Universidade Federal de Jataí, UFJ - Campus Riachuelo, Rua Riachuelo n° 1530 - Setor - Samuel Grahan, Jataí - GO, 75804-020, Jataí, Goiás, Brazil.
Universidade do Estado do Pará, Avenida Hiléia, s/n° - Agrópolis do Incra - Bairro Amapá CEP: 68502-100, Marabá, Pará, Brazil.
Eur J Obstet Gynecol Reprod Biol. 2023 Apr;283:100-111. doi: 10.1016/j.ejogrb.2023.02.008. Epub 2023 Feb 17.
To investigate the effectiveness of interventions to prevent the occurrence of perineal trauma in parturients.
A bibliographic search was carried out in Cochrane Library, MEDLINE via PUBMED, LILACS via Virtual Health Library (VHL), Embase, Scopus, CINAHL, Scielo, Web of Science, and PEDro databases. Randomized clinical trials evaluating the effects of any intervention to prevent perineal trauma during pregnancy and/or childbirth were included. There were no temporal or language restrictions. The risk of bias assessment was performed using the Revised Cochrane Risk-of-bias Tool for Randomized Trials.
Fifty studies, with a total of 17,221 participants, were included in this meta-analysis. No intervention during childbirth was effective for the prevention of perineal trauma (RR = 1.07, 95% CI [0.98.1.18], p < 0.01, I = 83%) when compared to no intervention. However, a lower risk of perineal laceration was verified with techniques performed during pregnancy, when compared to no intervention (RR = 0.81, 95% CI [0.71, 0.93], p = 0.05, I = 47%). Among them, highlight the effects of perineal massage in preventing lacerations (RR = 0.69, 95% CI [0.54, 0.87], p < 0.01) when compared to no intervention.
The techniques performed during pregnancy, especially perineal massage, are associated with a lower risk of perineal laceration.
调查干预措施预防产妇会阴创伤发生的效果。
在 Cochrane 图书馆、PUBMED 中的 MEDLINE、Virtual Health Library（VHL）中的 LILACS、Embase、Scopus、CINAHL、Scielo、Web of Science 和 PEDro 数据库中进行文献检索。纳入评估任何干预措施预防妊娠和/或分娩期间会阴创伤的效果的随机临床试验。没有时间或语言限制。使用修订后的 Cochrane 随机试验偏倚风险工具进行偏倚风险评估。
共有 50 项研究，总计 17221 名参与者，纳入本 meta 分析。与不干预相比，分娩期间没有干预措施对预防会阴创伤有效（RR=1.07，95%CI[0.98.1.18]，p<0.01，I=83%）。然而，与不干预相比，在妊娠期间进行的技术可降低会阴裂伤的风险（RR=0.81，95%CI[0.71,0.93]，p=0.05，I=47%）。其中，强调会阴按摩在预防裂伤方面的效果（RR=0.69，95%CI[0.54,0.87]，p<0.01）。
妊娠期间进行的技术，特别是会阴按摩，与降低会阴裂伤的风险相关。
