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Cochrane Database of Systematic Reviews

Masaje perineal prenatal para reducir el trauma perineal

Information

DOI:
https://doi.org/10.1002/14651858.CD005123.pub3Copy DOI
Database:
  1. Cochrane Database of Systematic Reviews
Version published:
  1. 30 April 2013see what's new
Type:
  1. Intervention
Stage:
  1. Review
Cochrane Editorial Group:
  1. Cochrane Pregnancy and Childbirth Group

Copyright:
  1. Copyright © 2013 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.

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Authors

  • Michael M Beckmann

    Correspondence to: Mater Health Services, Brisbane, Australia

    [email protected]

  • Owen M Stock

    Department of Obstetrics and Gynaecology, Mater Mothers' Hospital, Mater Health Services, Brisbane, Australia

Contributions of authors

The updated review was undertaken by Michael Beckmann, and checked and commented on by Owen Stock.

Sources of support

Internal sources

  • No sources of support supplied

External sources

  • Australian Department of Health and Ageing, Australia.

Declarations of interest

None known.

Acknowledgements

We thank Andrea Garrett for her contribution to previous versions of this review. Andrea worked collaboratively on the development of the protocol, undertook selection of trials for inclusion, quality assessment, data extraction and commented on drafts of the review.

Version history

Published

Title

Stage

Authors

Version

2013 Apr 30

Antenatal perineal massage for reducing perineal trauma

Review

Michael M Beckmann, Owen M Stock

https://doi.org/10.1002/14651858.CD005123.pub3

2006 Jan 25

Antenatal perineal massage for reducing perineal trauma

Review

Michael M Beckmann, Andrea J Garrett

https://doi.org/10.1002/14651858.CD005123.pub2

2005 Jan 24

Antenatal perineal massage for reducing perineal trauma

Protocol

Michael M Beckmann, Andrea J Garrett

https://doi.org/10.1002/14651858.CD005123

Differences between protocol and review

Updated methods added to an Appendix.

Keywords

MeSH

PICOs

Population
Intervention
Comparison
Outcome

The PICO model is widely used and taught in evidence-based health care as a strategy for formulating questions and search strategies and for characterizing clinical studies or meta-analyses. PICO stands for four different potential components of a clinical question: Patient, Population or Problem; Intervention; Comparison; Outcome.

See more on using PICO in the Cochrane Handbook.

'Risk of bias' graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.
Figures and Tables -
Figure 1

'Risk of bias' graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.

'Risk of bias' summary: review authors' judgements about each risk of bias item for each included study.
Figures and Tables -
Figure 2

'Risk of bias' summary: review authors' judgements about each risk of bias item for each included study.

Comparison 1 Digital perineal massage versus control: results by parity, Outcome 1 Perineal trauma requiring suturing.
Figures and Tables -
Analysis 1.1

Comparison 1 Digital perineal massage versus control: results by parity, Outcome 1 Perineal trauma requiring suturing.

Comparison 1 Digital perineal massage versus control: results by parity, Outcome 2 1st degree perineal tear.
Figures and Tables -
Analysis 1.2

Comparison 1 Digital perineal massage versus control: results by parity, Outcome 2 1st degree perineal tear.

Comparison 1 Digital perineal massage versus control: results by parity, Outcome 3 2nd degree perineal tear.
Figures and Tables -
Analysis 1.3

Comparison 1 Digital perineal massage versus control: results by parity, Outcome 3 2nd degree perineal tear.

Comparison 1 Digital perineal massage versus control: results by parity, Outcome 4 3rd or 4th degree perineal trauma.
Figures and Tables -
Analysis 1.4

Comparison 1 Digital perineal massage versus control: results by parity, Outcome 4 3rd or 4th degree perineal trauma.

Comparison 1 Digital perineal massage versus control: results by parity, Outcome 5 Incidence of episiotomy.
Figures and Tables -
Analysis 1.5

Comparison 1 Digital perineal massage versus control: results by parity, Outcome 5 Incidence of episiotomy.

