Cochrane · systematic review · CD006304
Local cooling for relieving pain from perineal trauma sustained during childbirth
East, CE, Dorward, EDF, Whale, RE, et al. · Cochrane Database of Systematic Reviews · 2020 · Cochrane Library
Pregnancy and ChildbirthAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
42
current version
GRADE rated
38
No studies
0
Included studies
NR
No studies 0 · 0%Ungraded 4 · 9.5%Very low 30 · 71.4%Low 8 · 19%Moderate 0 · 0%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Cooling treatment (ice pack or cold gel pad) compared to no treatment for relieving pain from perineal trauma sustained during childbirth
Population: Women with perineal trauma (tear or episiotomy, or both) sustained during childbirth
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Perineal pain within 4 ‐ 6 hours of giving birth Cooling treatment (ice pack or cold gel pad) vs no treatment | no estimate extracted | 1 study · 100 participants | Very low Downgraded: risk of bias, imprecision |
Perineal pain within 24 hours of giving birth ‐ Moderate + severe pain Cooling treatment (ice pack or cold gel pad) vs no treatment | RR 1.03 [0.82, 1.29] | 1 study · 316 participants | Very low Downgraded: risk of bias |
Perineal pain within 24 hours of giving birth Cooling treatment (ice pack or cold gel pad) vs no treatment | no estimate extracted | 3 studies · 166 participants | Very low Downgraded: risk of bias, imprecision |
Perineal pain between 24 ‐ 48 after giving birth ‐ Moderate + severe pain Cooling treatment (ice pack or cold gel pad) vs no treatment | RR 0.73 [0.57, 0.94] | 1 study · 316 participants | Very low Downgraded: risk of bias |
Perineal pain 24 ‐ 48 hours after giving birth Cooling treatment (ice pack or cold gel pad) vs no treatment | no estimate extracted | 1 study · 71 participants | Very low Downgraded: risk of bias, imprecision |
Perineal oedema within 24 hours of giving birth Cooling treatment (ice pack or cold gel pad) vs no treatment | RR 1 [0.87, 1.16] | 1 study · 316 participants | Very low Downgraded: risk of bias, imprecision |
Perineal bruising within 24 hours of giving birth Cooling treatment (ice pack or cold gel pad) vs no treatment | RR 0.98 [0.81, 1.19] | 1 study · 316 participants | Very low Downgraded: risk of bias, imprecision |
Perineal bruising 24 ‐ 48 hours after giving birth Cooling treatment (ice pack or cold gel pad) vs no treatment | RR 1.13 [0.97, 1.32] | 1 study · 316 participants | Very low Downgraded: risk of bias, imprecision |
Perineal redness, oedema, bruising, discharge, wound gaping 24 ‐ 48 hours of giving birth Cooling treatment (ice pack or cold gel pad) vs no treatment | no estimate extracted | 1 study · 71 participants | Very low Downgraded: risk of bias, imprecision |
Adverse effects on perineal wound healing: Day 5 ‐ Wound not healing Cooling treatment (ice pack or cold gel pad) vs no treatment | RR 1.24 [0.34, 4.58] | 1 study · 315 participants | Very low Downgraded: risk of bias |
Adverse effects on perineal wound healing: Day 5 ‐ Wound edges gaping Cooling treatment (ice pack or cold gel pad) vs no treatment | RR 2.56 [0.58, 11.33] | 1 study · 315 participants | Very low Downgraded: risk of bias |
Maternal views and experiences of treatment ‐ Satisfaction with overall perineal care (good + very good + excellent) Day 10 Cooling treatment (ice pack or cold gel pad) vs no treatment | RR 1.07 [0.97, 1.18] | 1 study · 308 participants | Very low Downgraded: risk of bias |
Maternal views and experiences of treatment ‐ Psychospiritual comfort within 6 hours of giving birth Cooling treatment (ice pack or cold gel pad) vs no treatment | no estimate extracted | 1 study · 100 participants | Low Downgraded: imprecision |
