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Related Experiment Video

Updated: May 3, 2026

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Hyaluronidase for reducing perineal trauma.

Fan Zhou1, Xiao Dong Wang, Jing Li

  • 1Department of Obstetrics and Gynaecology, West China Second University Hospital, Sichuan University, Renmin Nan Road, Chengdu, Sichuan, China, 610041.

The Cochrane Database of Systematic Reviews
|February 6, 2014
PubMed
Summary
This summary is machine-generated.

Perineal hyaluronidase (HAase) injection may reduce perineal trauma during vaginal delivery, but evidence is limited. Further high-quality trials are needed to confirm effectiveness and safety, as current data is inconclusive regarding benefits compared to placebo.

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Area of Science:

  • Obstetrics and Gynecology
  • Pharmacology
  • Evidence-Based Medicine

Background:

  • Perineal hyaluronidase (HAase) injection was historically used to prevent perineal trauma during vaginal deliveries.
  • Previous reports suggested HAase was a safe, low-cost method to reduce trauma without adverse effects.

Purpose of the Study:

  • To evaluate the effectiveness and safety of perineal HAase injections.
  • To assess the impact on spontaneous perineal trauma, episiotomy rates, and perineal pain in vaginal births.

Main Methods:

  • Systematic review of published and unpublished randomized and quasi-randomized controlled trials.
  • Searches included Cochrane Pregnancy and Childbirth Group's Trials Register, ICTRP, and NDLTD.
  • Two reviewers independently assessed trial eligibility, extracted data, and evaluated quality.

Main Results:

  • Four trials involving 599 women were included.
  • Perineal HAase injection showed a potential reduction in perineal trauma compared to control or no intervention, but not placebo.
  • No clear evidence of reduced episiotomy or severe perineal lacerations was found; no side effects were reported.

Conclusions:

  • Perineal HAase injection may lower perineal trauma incidence, but evidence compared to placebo is insufficient.
  • Lack of established dosage, follow-up data, and limited high-quality trials hinder definitive conclusions.
  • Further rigorous randomized controlled trials are necessary to determine the role and safety of perineal HAase injection.