Related Experiment Video
Updated: Jun 7, 2025
09:36
Effect of Hyaluronic Acid 35 kDa on an In Vitro Model of Preterm Small Intestinal Injury and Healing Using Enteroid-Derived Monolayers
Published on: July 28, 2022
2.2K
Hyaluronidase for reducing perineal trauma
Fan Zhou1,2, Jingwei Zhang1,2, Yaqian Li2,3
1Department of Medical Genetics/Prenatal Diagnostic Center, West China Second University Hospital, Sichuan University, Chengdu, China.
The Cochrane Database of Systematic Reviews
|November 14, 2024
Summary
Perineal hyaluronidase (HAase) injection may reduce perineal trauma during vaginal birth compared to no intervention, but not placebo. HAase injection also likely reduces perineal oedema 24 hours postpartum. Further research is needed to confirm effectiveness and safety.
Area of Science:
- Obstetrics and Gynecology
- Perinatal Care
- Pharmacological Interventions
Background:
- Perineal trauma is a common complication of vaginal birth, leading to short- and long-term health issues.
- Perineal hyaluronidase (HAase) injection has been utilized since the 1950s to mitigate perineal trauma, pain, and episiotomy rates.
- HAase administration is considered a low-risk, cost-effective method for reducing perineal trauma without adverse effects.
Purpose of the Study:
- To evaluate the efficacy and safety of perineal HAase injections in reducing perineal trauma, episiotomy, and pain during vaginal delivery.
- To synthesize evidence from randomized controlled trials on the impact of HAase on maternal and neonatal outcomes.
Main Methods:
- A systematic review and meta-analysis of randomized and quasi-randomized controlled trials.
- Searches conducted across major databases (Cochrane, MEDLINE, Embase, CINAHL) and clinical trial registries in November 2023.
- Primary outcomes included perineal trauma (tears/episiotomy), episiotomy rates, and perineal pain; secondary outcomes covered laceration degrees, perineal edema, and Apgar scores.
Main Results:
- Five trials involving 747 women were included, with evidence quality ranging from very low to moderate.
- Perineal HAase injection showed no significant difference compared to placebo for perineal trauma, episiotomy, or lacerations (low-certainty evidence).
- HAase injection likely reduced perineal edema 24 hours postpartum versus placebo (moderate-certainty evidence) and may reduce perineal trauma versus no intervention (low-certainty evidence).
Conclusions:
- Perineal HAase injection may decrease perineal trauma compared to no intervention but not placebo, and likely reduces postpartum perineal edema.
- The evidence is limited by the small number of high-quality trials and insufficient reported outcomes, necessitating further research.
- Rigorous randomized controlled trials are required to definitively establish the role, optimal dosage, and application of HAase in vaginal deliveries.
