Prospective randomised multicentre trial with the birth trainer EPI-NO® for the prevention of perineal trauma

Background: In several non-randomised trials training with EPI-NO (R) increased the rate of intact perineum and decreased episiotomy rates, shortened the second stage of labour and lowered use of pain killers. Aims: To verify the preliminary results with EPI-NO (R) in a prospective randomised trial. Methods: Randomised, single-blind multicentre trial in four university hospitals in Germany including 276 primigravidae. Results: After training with EPI-NO (R) we observed a significant increase in the incidence of intact perineum (37.4% vs 25.7%; P = 0.05) and a tendency towards lower episiotomy rates (41.9% vs 50.5%; P = 0.11). We found no significant differences between the two groups regarding incidence of perineal tears, duration of second stage of labour, use of pain relief and rate of vaginal infection. Conclusions: Training with EPI-NO (R) increases significantly the likelihood of having an intact perineum and reduces the episiotomy rate.