with considerable heterogeneity [I 2 =36%]. Episiotomy: Risk of episiotomy reported in the ten studies (14)(15)(16)(17)(18)(19)(20)(21)(22)(23) were combined and analyzed to assess the effect of perineal massage during labor. Findings of the meta-analysis presented as forest plot shown in figure 8, perineal massage reduces the risk of episiotomy (RR: 0.71, 95% CI 0.52-0.98 p < 0.01) compared to control group, with considerable heterogeneity [I 2 =82%, p<0.01] and it was statistically insignificant.…”