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 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 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 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 increases significantly the likelihood of having an intact perineum and reduces the episiotomy rate.