Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

144 questions · 146 findings · 34 reviews · Pregnancy and Childbirth

No studies found 17 · 11.6%GRADE not reported 23 · 15.8%Very low 58 · 39.7%Low 35 · 24%Moderate 11 · 7.5%High 2 · 1.4%

Cooling treatment (ice pack) vs cooling treatment (cold gel pad)

Perineal oedema within 4 ‐ 6 hours after giving birth · Women with perineal trauma (tear or episiotomy, or both) sustained during childbirth

It is very uncertain whether cooling treatment (ice pack) changes perineal oedema within 4 ‐ 6 hours of giving birth compared with cooling treatment (cold gel pad) (very low certainty).

1 finding from 1 review

Cooling treatment (ice pack) vs cooling treatment (cold gel pad)

Perineal oedema within 24 hours of giving birth · Women with perineal trauma (tear or episiotomy, or both) sustained during childbirth

It is very uncertain whether cooling treatment (ice pack) changes perineal oedema within 24 hours of giving birth compared with cooling treatment (cold gel pad) (very low certainty).

1 finding from 1 review

Cooling treatment (ice pack) vs cooling treatment (cold gel pad)

Perineal oedema 24 ‐ 48 hours after giving birth · Women with perineal trauma (tear or episiotomy, or both) sustained during childbirth

It is very uncertain whether cooling treatment (ice pack) changes perineal oedema 24 ‐ 48 hours after giving birth compared with cooling treatment (cold gel pad) (very low certainty).

1 finding from 1 review

Cooling treatment (ice pack) vs cooling treatment (cold gel pad)

Perineal bruising within 4 ‐ 6 hours of giving birth · Women with perineal trauma (tear or episiotomy, or both) sustained during childbirth

It is very uncertain whether cooling treatment (ice pack) changes perineal bruising within 4 ‐ 6 hours of giving birth compared with cooling treatment (cold gel pad) (very low certainty).

1 finding from 1 review

Cooling treatment (ice pack) vs cooling treatment (cold gel pad)

Perineal bruising within 24 hours of giving birth · Women with perineal trauma (tear or episiotomy, or both) sustained during childbirth

It is very uncertain whether cooling treatment (ice pack) changes perineal bruising within 24 hours of giving birth compared with cooling treatment (cold gel pad) (very low certainty).

1 finding from 1 review

Cooling treatment (ice pack) vs cooling treatment (cold gel pad)

Adverse effects on perineal wound healing: Day 5 ‐ Wound not healing · Women with perineal trauma (tear or episiotomy, or both) sustained during childbirth

It is very uncertain whether cooling treatment (ice pack) changes adverse effects on perineal wound healing: Day 5 ‐ Wound not healing compared with cooling treatment (cold gel pad) (very low certainty).

1 finding from 1 review

Cooling treatment (ice pack) vs no treatment

Perineal pain 24 ‐ 48 hours after giving birth ‐ Moderate + severe pain · Women with perineal trauma (tear or episiotomy, or both) sustained during childbirth

It is very uncertain whether cooling treatment (ice pack or cold gel pad) changes perineal pain between 24 ‐ 48 after giving birth ‐ Moderate + severe… compared with no treatment (very low certainty).

1 finding from 1 review

Cooling treatment (ice pack) vs cooling treatment (cold gel pad)

Adverse effects on perineal wound healing: Day 5 ‐ Wound edges gaping · Women with perineal trauma (tear or episiotomy, or both) sustained during childbirth

It is very uncertain whether cooling treatment (ice pack) changes adverse effects on perineal wound healing: Day 5 ‐ Wound edges gaping compared with cooling treatment (cold gel pad) (very low certainty).

1 finding from 1 review

Cooling treatment (ice pack) vs cooling treatment (cold gel pad)

Maternal views and experiences of treatment ‐ Satisfaction with overall perineal care (good + very good + excellent) Day 10 · Women with perineal trauma (tear or episiotomy, or both) sustained during childbirth

It is very uncertain whether cooling treatment (ice pack) changes maternal views and experiences with treatment ‐ Satisfaction with… compared with cooling treatment (cold gel pad) (very low certainty).

1 finding from 1 review

Cooling treatment (ice pack) vs no treatment

Perineal oedema within 24 hours of giving birth · Women with perineal trauma (tear or episiotomy, or both) sustained during childbirth

It is very uncertain whether cooling treatment (ice pack or cold gel pad) changes perineal oedema within 24 hours of giving birth compared with no treatment (very low certainty).

1 finding from 1 review

Cooling treatment (ice pack) vs no treatment

Perineal bruising within 24 hours of giving birth · Women with perineal trauma (tear or episiotomy, or both) sustained during childbirth

It is very uncertain whether cooling treatment (ice pack or cold gel pad) changes perineal bruising within 24 hours of giving birth compared with no treatment (very low certainty).

1 finding from 1 review

Cooling treatment (ice pack) vs no treatment

Perineal bruising 24 ‐ 48 hours after giving birth · Women with perineal trauma (tear or episiotomy, or both) sustained during childbirth

It is very uncertain whether cooling treatment (ice pack or cold gel pad) changes perineal bruising 24 ‐ 48 hours after giving birth compared with no treatment (very low certainty).

1 finding from 1 review

Antibiotic prophylaxis vs no treatment

Infection rate at 2 weeks postpartum ‐ perineal wound infection in third‐ or fourth‐degree tear · Women with third‐ and fourth‐degree perineal tear during vaginal birth

Antibiotic prophylaxis probably leads to lower infection rate at 2 weeks postpartum ‐ perineal wound infection in… compared with no treatment (moderate certainty).

1 finding from 1 review

Antibiotic prophylaxis vs no treatment

Infection rate at 6 weeks postpartum ‐ perineal wound infection in third‐ or fourth‐degree tear · Women with third‐ and fourth‐degree perineal tear during vaginal birth

Antibiotic prophylaxis showed no clear difference in infection rate at 6 weeks postpartum ‐ perineal wound infection in… compared with no treatment (low certainty).

1 finding from 1 review

Massage vs control (hands off or care

Perineal trauma requiring suturing · pregnant women expecting a vaginal birth, singleton vertex presentation at term, with no medical complications

It is very uncertain whether massage changes perineal trauma requiring suturing compared with control (hands off or care (very low certainty).

1 finding from 1 review

Massage vs control (hands off or care

1st degree perineal tear · pregnant women expecting a vaginal birth, singleton vertex presentation at term, with no medical complications

It is very uncertain whether massage changes 1st degree perineal tear compared with control (hands off or care (very low certainty).

1 finding from 1 review