The objective of this review was to examine the evidence from controlled trials investigating the use of therapeutic ultrasound, pulsed electromagnetic energy, ice or cold for the relief of perineal pain following childbirth. Medline and CINAHL CD-ROM were searched for trial reports (1977 to 1996 inclusive), then methodological quality assessment of trials was carried out. Two trials of ultrasound, one of pulsed electromagnetic energy and four of ice or cold were included. Main outcome measures considered were methodological quality score and the effect of intervention on perineal pain. Quality assessments ranged from 3 to 8 points (maximum 10 points). None of the included studies indicated that ultrasound, pulsed electromagnetic energy, ice or cold, was effective for perineal pain. We suggest that the small number, and variable quality, of trials means that no conclusions can be drawn about the effectiveness of ultrasound, pulsed electromagnetic energy, ice or cold for perineal pain. Further large scale, good quality, clinical trials are needed.

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A brief summary and a critical assessment of this review may be available at DARE