Gondim Edna Jéssica Lima, Nascimento Simony Lira, Gaitero Maria Victória Candida, Mira Ticiana Aparecida Alves, Surita Fernanda Garanhani
Obstetric and Gynecology Department, Universidade Estadual de Campinas, Tessália Vieira de Camargo Street, 126 - Cidade Universitária Zeferino Vaz - Barão Geraldo, Campinas, SP, 13083-970, Brazil.
Physiotherapy department, Federal University of Ceara, Major Weyne street 1440 - Rodolfo Teófilo, Fortaleza, CE, 60430-450, Brazil.
Midwifery. 2025 May;144:104341. doi: 10.1016/j.midw.2025.104341. Epub 2025 Feb 17.
Non-pharmacological interventions for perineal trauma are crucial for postpartum women's care, providing an alternative to excessive medication use and the associated potential adverse effects for both the woman and her newborn.
To map the non-pharmacological interventions studied in the context of childbirth-related perineal trauma over the years.
A systematic search was conducted on PubMed, BVS/Bireme, CINAHL, Embase, Scielo, ProQuest, ProQuest theses, Medline, Web of Science, and Scopus electronic databases. Studies were included if their population consisted of puerperal women with perineal trauma, the concept being non-pharmacological interventions, and the context being the immediate postpartum period. A descriptive summary presents the most studied non-pharmacological interventions for perineal trauma, the main outcomes investigated, the types of perineal trauma of greatest interest, and publications about the topic over the years.
This review encompassed 41 studies. Cryotherapy emerged as the most extensively studied non-pharmacological intervention, with 22 studies (53.65%). Other interventions were heat therapy, low-level light and electromagnetic therapy, therapeutic ultrasound, transcutaneous electrical nerve stimulation, pelvic floor muscle exercise, and complementary and alternative medicine. Perineal pain was the most investigated outcome (32 studies, 78.04%). Episiotomy was frequently the subject of research (20 studies, 48.78%). Interest in this topic has notably surged over the past 15 years.
A range of non-pharmacological interventions have been investigated for managing perineal trauma related to childbirth. Future studies could explore the efficacy and cost-effectiveness of these interventions to identify the most suitable options for postpartum women and facilitate their integration into clinical practice.
会阴创伤的非药物干预对产后女性护理至关重要，为过度用药及其给女性及其新生儿带来的潜在不良影响提供了一种替代方法。
梳理多年来在分娩相关会阴创伤背景下研究的非药物干预措施。
在PubMed、BVS/Bireme、CINAHL、Embase、Scielo、ProQuest、ProQuest论文数据库、Medline、科学引文索引和Scopus电子数据库中进行系统检索。纳入的研究需满足研究对象为有会阴创伤的产妇，研究概念为非药物干预，研究背景为产后即刻。描述性综述呈现了针对会阴创伤研究最多的非药物干预措施、主要研究结局、最受关注的会阴创伤类型以及多年来关于该主题的出版物。
本综述纳入了41项研究。冷冻疗法是研究最广泛的非药物干预措施，有22项研究（53.65%）。其他干预措施包括热疗法、低强度光和电磁疗法、治疗性超声、经皮电刺激神经疗法、盆底肌肉锻炼以及补充和替代医学。会阴疼痛是研究最多的结局（32项研究，78.04%）。会阴切开术经常是研究主题（20项研究，48.78%）。在过去15年中，对该主题的关注度显著上升。
已对一系列用于处理分娩相关会阴创伤的非药物干预措施进行了研究。未来的研究可以探索这些干预措施的疗效和成本效益，以确定对产后女性最合适的选择，并促进其纳入临床实践。
