The Evaluation of the Effect of Perineal Massage in the second stage of labor on Episiotomy and Laceration

Perineal trauma during natural vaginal delivery is associated with short and long term morbidity for women. Interventions to increase the possibility for an intact perineum are needed. This study aimed to determine the effect of perineal massage with a sterile lubricant on episiotomy and laceration. This clinical trial study was performed on 145 nulliparous women who referred to Amol Emam Ali teaching center for normal delivery. They were randomly participating massage with lubricant (45 cases) or control group (100 cases). In massage group when they progressed to full dilatation of the cervix, the midwife inserted two fingers inside vagina and using a sweeping motion gently stretch the perineum with lubricant 5up to 10 minute, in and between mother’s pushing in second stage of labor. In control group just Ritgen Maneuver was applied. At last we compared the rate of intact perineum, episiotomy and laceration, mean duration of second stage of labor and Apgar score in 1 and 5 minute between two groups. In case group, intact perineum, episiotomy and laceration were: 22.2% (10), 44.4% (20), 33.3 (15) respectively. In control group, intact perineum, episiotomy and laceration were: 20.2% (20), 49.3% (71), 28.3% (28) respectively. This difference was not statistically significant. In massage group, first degree laceration was 33.3% (15). In control group, first degree laceration was 28.3% (28).This difference was not statistically significant. In massaged control groups, Second, third and fourth degree laceration have not occurred. The results showed that massage with a sterile lubricant provides no apparent advantage or disadvantage in reducing perineal trauma. Therefore, the use of massage as technique for perineal control is safe based on labor criteria and women’s preference during delivery.