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This study evaluates the effectiveness of warm packs, perineal massage and hands off, during labour, in the perineal outcomes. The perineal outcomes are perineal tears, grade of perineal tears, need of suture, perineal edema, perineal pain, use of drugs for perineal pain, and satisfaction with the technique used.
This study is a randomised controled trial.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Warm packs | Experimental | The warm packs are held in the mother's perineum during birth. The warm packs are changed as needed to maintain warmth. |
|
| Perineal massage | Experimental | The perineal massage will be gently held in the longitudinal direction of the muscle fibers, with movements of the thumb and forefinger, like "count coins". |
|
| Hands off | No Intervention | Hands off group does not receive any perineal manipulation and they are only observed. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Warm packs | Procedure | : The warm packs are held in the mother's perineum during birth. The warm packs are changed as needed to maintain warmth. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Need of suture | Number of participants with perineal tear after vaginal delivery requiring suture (evaluated as yes or no). | 30 minutes |
| Measure | Description | Time Frame |
|---|---|---|
| Grade of perineal tear | Perineal tear ranked 1st, 2nd, 3rd and 4th degree | 30 minutes |
| perineal edema | Perineal edema is scored 0-4 (0 = no edema; 4 = edema invades the perineal body) . |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Jânio N Alves, Graduate | Contact | +55 83 999812006 | janiourofisio@gmail.com | |
| Melania MR Amorim, PHD | Contact | +5583988221514 | melamorim@uol.com.br |
| Name | Affiliation | Role |
|---|---|---|
| Caroline WS Ferreira, PHD | Universidade Federal de Pernambuco | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| UFPernambuco | Recruiting | Recife | Pernambuco | Brazil |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 22161407 | Background | Aasheim V, Nilsen AB, Lukasse M, Reinar LM. Perineal techniques during the second stage of labour for reducing perineal trauma. Cochrane Database Syst Rev. 2011 Dec 7;(12):CD006672. doi: 10.1002/14651858.CD006672.pub2. | |
| 16154062 | Background | Albers LL, Sedler KD, Bedrick EJ, Teaf D, Peralta P. Midwifery care measures in the second stage of labor and reduction of genital tract trauma at birth: a randomized trial. J Midwifery Womens Health. 2005 Sep-Oct;50(5):365-72. doi: 10.1016/j.jmwh.2005.05.012. |
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| ID | Term |
|---|---|
| D010146 | Pain |
| ID | Term |
|---|---|
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
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| Perineal massage | Procedure | The perineal massage will be gently held in the longitudinal direction of the muscle fibers, with movements of the thumb and forefinger, like "count coins". |
|
| 1 hour |
| Perineal pain | self reported ´perineal pain intensity. Perineal pain is scored 0-10 (0 = no pain; 10 = pain as bad as can be). | 24 hours |
| Use of drugs for perineal pain | Number of participants using drugs for perineal pain at the time of 24 hours after vaginal delivery (evaluated as yes or no). | 24 hours |
| Satisfaction with the technique used | Satisfaction of the woman with the technique used for perineal care. Satisfaction is scored 0-4 (0 = very satisfied; 4 = very dissatisfied) | 24 hours |
| Perineal tear | Number of participants with perineal tear after vaginal delivery (evaluated as yes or no). | 30 minutes |
| 16732773 | Background | Albers LL, Sedler KD, Bedrick EJ, Teaf D, Peralta P. Factors related to genital tract trauma in normal spontaneous vaginal births. Birth. 2006 Jun;33(2):94-100. doi: 10.1111/j.0730-7659.2006.00085.x. |
