Most Proposed Topic :
Healthcare Advances, Research and Innovations (new projects / technology)
Proposed Topic (Second preferred): :
Enhancing Partnership with Patients and Community (Projects initiated to engage patient and improve patient communication)
Authors: (including presenting author): :
Cheung NL, Hsu LL, Li OC, Yip MY.
Affiliation: :
Department of Obstetrics & Gynaecology, Pamela Youde Nethersole Eastern Hospital
Introduction: :
In Hong Kong, around 90% of local women who gave birth vaginally suffer from various degrees of perineal damage. Perineal trauma during childbirth is a common health problem. It has been proven that perineal trauma can have both physical and psychological consequences, which are associated with short- and long-term complications and may need a lengthier hospital stay or additional follow up, resulting in more medical expenditures. These morbidities also negatively affect the psychosocial and emotional well-being of the women, which affect the quality of childbirth experience, maternal-infant bonding, breastfeeding, and sexual relationships, etc. Therefore, the importance of enhancement of obstetric practice and interventions to minimize perineal trauma is crucial. Evidence support that Antenatal perineal massage (APM) is an effective non-invasive intervention to minimize perineal trauma, it is highly recommended to perform during antenatal period. Thus, PYNEH O&G has introduced APM to low risk pregnant women since March 2023.
Objectives: :
♦ To uphold the quality of care to the women undergoes vaginal delivery
♦ To reduce the incidence and degree of perineal trauma and complications
♦ To enhance women's experience of delivery
Methodology: :
Low risk pregnant women were recruited in Midwife Clinic for the pilot from March 2023 and the one-off training workshop began after 36 weeks of gestation. Couples were invited to join the workshop. A 30 minutes self-developed education workshop with a pamphlet was developed to target couples. They are instructed to perform daily 5-10 minute perineal massage beginning at 36 weeks, with subsequent phone follow-up for ensuring the compliance. An evaluation and satisfaction survey was conducted after delivery.
Result & Outcome: :
23 primiparous women who met the inclusion criteria were recruited to attend the workshop from March – Sept 2023, with 95.6% delivered vaginally. Among them who underwent a normal vaginal delivery, 7.2% had an intact perineum, 21.4% experienced a first-degree tear, 35.7% had a second-degree tear, and 35.7% received an episiotomy with performing APM daily, alternative day, weekly and rarely respectively. 100% women expressed that they believe perineal massage has positive effect in protecting their perineum, and they had better preparation for their delivery. 100% women would perform the perineal massage again in subsequent pregnancies and they would also recommend it to others. Results showed perineal trauma is significantly reduced for women who performed APM daily. More frequent practice of APM result in better perineal condition were demostrated. Mothers expressed it can help to reduce pain and swelling in the perineal area. The program can also strengthen the pregnant women's confidence with positive delivery experience. However, the variations of performing APM frequency will affect the outcome noted, thus, the compliance of APM might need further reinforcement before full program launch.
