Capacitive-resistive radiofrequency therapy to treat postpartum perineal pain: A randomized study.

OBJECTIVE: To evaluate the reduction of perineal pain after vaginal deliveries by capacitive resistive radiofrequency therapy (RF). METHODS: We conducted a double-blind randomized study in University Hospital Centre in France. We included women presenting either perineal tears or an episiotomy after vaginal delivery (instrumental assisted or not). The participants were randomly assigned to RF or not at day 1 and day 2 postpartum. The primary outcome was pain evaluated as visual analog scale (VAS) score >4 at rest on day 2 after the treatment. Secondary outcomes included discomfort and pain while walking and seating two days after treatment, type of pain two days after treatment and analgesics intake two days after treatment, sexual intercourse retake and painful of intercourse were also assessed by phone call 30 days after delivery. We performed univariate analysis and multivariable regressions adjusting on the value of the outcome at baseline to improve precision of the estimated intervention effect. RESULTS: Between June 1, 2017 and October 8, 2017, the RF group included 29 women compared with 31 women in the group without RF. There was no significant difference on VAS >4 between the two groups (13.8% vs. 9.7% p = 0.69; difference = 4.1%, 95%CI -12.2%- 20.4%); consumption of paracetamol was lower in the RF group (978.3 mg (sd = 804.5) vs 1703.7 mg (sd = 1381.6), p = 0.035; difference = -725.3 mg, 95%CI -1359.6 - -91.3). Multivariate analysis showed no association between RF and pain. Nevertheless, we found an association between RF and discomfort while walking (adjusted OR 0.24, 95% CI 0.07-0.90; p = 0.03). CONCLUSION: VAS>4 at day 2 was not different in the experimental and the control groups but RF was associated with less perineal discomfort while walking and lower consumption of paracetamol after delivery. CLINICAL TRIAL REGISTRATIONS: The study was registered in the Clinical Government trial (https://clinicaltrials.gov/ct2/show/NCT03172286?term=bretelle&rank=2) under the number NCT03172286.

[An educational group talk on caring for a child that prepares families for their discharge from the maternity unit: An evaluation and proposals]. / Évaluation et proposition d'un entretien éducatif de groupe en puériculture préparant à la sortie de la maternité.

INTRODUCTION: An educational group talk on caring for a child is offered to all parents as part of their preparation for being discharged from the maternity unit. A nursey nurse and a childcare assistant lead a group of parents on the following themes: the rhythms of a newborn, sleeping, feeding, and caring for a child. Videos and leaflets are used as teaching aids. METHOD: 100 parents completed a satisfaction questionnaire that also questioned their sense of competence. RESULTS: 80% of parents were totally satisfied with the session but only 52% felt fully competent when it came to taking care of their child. This figure was at 69% for sleeping, 71% for temperature, and 57% for preventing infections and accidents. Mothers' satisfaction with participation was significant (p<0.013) for primiparous women (n=46) if they were listened to about their concerns. The same was true for multiparous women (n=35) if they were able to express themselves freely (p<0.018) by sharing their experiences. DISCUSSION: This educational group talk that prepares families for leaving the maternity unit must evolve into a sharing by the group of knowledge and practices where care-givers remain guarantors of their validity. It helps parents to develop child care skills for a more confident return home. The above-average sense of self-efficacy demonstrates the benefits of this method of family health education.