Saturday, December 22, 2007

Research suppports hot packs to the perineum

BIRTH is one of my favorite journals to read. And if you are a member of Lamaze you can get a subscription for half price! (I think that's now $44 but don't quote me) You can get it on-line which makes it so easy to save pdfs - so much easier than the old way of cutting up the journal and scanning etc. (or remembering which issue or what file you stuck the article)

In the December issue there is a research article on the use of hot packs in second stage. Here is the abstract:

Perineal outcomes and maternal comfort related to the application of
perineal warm packs in the second stage of labor: a randomized controlled
trial - Birth , vol 34, no 4, December 2007, pp 282-290 Dahlen HG; Homer
CSE; Cooke M; et al - (2007) BACKGROUND: Perineal warm packs are widely used
during childbirth in the belief that they reduce perineal trauma and
increase comfort during late second stage of labor. The aim of this study
was to determine the effects of applying warm packs to the perineum on
perineal trauma and maternal comfort during the late second stage of labor.
METHODS: A randomized controlled trial was undertaken. In the late second
stage of labor, nulliparous women (n = 717) giving birth were randomly
allocated to have warm packs (n = 360) applied to their perineum or to
receive standard care (n = 357). Standard care was defined as any
second-stage practice carried out by midwives that did not include the
application of warm packs to the perineum. Analysis was on an
intention-to-treat basis, and the primary outcome measures were requirement
for perineal suturing and maternal comfort. RESULTS: The difference in the
number of women who required suturing after birth was not significant. Women
in the warm pack group had significantly fewer third- and fourth-degree
tears and they had significantly lower perineal pain scores when giving
birth and on "day 1" and "day 2" after the birth compared with the standard
care group. At 3 months, they were significantly less likely to have urinary
incontinence compared with women in the standard care group. CONCLUSIONS:
The application of perineal warm packs in late second stage does not reduce
the likelihood of nulliparous women requiring perineal suturing but
significantly reduces third- and fourth-degree lacerations, pain during the
birth and on days 1 and 2, and urinary incontinence. This simple,
inexpensive practice should be incorporated into second stage labor care.
(42 references) (Author)

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