Comparison 1 Digital perineal massage versus control: results by parity, Outcome 6 Length of second stage.
Figures and Tables -
Analysis 1.6

Comparison 1 Digital perineal massage versus control: results by parity, Outcome 6 Length of second stage.

Comparison 1 Digital perineal massage versus control: results by parity, Outcome 7 Instrumental delivery.
Figures and Tables -
Analysis 1.7

Comparison 1 Digital perineal massage versus control: results by parity, Outcome 7 Instrumental delivery.

Comparison 1 Digital perineal massage versus control: results by parity, Outcome 13 Perineal pain at 3 months postpartum.
Figures and Tables -
Analysis 1.13

Comparison 1 Digital perineal massage versus control: results by parity, Outcome 13 Perineal pain at 3 months postpartum.

Comparison 1 Digital perineal massage versus control: results by parity, Outcome 14 Painful sex at 3 months postpartum.
Figures and Tables -
Analysis 1.14

Comparison 1 Digital perineal massage versus control: results by parity, Outcome 14 Painful sex at 3 months postpartum.

Comparison 1 Digital perineal massage versus control: results by parity, Outcome 15 Woman's sexual satisfaction at 3 months postpartum.
Figures and Tables -
Analysis 1.15

Comparison 1 Digital perineal massage versus control: results by parity, Outcome 15 Woman's sexual satisfaction at 3 months postpartum.

Comparison 1 Digital perineal massage versus control: results by parity, Outcome 16 Partner's sexual satisfaction at 3 months postpartum.
Figures and Tables -
Analysis 1.16

Comparison 1 Digital perineal massage versus control: results by parity, Outcome 16 Partner's sexual satisfaction at 3 months postpartum.

Comparison 1 Digital perineal massage versus control: results by parity, Outcome 17 Uncontrolled loss of urine at 3 months postpartum.
Figures and Tables -
Analysis 1.17

Comparison 1 Digital perineal massage versus control: results by parity, Outcome 17 Uncontrolled loss of urine at 3 months postpartum.

Comparison 1 Digital perineal massage versus control: results by parity, Outcome 18 Uncontrolled loss of faeces at 3 months postpartum.
Figures and Tables -
Analysis 1.18

Comparison 1 Digital perineal massage versus control: results by parity, Outcome 18 Uncontrolled loss of faeces at 3 months postpartum.

Comparison 1 Digital perineal massage versus control: results by parity, Outcome 19 Uncontrolled loss of flatus at 3 months postpartum.
Figures and Tables -
Analysis 1.19

Comparison 1 Digital perineal massage versus control: results by parity, Outcome 19 Uncontrolled loss of flatus at 3 months postpartum.

Comparison 2 Digital perineal massage versus control: results by frequency of massage, Outcome 1 Perineal trauma requiring suturing.
Figures and Tables -
Analysis 2.1

Comparison 2 Digital perineal massage versus control: results by frequency of massage, Outcome 1 Perineal trauma requiring suturing.

Comparison 2 Digital perineal massage versus control: results by frequency of massage, Outcome 2 1st degree perineal tear.
Figures and Tables -
Analysis 2.2

Comparison 2 Digital perineal massage versus control: results by frequency of massage, Outcome 2 1st degree perineal tear.

Comparison 2 Digital perineal massage versus control: results by frequency of massage, Outcome 3 2nd degree perineal tear.
Figures and Tables -
Analysis 2.3

Comparison 2 Digital perineal massage versus control: results by frequency of massage, Outcome 3 2nd degree perineal tear.

Comparison 2 Digital perineal massage versus control: results by frequency of massage, Outcome 4 3rd or 4th degree perineal trauma.
Figures and Tables -
Analysis 2.4

Comparison 2 Digital perineal massage versus control: results by frequency of massage, Outcome 4 3rd or 4th degree perineal trauma.

