Abstract
Background
In the last years, there has been a growing interest in non-invasive biophysical treatments to support surgical healing techniques beyond pharmacological therapies. Among these, the Pulsating Electromagnetic Fields (PEMFs), and in particular the Therapeutic Magnetic Resonance (TMR), had been studied in orthopedics with promising results. The aim of our study was to assess the possible benefits of this technology in the treatment of spontaneous perineal lacerations and episiotomies in the postpartum.
Methods
We performed a prospective, non-pharmacologic, non-profit, monocentric interventional study on women who delivered and were admitted to our postpartum ward with a spontaneous laceration and/or an episiotomy at delivery. 172 women were eligible for this study. 52 women accepted to undergo treatment with TMR device, while 120 women underwent standard care and were followed-up according to the same protocol. Patients were visited one day post-partum, before starting the treatment; then a follow-up visit was performed at three weeks (time 1), five weeks (time 2), and three months (time 3) after delivery. The main endpoint was the time required for complete healing of the laceration and/or the episiotomy. Secondary endpoints were the prevalence of dehiscence, infections, urinary discomfort, urinary leakage, and the quality of restoration of sexual function.
Results
The REEDA score, used to assess the progression of wound healing, was significantly better both at three- and five-weeks postpartum follow-up. At three weeks and five weeks postpartum, we observed a significantly better outcome in the treatment group for all subjective complaints and perineal complications associated with lacerations and episiotomies. The percentage of patients who scored above the cutoff for sexual dysfunction (26, 5) was significantly better in the treatment group (83%) than in the control group (29%) (p < 0,001).
Conclusions
With this pilot study, we introduced low dose Pulsating Electromagnetic Fields (PEMFs) as a novel conservative and not pharmacological approach to reduce complications of perineal lesions. This technology is compatible with breastfeeding, easy to use and therefore well accepted by women. Our results demonstrated to significantly improve perineal wound healing and to ameliorate the sexual function in the post-partum.