• Elad Mei-dan, Asnat Walfisch, Iris Raz, Amalia Levy, and Mordechai Hallak.
• Department of Obstetrics and Gynecology, Hillel Yaffe Medical Center, Hadera, Israel. eladmei@yahoo.com
• Isr Med Assoc J. 2008 Jul 1; 10 (7): 499-502.

BackgroundWomen frequently suffer perineal trauma while giving birth. Interventions to increase the possibility for an intact perineum are needed.ObjectivesTo evaluate the effectiveness of antenatal perineal massage in increasing the likelihood of delivering with an intact perineum.MethodsThis single blinded prospective controlled trial included 234 nulliparous women with a singleton fetus. Women allocated to the study group were instructed to practice a 10 minute perineal massage daily from the 34th week of gestation until delivery. Primary outcome measures included the episiotomy rate; first, second, third and fourth-degree perineal tear rates; and intact perineum. Secondary outcomes were related to specific tear locations and the amount of suture material required for repair.ResultsEpisiotomy rates, overall spontaneous tears and intact perineum rates were similar in the study and control groups. Women in the massage group had slightly lower rates of first-degree tears (73.3% vs. 78.9%, P = 0.39) and slightly higher rates of second-degree tears (26.7% vs. 19.3%, P= 0.39), although both of these outcomes did not reach statistical significance. The rates of anterior perineal tears were significantly higher in the massage group (9.5% vs. 3%, P = 0.05), whereas internal lateral tears rates were slightly lower but without statistical significance (11.5% vs.13.1%, P=0.44).ConclusionsThe practice of antenatal perineal massage showed neither a protective nor a detrimental significant effect on the occurrence of perineal trauma.

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