Maternal views and experiences of treatment ‐ Sociocultural comfort Cooling treatment (ice pack or cold gel pad) vs no treatment | no estimate extracted | 1 study · 100 participants | Low Downgraded: imprecision |
Cooling treatment (cold gel pad)+compression compared to placebo (gel pad+compression) for relieving pain from perineal trauma sustained during childbirth
Population: Women with perineal trauma (tear or episiotomy, or both) sustained during childbirth
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Perineal pain within 4 ‐ 6 hours of giving birth Cooling treatment (cold gel pad)+compression vs placebo (gel pad+compression) | no estimate extracted | 1 study · 250 participants | Low Downgraded: imprecision |
Perineal pain within 24 ‐ 48 hours after giving birth Cooling treatment (cold gel pad)+compression vs placebo (gel pad+compression) | no estimate extracted | 1 study · 250 participants | Low Downgraded: imprecision |
Perineal oedema 24 ‐ 48 hours after giving birth Cooling treatment (cold gel pad)+compression vs placebo (gel pad+compression) | no estimate extracted | 1 study · 250 participants | Low Downgraded: imprecision |
Perineal bruising 24 ‐ 48 hours after giving birth Cooling treatment (cold gel pad)+compression vs placebo (gel pad+compression) | no estimate extracted | 1 study · 250 participants | Ungraded |
Adverse effects Cooling treatment (cold gel pad)+compression vs placebo (gel pad+compression) | no estimate extracted | 0 studies · 0 participants | Ungraded |
Satisfaction with perineal care Cooling treatment (cold gel pad)+compression vs placebo (gel pad+compression) | no estimate extracted | 1 study · 250 participants | Low Downgraded: imprecision |
Cooling treatment (ice pack) compared to placebo (water pack) for relieving pain from perineal trauma sustained during childbirth
Population: Women with perineal trauma (tear or episiotomy, or both) sustained during childbirth
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Perineal pain within 24 hours after giving birth Cooling treatment (ice pack) vs placebo (water pack) | no estimate extracted | 1 study · 63 participants | Ungraded |
Perineal oedema within 4 ‐ 6 hours after giving birth Cooling treatment (ice pack) vs placebo (water pack) | RR 0.96 [0.5, 1.86] | 1 study · 63 participants | Low Downgraded: imprecision |
Perineal oedema within 24 hours after giving birth Cooling treatment (ice pack) vs placebo (water pack) | RR 0.36 [0.08, 1.59] | 1 study · 63 participants | Low Downgraded: imprecision |
Adverse effects on perineal healing Cooling treatment (ice pack) vs placebo (water pack) | no estimate extracted | 1 study · 63 participants | Ungraded |
Maternal views and experiences with treatment ‐ Satisfied with treatment Cooling treatment (ice pack) vs placebo (water pack) | RR 0.91 [0.77, 1.08] | 1 study · 63 participants | Very low Downgraded: imprecision |
Maternal views and experiences with treatment ‐ Would repeat treatment in future childbirth Cooling treatment (ice pack) vs placebo (water pack) | RR 0.88 [0.75, 1.04] | 1 study · 63 participants | Very low Downgraded: imprecision |
Maternal views and experiences with treatment ‐ Would recommend treatment Cooling treatment (ice pack) vs placebo (water pack) | RR 0.89 [0.77, 1.03] | 1 study · 63 participants | Very low Downgraded: imprecision |
Cooling treatment (ice pack) compared to cooling treatment (cold gel pad) for relieving pain from perineal trauma sustained during childbirth
