Can pelvic floor muscle training prevent perineal laceration? A systematic review and meta-analysis.

Background: Pelvic floor muscle training (PFMT) is reportedly able to reduce risk factors for perineal trauma. However, the effects of these exercises on perineal injuries are unclear.
Objective: To investigate the effectiveness of PFMT in the prevention of perineal laceration.
Search Strategy: Searches were conducted in PubMed/Medline, LILACS, Scopus, Cochrane Library, Web of Science, and CINAHL. For search strategies, we combined the terms PFMT, tear, laceration, perineum, and delivery.
Selection Criteria: We included randomized controlled trials that evaluated the effectiveness of PFMT for the prevention of perineal laceration during vaginal delivery. There were no period or language limitations.
Data Collection and Analysis: We conducted data extraction and synthesis. We performed a quality appraisal, a qualitative synthesis, and for meta-analysis we used the Software R.
Main Results: Nine studies were included. In most studies, PFMT was performed daily, with a wide range of the number of contractions and sustainability. Prevalence of perineal laceration had a wide range and information on laceration degree was limited. Meta-analysis showed that PFMT was not effective to prevent perineal laceration.
Conclusion: Pelvic floor muscle training does not prevent perineal laceration. Further studies are needed to investigate different protocols and interventions.
(© 2021 International Federation of Gynecology and Obstetrics.)