Comparison 2 Digital perineal massage versus control: results by frequency of massage, Outcome 5 Incidence of episiotomy.
Figures and Tables -
Analysis 2.5

Comparison 2 Digital perineal massage versus control: results by frequency of massage, Outcome 5 Incidence of episiotomy.

Comparison 2 Digital perineal massage versus control: results by frequency of massage, Outcome 6 Length of second stage.
Figures and Tables -
Analysis 2.6

Comparison 2 Digital perineal massage versus control: results by frequency of massage, Outcome 6 Length of second stage.

Comparison 2 Digital perineal massage versus control: results by frequency of massage, Outcome 7 Instrumental delivery.
Figures and Tables -
Analysis 2.7

Comparison 2 Digital perineal massage versus control: results by frequency of massage, Outcome 7 Instrumental delivery.

Comparison 2 Digital perineal massage versus control: results by frequency of massage, Outcome 13 Perineal pain at 3 months postpartum.
Figures and Tables -
Analysis 2.13

Comparison 2 Digital perineal massage versus control: results by frequency of massage, Outcome 13 Perineal pain at 3 months postpartum.

Comparison 2 Digital perineal massage versus control: results by frequency of massage, Outcome 14 Painful sex at 3 months postpartum.
Figures and Tables -
Analysis 2.14

Comparison 2 Digital perineal massage versus control: results by frequency of massage, Outcome 14 Painful sex at 3 months postpartum.

Comparison 2 Digital perineal massage versus control: results by frequency of massage, Outcome 15 Woman's sexual satisfaction at 3 months postpartum.
Figures and Tables -
Analysis 2.15

Comparison 2 Digital perineal massage versus control: results by frequency of massage, Outcome 15 Woman's sexual satisfaction at 3 months postpartum.

Comparison 2 Digital perineal massage versus control: results by frequency of massage, Outcome 16 Partner's sexual satisfaction at 3 months postpartum.
Figures and Tables -
Analysis 2.16

Comparison 2 Digital perineal massage versus control: results by frequency of massage, Outcome 16 Partner's sexual satisfaction at 3 months postpartum.

Comparison 2 Digital perineal massage versus control: results by frequency of massage, Outcome 17 Uncontrolled loss of urine at 3 months postpartum.
Figures and Tables -
Analysis 2.17

Comparison 2 Digital perineal massage versus control: results by frequency of massage, Outcome 17 Uncontrolled loss of urine at 3 months postpartum.

Comparison 2 Digital perineal massage versus control: results by frequency of massage, Outcome 18 Uncontrolled loss of faeces at 3 months postpartum.
Figures and Tables -
Analysis 2.18

Comparison 2 Digital perineal massage versus control: results by frequency of massage, Outcome 18 Uncontrolled loss of faeces at 3 months postpartum.

Comparison 2 Digital perineal massage versus control: results by frequency of massage, Outcome 19 Uncontrolled loss of flatus at 3 months postpartum.
Figures and Tables -
Analysis 2.19

Comparison 2 Digital perineal massage versus control: results by frequency of massage, Outcome 19 Uncontrolled loss of flatus at 3 months postpartum.

Table 1. Flatal incontinence at 3 months postpartum in women who massage less than 1.5 times per week

Treatment

Control

Risk ratio, M‐H, Fixed, 95% CI

Events

Total

Events

Total

Reporting of infrequent flatal incontinence

21

108

107

479

0.87 (0.57,1.32)

Reporting of flatal incontinence at least daily

6

108

10

479

2.66 (0.99,7.16)

Figures and Tables -
Table 1. Flatal incontinence at 3 months postpartum in women who massage less than 1.5 times per week
Table 2. Length of second stage perineal massage versus control: analysis excluding episiotomies

Duration

All women

Excl episiotomy

Length of 2nd stage (mins)

+3.84 (95% CI ‐0.26 to +7.95)

+3.57 (95% CI ‐0.86 to +8.00)

Length of 2nd stage for women massaging more than 3.5 times/week (mins)

+10.80 (95% CI +4.03 to +17.58)

