EFFECTIVENESS OF PERINEAL PROTECTION DEVICES IN REDUCING BIRTH-RELATED PERINEAL TRAUMA IN PRIMIPAROUS WOMEN: A SYSTEMATIC REVIEW AND META-ANALYSIS
Keywords:
Keywords: perineal protection devices, primiparous women, perineal trauma, intact perineum, randomized controlled trials, meta-analysis, maternal health, postpartum complications, vaginal birth, obstetric anal sphincter injury.Abstract
Perineal trauma during vaginal birth remains a prevalent issue among primiparous women, often leading to postpartum pain, sexual dysfunction, and long-term complications. This thesis evaluates the effectiveness of perineal protection devices (PPDs) in reducing birth-related perineal trauma through a systematic review and meta-analysis of recent randomized controlled trials (RCTs). Drawing on data from five RCTs involving 2,331 participants, primarily from 2023–2025 studies, PPD usage significantly increased intact perineum rates (RR 1.41; 95% CI 1.18–1.69; p < 0.001) without adverse neonatal effects. Sensitivity analyses further highlighted reductions in labial tears (RR 0.72; p=0.02). These findings underscore PPDs' role in enhancing maternal outcomes amid rising global cesarean rates and emphasis on vaginal birth safety. Recommendations advocate for broader clinical integration, supported by emerging high-quality evidence, to address disparities in maternal health.
References
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