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Published on: January 7, 2019
Effectiveness of Supervised Epi-No® Use in Preventing Perineal Trauma and Urinary Incontinence: A Quasi-Experimental
Cíntia Spagnolo Gomes1,2, Fabiana Rotondo Pedriali1, Eliane Cristina Hilberath Moreira1
1Department of Physiotherapy, Center for Health Sciences, State University of Londrina, 86057-970 Londrina, Paraná, Brazil.
Objective:
To evaluate the efficacy of supervised and early use of the Epi-No® device in preventing urinary incontinence (UI) and perineal injury six months post-delivery in primigravid women.
Methods:
A quasi-experimental matched study was carried out in a low-risk obstetric unit hospital. Gravid women in the study group (SG) underwent 10 sessions (twice weekly for five weeks) using the Epi-No® device from the 34th gestational week onwards. SG was valued prior to the intervention (between the 30th and 32nd gestational weeks) and six months post-delivery. UI was measured using the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF).
Results:
Thirty-seven participants were included in the SG, conversely 32 participants in the control group (CG) were included in the analysis. The SG demonstrated a higher number of participants with intact perineum or first-degree laceration only, compared with the CG (p < 0.001). Women in the CG had a 9.86% greater likelihood of experiencing second- or third-degree perineal lacerations or undergoing episiotomy, whereas those in the SG had a 96.70% lower likelihood of deep laceration (p < 0.001). In addition, the SG exhibited a significantly greater maximum perineal strength than the CG (p = 0.004). A significant inverse correlation (-0.38) was observed between perineal strength and ICIQ-UI SF score in the SG (p = 0.001).
Conclusions:
Assisted use of the Epi-No® device from 34 weeks of pregnancy correlated with less severe deep perineal injuries, better quality of life, and significantly reduced postpartum ICIQ-UI SF scores.
