摘要：Background: Perineal traumas particularly caused by following
vaginal delivery are associated with short and long term morbidity for women. Therefore,
interventions that increase the probability of intact perineum are
necessary. The aim of study was to determine the effect of perineal massage
with a sterile lubricant on the incidence of episiotomy and perinea laceration.
Materials: This clinical trial
study was performed on 145 nulliparous women who referred to Amol Emam Ali
teaching center for normal delivery. They were randomly participating in
interventional group (massage with lubricant) (45 cases) or control group (100
cases). In massage group when they progressed to full dilatation of the cervix,
the midwife inserted two fingers inside vagina and using a sweeping motion
gently stretched the perineum with lubricant 5 up to 10 minutes, in and between
mother’s pushing in the second stage of labour. In control group just Ritgen
Maneuver was applied. At last, we compared
the rate of intact perineum, episiotomy and laceration, mean duration of
the second stage of labor and Apgar score in 1 and 5 minutes between two
groups. Statistical analyses were performed using t-test, Chi Square to
determine potentially significant
associations, and a p value less than 0.05 was considered
significant. Results: The
incidences of intact perineum, episiotomy and laceration were 22.2% (10), 44.4%
(20), 33.3% (15) respectively in
interventional group. In control group, intact perineum, episiotomy and laceration
were: 20.2% (20), 49.3% (71), 28.3% (28) respectively. This difference was not
statis-
tically significant.
Rate of first-degree laceration was 33.3% (15) in massage group, while this
percent was 28.3% (28) in control group. This difference was not statistically
significant. In massage and control groups, second, third and fourth-degree lacerations did not occur. Conclusion: The results showed that
massage with a sterile lubricant provides no apparent and significant advantage
or disadvantage in reducing perineal trauma. Therefore, the use of massage as
technique for perineal control is safe based on labour criteria and woman’s
preference during delivery.
