Pelvic floor dysfunction at 3 and 6 months postpartum. A sub-analysis of the Perineal Massage and Warm Compresses technique during second stage of labor randomized controlled trial (PeMWaC)

Abstract

Abstract Purpose: The influence of perineal trauma in pelvic floor dysfunction (PFD) has been described. Although the perineal massage and warm compresses techniques during the second stage of labor reduce perineal trauma, but the impact of combined perineal massage and warm compresses technique in PFD has never been investigated. To evaluate the effects of combined perineal massage and warm compresses or hands-on technique on PFD symptoms at 3 and 6 months. Methods: Randomised controlled trial (PeMWaC - Perineal Massage and Warm Compresses) was carried out at Hospital of Braga from March 1st, 2019 to December 31st, 2020. The sample included 496 women (242 perineal massage and warm compresses and 254 hands-on) who had a singleton term spontaneous vaginal delivery. A sub-analysis of primary data was performed to assess postpartum PFD symptoms, Pelvic Floor Distress Inventory-20 (PFDI-20) survey was applied at 3 and 6 months postpartum. Results: Of the 800 women recruited, 496 were included, 48.8% with combined perineal massage and warm compresses and 51.2% with standard-care. Frequency of intact perineum (p<0.001) and vaginal tears (p<0.001) were significantly higher in combined perineal massage and warm compresses. At 3 months postpartum, women undergoing standard care during the second stage of labor had higher Urinary Distress Inventory (UDI) score and global score with no differences at 6 months. After controlling for confounding variables, combined perineal massage and warm compresses technique were associated with lower UDI scores at 3 months postpartum. Conclusion: Combined perineal massage and warm compresses technique, seems to be associated with a lower prevalence of early PFD symptoms, mainly regarding urinary distress.