First clinical experiences with the new birth trainer Epi-no® in primiparous women

In this prospective pilot study the efficiency of an inflatable, balloon-shaped vaginal dilatator (Epi-no®) was examined. This Birth Trainer is designed to gently mechanically expand the birth canal and to therefore reduce the episiotomy rate and improve the fetal outcome. 50 primiparae with a gestational age of 38 completed weeks aiming at a spontaneous birth participated in this Birth Training with the vaginal dilatator. 5 patients were subsequently excluded as a result of training times which did not comply with the study protocol. In the comparison of episiotomy rates of matched-pairs a significant difference was found: 82% of the women in the Control-group (CG) delivered with episiotomy, whereas its percentage in the Epi-No® group (EG) was only 49%. Perineal tears of first and second degree occurred as frequent as in the EG (4% vs. 2%). Moreover children of trained mothers from the EG group showed significantly improved one-minute APGAR-scores. In addition to this we found a considerable reduction in the average duration of Second stage of labour in the EG (29min), in comparison with the CG (54min). Women in the EG also required by far less analgesics than those in the CG. By training with Epi-No® it was also possible to reduce the PDA rate from 36% to 16%. The probability of delivery without episiotomy rose with the number of training days: women without episiotomy had trained on average for 11 days – on average two days longer than women who had had an episiotomy.