Antenatal Perineal Training for Injuries Prevention: Follow Up after Puerperium
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Protocol
2.2. Birth Preparation Methods
2.3. Statistical Analysis
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Parameters | Total (N = 150) | ||
---|---|---|---|
N | % | ||
Age_category | 25–29 years | 19 | 12.7 |
30–34 years | 61 | 40.7 | |
35–39 years | 50 | 33.3 | |
40–44 years | 17 | 11.3 | |
45–49 years | 3 | 2.0 | |
Environment | urban | 135 | 90.0 |
rural | 15 | 10.0 | |
Birth type | Spontaneous at term | 74 | 49.3 |
Induced at term | 34 | 22.7 | |
Ventouse delivery | 25 | 16.7 | |
Spontaneous 39 weeks | 3 | 2.0 | |
Spontaneous 38 weeks | 7 | 4.7 | |
Spontaneous 37 weeks | 5 | 3.3 | |
Spontaneous 36 weeks | 2 | 1.3 | |
Perineal tears | Laceration grade 0 | 76 | 50.7 |
Laceration grade 1 | 24 | 16.0 | |
Laceration grade 2 | 36 | 24.0 | |
Laceration grade 3 | 11 | 7.3 | |
Laceration grade 4 | 3 | 2.0 | |
Episiotomy | No | 111 | 74.0 |
Yes | 39 | 26.0 | |
Kristeller maneuver | No | 123 | 82.0 |
Yes | 27 | 18.0 | |
Maternal position at birth | Free | 35 | 23.3 |
Lithotomy | 113 | 75.3 | |
Crouched | 2 | 1.3 | |
Epidural anesthesia | No | 92 | 61.3 |
Yes | 58 | 38.7 | |
Puerperium | Regular | 130 | 86.7 |
Peri sutural hematoma | 3 | 2.0 | |
Postpartum hemorrhage | 3 | 2.0 | |
Perineal pain and tension | 10 | 6.7 | |
Congested hemorrhoid and suture pain | 2 | 1.3 | |
Suture diastasis | 2 | 1.3 | |
Urinary incontinence | No | 86 | 57.3 |
Episodic | 12 | 8,0 | |
Mixt | 6 | 4,0 | |
SUI | 46 | 30,7 | |
Anal incontinence | No | 116 | 773 |
Yes | 34 | 22.7 | |
Dyspareunia | No | 73 | 48.7 |
Unrated | 18 | 12.0 | |
Present before birth | 2 | 1.3 | |
Yes | 57 | 38.0 |
Age Category (Years) | χ2 | p 1 | |||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
25–29 (N = 19) | 30–34 (N = 61) | 35–39 (N = 50) | 40–44 (N = 17) | 45–49 (N = 3) | |||||||||
N | % | N | % | N | % | N | % | N | % | ||||
Perineal tears | 0 | 11 | 57.9 | 32 | 52.5 | 23 | 46.0 | 8 | 47.1 | 2 | 66.7 | 17.311 | 066 0.386 |
1 | 1 | 5.3 | 13 | 21.3 | 6 | 12.0 | 4 | 23.5 | 0 | 0.0 | |||
2 | 5 | 26.3 | 14 | 23.0 | 13 | 26.0 | 4 | 23.5 | 0 | 0.0 | |||
3 | 2 | 10.5 | 1 | 1.6 | 7 | 14.0 | 0 | 0.0 | 1 | 33.3 | |||
4 | 0 | 0.0 | 1 | 1.6 | 1 | 2.0 | 1 | 5.9 | 0 | 0.0 | |||
Episiotomy | No | 13 | 68.4 | 52 | 85.2 | 35 | 70.0 | 10 | 58.8 | 1 | 33.3 | 9.347 | 0.053 |