+5.21 (95% CI ‐1.45 to +11.86)

mins: minutes
CI: confidence interval

Figures and Tables -
Table 2. Length of second stage perineal massage versus control: analysis excluding episiotomies
Comparison 1. Digital perineal massage versus control: results by parity

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Perineal trauma requiring suturing Show forest plot

4

2480

Risk Ratio (M‐H, Fixed, 95% CI)

0.91 [0.86, 0.96]

1.1 Women without previous vaginal birth

4

1988

Risk Ratio (M‐H, Fixed, 95% CI)

0.90 [0.84, 0.96]

1.2 Women with previous vaginal birth

1

492

Risk Ratio (M‐H, Fixed, 95% CI)

0.95 [0.83, 1.08]

2 1st degree perineal tear Show forest plot

4

2480

Risk Ratio (M‐H, Random, 95% CI)

0.96 [0.78, 1.19]

2.1 Women without previous vaginal birth

4

1988

Risk Ratio (M‐H, Random, 95% CI)

0.97 [0.69, 1.36]

2.2 Women with previous vaginal birth

1

492

Risk Ratio (M‐H, Random, 95% CI)

1.01 [0.72, 1.41]

3 2nd degree perineal tear Show forest plot

4

2480

Risk Ratio (M‐H, Fixed, 95% CI)

0.99 [0.85, 1.15]

3.1 Women without previous vaginal birth

4

1988

Risk Ratio (M‐H, Fixed, 95% CI)

1.00 [0.84, 1.19]

3.2 Women with previous vaginal birth

1

492

Risk Ratio (M‐H, Fixed, 95% CI)

0.96 [0.72, 1.29]

4 3rd or 4th degree perineal trauma Show forest plot

4

2480

Risk Ratio (M‐H, Fixed, 95% CI)

0.81 [0.56, 1.18]

4.1 Women without previous vaginal birth

4

1988

Risk Ratio (M‐H, Fixed, 95% CI)

0.82 [0.56, 1.20]

4.2 Women with previous vaginal birth

1

492

Risk Ratio (M‐H, Fixed, 95% CI)

0.50 [0.05, 5.52]

5 Incidence of episiotomy Show forest plot

4

2480

Risk Ratio (M‐H, Fixed, 95% CI)

0.84 [0.74, 0.95]

5.1 Women without previous vaginal birth

4

1988

Risk Ratio (M‐H, Fixed, 95% CI)

0.83 [0.73, 0.95]

5.2 Women with previous vaginal birth

1

492

Risk Ratio (M‐H, Fixed, 95% CI)

0.86 [0.57, 1.30]

6 Length of second stage Show forest plot

2

2211

Mean Difference (IV, Fixed, 95% CI)

3.84 [‐0.26, 7.95]

6.1 Women without previous vaginal birth

2

1719

Mean Difference (IV, Fixed, 95% CI)

2.16 [‐3.58, 7.91]

6.2 Women with previous vaginal birth

1

492

Mean Difference (IV, Fixed, 95% CI)

5.60 [‐0.27, 11.47]

7 Instrumental delivery Show forest plot

3

2417

Risk Ratio (M‐H, Random, 95% CI)

0.94 [0.77, 1.16]

7.1 Women without previous vaginal birth

3

1925

Risk Ratio (M‐H, Random, 95% CI)

0.90 [0.78, 1.04]

7.2 Women with previous vaginal birth

1

492

Risk Ratio (M‐H, Random, 95% CI)

1.58 [0.83, 3.02]

