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Methods for preventing perineal injury and dysfunction during pregnancy.

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eMediNexus    27 November 2018

A new study published in Gynecology, Obstetrics, Fertility & Senology evaluated the effectiveness of these different interventions during pregnancy which aid in preventing the risk of postnatal perineal injury or dysfunction – prenatal perineal massage, use of the Epi-No device, and pelvic floor muscle training exercises, in the post-partum period. This study entailed a literature review from PubMed, including relevant articles published before May 2018. The results revealed that perineal massage during pregnancy decreases the rate of episiotomy as well as post-partum perineal pain and flatus. Contrastingly, perineal massage neither reduces the rate of either obstetric anal sphincter injuries (OASIS) nor of post-partum urinary incontinence. On the other hand, the Epi-No device does not provide benefits for perineal protection. Meanwhile, prenatal pelvic floor muscle training exercises do not reduce the risk of perineal lacerations. Nevertheless, they can reduce the prevalence of post-partum urinary incontinence at 3-6 months, but not at 12 months post-partum. Hence, it was concluded that perineal massage during pregnancy must be encouraged among women. While the use of the Epi-No device during pregnancy should not be recommended for the prevention of OASIS. In addition, pelvic floor muscle training during pregnancy should not be recommended for the prevention of OASIS and its absence of effect in the medium term does not allow us to recommend it for urinary incontinence.

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