Repercusión del embarazo y parto sobre el suelo pélvico. ¿Se pueden prevenir las lesiones de origen obstétrico?.

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Abstract

Introduction: Pelvic floor antenatal physiotherapy is a technique to prevent perineal trauma during childbirth. Objective: To study the efficacy of the perineal massage and Epi-no® device to prevent perineal trauma. Methods: We performed a comparative single-center, national, prospective, observational study of 332 patients: Group A (129): Control group; Group B (103): Perineal massage group; Grupo C (100): Epi-no® device group. Results: The study showed a significant reduction in the rate of episiotomies in the Epino ® group (37%) compared to massage group (55.3%) and control group (69%). Higher rate of intact perineum was also shown in the Epi-no® group (32%), compared to massage group (8.7%) and control group (2.3%), p <0.001. Patients from Epi-no® group had a significant reduction in the duration of the second stage of labour than patients from perineal massage group and control group. We also found that Epi-no® group had lower rates of instrumental deliveries (28%), compared to massage group (35.9%) and control group (50.4%) (p=0.002). No statistically significant differences in fetal outcomes as fetal APGAR scores and fetal pH, between groups were demonstrated. Discussion: The Epi-no® device device is beneficial in decreasing perineal damage during vaginal delivery. Conclusion: Training with Epi-no® device decreases episiotomy rates and increases intact perineum outcomes.