The role of prelabor pelvic floor muscle training in reducing perineal tear incidence during vaginal delivery: A systematic review and meta-analysis.

Abstract

Objectives: Pelvic floor muscle training (PFMT) is a group of exercises that can improve muscle strength and elasticity and may potentially decrease the incidence of perineal tears. However, the effectiveness of PFMT needs further investigation.

Materials and methods: A literature search was conducted to identify studies published between 2014 and 2024 across several electronic databases, including MEDLINE, ProQuest, SpringerLink, Google Scholar, and the Cochrane Library. This systematic review included articles designed as randomized controlled trials (RCTs) and quasi-experimental studies that examined the effect of prelabor PFMT in preventing perineal tears during vaginal delivery. Review Manager version 5.4 was used to extract and pool data for quantitative synthesis. Participants were divided into two groups to allow for comparison between the intervention group (PFMT exercises) and the control group (standard treatment).

Results: Six studies were included in the systematic review and meta-analysis. In most studies, the subjects performed PFMT daily during their third trimester of pregnancy. Meta-analysis showed that PFMT can effectively reduce the incidence of perineal tears, with significant results for grade 3 and 4 tears. Our findings also indicate that PFMT effectively shortens the postpartum length of stay (LoS), improves Redness, Edema, Ecchymosis, Discharge, Approximation scale scores, enhances 5-min APGAR scores, and decreases the need for epidural anesthesia.

Conclusion: PFMT effectively reduces the incidence of perineal trauma, though statistical significance varies by tear grade. PFMT may be considered for routine inclusion in antenatal care for its broad maternal and neonatal benefits.