Comparison of Warm Compresses and Modified Ritgen’s Techniques in Preventing Perineal Trauma During the Second Stage of Labour

Abstract

Objective: This study aims to compare the effectiveness of warm compresses and the modified Ritgen’s maneuver in preventing perineal trauma during the second stage of labor.

Methodology: A randomized controlled trial was conducted at the Department of Obstetrics and Gynecology, Federal Government Polyclinic (PGMI), Islamabad, from December 2022 to December 2023. A total of 340 pregnant women were enrolled, with 170 participants in each group. Group A underwent delivery with the modified Ritgen’s maneuver, while Group B received warm compresses. Patients were assigned randomly using the lottery method. Data were collected after obtaining ethical approval and informed consent. The primary outcome was the incidence and severity of perineal tears, analyzed using SPSS version 22.0.

Results: The mean age of participants was 26.1 ± 2.8 years in Group A and 25.6 ± 3.9 years in Group B. The overall incidence of perineal tears was 10% in Group A and 14.1% in Group B, though this difference was not statistically significant (p = 0.244). However, the incidence of severe perineal tears (third- and fourth-degree) was significantly lower in the modified Ritgen’s maneuver group compared to the warm compress group (1.2% vs. 2.4%, p = 0.003).

Conclusion: The modified Ritgen’s maneuver is more effective in reducing the occurrence of severe perineal tears than warm compresses. Given its non-invasive nature and ease of application, this technique could be a valuable strategy in perineal trauma prevention during vaginal deliveries.