title: Does the Epi-No Birth Trainer reduce levator trauma? A randomised controlled trial.
abstract: OBJECTIVE
  The purpose of this study is to evaluate whether antepartum use of a birth trainer may reduce levator trauma.
  
  
  METHODS
  Two hundred nulliparous women were examined with four-dimensional translabial ultrasonography at 35-37 weeks of gestation and 3 months postpartum in a randomised controlled pilot study. Women in the intervention group were instructed to use the birth trainer from 37 weeks onwards.
  
  
  RESULTS
  One hundred forty-six women returned for follow-up 5.6 months (range 2.3-22.1) after childbirth. Seventy-eight of them had had normal vaginal deliveries (53%), 32 vacuum/forceps (22%) and 36 a caesarean section (25%). The risk of avulsion was halved in the intervention group (6% vs 13%, P = 0.19) on modified intention to treat analysis. A treatment received analysis revealed a nonsignificant 42% and 30% reduction in levator avulsion and microtrauma, respectively (P ≥ 0.22).
  
  
  CONCLUSIONS
  This pilot randomised controlled trial showed a nonsignificantly lower incidence of pelvic floor muscle injury in women who used the Epi-No device from 37 weeks onwards.
authors.affiliation: Nepean Clinical School, Nepean Hospital, University of Sydney, Sydney, NSW 2750, Australia. shekkalai@yahoo.com.hk
authors.forename: Ka Lai
authors.initials: KL
authors.lastname: Shek
authors.forename: Varisara
authors.initials: V
authors.lastname: Chantarasorn
authors.forename: Susanne
authors.initials: S
authors.lastname: Langer
authors.forename: Hala
authors.initials: H
authors.lastname: Phipps
authors.forename: Hans Peter
authors.initials: HP
authors.lastname: Dietz
mesh_terms: D000328:Adult; D002404:Catheterization / Q000295:instrumentation* / Q000379:methods; D002585:Cesarean Section; D036861:Delivery, Obstetric; D005260:Female; D006801:Humans; D015994:Incidence; D017773:Pelvic Floor / Q000000981:diagnostic imaging; D059952:Pelvic Floor Disorders / Q000453:epidemiology* / Q000517:prevention & control; D056887:Pelvic Organ Prolapse / Q000453:epidemiology* / Q000517:prevention & control; D010865:Pilot Projects; D011295:Prenatal Care / Q000379:methods*; D011446:Prospective Studies; D012189:Retrospective Studies; D014463:Ultrasonography