" Effect of Warm Compresses Versus Lubricated Massage During the Second Stage of Labor on Perineal Outcomes Among Primiparous Women"

Research Abstract

Background: Numerous parturient women suffer from perineal trauma during vaginal delivery. Perineal trauma is mostly coupled with pain and serious long life complications. Consequently, prevention of perineal trauma become an urgent need. Aim: This study aimed to compare the effect of warm compresses versus lubricated massage during the second stage of labor on perineal outcomes among primiparous women. Subjects & Methods: A quasi-experimental design was utilized. Setting: The study was conducted at labor room in Beni-Suef general hospital, Beni-Suef city. A convenience sample of 304 parturient women undergoing normal vaginal delivery was randomly assigned to three groups warm compresses group (102 women), lubricated massage group (102 women) and control group (100 women). Three tools were used for data collection; 1) structured interview schedule to collect data about the women' demographic data, and their current pregnancy profile. 2) second stage and perineal outcome assessment sheet, 3) pain assessment tools, it involved two parts, pain analogue scale and behavioral pain scale. Results: There were no significant differences between the three groups as regards the rate of intact perineum, spontaneous tears not requiring repair, tear requiring repair and episiotomy (P = 0.174, 0.111, 0.114 and 0.660), respectively. In contrast, a significant difference was observed between the lubricated massage, warm compresses and control groups in favor of the former as regards the degree of tears (P = 0.012). perineal pain intensity and behavioral response parameters significantly reduced among the warm compress and lubricated massage groups 15 minutes after starting the intervention (P = 0.000) with a significant difference between the three groups. Conclusion and recommendation: perineal warm compresses and lubricated massage didn’t significantly decrease the rate of episiotomy and genital tract tears, but significantly reduce the degree of tears and the degree of extension of an episiotomy, when compared to control group. Lubricated massage seems to be more effective than warm compresses in this respect. perineal pain intensity and behavioral pain response parameters had significantly reduced in lubricated massage and warm compresses groups than the control group. Adequately planned in-service training programs for the maternity nurses regarding the benefits of warm compresses and lubricated massage during the 2nd stage of labor in order to develop the best practice.

Research Keywords

Warm compresses, perineal massage, Perineal outcomes, Primiparous women.