Combined massage and warm compress to the perineum during active second stage of labor in nulliparas: A randomized trial

Goh, Yi Pei and Tan, Peng Chiong and Hong, Jesrine Gek Shan and Sulaiman, Sofiah and Omar, Siti Zawiah (2021) Combined massage and warm compress to the perineum during active second stage of labor in nulliparas: A randomized trial. International Journal of Gynecology & Obstetrics, 155 (3). pp. 532-538. ISSN 0020-7292, DOI

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Objective To evaluate the combined effect of massage and warm compress to the perineum (MassComp) compared with standard ``hands-off'' in the second stage of labor. Methods A randomized trial was conducted in a University hospital in Malaysia. Nulliparous women at term who were about to start pushing were randomized to massage during pushing and warm compress to the perineum in between pushes or to standard ``hands-off'' care. Primary outcome was suturing for perineal injury (episiotomy or tear). Results A total of 156 participants were analyzed based on intention to treat. Perineal repair rates were 53/79 (67%) for MassComp versus 70/77 (91%) for control (relative risk RR] 0.72, 95% confidence interval CI] 0.61-0.98, number needed to treat for an additional beneficial outcome NNTb] 5, 95% CI 2.83-8.62, P < 0.001). Of the secondary outcomes, participants' satisfaction with care (visual numerical rating scale 0-10; 8.3 +/- 1.2 vs 7.8 +/- 1.2, P = 0.014), major perineal injury (second degree or higher) rates 34/79 (43%) versus 51/77 (66%) (RR 0.72, 95% CI 0.58-0.97, NNTb 5, 95% CI 2.61-12.56, P = 0.004), episiotomy rates 28/79 (37%) versus 40/77 (53%) (RR 0.72, 95% CI 0.52-0.98, NNTb 8, 95% CI 3.63-36.46, P = 0.043), intervention to delivery intervals 29.5 +/- 13.6 versus 27.9 +/- 13.8 minutes (P = 0.472) and spontaneous vaginal delivery rates 63/79 (79.7%) versus 56/77 (72.7%) (RR 1.11, 95% CI 0.92-1.34, P = 0.306) for MassComp versus control, respectively. Conclusion Massage and warm compress during pushing decreased the perineal suturing, major perineal injury, and episiotomy rates and improved maternal satisfaction.

Item Type: Article
Funders: Department of Obstetrics and Gynecology, Universiti Malaya
Uncontrolled Keywords: Perineal massage; Warm compress; Nulliparous women; Perineal injury (episiotomy or tear)
Subjects: R Medicine > RG Gynecology and obstetrics
Divisions: Faculty of Medicine
Depositing User: Ms Zaharah Ramly
Date Deposited: 01 Apr 2022 02:42
Last Modified: 01 Apr 2022 02:42

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