Taylor Kathryn E, Stulz Virginia
Nepean Hospital, Kingswood, Australia.
Faculty of Health, University of Canberra, Bruce, Australia.
Eur J Midwifery. 2024 Sep 5;8. doi: 10.18332/ejm/191749. eCollection 2024.
Women experience medical interventions, episiotomy, and perineal lacerations during childbirth, impacting their physical, psychological, and sexual well-being. This study compares the perineal status of prospective women who had the midwifery intervention of perineal myofascial release during childbirth, to a matched retrospective control sample of women who received standard care during childbirth.
A non-randomized pilot study with prospective data collected for 50 women after informed verbal consent was obtained to having the midwifery intervention of perineal myofascial release during childbirth, and the matched retrospective data for the control group of 49 women were collected from a random sample generated from the medical records. Quantitative analyses included descriptive statistics, independent t-tests, regression, and chi-squared analyses. Retrospective trial registration was granted with The Australian New Zealand Clinical Trials Registry ANZTR.
Women were six times (OR=0.15; 95% CI: 0.0-0.37) less likely to have a non-intact perineum and twice (OR=0.44; 95% CI: 0.35-0.56) less likely to have an episiotomy if they were in the intervention group. Chi-squared analysis found no statistically significant differences between groups for normal vaginal birth and instrumental births, excluding cesareans and waterbirth [χ(1)= -0.37, p=0.542].
This study found perineal myofascial release benefits women by reducing perineal trauma and episiotomy. However, there were no significant differences in the duration of the active pushing stage of labor or mode of birth. This study has shown some promise in obtaining data for a larger, definitive, randomized controlled trial.
The study was registered on the Australian New Zealand Clinical Trials Registry ANZTR.
ID ACTRN12623000807651.
女性在分娩过程中会经历医疗干预、会阴切开术和会阴撕裂，这会影响她们的身体、心理和性健康。本研究将分娩时接受会阴肌筋膜松解助产干预的前瞻性女性的会阴状况，与分娩时接受标准护理的匹配回顾性对照样本进行比较。
一项非随机试点研究，在获得50名女性的知情口头同意后收集前瞻性数据，她们将在分娩时接受会阴肌筋膜松解助产干预，对照组49名女性的匹配回顾性数据则从病历中随机抽取的样本中收集。定量分析包括描述性统计、独立t检验、回归分析和卡方分析。该研究已在澳大利亚新西兰临床试验注册中心ANZTR进行回顾性试验注册。
如果女性属于干预组，她们会阴不完整的可能性降低了六倍（OR=0.15；95%CI：0.0-0.37），会阴切开术的可能性降低了两倍（OR=0.44；95%CI：0.35-0.56）。卡方分析发现，除剖宫产和水中分娩外，正常阴道分娩和器械助产分娩的组间差异无统计学意义[χ(1)= -0.37，p=0.542]。
本研究发现会阴肌筋膜松解术可减少会阴创伤和会阴切开术，对女性有益。然而，活跃产程阶段的持续时间或分娩方式并无显著差异。本研究在为更大规模、确定性的随机对照试验获取数据方面显示出了一定前景。
该研究已在澳大利亚新西兰临床试验注册中心ANZTR注册。
ID ACTRN12623000807651。
