Non-pharmacological interventions for perineal trauma in the postpartum period: A scoping review.

Background: Non-pharmacological interventions for perineal trauma are crucial for postpartum women's care, providing an alternative to excessive medication use and the associated potential adverse effects for both the woman and her newborn.

Aim: To map the non-pharmacological interventions studied in the context of childbirth-related perineal trauma over the years.

Methods: A systematic search was conducted on PubMed, BVS/Bireme, CINAHL, Embase, Scielo, ProQuest, ProQuest theses, Medline, Web of Science, and Scopus electronic databases. Studies were included if their population consisted of puerperal women with perineal trauma, the concept being non-pharmacological interventions, and the context being the immediate postpartum period. A descriptive summary presents the most studied non-pharmacological interventions for perineal trauma, the main outcomes investigated, the types of perineal trauma of greatest interest, and publications about the topic over the years.

Results: This review encompassed 41 studies. Cryotherapy emerged as the most extensively studied non-pharmacological intervention, with 22 studies (53.65%). Other interventions were heat therapy, low-level light and electromagnetic therapy, therapeutic ultrasound, transcutaneous electrical nerve stimulation, pelvic floor muscle exercise, and complementary and alternative medicine. Perineal pain was the most investigated outcome (32 studies, 78.04%). Episiotomy was frequently the subject of research (20 studies, 48.78%). Interest in this topic has notably surged over the past 15 years.

Conclusion: A range of non-pharmacological interventions have been investigated for managing perineal trauma related to childbirth. Future studies could explore the efficacy and cost-effectiveness of these interventions to identify the most suitable options for postpartum women and facilitate their integration into clinical practice.