ANTENATAL PERINEAL MASSAGE AND SUBSEQUENT PERINEAL OUTCOMES - A RANDOMIZED CONTROLLED TRIAL

Objective To study the effects of antenatal perineal massage on subseq uent perineal outcomes at delivery. Design A randomised, single-blind prospective study. Setting Dependent of Obstetrics and Gynaecology, Wa tford General Hospital. Participants Eight hundred and sixty-one nulli parous women with singleton pregnancy and fulfilling criteria for entr y to the trial between June 1994 and October 1995. Results Comparison of the group assigned to massage with the group assigned to no massage showed a reduction of 6.1% in second or third degree tears or episiot omies. This corresponded to tear rates of 75.1% in the no-massage grou p and 69.0% in the massage group (P = 0.073). There was a correspondin g reduction in instrumental deliveries from 40.9% to 34.6% (P = 0.094) . After adjustment for mother's age and infant's birthweight these red uctions achieved statistical significance (P = 0.024 and P = 0.034, re spectively). Analysis by mother's age showed a much larger benefit due to massage in those aged 30 and over and a smaller benefit in those u nder 30. Conclusion Antenatal perineal massage appears to have some be nefit in reducing second or third degree tears or episiotomies and ins trumental deliveries. This effect was stronger in the age group 30 yea rs and above.