Dataset Information

Influence of a Virtual Exercise Program throughout Pregnancy during the COVID-19 Pandemic on Perineal Tears and Episiotomy Rates: A Randomized Clinical Trial.

ABSTRACT: The complications associated with COVID-19 confinement (impossibility of grouping, reduced mobility, distance between people, etc.) influence the lifestyle of pregnant women with important associated complications regarding pregnancy outcomes. Therefore, perineal traumas are the most common obstetric complications during childbirth. The aim of the present study was to examine the influence of a supervised virtual exercise program throughout pregnancy on perineal injury and episiotomy rates during childbirth. A randomized clinical trial design (NCT04563065) was used. Data were collected from 98 pregnant women without obstetric contraindications who attended their prenatal medical consultations. Women were randomly assigned to the intervention (IG, N = 48) or the control group (CG, N = 50). A virtual and supervised exercise program was conducted from 8-10 to 38-39 weeks of pregnancy. Significant differences were found between the study groups in the percentage of episiotomies, showing a lower episiotomy rate in the IG (N = 9/12%) compared to the CG (N = 18/38%) (χ2 (3) = 4.665; p = 0.031) and tears (IG, N = 25/52% vs. CG, N = 36/73%) (χ2 (3) = 4.559; p = 0.033). A virtual program of supervised exercise throughout pregnancy during the current COVID-19 pandemic may help reduce rates of episiotomy and perineal tears during delivery in healthy pregnant women.

SUBMITTER: Silva-Jose C

PROVIDER: S-EPMC8621123 | biostudies-literature | 2021 Nov

REPOSITORIES: biostudies-literature

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Influence of a Virtual Exercise Program throughout Pregnancy during the COVID-19 Pandemic on Perineal Tears and Episiotomy Rates: A Randomized Clinical Trial.

Silva-Jose Cristina C Sánchez-Polán Miguel M Díaz-Blanco Ángeles Á Pérez-Medina Tirso T Pérez-Medina Tirso T Carrero Martínez Vanessa V Alzola Irune I Barakat Rubén R Refoyo Ignacio I Mottola Michelle F MF

Journal of clinical medicine 20211111 22

The complications associated with COVID-19 confinement (impossibility of grouping, reduced mobility, distance between people, etc.) influence the lifestyle of pregnant women with important associated complications regarding pregnancy outcomes. Therefore, perineal traumas are the most common obstetric complications during childbirth. The aim of the present study was to examine the influence of a supervised virtual exercise program throughout pregnancy on perineal injury and episiotomy rates durin ...[more]

PMID: 34830530

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Project description:BackgroundWomen who undergo perineal episiotomy can be affected by several complications such as bleeding, infection, perineal pain, dyspareunia, reduction of sexual desire, as well as urinary and anal incontinence. Perineal pain related to episiotomy has been reported to interfere with women's daily activities postpartum and can prevent proper breastfeeding, proper rooming-in, and maternal-infant bonding. The purpose of this study was to determine the effect of dry heat application on perineal pain and episiotomy wound Healing among primipara women.MethodA quasi-experimental, two-group, pre-post-test research study was conducted at the postnatal inpatient ward and the outpatient clinic of the El-Shatby Maternity University Hospital in Alexandria. A sample of 100 parturient women was divided into the following two groups at random: dry heat and moist (control) heat. Women in the moist heat group were advised to sit in a basin (tub) of warm water for 10 minutes, while those in the dry heat group were instructed to set an infrared light (230 volts) at a distance of 45 cm from the perineum after 12 hours post episiotomy. Both interventions were applied twice a day for ten consecutive days. They evaluated the severity of their perineal pain at baseline and repeated it on the 5th and 10th days after obtaining the interventions while the episiotomy wound healing was assessed on the 5th and 10th days.ResultsIt was discovered that the dry heat group had a significantly improved episiotomy wound healing as regards perineal redness, edema of the perineal area, ecchymosis, wound discharge, and approximation of wound edges on the 5th (P < 0.001, P < 0.001, P < 0.007, P < 0.003, and P < 0.001, respectively) and 10th day after intervention (P < 0.001, P < 0.001, P < 0.001, P < 0.005, and P < 0.001, respectively) than the moist heat group. The primipara women had significantly lower perineal pain intensity in the dry heat group on the 5th and 10th days after intervention than in the moist heat group (MH P < 0.001 for the dry heat group and MH P = 0.004 for the moist heat group).ConclusionThe application of dry heat promoted episiotomy wound healing among primipara women and reduced their perineal pain during early postpartum days than moist heat.

