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产前会阴训练预防损伤:产褥期随访。

Antenatal Perineal Training for Injuries Prevention: Follow Up after Puerperium.

机构信息

Multidisciplinary Doctoral School, "Vasile Goldis" Western University of Arad, 310414 Arad, Romania.

Department of Pathophysiology, Faculty of Medicine, "Vasile Goldis" Western University of Arad, 310414 Arad, Romania.

出版信息

Medicina (Kaunas). 2024 Aug 5;60(8):1264. doi: 10.3390/medicina60081264.

Abstract

This retrospective analysis investigated the impact of preparation of the pelvic floor for childbirth with stretching balloons and perineal massage on the risk of pelvic floor injuries. : We analyzed 150 primiparous women who accessed private clinics in Padua (Italy) in the period 2019-2023 regarding the rate of perineal trauma and postpartum dysfunction across three groups: the balloon stretching group (BSG, N = 50, 33.3%), the perineal massage group (PMG, N = 39, 26.0%), and the control group (CG, 61, 40.7%). Prenatal perineal training had a significant impact on reducing the rate of perineal injury and episiotomy (27.5% in BSG vs. 48.7% in PMG and 68.3% in CG, = 0.008, respectively, 9.8% vs. 26% and 40%, = 0.046) and the duration of the second stage of labor (BSG and PMG had a shorter duration compared to CG with a mean difference of -0.97892 h, < 0.001, respectively, -0.63372 h, = 0.002). Patients who carry out the preparation with the stretching balloon are less likely to develop urinary and anal incontinence and pain during intercourse. Specifically, the rate of urinary incontinence in BSG stands at around 23.5% compared to 43.6% in PMG ( = 0.345) and 55% in CG ( = 0.034). Dyspareunia in BSG was detected in 11.8% of cases compared to 35.5% in PMG ( = 0.035) and 61.7% in CG ( < 0.01). Symptomatology inherent to the posterior compartment was reported in 9.8% of cases in BSG vs. 23.11% in PMG ( = 0.085) and 33.3% in CG ( = 0.03%). : Stretching balloons and perineal massage can be chosen as tools to prevent and reduce the rates of obstetric trauma during childbirth and to reduce the use of episiotomies as well as protect against the development of dysfunctions of the pelvic floor.

摘要

本回顾性分析研究了分娩前使用拉伸气球和会阴按摩来准备盆底对盆底损伤风险的影响。我们分析了 2019 年至 2023 年间在意大利帕多瓦的私人诊所就诊的 150 名初产妇,比较了三组的会阴损伤和产后功能障碍发生率:气球拉伸组(BSG,N=50,33.3%)、会阴按摩组(PMG,N=39,26.0%)和对照组(CG,61,40.7%)。产前会阴训练对降低会阴损伤和会阴切开率(BSG 为 27.5%,PMG 为 48.7%,CG 为 68.3%, = 0.008,9.8%比 26%和 40%, = 0.046)和第二产程时间(BSG 和 PMG 比 CG 短,平均差为-0.97892 小时, < 0.001,-0.63372 小时, = 0.002)有显著影响。进行拉伸气球准备的患者发生尿失禁和性交疼痛的可能性较低。具体来说,BSG 的尿失禁发生率约为 23.5%,而 PMG 为 43.6%( = 0.345),CG 为 55%( = 0.034)。BSG 的性交困难发生率为 11.8%,而 PMG 为 35.5%( = 0.035),CG 为 61.7%( < 0.01)。BSG 后盆腔综合征的发生率为 9.8%,而 PMG 为 23.11%( = 0.085),CG 为 33.3%( = 0.03)。因此,拉伸气球和会阴按摩可作为预防和降低分娩时产科创伤发生率以及减少会阴切开术和保护盆底功能障碍发生的工具。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4805/11356163/1ca9068c307a/medicina-60-01264-g001.jpg

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