| 17467591 | Background | Albers LL, Borders N. Minimizing genital tract trauma and related pain following spontaneous vaginal birth. J Midwifery Womens Health. 2007 May-Jun;52(3):246-53. doi: 10.1016/j.jmwh.2006.12.008. |
| 11964339 | Background | Althabe F, Belizan JM, Bergel E. Episiotomy rates in primiparous women in Latin America: hospital based descriptive study. BMJ. 2002 Apr 20;324(7343):945-6. doi: 10.1136/bmj.324.7343.945. No abstract available. |
| Background | AMORIM, M. M. R. DE et al. Assistência humanizada ao parto no Instituto de Saúde Elpídio de Almeida (ISEA): resultados maternos. Revista Saúde & Ciência, v. v. I, n. n. 1, p. 80 - 7, 2010. |
| Background | AMORIM, M. M. R. DE; PORTO, A. M. F.; SOUZA, A. S. R. Assistência ao segundo e terceiro períodos do trabalho de parto baseada em evidências. Femina, v. 38, n. 11, p. 583-91, 2010. |
| 16437520 | Background | Beckmann MM, Garrett AJ. Antenatal perineal massage for reducing perineal trauma. Cochrane Database Syst Rev. 2006 Jan 25;(1):CD005123. doi: 10.1002/14651858.CD005123.pub2. |
| 10796120 | Background | Carroli G, Belizan J. Episiotomy for vaginal birth. Cochrane Database Syst Rev. 2000;(2):CD000081. doi: 10.1002/14651858.CD000081. |
| Background | COELHO, L. F. S. O treino de flexibilidade muscular e o aumento da amplitude de movimento: uma revisão crítica da literatura. Revista de Desporto e Saúde, v. 4, n. 3, p. 61-72, 2007. |
| 16504907 | Background | de Souza Caroci da Costa A, Gonzalez Riesco ML. A comparison of "hands off" versus "hands on" techniques for decreasing perineal lacerations during birth. J Midwifery Womens Health. 2006 Mar-Apr;51(2):106-11. doi: 10.1016/j.jmwh.2005.10.017. |
| 18021143 | Background | Dahlen HG, Homer CS, Cooke M, Upton AM, Nunn R, Brodrick B. Perineal outcomes and maternal comfort related to the application of perineal warm packs in the second stage of labor: a randomized controlled trial. Birth. 2007 Dec;34(4):282-90. doi: 10.1111/j.1523-536X.2007.00186.x. |
| 18031878 | Background | Dahlen HG, Homer CS, Cooke M, Upton AM, Nunn RA, Brodrick BS. 'Soothing the ring of fire': Australian women's and midwives' experiences of using perineal warm packs in the second stage of labour. Midwifery. 2009 Apr;25(2):e39-48. doi: 10.1016/j.midw.2007.08.002. Epub 2007 Nov 26. |
| 21833968 | Background | Elharmeel SM, Chaudhary Y, Tan S, Scheermeyer E, Hanafy A, van Driel ML. Surgical repair of spontaneous perineal tears that occur during childbirth versus no intervention. Cochrane Database Syst Rev. 2011 Aug 10;2011(8):CD008534. doi: 10.1002/14651858.CD008534.pub2. |
| 22691406 | Background | Dahlen HG. Perineal warm compress reduces risk of third- and fourth- degree tears and should be part of second stage care. Evid Based Nurs. 2012 Oct;15(4):103-4. doi: 10.1136/ebnurs-2012-100685. Epub 2012 Jun 12. No abstract available. |
| Background | FELICE, T.; SANTANA, L. Recursos fisioterapêuticos (crioterapia e termoterapia) na espasticidade: revisão de literatura. Rev Neurocienc, v. 17, n. 1, p. 57-62, 2009. |
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| Background | OMS. Integrated management of pregnancy and childbirth. Manejo de las complicaciones del embarazo e el parto: Guía para obstetrices y médicos. OMS ed. Ginebra: [s.n.]. p. 438 |
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| Background | TORRES, I. M. Efetividade da crioterapia para o controle da dor perineal no pós-parto vaginal imediato: ensaio clínico randomizado. 2013. Dissertação (Mestrado em Saúde Materno-Infantil). Instituto de Medicina Integral Professor Fernando Figueira, Recife, 2013. |
| Background | ZANETTI, M. R. D. et al. Episiotomia : revendo conceitos. Femina, v. 37, n. 7, p. 5-9, 2009. |