Does the Epi-No Birth Trainer reduce levator trauma? A randomised controlled trial.

Area of Science:

• Obstetrics and Gynecology
• Pelvic Floor Disorders
• Maternal Health

Background:

• Childbirth can cause levator trauma, leading to pelvic floor dysfunction.
• The Epi-No birth trainer is a device used during pregnancy to potentially prepare for delivery.
• Minimizing birth-related trauma is crucial for long-term maternal well-being.

Purpose of the Study:

• To investigate if antepartum use of a birth trainer can decrease levator trauma.
• To assess the impact of the Epi-No device on pelvic floor muscle injury.
• To evaluate the efficacy of birth preparation devices in reducing childbirth-related trauma.

Main Methods:

• A randomized controlled pilot study involving 200 nulliparous women.
• Four-dimensional translabial ultrasonography used for assessment at 35-37 weeks gestation and 3 months postpartum.
• Intervention group used the Epi-No birth trainer from 37 weeks gestation.

Main Results:

• Follow-up data available for 146 women (5.6 months postpartum).
• The risk of levator avulsion was halved in the intervention group (6% vs. 13%, P=0.19) in a modified intention-to-treat analysis.
• A treatment-received analysis showed non-significant reductions in levator avulsion (42%) and microtrauma (30%).

Conclusions:

• This pilot randomized controlled trial suggests a non-significant trend towards lower pelvic floor muscle injury.
• Women using the Epi-No birth trainer from 37 weeks onwards showed a potentially reduced incidence of levator trauma.
• Further research with larger sample sizes is warranted to confirm these findings.