HELPDESK ANSWERSAre there any antenatal interventions that reduce trauma during vaginal delivery?Cavanagh, Christina MD, FAAFP; Sanchious, Alyson Lewis MD Author Information Florida State University COM FMRP at Lee Health Fort Myers, FL Evidence-Based Practice 20(8):p E10-E11, August 2017. | DOI: 10.1097/01.EBP.0000541807.07781.91 Buy Metrics Abstract EVIDENCE-BASED ANSWER Antenatal perineal massage decreases risk of perineal trauma and episiotomies in primiparous but not multiparous women (SOR: A, meta-analysis of RCTs). Using warm compresses and perineal massage during second stage of labor reduces the risk of third- and fourth-degree perineal lacerations (SOR: A, metaanalysis of RCTs). Perineal injection of hyaluronidase at the onset of the second stage of labor does not appear to prevent perineal trauma (SOR: A, meta-analysis of RCTs). © Copyright 2017 Family Physicians Inquiries Network, Inc.