Effectiveness of antenatal perineal massage in reducing perineal trauma and post‐partum morbidities: A randomized controlled trial

Abstract

APM reduces the incidence of episiotomy and increases the incidence of women with an intact perineum after vaginal delivery. It also reduces the risk of flatus incontinence after childbirth without increased maternal or neonatal complications. Women should therefore be counseled on the likely benefits of APM and the information provided during antenatal care. Obstetricians should consider the technique as routine prenatal care for nulliparous women so as to reduce the incidence of perineal trauma during vaginal birth.

Response to Letter to ‘Effectiveness of antenatal perineal massage in reducing perineal trauma and postpartum morbidities: A randomized controlled trial’

“…2 Our study was limited to 3 months follow up in view of anticipated huge loss if follow up had extended beyond. [1][2][3] Third, the only indication for episiotomy in our study was 'impending/threatening spontaneous perineal tears (SPTs).' 1 We agree that third and fourth degree SPTs are associated with morbidity, however, they are indicators of poorly conducted and neglected second stage labor which episiotomy aims to avert.…”

“…[1][2][3] Third, the only indication for episiotomy in our study was 'impending/threatening spontaneous perineal tears (SPTs).' 1 We agree that third and fourth degree SPTs are associated with morbidity, however, they are indicators of poorly conducted and neglected second stage labor which episiotomy aims to avert. 2 This explains absence of third and fourth degree SPTs in our study.…”

“…1 Those who did not comply strictly were excluded. 1 Sample size calculated was based on the primary outcome measure. Wide confidence intervals obtained in some secondary outcome measures suggest that a larger sample size would have improved study's precision and external validity as stated in study's limitations.…”

“…Wide confidence intervals obtained in some secondary outcome measures suggest that a larger sample size would have improved study's precision and external validity as stated in study's limitations. 1 Second, we used an anal incontinence (AI) questionnaire which was used in recently published study. 2 This was because there is yet a universally accepted validated questionnaire for AI unlike urinary incontinence (UI).…”

Letter to ‘Effectiveness of antenatal perineal massage in reducing perineal trauma and post‐partum morbidities: A randomized controlled trial’

“…We have read with interest the article by Ugwu et al 1 The authors evaluated the effectiveness of antenatal perineal massage (APM) in reducing perineal trauma. There are some questions regarding the study that need to be further clarified.…”