title: The Effect of Warm Compress Bistage Intervention on the Rate of Episiotomy, Perineal Trauma, and Postpartum Pain Intensity in Primiparous Women with Delayed Valsalva Maneuver Referring to the Selected Hospitals of Shiraz University of Medical Sciences in 2012-2013.
abstract: BACKGROUND
  Genital trauma during vaginal delivery may result from episiotomy, spontaneous perineal tears (perineum, vagina), or both. In 2012, this study aimed to investigate the effect of warm compress bistage intervention on the rate of episiotomy, perineal trauma, and postpartum pain intensity in the primiparous woman with delayed Valsalva maneuver.
  
  
  METHODS
  In this randomized clinical trial, which was performed in hospitals in Shiraz, Iran, in 2012-2013, 150 women were randomly divided into 2 groups: 1 intervention and 1 control. The intervention group received warm compress bistage intervention at 7-cm and 10-cm dilatation and zero position during the first and second stages of labor for 15 to 20 minutes, whereas the control group received the hospitals' routine care. After delivery, the prevalence of episiotomy; intact perineum; location, degree, and length of rupture; and postpartum pain intensity were assessed in the 2 groups. Following that, the data were analyzed with SPSS statistical software (version 16) using χ test, t test, and odds ratio.
  
  
  RESULTS
  The results revealed a significant difference between the intervention and control groups regarding the frequency of intact perinea (27% vs 6.7%) and the frequency of episiotomy (45% vs 90.70%). In addition, the frequency of the location of rupture (P = .019), mean length of episiotomy incision (P = .02), and mean intensity of pain the day after delivery (P < .001) were significantly lower in the intervention group compared with the control group. However, the rate of ruptures was higher in the intervention group.
  
  
  CONCLUSIONS
  Warm compress bistage intervention was effective in reducing episiotomies and the mean length of episiotomy incision, reducing pain after delivery, and increasing the rate of intact perinea. However, the rate of ruptures slightly increased in the intervention group compared with the control group.
authors.affiliation: Marzieh Akbarzadeh is an Instructor of Midwifery at the Nursing and Midwifery College, Maternal-Fetal Medicine Research Center, Shiraz University of Medical Sciences, Iran. Faride Vaziri, MSc, is an Instructor of Midwifery at the Nursing and Midwifery College, Shiraz University of Medical Sciences, Iran. Mahnaz Farahman, MSc, is a Midwife at Lordegan Hospital, Esfahan University of Medical Sciences, Iran. Zahra Masoudi, MSc, is a Midwife in the Department of Midwifery, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Iran. Sedigheh Amooee, MD, is an Assistant Professor of Medicine, Infertility Fellowship, Department of Obstetrics and Gynecology, Shiraz University of Medical Sciences, Iran. Najaf Zare, PhD, is an Instructor in the Department of Biostatistics, Infertility Research Center, Shiraz University of Medical Sciences, Iran.
authors.forename: Marzieh
authors.initials: M
authors.lastname: Akbarzadeh
authors.forename: Faride
authors.initials: F
authors.lastname: Vaziri
authors.forename: Mahnaz
authors.initials: M
authors.lastname: Farahmand
authors.forename: Zahra
authors.initials: Z
authors.lastname: Masoudi
authors.forename: Sedigheh
authors.initials: S
authors.lastname: Amooee
authors.forename: Najaf
authors.initials: N
authors.lastname: Zare
mesh_terms: D000293:Adolescent; D000328:Adult; D058128:Compression Bandages; D004841:Episiotomy / Q000009:adverse effects*; D005260:Female; D006801:Humans; D006979:Hyperthermia, Induced; D007492:Iran; D010149:Postoperative Pain / Q000517:prevention & control*; D010502:Perineum / Q000293:injuries*; D011644:Puerperal Disorders / Q000517:prevention & control*; D014636:Valsalva Maneuver; D055815:Young Adult