Non-steroidal anti-inflammatory drugs (NSAIDS) for perineal pain in the early postpartum period

Review objective: To determine the efficacy and safety of Non-steroidal anti-inflammatory drugs (NSAIDs) in relieving perineal pain in the early postpartum period. Perineal pain is commonly experienced by women after childbirth, particularly, although not exclusively, following episiotomy, spontaneous tears or bruising (Lawn and Sullivan 2009). A recent study in the UK found that 92% of all women who gave birth had perineal pain the first day postpartum, persisting in 12% at two months (Andrews et al., 2008). Perineal pain interferes with a woman's mobility, can affect her ability to care for her baby (East et al., 2012a) and disrupts sleep (Woolhouse et al., 2013). Pain management strategies for perineal pain are an important part of postpartum care. Various treatments are used in clinical practice including oral analgesia, topical anaesthesia, rectal suppositories, and ice/cold packs. Oral analgesia, particularly paracetamol and NSAIDs, are the most commonly used method of pain relief used by women suffering from postpartum perineal pain (East et al., 2012a). Systematic reviews examining the effectiveness of paracetamol (Chou et al., 2013), topical anaesthesia (Hedayati et al. 2005), rectal suppositories (Hedayati et al., 2003), cooling (East et al., 2012b) and therapeutic ultrasound (Hay-Smith, 1995) have already been conducted. The objective of this systematic review is to determine the efficacy and safety of NSAIDs in relieving perineal pain in the early postpartum period. This review will provide information directly relevant for women suffering from postpartum perineal pain. Moreover, it can provide guidance to stakeholders in developing postpartum care policies/strategies.

Award Date
30 September 2013
Award Value
€4,000
Principal Investigator
Ms Francesca Wuytack
Host Institution
Trinity College Dublin
Scheme
Cochrane Training Fellowships