Could a simple manual technique performed by a midwife reduce the incidence of episiotomy and perineal lacerations? A non-randomized pilot study.

IF 1.5 Q3 NURSING

European Journal of Midwifery Pub Date : 2024-09-05 eCollection Date: 2024-01-01 DOI:10.18332/ejm/191749

Kathryn E Taylor, Virginia Stulz

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Abstract

Introduction: Women experience medical interventions, episiotomy, and perineal lacerations during childbirth, impacting their physical, psychological, and sexual well-being. This study compares the perineal status of prospective women who had the midwifery intervention of perineal myofascial release during childbirth, to a matched retrospective control sample of women who received standard care during childbirth.

Methods: A non-randomized pilot study with prospective data collected for 50 women after informed verbal consent was obtained to having the midwifery intervention of perineal myofascial release during childbirth, and the matched retrospective data for the control group of 49 women were collected from a random sample generated from the medical records. Quantitative analyses included descriptive statistics, independent t-tests, regression, and chi-squared analyses. Retrospective trial registration was granted with The Australian New Zealand Clinical Trials Registry ANZTR.

Results: Women were six times (OR=0.15; 95% CI: 0.0-0.37) less likely to have a non-intact perineum and twice (OR=0.44; 95% CI: 0.35-0.56) less likely to have an episiotomy if they were in the intervention group. Chi-squared analysis found no statistically significant differences between groups for normal vaginal birth and instrumental births, excluding cesareans and waterbirth [χ²(1)= -0.37, p=0.542].

Conclusions: This study found perineal myofascial release benefits women by reducing perineal trauma and episiotomy. However, there were no significant differences in the duration of the active pushing stage of labor or mode of birth. This study has shown some promise in obtaining data for a larger, definitive, randomized controlled trial.

Clinical trial registration: The study was registered on the Australian New Zealand Clinical Trials Registry ANZTR.

Identifier: ID ACTRN12623000807651.

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助产士采用简单的手工技术能否降低外阴切开术和会阴撕裂伤的发生率？一项非随机试验研究。

简介妇女在分娩过程中会经历医疗干预、外阴切开术和会阴撕裂伤，这些都会影响她们的生理、心理和性健康。本研究比较了在分娩过程中接受助产士会阴肌筋膜松解术干预的产妇与在分娩过程中接受标准护理的产妇的会阴状况：方法：这是一项非随机的试验性研究，收集了50名产妇的前瞻性数据，这些产妇在获得知情口头同意后，在分娩过程中接受了会阴肌筋膜松解术的助产干预，对照组49名产妇的匹配回顾性数据则是从医疗记录中随机抽样收集的。定量分析包括描述性统计、独立 t 检验、回归和卡方分析。澳大利亚-新西兰临床试验注册中心（ANZTR）对回顾性试验进行了注册：如果妇女属于干预组，其会阴不完整的可能性降低六倍（OR=0.15；95% CI：0.0-0.37），会阴切开术的可能性降低两倍（OR=0.44；95% CI：0.35-0.56）。卡方分析发现，正常阴道分娩和器械助产（不包括剖宫产和水中分娩）组间差异无统计学意义[χ2(1)=-0.37, p=0.542]：本研究发现，会阴肌筋膜松解术可减少会阴创伤和外阴切开术，从而使产妇受益。然而，在主动助产阶段的持续时间或分娩方式上没有明显差异。这项研究为更大规模的、明确的随机对照试验获取数据提供了一些希望：该研究已在澳大利亚-新西兰临床试验注册中心（ANZTR.Identifier）注册：id actrn12623000807651。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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