8 Length of inpatient stay

0

0

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

8.1 Women without previous vaginal birth

0

0

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

8.2 Women with previous vaginal birth

0

0

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

9 Admission to nursery

0

0

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

9.1 Women without previous vaginal birth

0

0

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

9.2 Women with previous vaginal birth

0

0

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

10 Apgar < 4 at 1 minute and/or Apgar < 7 at 5 minutes

0

0

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

10.1 Women without previous vaginal birth

0

0

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

10.2 Women with previous vaginal birth

0

0

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

11 Woman's satisfaction with perineal massage

0

0

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

11.1 Women without previous vaginal birth

0

0

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

11.2 Women with previous vaginal birth

0

0

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

12 Perineal pain postpartum

0

0

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

12.1 Women without previous vaginal birth

0

0

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

12.2 Women with previous vaginal birth

0

0

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

13 Perineal pain at 3 months postpartum Show forest plot

1

931

Risk Ratio (M‐H, Random, 95% CI)

0.64 [0.39, 1.06]

13.1 Women without previous vaginal birth

1

555

Risk Ratio (M‐H, Random, 95% CI)

0.77 [0.55, 1.09]

13.2 Women with previous vaginal birth

1

376

Risk Ratio (M‐H, Random, 95% CI)

0.45 [0.24, 0.87]

14 Painful sex at 3 months postpartum Show forest plot

1

831

Risk Ratio (M‐H, Fixed, 95% CI)

0.96 [0.84, 1.08]

14.1 Women without previous vaginal birth

1

493

Risk Ratio (M‐H, Fixed, 95% CI)

0.97 [0.85, 1.11]

14.2 Women with previous vaginal birth

1

338

Risk Ratio (M‐H, Fixed, 95% CI)

0.92 [0.68, 1.24]

15 Woman's sexual satisfaction at 3 months postpartum Show forest plot

1

921

Risk Ratio (M‐H, Fixed, 95% CI)

1.02 [0.96, 1.10]

15.1 Women without previous vaginal birth

1

552

Risk Ratio (M‐H, Fixed, 95% CI)

1.03 [0.93, 1.14]

15.2 Women with previous vaginal birth

1

369

Risk Ratio (M‐H, Fixed, 95% CI)

1.02 [0.93, 1.11]

16 Partner's sexual satisfaction at 3 months postpartum Show forest plot

1

916

Risk Ratio (M‐H, Fixed, 95% CI)

0.97 [0.91, 1.04]

16.1 Women without previous vaginal birth

1

548

Risk Ratio (M‐H, Fixed, 95% CI)

0.99 [0.90, 1.09]

16.2 Women with previous vaginal birth

1

368

Risk Ratio (M‐H, Fixed, 95% CI)

0.94 [0.87, 1.03]

17 Uncontrolled loss of urine at 3 months postpartum Show forest plot

1

949

Risk Ratio (M‐H, Fixed, 95% CI)

0.90 [0.74, 1.08]

17.1 Women without previous vaginal birth

1

572

Risk Ratio (M‐H, Fixed, 95% CI)

0.92 [0.71, 1.20]

17.2 Women with previous vaginal birth

1

377

Risk Ratio (M‐H, Fixed, 95% CI)

0.87 [0.66, 1.13]

18 Uncontrolled loss of faeces at 3 months postpartum Show forest plot

1

948

Risk Ratio (M‐H, Random, 95% CI)

0.70 [0.27, 1.80]

18.1 Women without previous vaginal birth

1

572

Risk Ratio (M‐H, Random, 95% CI)

1.02 [0.41, 2.54]

18.2 Women with previous vaginal birth

1

376

Risk Ratio (M‐H, Random, 95% CI)

0.38 [0.10, 1.41]

19 Uncontrolled loss of flatus at 3 months postpartum Show forest plot

1

948

Risk Ratio (M‐H, Fixed, 95% CI)

1.09 [0.88, 1.36]

19.1 Women without previous vaginal birth

1

571

Risk Ratio (M‐H, Fixed, 95% CI)

1.13 [0.85, 1.50]

19.2 Women with previous vaginal birth

1

377

Risk Ratio (M‐H, Fixed, 95% CI)

1.04 [0.74, 1.45]

Figures and Tables -
Comparison 1. Digital perineal massage versus control: results by parity
Comparison 2. Digital perineal massage versus control: results by frequency of massage

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Perineal trauma requiring suturing Show forest plot