Project description:BackgroundAsian American, Native Hawaiian, and Pacific Islander individuals have increased risks for episiotomy and severe perineal laceration during vaginal delivery. The Asian American, Native Hawaiian, and Pacific Islander population in the US is diverse yet few studies disaggregate results within specific ethnicity populations.ObjectiveThis study investigated the variability in risks for episiotomy and severe perineal laceration among 16 disaggregated Asian American, Native Hawaiian, and Pacific Islander groups, compared to Non-Hispanic White nulliparous individuals, and assessed what factors may explain the variability in risk.Study designBirth and fetal death certificate files linked to hospital discharge records were used to identify nulliparous, term, singleton, vertex vaginal deliveries among California births, 2007 to 2020. Poisson regression models were used to examine risks of episiotomy and severe perineal laceration among 16 Asian American, Native Hawaiian, and Pacific Islander ethnicity subgroups compared with Non-Hispanic White individuals. Sequential adjustment was utilized to assess if maternal social, health-related, and delivery-related factors may explain the variability in risk for episiotomy and severe perineal laceration.ResultsAmong the 224,964 Asian American, Native Hawaiian, and Pacific Islander individuals in this study cohort, the overall prevalence of episiotomy was 18.5% (N = 41,559) and prevalence of severe perineal laceration was 8.9% (N = 20,013); the prevalence of both outcomes declined during the study period. Within subgroups, prevalence of episiotomy ranged from 9.8% among Other-Pacific Islander individuals to 24.5% among Korean individuals. Prevalence of severe perineal laceration ranged from 3.4% in Guamanian individuals to 15.2% in Indian individuals. In fully adjusted models, risk ratios were greater than 1.0 (with confidence intervals excluding 1.0) for 6 subgroups for episiotomy and 9 subgroups for severe perineal laceration, compared to Non-Hispanic White individuals. After adjustment, Korean individuals were at highest risk of episiotomy (adjusted risk ratio 1.80 [95% CI 1.75, 1.85]), and Indian individuals were at highest risk of severe perineal laceration (adjusted risk ratio 2.14 [95% CI 2.07, 2.21]). Adjustment for social factors (nativity; education; payer) tended to attenuate risk ratios; subsequent adjustment for maternal health and delivery-related factors including maternal age, height, pre-pregnancy body mass index, hypertension, diabetes, gestational weight gain, fetal stress/incomplete fetal head rotation (occiput transverse or posterior), large infant size or shoulder dystocia, and forceps/vacuum did not impact risk ratios substantially.ConclusionPrevalence and risks of episiotomy and severe perineal laceration varied widely among Asian American, Native Hawaiian, and Pacific Islander births in California from 2007 to 2020. The variability in risks was more influenced by differences in social rather than maternal health and delivery-related factors. This study adds to the growing understanding of disparities in health outcomes among Asian American, Native Hawaiian, and Pacific Islander subgroups.

Project description:IntroductionPostnatal perineal pain is prevalent following childbirth and can impact women both physically and emotionally. The aim of the study was to study the effect of collegial midwifery assistance on perineal pain and pain medication 1 month after birth and to investigate the associations between the type of tear and perineal pain, satisfaction with healing, and resumption of intercourse.Material and methodsA follow-up questionnaire was sent 1 month postpartum to women with a first spontaneous vaginal birth participating in a randomized controlled trial (Oneplus trial). Data were collected from December 2019 to May 2020. Differences in perineal pain between women attended by one or two midwives were analyzed according to intention-to-treat using bivariate analyses. Associations between the type of tear and perineal pain, satisfaction with healing, and resumption of sexual intercourse were investigated using univariable and multivariable logistic regression. The category no tear/first-degree tear was compared separately to each of the other tear categories.Trial registration numberClinicalTrials.gov, NCT03770962.ResultsOut of 2233 women, 1762 responded within 30-60 days postpartum. Of women in the no tear/first-degree tear category, 27.7% reported perineal pain during the past week, in contrast to women with OASI, where 64.2% reported perineal pain. Women with OASI experienced the highest odds of perineal pain (aOR 4.51, 95% CI 2.72-7.47) compared to those with no tear/first-degree tear, followed by women with major second-degree tears (aOR 1.87, 95% CI 1.45-2.41), women with an episiotomy (aOR 1.78, 95% CI 1.11-2.87), and those with minor second-degree tears (aOR 1.43, 95% CI 1.06-1.94). Women with episiotomy reported the highest odds ratios for dissatisfaction with tear healing (aOR 3.48, 95% CI 1.92-6.31). No significant differences in perineal pain and pain medication were observed between women allocated to collegial midwifery assistance and those allocated to standard care.ConclusionsWomen with OASI reported the highest odds of perineal pain 30-60 days after birth compared to women with no tear or first-degree tear, followed by women with major second-degree tears. Women subjected to an episiotomy reported highest odds ratios of dissatisfaction with tear healing.

Dataset Information

Influence of a Virtual Exercise Program throughout Pregnancy during the COVID-19 Pandemic on Perineal Tears and Episiotomy Rates: A Randomized Clinical Trial.

Publications

Influence of a Virtual Exercise Program throughout Pregnancy during the COVID-19 Pandemic on Perineal Tears and Episiotomy Rates: A Randomized Clinical Trial.

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