The Efficacy of Antenatal Perineal Massage in Reducing Postpartum Anal Incontinence: A Randomized Controlled Trial
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Abstract
Objective: This study evaluated the efficacy of antenatal perineal massage (APM) in reducing postpartum morbidities, particularly anal incontinence (AI).
Material and Methods: A randomized controlled trial was conducted at Rajavithi Hospital, Bangkok, from October 2023 to April 2024. Nulliparous women with singleton pregnancies were randomly assigned to the APM or control group using block randomization. Participants in the APM group performed a daily 5-minute perineal massage on themselves from 34–36 weeks of gestation until delivery. Both groups received standard prenatal, intrapartum, and postpartum care. The primary outcome was AI incidence at 3 months postpartum, assessed using the Pelvic Floor Distress Inventory-20 (PFDI-20). Secondary outcomes included intrapartum variables, urinary incontinence, and dyspareunia
Results: 106 women were randomized into two groups of 53 each. After exclusions, 37 participants per group were analyzed. At 3 months postpartum, AI incidence was lower in the APM group (32.43%) compared to the control group (56.76%), though not statistically significant (p = 0.061). The APM group showed significantly reduced AI severity (p = 0.017) and fecal incontinence incidence (p = 0.030).
Conclusion: Although the reduction in AI incidence was not statistically significant, the findings suggest potential clinical benefits that warrant further investigation. APM significantly reduced fecal incontinence incidence and AI severity without increasing maternal or neonatal complications. These findings support incorporating APM into routine prenatal care to reduce postpartum morbidities.
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