Authors (including presenting author) :
Leung CYJ(1), Siu YLC(1), Chan Y(1), Siu PW(1), Lam HP(1), Ip LY(1), Leung PH(1)
Affiliation :
(1) Department of Obstetrics and Gynaecology, Princess Margaret Hospital
Introduction :
According to the Royal College of Obstetrics and Gynaecology, approximately 90% of women who undergo vaginal births will experience some form of perineal trauma. Unfortunately, a few of them may experience severe perineal trauma, obstetrics anal sphincter injuries (OASIS), the complications of which can significantly impact client’s quality of life and the preservation of normal birth in future. As increasing trend of OASIS was observed in our department in 2023, prompting the initiation of an EBP project to explore the use of warm compresses as an alternatives method to reduce severe perineal trauma during the second stage of labour.
Objectives :
(1) To summarize the standard of practice of applying warm compresses during the second stage of labour
(2) To reduce the severity of perineal trauma after delivery
(3) To explore the perspectives of pregnant women and midwives regarding the use of warm compresses during second stage of labour
Methodology :
A literature search was conducted based on our EBP topic. Research meeting the criteria of term, singleton, uncomplicated pregnancy, clear explanations on the use of warm compresses and outcome measures, written in either English or Chinese from year 2014 to 2024 was included. Exclusions included teenage pregnancy, incomplete data, irrelevant studies and editorial opinions. Finally, six articles, 4 systematic reviews (with or without meta-analysis), 1 Cochrane review and 1 quasi-experimental study underwent appraisal using AMSTAR 2 or the John Hopkins Research Evidence Appraisal Tool.
Result & Outcome :
The moderate/good to high quality of evidences indicate that applying warm perineal compresses during the second stage of labour may increase the incidence of intact perineum and reduce the episiotomy rate. Additionally, it could reduce severe perineal trauma and alleviate postpartum perineal pain.
For translation, our workgroup is developing a department guideline for clinical application of warm compresses. Record of warm compresses application (e.g. duration, pain score, maternal and neonatal outcomes) and evaluations of client’s satisfaction and midwives’ perspectives will be reviewed to assess the effectiveness of this alternative method.