Yes | 6 | 31.6 | 9 | 14.8 | 15 | 30.0 | 7 | 41.2 | 2 | 66.7 | |||
Epidural anesthesia | No | 12 | 63.2 | 38 | 62.3 | 31 | 62.0 | 11 | 64.7 | 0 | 0.0 | 4.900 | 0.298 |
Yes | 7 | 36.8 | 23 | 37.7 | 19 | 38.0 | 6 | 35.3 | 3 | 100.0 | |||
Urinary incontinence | No | 8 | 42.1 | 40 | 65.6 | 29 | 58.0 | 7 | 41.2 | 2 | 66.7 | 12.752 | 0.387 |
Episodic | 3 | 15.8 | 5 | 8.2 | 4 | 8.0 | 0 | 0.0 | 0 | 0.0 | |||
Mixt | 1 | 5.3 | 2 | 3.3 | 3 | 6.0 | 0 | 0.0 | 0 | 0.0 | |||
SUI | 7 | 36.8 | 14 | 23.0 | 14 | 28.0 | 10 | 58.8 | 1 | 33.3 | |||
Fecal incontinence | No | 16 | 84.2 | 50 | 82.0 | 34 | 68.0 | 14 | 82.4 | 2 | 66.7 | 4.184 | 0.382 |
Yes | 3 | 15.8 | 11 | 18.0 | 16 | 32.0 | 3 | 17.6 | 1 | 33.3 | |||
Dyspareunia | No | 7 | 36.8 | 33 | 54.1 | 28 | 56.0 | 4 | 23.5 | 1 | 33.3 | 24.981 | 0.015 * |
Unrated | 1 | 5.3 | 7 | 11.5 | 10 | 20.0 | 0 | 0.0 | 0 | 0.0 | |||
BB | 1 | 5.3 | 0 | 0.0 | 1 | 2.0 | 0 | 0.0 | 0 | 0.0 | |||
Yes | 10 | 52.6 | 21 | 34.4 | 11 | 22.0 | 13 | 76.5 | 2 | 66.7 |
Parameters | Mean Age (Years) | p 1 | |
---|---|---|---|
Yes | No | ||
Epidural anesthesia | 34.7 | 33.9 | 0.429 |
Perineal tears | |||
Laceration grade 1 | 34.7 | 33.9 | 0.481 |
Laceration grade 2 | 34.1 | 33.9 | 0.731 |
Laceration grade 3 | 35.8 | 33.9 | 0.427 |
Laceration grade 4 | 36.0 | 33.9 | 0.432 |
Episiotomy | 35.3. | 33.8 | 0.089 |
Urinary incontinence | 33.6 | 34.0 | 0.261 |
Episodic | 32.4 | 34.0 | 0.219 |
Mixt | 33.3 | 34.0 | 0.981 |
SUI | 35.2 | 34.0 | 0.189 |
Fecal incontinence | 34.9 | 34.0 | 0.230 |
Dyspareunia | 33.5 | 34.1 | 0.164 |
Unrated | 34.0 | 34.1 | 0.984 |
Present before birth | 32.0 | 34.1 | 0.563 |
Yes | 34.4 | 34.1 | 0.914 |
Birth Results | BSG (N = 50) | PMG (N = 39) | CG (N = 61) | χ2 | p 1 | ||||
---|---|---|---|---|---|---|---|---|---|
N | % | N | % | N | % | ||||
Birth type | Spontaneous at term | 31 | 60.8 | 23 | 59.0 | 20 | 33.3 | 11.305 | 0.004 * |
Induced at term | 9 | 17.6 | 10 | 25.6 | 15 | 25.0 | |||
Ventouse delivery | 3 | 5.9 | 6 | 15.4 | 16 | 26.7 | |||
Spontaneous 39 weeks | 1 | 2.0 | 0 | 0.0 | 2 | 3.3 | |||
Spontaneous 38 weeks | 4 | 7.8 | 0 | 0.0 | 3 | 5.0 | |||
Spontaneous 37 weeks | 2 | 3.9 | 0 | 0.0 | 3 | 5.0 | |||
Spontaneous 36 weeks | 1 | 2.0 | 0 | 0.0 | 1 | 1.7 | |||
Maternal position | Free | 25 | 49.0 | 10 | 25.6 | 0 | 0.0 | 34.317 | <0.001 * |
Lithotomy | 25 | 49.0 | 29 | 74.4 | 59 | 98.3 | |||
