Department Obstetrics, Hainan Women and Children's Medical Center, Haikou, 570216 Hainan, China.
Department of Medical Genetics, Haikou Maternal and Child Health Hospital, Haikou, 570203 Hainan, China.
Comput Math Methods Med. 2022 Jul 14;2022:3315638. doi: 10.1155/2022/3315638. eCollection 2022.
The efficacy of perineal massage is controversial. The study was aimed at comparing the effects of perineal massage on perineal injury and complications.
PubMed, Embase, the Cochrane Library, and ISI Web of Science were searched for literature on the relationship between prenatal perineal massage and postpartum perineal injury and complications until April 2022. Indicators included postpartum perineal tears, perineotomy, postpartum perineal pain, natural labour, and postpartum incontinence. Finally, RevMan5.4 software was used to analyze the extracted data.
A total of 6487 subjects in 16 studies were included, with 3211 who received perineal massage and 3276 did not. There was no significant difference in 1-2 degree perineal tearing between the intervention group and the control group (RR = 0.96, 95% CI [0.90, 1.03], = 0.30), and there was no heterogeneity between studies ( = 0.62, = 0%), indicating publication bias. Compared with the control group, prenatal perineal massage significantly reduced the incidence of 3-4 degree perineal tears (RR = 0.56, 95% CI [0.47, 0.67], < 0.00001), and there was no heterogeneity between studies ( = 0.16, = 30%), indicating publication bias. Compared with the control group, prenatal perineal massage reduced the risk of lateral perineal resection (RR = 0.87, 95% CI [0.80, 0.95], = 0.001), and there was no heterogeneity between studies ( = 0.14, = 31%), and there was no publication bias. Compared with the control group, prenatal perineal massage reduced the risk of postpartum pain at 3 months (RR = 0.64, 95% CI [0.51, 0.81], = 0.0002). There was no significant heterogeneity among studies ( = 0.23, = 31%).
Compared with no prenatal perineal massage, prenatal perineal massage can reduce the risk of perineal injury, the incidence of lateral perineal resection, and the incidence of long-term pain.
会阴按摩的效果存在争议。本研究旨在比较会阴按摩对会阴损伤和并发症的影响。
检索PubMed、Embase、Cochrane 图书馆和 ISI Web of Science 中关于产前会阴按摩与产后会阴损伤和并发症关系的文献，检索时间截至 2022 年 4 月。指标包括产后会阴裂伤、会阴切开术、产后会阴疼痛、自然分娩和产后尿失禁。最后，采用 RevMan5.4 软件对提取的数据进行分析。
纳入 16 项研究的 6487 名受试者，其中 3211 名接受了会阴按摩，3276 名未接受。干预组和对照组 1-2 度会阴撕裂发生率无显著差异（RR=0.96，95%CI[0.90，1.03]， =0.30），且研究间无异质性（ =0.62， =0%），提示存在发表偏倚。与对照组相比，产前会阴按摩显著降低 3-4 度会阴撕裂的发生率（RR=0.56，95%CI[0.47，0.67]， < 0.00001），且研究间无异质性（ =0.16， =30%），提示存在发表偏倚。与对照组相比，产前会阴按摩降低了会阴侧切的风险（RR=0.87，95%CI[0.80，0.95]， =0.001），且研究间无异质性（ =0.14， =31%），且不存在发表偏倚。与对照组相比，产前会阴按摩降低了产后 3 个月疼痛的风险（RR=0.64，95%CI[0.51，0.81]， =0.0002）。研究间无显著异质性（ =0.23， =31%）。
与无产前会阴按摩相比，产前会阴按摩可降低会阴损伤、会阴侧切发生率和长期疼痛的风险。
