Can pelvic floor muscle training prevent perineal laceration? A systematic review and meta-analysis

Int J Gynaecol Obstet. 2022 May;157(2):248-254. doi: 10.1002/ijgo.13826. Epub 2021 Aug 4.

Abstract

Background: Pelvic floor muscle training (PFMT) is reportedly able to reduce risk factors for perineal trauma. However, the effects of these exercises on perineal injuries are unclear.

Objective: To investigate the effectiveness of PFMT in the prevention of perineal laceration.

Search strategy: Searches were conducted in PubMed/Medline, LILACS, Scopus, Cochrane Library, Web of Science, and CINAHL. For search strategies, we combined the terms PFMT, tear, laceration, perineum, and delivery.

Selection criteria: We included randomized controlled trials that evaluated the effectiveness of PFMT for the prevention of perineal laceration during vaginal delivery. There were no period or language limitations.

Data collection and analysis: We conducted data extraction and synthesis. We performed a quality appraisal, a qualitative synthesis, and for meta-analysis we used the Software R.

Main results: Nine studies were included. In most studies, PFMT was performed daily, with a wide range of the number of contractions and sustainability. Prevalence of perineal laceration had a wide range and information on laceration degree was limited. Meta-analysis showed that PFMT was not effective to prevent perineal laceration.

Conclusion: Pelvic floor muscle training does not prevent perineal laceration. Further studies are needed to investigate different protocols and interventions.

Keywords: lacerations; natural childbirth; pelvic floor; perineum.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Delivery, Obstetric / adverse effects
  • Exercise Therapy / methods
  • Female
  • Humans
  • Lacerations* / prevention & control
  • Pelvic Floor*
  • Perineum / injuries
  • Pregnancy