3

Risk Ratio (M‐H, Random, 95% CI)

Subtotals only

1.1 Average number of massages per week < 1.5

2

1500

Risk Ratio (M‐H, Random, 95% CI)

0.84 [0.74, 0.96]

1.2 Average number of massages per week = 1.5 to 3.4

2

1650

Risk Ratio (M‐H, Random, 95% CI)

0.92 [0.85, 1.00]

1.3 Average number of massages per week > 3.5

2

1598

Risk Ratio (M‐H, Random, 95% CI)

0.94 [0.86, 1.02]

1.4 Any frequency of massage

3

2417

Risk Ratio (M‐H, Random, 95% CI)

0.91 [0.86, 0.96]

2 1st degree perineal tear Show forest plot

3

Risk Ratio (M‐H, Random, 95% CI)

Subtotals only

2.1 Average number of massages per week < 1.5

2

1500

Risk Ratio (M‐H, Random, 95% CI)

1.04 [0.60, 1.83]

2.2 Average number of massages per week = 1.5 to 3.4

2

1650

Risk Ratio (M‐H, Random, 95% CI)

1.00 [0.75, 1.33]

2.3 Average number of massages per week > 3.5

2

1598

Risk Ratio (M‐H, Random, 95% CI)

0.89 [0.67, 1.17]

2.4 Any frequency of massage

3

2417

Risk Ratio (M‐H, Random, 95% CI)

0.99 [0.71, 1.38]

3 2nd degree perineal tear Show forest plot

3

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

3.1 Average number of massages per week < 1.5

2

1500

Risk Ratio (M‐H, Fixed, 95% CI)

1.00 [0.78, 1.27]

3.2 Average number of massages per week = 1.5 to 3.4

2

1650

Risk Ratio (M‐H, Fixed, 95% CI)

0.94 [0.75, 1.16]

3.3 Average number of massages per week > 3.5

2

1598

Risk Ratio (M‐H, Fixed, 95% CI)

1.02 [0.82, 1.27]

3.4 Any frequency of massage

3

2417

Risk Ratio (M‐H, Fixed, 95% CI)

0.98 [0.84, 1.14]

4 3rd or 4th degree perineal trauma Show forest plot

3

Risk Ratio (M‐H, Random, 95% CI)

Subtotals only

4.1 Average number of massages per week < 1.5

2

1500

Risk Ratio (M‐H, Random, 95% CI)

0.82 [0.08, 8.48]

4.2 Average number of massages per week = 1.5 to 3.4

2

1650

Risk Ratio (M‐H, Random, 95% CI)

0.64 [0.33, 1.25]

4.3 Average number of massages per week > 3.5

2

1598

Risk Ratio (M‐H, Random, 95% CI)

1.19 [0.78, 1.81]

4.4 Any frequency of massage

3

2417

Risk Ratio (M‐H, Random, 95% CI)

0.81 [0.56, 1.19]

5 Incidence of episiotomy Show forest plot

3

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

5.1 Average number of massages per week < 1.5

2

1500

Risk Ratio (M‐H, Fixed, 95% CI)

0.72 [0.57, 0.91]

5.2 Average number of massages per week = 1.5 to 3.4

2

1650

Risk Ratio (M‐H, Fixed, 95% CI)

0.91 [0.77, 1.08]

5.3 Average number of massages per week > 3.5

2

1598

Risk Ratio (M‐H, Fixed, 95% CI)

0.84 [0.67, 1.04]

5.4 Any frequency of massage

3

2417

Risk Ratio (M‐H, Fixed, 95% CI)

0.85 [0.75, 0.97]

6 Length of second stage Show forest plot

2

Mean Difference (IV, Random, 95% CI)

Subtotals only

6.1 Average number of massages per week < 1.5

2

1403

Mean Difference (IV, Random, 95% CI)

0.97 [‐6.45, 8.39]

6.2 Average number of massages per week = 1.5 to 3.4

2

1525

Mean Difference (IV, Random, 95% CI)

