Are there any antenatal interventions that reduce trauma during vaginal delivery?

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EVIDENCE-BASED ANSWERAntenatal perineal massage decreases risk of perineal trauma and episiotomies in primiparous but not multiparous women (SOR: A, meta-analysis of RCTs). Using warm compresses and perineal massage during second stage of labor reduces the risk of third- and fourth-degree perineal lacerations (SOR: A, metaanalysis of RCTs). Perineal injection of hyaluronidase at the onset of the second stage of labor does not appear to prevent perineal trauma (SOR: A, meta-analysis of RCTs).

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