Squatting position | 1 | 2.0 | 0 | 0.0 | 1 | 1.7 | |||
Kristeller maneuver | No | 45 | 88.2 | 35 | 89.7 | 43 | 71.7 | 7.220 | 0.027 * |
Yes | 6 | 11.8 | 4 | 10.3 | 17 | 28.3 | |||
Epidural anesthesia | No | 32 | 62.7 | 29 | 74.4 | 31 | 51.7 | 5.163 | 0.076 |
Yes | 19 | 37.3 | 10 | 25.6 | 29 | 48.3 | |||
Perineal tears | No | 37 | 72.5 | 20 | 51.3 | 19 | 31.7 | 23.239 | <0.001 * |
Laceration grade 1 | 9 | 17.6 | 4 | 10.3 | 11 | 18.3 | |||
Laceration grade 2 | 5 | 9.8 | 11 | 28.2 | 20 | 33.3 | |||
Laceration grade 3 | 0 | 0.0 | 4 | 10.3 | 7 | 11.7 | |||
Laceration grade 4 | 0 | 0.0 | 0 | 0.0 | 3 | 5.0 | |||
Episiotomy | No | 46 | 90.2 | 29 | 74.4 | 36 | 60.0 | 12.981 | 0.002 * |
Yes | 5 | 9.8 | 10 | 25.6 | 24 | 40.0 |
Variable | BSG vs. PMG | BSG vs. CG | PMG vs. CG | |||
---|---|---|---|---|---|---|
χ2 | p 1 | χ2 | p 1 | χ2 | p 1 | |
Birth type | 8.794 | 0.195 | 12.798 | 0.046 * | 10.786 | 0.095 |
Maternal position | 1.365 | 0.054 | 38.248 | <0.001 * | 173.563 | <0.001 * |
Kristeller maneuver | 0.051 | 0.821 | 4.607 | 0.032 * | 4.632 | 0.032 * |
Perineal tears | 111.834 | 0.008 * | 24.417 | <0.001 * | 5.517 | 0.238 |
Episiotomy | 3.991 | 0.046 * | 13.024 | <0.001 * | 2.161 | 0.142 |
Groups | N | % | Newborn Weight (g) | Second Stage of Labor (Hours) | |||||||
---|---|---|---|---|---|---|---|---|---|---|---|
Mean | SD | Statistics | p | Mean | SD | Statistics | p | ||||
EG | Yes | 39 | 26.0 | 3404.026 | 429.681 | 1863.500 1 | 0.198 1 | 1.918 | 1.147 | 1429.500 1 | <0.001 * 1 |
No | 111 | 74.0 | 3313.640 | 415.693 | 1.345 | 0.879 | |||||
PTG (Laceration grade) | 0 | 76 | 50.7 | 3291.039 | 453.294 | 4.560 2 | 0.335 2 | 1.302 | 0.989 | 15.423 2 | 0.004 * 2 |
1 | 24 | 16.0 | 3357.500 | 449.125 | 1.354 | 0.827 | |||||
2 | 36 | 24.0 | 3341.694 | 352.869 | 1.819 | 0.972 | |||||
3 | 11 | 7.3 | 3563.727 | 327.232 | 1.924 | 1.016 | |||||
4 | 3 | 2.0 | 3456.667 | 20.817 | 2.000 | 1.000 |
Puerperium | BSG (N = 50) | PMG (N = 39) | CG (N = 61) | χ2 | p 1 | |||
---|---|---|---|---|---|---|---|---|
N | % | N | % | N | % | |||
Regular | 49 | 96.1 | 34 | 87.2 | 47 | 78.3 | 12.906 | 0.229 |
Perisutural hematoma | 1 | 2.0 | 1 | 2.6 | 1 | 1.7 | ||
Postpartum hemorrhage | 1 | 2.0 | 1 | 2.6 | 1 | 1.7 | ||
Perineal pain and tension | 0 | 0.0 | 2 | 5.1 | 8 | 13.3 | ||
Congested hemorrhoid and suture pain | 0 | 0.0 | 1 | 2.6 | 1 | 1.7 | ||
Suture diastasis | 0 | 0.0 | 0 | 0.0 | 2 | 3.3 |