‐2.38 [‐8.55, 3.79]

6.3 Average number of massages per week > 3.5

2

1509

Mean Difference (IV, Random, 95% CI)

10.80 [4.03, 17.58]

6.4 Any frequency of massage

2

2211

Mean Difference (IV, Random, 95% CI)

3.35 [‐1.29, 8.00]

7 Instrumental delivery Show forest plot

3

Risk Ratio (M‐H, Random, 95% CI)

Subtotals only

7.1 Average number of massages per week < 1.5

2

1500

Risk Ratio (M‐H, Random, 95% CI)

0.89 [0.71, 1.13]

7.2 Average number of massages per week = 1.5 to 3.4

2

1650

Risk Ratio (M‐H, Random, 95% CI)

0.88 [0.72, 1.07]

7.3 Average number of massages per week > 3.5

2

1598

Risk Ratio (M‐H, Random, 95% CI)

1.07 [0.86, 1.33]

7.4 Any frequency of massage

3

2417

Risk Ratio (M‐H, Random, 95% CI)

0.93 [0.76, 1.13]

8 Length of inpatient stay

0

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

8.1 Average number of massages per week < 1.5

0

0

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

8.2 Average number of massages per week = 1.5 to 3.4

0

0

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

8.3 Average number of massages per week > 3.5

0

0

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

8.4 Any frequency of massage

0

0

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

9 Admission to nursery

0

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

9.1 Average number of massages per week < 1.5

0

0

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

9.2 Average number of massages per week = 1.5 to 3.4

0

0

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

9.3 Average number of massages per week > 3.5

0

0

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

9.4 Any frequency of massage

0

0

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

10 Apgar < 4 at 1 minute and/or Apgar < 7 at 5 minutes

0

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

10.1 Average number of massages per week < 1.5

0

0

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

10.2 Average number of massages per week = 1.5 to 3.4

0

0

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

10.3 Average number of massages per week > 3.5

0

0

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

10.4 Any frequency of massage

0

0

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

11 Woman's satisfaction with perineal massage

0

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

11.1 Average number of massages per week < 1.5

0

0

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

11.2 Average number of massages per week = 1.5 to 3.4

0

0

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

11.3 Average number of massages per week > 3.5

0

0

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

11.4 Any frequency of massage

0

0

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

12 Perineal pain postpartum

0

Mean Difference (IV, Fixed, 95% CI)

Subtotals only

12.1 Average number of massages per week < 1.5

0

0

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

12.2 Average number of massages per week = 1.5 to 3.4

0

0

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

12.3 Average number of massages per week > 3.5

0

0

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

12.4 Any frequency of massage

0

0

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

13 Perineal pain at 3 months postpartum Show forest plot

1

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

13.1 Average number of massages per week < 1.5

1

577

Risk Ratio (M‐H, Fixed, 95% CI)

1.01 [0.65, 1.56]

13.2 Average number of massages per week = 1.5 to 3.4

1

595

Risk Ratio (M‐H, Fixed, 95% CI)

0.69 [0.42, 1.13]

13.3 Average number of massages per week > 3.5

1

701

Risk Ratio (M‐H, Fixed, 95% CI)

0.51 [0.33, 0.79]

13.4 Any frequency of massage

1

931

Risk Ratio (M‐H, Fixed, 95% CI)

0.67 [0.50, 0.92]

14 Painful sex at 3 months postpartum Show forest plot

1

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

14.1 Average number of massages per week < 1.5

1

521

Risk Ratio (M‐H, Fixed, 95% CI)

0.85 [0.67, 1.08]

14.2 Average number of massages per week = 1.5 to 3.4

1

538

Risk Ratio (M‐H, Fixed, 95% CI)

1.03 [0.85, 1.25]

14.3 Average number of massages per week > 3.5

1

622

Risk Ratio (M‐H, Fixed, 95% CI)

0.96 [0.81, 1.13]

