Research Article
Volume 9 Issue 7 - 2020
Evaluation of the Perineal Massage Effectiveness by Using a Vulvar Gel (Palomacare®) Containing Centella asiatica Phytosome during Pregnancy and Labor
Aragón P1, Losa F2, Abad MC3, Vallbuena I4 and Khorsandi D5,6*
1Department of Gynaecology, Hospital Universitario General de Catalunya, Barcelona, Spain
2Department of Gynaecology, Sagrada Familia Clinic, Barcelona, Spain
3Matron, Sagrada Familia Clinic, Barcelona, Spain
4Matron, Hospital Universitario General de Catalunya, Barcelona, Spain
5Faculty of Pharmacy, University of Barcelona, Barcelona, Spain
6Department of Research and Medical Affairs, Procare Health, Castelldefels, Barcelona, Spain
*Corresponding Author: Khorsandi D, Faculty of Pharmacy, University of Barcelona and Department of Research and Medical Affairs, Procare Health, Castelldefels, Barcelona, Spainc
Received: March 14, 2020; Published: June 02, 2020


Objective: To assess the beneficial effects in delivery and postpartum of perineal massage during pregnancy and labor in primiparous women.

Methods: Observational, multicenter, open, prospective pilot study with control group. Women with a first pregnancy were included who were assigned in a non-randomized way to one of the two study groups: intervention group (A) with daily perineal massage using Palomacare® Gel vulvar from the 35th week of pregnancy and during labor and control group (B) with usual clinical practice without performing perineal massage.

The following variables were evaluated at the time of delivery: need for episiotomy, presence and characteristics of tears, volume of bleeding caused by them and time of expulsion of the newborn from complete dilation. In the postpartum visit, the appearance of the episiotomy or lesions, the degree of pain and the degree of satisfaction with the appearance and evolution of the vulvo-perineal wound were assessed.

Results: 40 women (20 per group) between 23 and 45 years were evaluated. There were no significant differences between groups in the number of episiotomies and in the time of delivery of the newborn. In group A, there was a tendency towards a lower number of tears (35% vs 25%) and a significant lower volume of bleeding: 65% vs. 40% of patients without bleeding or with minimal bleeding in groups A and B, respectively (p < 0.02). At the postpartum visit, the appearance and healing of the episiotomy was rated excellent in 85% of patients in group A vs. 35% in group B (p < 0.0001). Pain was mild in 75% vs. 30% of patients in group A and B, respectively (p < 0.0001). 95% of patients in group A were satisfied or very satisfied with the postpartum evolution of the wound compared to 25% in group B (p < 0.0001).

Conclusion: The application of a daily perineal massage from the 35th week of pregnancy and during labor using Palomacare® Vulvar Gel shows beneficial effects on the delivery and postpartum of primiparous women. These results should be validated in a larger study.

Keywords: Perineal massage; Episiotomy; Vulvar Gel; Primiparous


  1. Schreiner L., et al. “Systematic review of pelvic floor interventions during pregnancy”. International Journal of Gynecology and Obstetrics 1 (2018): 10-18.
  2. Hamadan Masoumi SZ., et al. “Iran Effect of training preparation for childbirth on fear of normal vaginal delivery and choosing the type of delivery among pregnant women in a randomized controlled trial”. Journal of Family and Reproductive Health 3 (2016): 115.
  3. Rikard-Bell J., et al. “Perineal outcome and the risk of pelvic floor dysfunction: A cohort study of primiparous women”. Australian and New Zealand Journal of Obstetrics and Gynaecology4 (2014): 371-376.
  4. Ugwu EO., et al. “Effectiveness of antenatal perineal massage in reducing perineal trauma and postpartum morbidities: A randomized controlled trial”. Journal of Obstetrics and Gynaecology Research 7 (2018): 1252-1258.
  5. Carneiro M and Ferreira Couto CM. “Prevención del trauma perineal: una revisión integradora de la literature”. Enfermería Global47 (2017): 539575.
  6. Jiang H., et al. “Selective versus routine use of episiotomy for vaginal birth”. Cochrane Database of Systematic Reviews 2 (2017): CD000081.
  7. Dame J., et al. “Does antepartum perineal massage reduce intrapartum lacerations?” The Journal of Family Practice 7 (2008): 480-482.
  8. Lavesson T., et al. “A perineal protection device designed to protect the perineum during labor: a multicenter randomized controlled trial”. European Journal of Obstetrics and Gynecology and Reproductive Biology 181 (2014): 10-14.
  9. Dahlen HG., et al. “Perineal outcomes and maternal comfort related to the application of perineal warm packs in the second stage of labor: a randomized controlled trial”. Birth 4 (2007): 282-290.
  10. Geranmayeh M., et al. “Reducing perineal trauma through perineal massage with vaseline in second stage of labor”. Archives of Gynecology and Obstetrics 1 (2012): 77-81.
  11. Aquino C., et al. “Perineal massage during labor: a systematic review and meta-analysis of randomized controlled trials”. Journal of Maternal-Fetal and Neonatal Medicine 19 (2018): 1-13.
  12. Korshandi Danial., et al. “Evaluation of the benefits of a newly marketed vaginal gel (Palomacare®) on vaginal health of peri and postmenopausal women (Atrovag survey)”. EG Gynaecology 7 (2018): 104-106.
  13. Palacios S., et al. “Evaluation of the Level of Satisfaction of Patients with the Use of a Newly Marketed Vaginal Gel (Satisvag Survey)”. Obstetrics and Gynecology 467 (2018): 2161-0932.
  14. Palacios S., et al. “Therapies for the management of genitourinary syndrome of menopause”. Post Reproductive Health (2019): 2053369119866341.
  15. Collins S L., et al. “The visual analogue pain intensity scale: What is moderate pain in millimetres?” Pain 1-2 (1997): 95-97.
  16. Lu L., et al. “Asiaticoside induction for cell-cycle progression proliferation and collagen synthesis in human dermal fibroblasts”. The International Journal of Dermatology 11 (2004): 801-807.
  17. Lee JH., et al. “Asiaticoside enhances normal human skin cell migration, attachment and growth in vitro wound healing model”. Phytomedicine13 (2012): 1223-1227.
  18. Molazem Z., et al. “Aloe Vera Gel and Cesarean Wound Healing; A Randomized Controlled Clinical Trial”. Global Journal of Health Science 31:7.1 (2014): 801807.
  19. Khan AW., et al. “Formulation development, optimization and evaluation of aloe vera gel for wound healing”. Pharmacognosy Magazine 1 (2013): S6-S10.
Citation: Khorsandi D., et al. “Evaluation of the Perineal Massage Effectiveness by Using a Vulvar Gel (Palomacare®) Containing Centella asiatica Phytosome during Pregnancy and Labor”. EC Gynaecology 9.7 (2020): 01-09.

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