Pelvic Floor Dysfunctions | BSG (N = 50) | PMG (N = 39) | CG (N = 61) | χ2 | p 1 | ||||
---|---|---|---|---|---|---|---|---|---|
N | % | N | % | N | % | ||||
Urinary incontinence | No | 37 | 72.5 | 22 | 56.4 | 27 | 45.0 | 8506 | 0.014 * |
Episodic | 3 | 5.9 | 3 | 7.7 | 6 | 10 | |||
Mixt | 1 | 2.0 | 3 | 7.7 | 2 | 3.3 | |||
SUI | 10 | 19.6 | 11 | 28.2 | 25 | 41.7 | |||
Fecal incontinence | No | 46 | 90.2 | 30 | 76.9 | 40 | 66.7 | 8654 | 0.013 * |
Yes | 5 | 9.8 | 9 | 23.1 | 20 | 33.3 | |||
Dyspareunia | No | 35 | 68.6 | 21 | 53.8 | 17 | 28.3 | 25,375 | <0.001 * |
Minim | 0 | 0.0 | 0 | 0.0 | 0 | 0.0 | |||
Unrated | 8 | 15.7 | 4 | 10.3 | 6 | 10.0 | |||
Present before birth | 2 | 3.9 | 0 | 0.0 | 0 | 0.0 | |||
Yes | 6 | 11.8 | 14 | 35.9 | 37 | 61.7 |
Variable | BSG vs. PMG | BSG vs. CG | PMG vs. CG | |||
---|---|---|---|---|---|---|
χ2 | p 1 | χ2 | p 1 | χ2 | p 1 | |
Urinary incontinence | 3.320 | 0.345 | 8.625 | 0.034 * | 2.827 | 0.419 |
Fecal incontinence | 2.964 | 0.085 | 8.746 | 0.003 * | 1.200 | 0.273 |
Dyspareunia | 8.586 | 0.035 * | 30.335 | <0.001 * | 7.057 | 0.029 * |
Predictor Factors | Regression Coefficients | OR | p |
---|---|---|---|
(Intercept) | −0.299 | 0.741 | 0.871 |
Newborn weight | −0.001 | 0.999 | 0.125 |
Stage 2 duration (hours) | 0.392 | 1.480 | 0.193 |
Episiotomy (yes) | 1.666 | 5.289 | 0.014 * |
Perineal tears (yes) | 2.050 | 7.768 | 0.001 * |
Epidural anesthesia (yes) | 0.622 | 1.862 | 0.198 |
Kristeller maneuver (yes) | 0.099 | 1.104 | 0.866 |
Perineal preparation (no) | 1.064 | 2.898 | 0.026 * |
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Villani, F.; Furau, C.; Mazzucato, B.; Cavalieri, A.; Todut, O.C.; Ciobanu, V.; Dodi, G.; Petre, I. Antenatal Perineal Training for Injuries Prevention: Follow Up after Puerperium. Medicina 2024, 60, 1264. https://doi.org/10.3390/medicina60081264
Villani F, Furau C, Mazzucato B, Cavalieri A, Todut OC, Ciobanu V, Dodi G, Petre I. Antenatal Perineal Training for Injuries Prevention: Follow Up after Puerperium. Medicina. 2024; 60(8):1264. https://doi.org/10.3390/medicina60081264
Chicago/Turabian StyleVillani, Federico, Cristian Furau, Barbara Mazzucato, Antonella Cavalieri, Oana Cristina Todut, Victoria Ciobanu, Giuseppe Dodi, and Ion Petre. 2024. "Antenatal Perineal Training for Injuries Prevention: Follow Up after Puerperium" Medicina 60, no. 8: 1264. https://doi.org/10.3390/medicina60081264