Effects of antenatal pelvic floor preparation techniques on the perineal integrity: a randomized controlled trial protocol

Abstract

<p class="abstract"><strong>Background:</strong> The objective of the present study was to compare the effects of perineal massage, vaginal dilator and pelvic floor muscles training on the perineal integrity of primiparae women<span lang="EN-IN">. </span></p><p class="abstract"><strong>Methods:</strong> Primigravidae women over 18 years old will be selected, from the 32th gestational week and wishing to have a vaginal delivery<span lang="EN-IN">.</span>Pregnant women will be randomly allocated from a sequence generated by a computer program into three groups: perineal massage, vaginal dilator and pelvic floor muscles training. The technique should be practiced from the 34th week of pregnancy until the beginning of labor. Randomization will be done by a researcher who was not involved with the recruitment, assessment and treatment of the participants. All participants will undergo a clinical and functional assessment of the pelvic floor before the beginning of the technique practice, as well as a reassessment of these items and an assessment of perineal integrity between 45 and 60 days after delivery for a blind physiotherapist regarding the interventional procedures. The evaluative procedures will be done by a ‘blinded’ physiotherapist in relation to the intervention procedures.<span lang="EN-IN"> The outcome will be determined by </span>the perineal integrity by the presence or absence of perineal laceration as well as their characteristics observed immediately after delivery<span lang="EN-IN">. </span></p><p class="abstract"><strong>Conclusions:</strong> The knowledge of the effects of antenatal pelvic floor preparation techniques on the perineal integrity and pelvic floor muscles function after delivery, will allow a better choice about which approach is the best to pregnant women to prevent perineal trauma.</p>

Fisioterapia no controle das emoções durante o pré-natal: Um ensaio clínico randomizado

“…Em relação aos programas de preparação para o parto, a maioria dos estudos relacionados a fisioterapia no pré-natal têm como objetivo principal analisar os desfechos de lesão perineal e não o impacto nas emoções (Pereira, et al, 2015;Alves, et al 2016). Porém, uma revisão sistemática acerca da eficácia do Epi-No® no pré-natal corrobora com os achados do nosso estudo, pois afirma que gestantes que se preparam para o parto com o equipamento se sentem mais confiantes, e aprendem técnicas de controle de dor e de estímulos para o trabalho de parto (Pereira et al, 2015).…”

“…Ainda somente para o grupo fisioterapia, a partir da 34° semana de gestação até a 40° semana ou data do parto foram interrompidos os exercícios pélvicos e foi realizado técnicas individuais para aumento da extensibilidade e alongamento muscular do assoalho pélvico com a massagem perineal e com o uso do perineômetro vaginal da marca Epi-no® (Alves et al, 2016). A massagem perineal era realizada em dez minutos utilizando a técnica primeiramente descrita por Labrecque e colaboradores (1994), sendo introduzido de um a dois dedos aproximadamente 3 a 4 cm na vagina, aplicando e mantendo pressão no sentido anteroposterior durante dois minutos e posteriormente nas paredes laterais da vagina por mais dois minutos, sendo repetida a sequência dos movimentos por três vezes utilizando-se lubrificante à base d'água da marca KY ® .…”

Evaluation of the effect of an antenatal pelvic floor muscle exercise programme on female sexual function during pregnancy and the first 3 months following birth: study protocol for a pragmatic randomised controlled trial

“…To design the PFME programme in this study, the researchers used a combination of information obtained from the physiotherapy department in the intended hospital setting as well as the recent literature available on PFME programmes. The final PFME programme in this study was developed using six references: effective functional motor activation patterns (the Knack method) [38, 39] and the studies carried out by Elbegway et al [13], Mørkved et al [22], Mørkved and Bø [40] and Alves et al [41] (Fig. 2).…”

The benefits of Kegel’s exercises during pregnancy

“…The antenatal Kegel's exercise was effective when pregnant women done it at 34 weeks of gestational age can be helped in promotion of uterine contraction and improved the perineum to be an intact after vaginal delivery (15).…”