Table 1.
Characteristics of the included studies (N = 7).
| Dahlen et al., 2007 [32] | Ahmad et al., 2010 [33] | Essa et al., 2015 [34] | Alihosseni et al., 2018 [35] | Modoor et al., 2021 [36] | Türkmen et al., 2021 [25] | Liao, 2021 [37] | |
|---|---|---|---|---|---|---|---|
| Study location | Australia | Saudi, Arabia | Egypt | Iran | Saudi, Arabia | Turkey | China |
| Participant | Primiparous women | Primiparous women | Primiparous women | Primiparous women | Primiparous women | Primiparous women | Primiparous women |
| Size (I/C) | 717 (360/357) | 100 (50/50) | 160 (80/80) | 107 (54/53) | 100 (50/50) | 100 (50/50) | 78 (39/39) |
| Intervention | Perineal warm compresses | Perineal warm compresses | Perineal warm compresses | Perineal heating pad | Perineal warm compresses | Perineal warm compresses | Perineal warm compresses |
| Performer | Midwives | Researcher | Researcher | Midwives | Researcher | Researcher | Researcher |
| Time to start | When the baby’s head began to distend the perineum and the woman felt perineal extension | During the whole second stage of labor | NR | The start of the second stage of labor | In the second stage of labor | In the second stage of labor after women were taken to the obstetrical table | When the fetal head is exposed and the mother feels perineal extension |
| Duration packs were held to perineum every time | During contractions until delivery | During each uterine contraction for 10 min | During each uterine contraction | Continuously during the second stage of labor | Continuously during the second stage of labor | 5–15 min with no interruption | 5–6 min |
| Temperature of the warm packs | 38–44 °C | NR | 38–44 °C | 50 °C continuously | NR | NR | NR |
| Water temperature of the jug | 45–59 °C | 45° C | 45–49 °C | NR | 45–49 °C | 45–50 °C | 45–48 °C thermostat |
| Time to keep packs in water | Resoaked between uterine contractions | Resoaked between uterine contractions | Resoaked between uterine contractions | NR | NR | NR | NR |
| Frequency to replace water in the jug | Every 15 min | Every 15 min | Every 15 min or if the temperature dropped below 45 °C | NR | NR | NR | NR |
| Time to stop | Until delivery | Until delivery of the fetal head | During the whole second stage of labor until delivery | During the whole second stage of labor until delivery | Until the fetal head is crowned | After 5–15 minutes’ intervention | Until the fetal head is crowned |
| Comparison | Standard midwifery care | Standard midwifery care | Standard midwifery care | Standard midwifery care | Standard midwifery care | Standard midwifery care | Standard midwifery care |
| Outcome 1 | Perineal pain | Perineal pain | Perineal pain/Behavioral pain | NR | Perineal pain | Perineal pain | Perineal pain |
| Measurement | VAS | VAS | NRS/BPS | NR | NRS | VAS | NRS |
| Data Collection time point | Three times: immediately after delivery; on the first day after delivery; and on the second day after delivery |
Three times: before intervention; immediately after delivery; and on the first day after delivery |
Twice: before intervention and immediately after delivery |
NR | NR | Four times: before intervention; 10 min after intervention; immediately after delivery; and 2 h after delivery |
Twice: on the first day after delivery and on the second day after delivery |
| Appraiser | Women themselves | Women themselves | Women themselves and the researcher | NR | Women themselves | Women themselves | Women themselves |
| Outcome 2 | Perineal outcomes | NR | Perineal outcomes | Perineal outcomes | Perineal outcomes | Perineal outcomes | Perineal outcomes |
| Measurement | (1) Intact perineum; (2) Perineal laceration: first-degree; second-degree; third-degree; and fourth-degree (3) Episiotomy (4) Suture need for perinea |
NR | (1) Intact perineum; (2) Perineal laceration: first-degree; second-degree; third-degree; and fourth-degree (3) Episiotomy (4) Suture need for perinea |
(1) Intact perineum; (2) Perineal laceration: first-degree; second-degree; third-degree; and fourth-degree (3) Episiotomy (4) Suture need for perinea |
(1) Intact perineum; (2) Perineal laceration: first-degree; second-degree; third-degree; and fourth-degree (3) Episiotomy (4) Suture need for perinea |
(1) Intact perineum; (2) Perineal laceration: first-degree; second-degree; third-degree; and fourth-degree (3) Episiotomy (4) Suture need for perinea |
(1) Intact perineum; (2) Perineal laceration: first-degree; second-degree; third-degree; and fourth-degree |
| Data Collection time point | Immediately after delivery | NR | Immediately after delivery | Immediately after delivery | Immediately after delivery | Immediately after delivery | Immediately after delivery |
| Appraiser | Researcher | Researcher | Researcher | The evaluator was blinded | Researcher | Researcher | Researcher |
| Outcome 3 | Urinary incontinence | NR | Need for pain relief | NR | NR | The comfort of the women | Perineal swelling |
| Measurement | By telephone | NR | Assessment tool | NR | NR | Postpartum Comfort Scale | By the soft ruler |
| Data Collection time point | At 6 weeks postpartum and 3 months postpartum |
NR | During the second stage of labor | NR | NR | 2 h after delivery | Immediately after delivery |
| Appraiser | Researcher | NR | Researcher | NR | NR | Researcher | Midwives |
VAS: Visual Analog Scale; NRS: Numerical Rating Scale; BPS: Behavioral Pain Scale; NR: not reported.