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The effectiveness of perineal warm compresses during the second stage of labor on reducing perineal trauma and relieving postpartum perineal pain in primiparous women: a systematic review and meta-analyses
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  • Ruiyang SUN,
  • Jing Huang,
  • Xiu Zhu,
  • Rui Hou,
  • Yu Zang,
  • Jingyu Pan,
  • Yuxuan Li,
  • Hong Lu
Ruiyang SUN
Beijing University of Chinese Medicine
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Jing Huang
King's College London Florence Nightingale Faculty of Nursing Midwifery & Palliative Care
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Xiu Zhu
Peking University School of Nursing
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Rui Hou
Peking University School of Nursing
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Yu Zang
Hebei Medical University
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Jingyu Pan
Peking University School of Nursing
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Yuxuan Li
Tsinghua University
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Hong Lu
Peking University School of Nursing

Corresponding Author:[email protected]

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Abstract

Background: Perineal trauma during childbirth and postpartum perineal pain significantly affected the new mother’s physical, psychological, and social experiences toward spontaneous vaginal birth. The effects of perineal warm compresses remain inconclusive. Objectives: To assess the effects of perineal warm compresses during the second stage of labor on reducing perineal trauma and postpartum perineal pain relief. Search Strategy: We searched seven bibliographic databases, three register websites of randomized controlled trials (RCTs), and two dissertation databases for publications from inception to March 15, 2023. Selection Criteria: RCTs published in Chinese and English. Data Collection and Analyses: Two independent reviewers conducted the risk of bias assessing, data extraction, and the certainty of the evidence evaluation utilizing the Cochrane risk of bias 2.0 assessment criteria, the Review Manager 5.4, and the online GRADEpro tool respectively. Main Results: Seven RCTs involving 1362 primiparous women were included. The combined results demonstrated a statistical reduction on the second-(RR=0.40, 95 %CI: [0.27,0.59]), third- and/or fourth- degree perineal lacerations(RR=0.34, 95 %CI: [0.20,0.57]), the incidence of episiotomy (RR=0.69, 95 %CI: [0.58,0.83]) and relief on the short-term perineal pain postpartum (within two days) (MD=-0.94, 95 %CI: [-1.10,-0.77]); a potential favorable effect on improving the integrity of perineum (RR=3.36, 95 %CI: [1.22,9.27]); did not show a statistically significant supportive effect on reducing the first-degree perineal lacerations ((RR=1.43, 95 %CI: [1.05,1.95])) and the rate of perineal lacerations requiring suture (RR=0.68, 95 %CI: [0.45,1.02]). Conclusions: Perineal warm compresses effectively reduced the second-, third-/or fourth-degree perineal trauma and decreased the short-term perineal pain after birth.