Population: Women with perineal trauma (tear or episiotomy, or both) sustained during childbirth
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Perineal pain within 4 ‐ 6 hours of giving birth ‐ Moderate + severe pain Cooling treatment (ice pack) vs cooling treatment (cold gel pad) | RR 0.57 [0.26, 1.24] | 1 study · 49 participants | Very low Downgraded: risk of bias, imprecision |
Perineal pain within 24 hours of giving birth ‐ Moderate + severe pain Cooling treatment (ice pack) vs cooling treatment (cold gel pad) | RR 0.98 [0.78, 1.22] | 2 studies · 264 participants | Very low Downgraded: risk of bias, imprecision |
Perineal pain within 24 hours of giving birth Cooling treatment (ice pack) vs cooling treatment (cold gel pad) | no estimate extracted | 1 study · 74 participants | Very low Downgraded: risk of bias, imprecision |
Perineal pain 24 ‐ 48 hours after giving birth ‐ Moderate + severe pain Cooling treatment (ice pack) vs cooling treatment (cold gel pad) | RR 1.21 [0.89, 1.65] | 2 studies · 263 participants | Very low Downgraded: risk of bias, imprecision |
Perineal pain 24 ‐ 48 hours of giving birth Cooling treatment (ice pack) vs cooling treatment (cold gel pad) | no estimate extracted | 1 study · 74 participants | Very low Downgraded: risk of bias, imprecision |
Perineal oedema within 4 ‐ 6 hours of giving birth Cooling treatment (ice pack) vs cooling treatment (cold gel pad) | RR 1.39 [0.93, 2.09] | 1 study · 49 participants | Very low Downgraded: risk of bias, imprecision |
Perineal oedema within 24 hours of giving birth Cooling treatment (ice pack) vs cooling treatment (cold gel pad) | RR 0.97 [0.84, 1.13] | 2 studies · 264 participants | Very low Downgraded: risk of bias, imprecision |
Perineal oedema 24 ‐ 48 hours after giving birth Cooling treatment (ice pack) vs cooling treatment (cold gel pad) | RR 1.69 [1.03, 2.77] | 2 studies · 264 participants | Very low Downgraded: risk of bias, imprecision |
Perineal bruising within 4 ‐ 6 hours of giving birth Cooling treatment (ice pack) vs cooling treatment (cold gel pad) | RR 1.23 [0.51, 2.97] | 1 study · 49 participants | Very low Downgraded: risk of bias, imprecision |
Perineal bruising within 24 hours of giving birth Cooling treatment (ice pack) vs cooling treatment (cold gel pad) | RR 0.95 [0.79, 1.14] | 2 studies · 264 participants | Very low Downgraded: risk of bias, imprecision |
Perineal redness, oedema, bruising, discharge, wound gaping within 24 hours of giving birth Cooling treatment (ice pack) vs cooling treatment (cold gel pad) | no estimate extracted | 1 study · 74 participants | Very low Downgraded: imprecision |
Adverse effects on perineal wound healing: Day 5 ‐ Wound not healing Cooling treatment (ice pack) vs cooling treatment (cold gel pad) | RR 1.01 [0.26, 3.93] | 1 study · 215 participants | Very low Downgraded: risk of bias, imprecision |
Adverse effects on perineal wound healing: Day 5 ‐ Wound edges gaping Cooling treatment (ice pack) vs cooling treatment (cold gel pad) | RR 0.22 [0.05, 1.01] | 1 study · 215 participants | Very low Downgraded: risk of bias, imprecision |
Maternal views and experiences with treatment ‐ Opinion on treatment effects (good + very good + excellent) Day 5 Cooling treatment (ice pack) vs cooling treatment (cold gel pad) | RR 0.33 [0.17, 0.68] | 1 study · 49 participants | Very low Downgraded: risk of bias, imprecision |
Maternal views and experiences with treatment ‐ Satisfaction with overall perineal care (good + very good + excellent) Day 10 Cooling treatment (ice pack) vs cooling treatment (cold gel pad) | RR 0.82 [0.73, 0.92] | 1 study · 208 participants | Very low Downgraded: risk of bias |