14.4 Any frequency of massage

1

831

Risk Ratio (M‐H, Fixed, 95% CI)

0.95 [0.83, 1.09]

15 Woman's sexual satisfaction at 3 months postpartum Show forest plot

1

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

15.1 Average number of massages per week < 1.5

1

569

Risk Ratio (M‐H, Fixed, 95% CI)

1.04 [0.93, 1.16]

15.2 Average number of massages per week = 1.5 to 3.4

1

588

Risk Ratio (M‐H, Fixed, 95% CI)

1.08 [0.98, 1.19]

15.3 Average number of massages per week > 3.5

1

692

Risk Ratio (M‐H, Fixed, 95% CI)

0.99 [0.90, 1.08]

15.4 Any frequency of massage

1

921

Risk Ratio (M‐H, Fixed, 95% CI)

1.02 [0.96, 1.10]

16 Partner's sexual satisfaction at 3 months postpartum Show forest plot

1

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

16.1 Average number of massages per week < 1.5

1

576

Risk Ratio (M‐H, Fixed, 95% CI)

1.01 [0.91, 1.11]

16.2 Average number of massages per week = 1.5 to 3.4

1

586

Risk Ratio (M‐H, Fixed, 95% CI)

1.03 [0.95, 1.13]

16.3 Average number of massages per week > 3.5

1

688

Risk Ratio (M‐H, Fixed, 95% CI)

0.93 [0.86, 1.02]

16.4 Any frequency of massage

1

916

Risk Ratio (M‐H, Fixed, 95% CI)

0.97 [0.91, 1.04]

17 Uncontrolled loss of urine at 3 months postpartum Show forest plot

1

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

17.1 Average number of massages per week < 1.5

1

587

Risk Ratio (M‐H, Fixed, 95% CI)

1.10 [0.83, 1.46]

17.2 Average number of massages per week = 1.5 to 3.4

1

606

Risk Ratio (M‐H, Fixed, 95% CI)

0.84 [0.62, 1.15]

17.3 Average number of massages per week > 3.5

1

714

Risk Ratio (M‐H, Fixed, 95% CI)

0.83 [0.65, 1.06]

17.4 Any frequency of massage

1

949

Risk Ratio (M‐H, Fixed, 95% CI)

0.90 [0.74, 1.08]

18 Uncontrolled loss of faeces at 3 months postpartum Show forest plot

1

Risk Ratio (M‐H, Fixed, 95% CI)

Subtotals only

18.1 Average number of massages per week < 1.5

1

586

Risk Ratio (M‐H, Fixed, 95% CI)

1.04 [0.36, 3.03]

18.2 Average number of massages per week = 1.5 to 3.4

1

605

Risk Ratio (M‐H, Fixed, 95% CI)

0.44 [0.10, 1.89]

18.3 Average number of massages per week > 3.5

1

713

Risk Ratio (M‐H, Fixed, 95% CI)

0.72 [0.29, 1.80]

18.4 Any frequency of massage

1

948

Risk Ratio (M‐H, Fixed, 95% CI)

0.72 [0.35, 1.49]

19 Uncontrolled loss of flatus at 3 months postpartum Show forest plot

1

2854

Risk Ratio (M‐H, Fixed, 95% CI)

1.09 [0.95, 1.25]

19.1 Average number of massages per week < 1.5

1

587

Risk Ratio (M‐H, Fixed, 95% CI)

1.40 [1.03, 1.90]

19.2 Average number of massages per week = 1.5 to 3.4

1

606

Risk Ratio (M‐H, Fixed, 95% CI)

0.87 [0.60, 1.26]

19.3 Average number of massages per week > 3.5

1

713

Risk Ratio (M‐H, Fixed, 95% CI)

1.07 [0.82, 1.39]

19.4 Any frequency of massage

1

948

Risk Ratio (M‐H, Fixed, 95% CI)

1.09 [0.88, 1.36]

Figures and Tables -
Comparison 2. Digital perineal massage versus control: results by frequency of massage