scholarly journals Efeitos da massagem perineal durante o trabalho de parto

2021 ◽  
Vol 2 (1) ◽  
pp. 519-530
Author(s):  
Mariana Fernandes Lopes ◽  
Emília De Carvalho Coutinho ◽  
Maria José Santos ◽  
Manuela Ferreira ◽  
Hélia Dias
Keyword(s):  
Perineal Trauma ◽  
Perineal Laceration ◽  
Perineal Tear ◽  
Perineal Injury

Durante o trabalho de parto o traumatismo do períneo é frequente. A massagem perineal é considerada uma técnica que promove a integridade do períneo. Como objetivo pretende-se identificar os efeitos da massagem perineal durante o trabalho de parto. Foi realizada uma revisão integrativa da literatura, com pesquisa a 18 de janeiro de 2021. Foram considerados artigos de estudos primários e revisões sistemáticas da literatura, publicados em Português, Inglês e Espanhol, disponíveis nas bases B-ON, PubMed e CINAHL, em texto integral e de livre acesso, no ano de 2016 a 2020. A questão de pesquisa “Quais os efeitos da massagem perineal durante o trabalho de parto?” teve por base o método de PI[C]OD. Aquando a pesquisa nas bases de dados com a expressão -“(injury) AND (massage) AND (perineum) AND (labor) obteve-se 53 artigos na Pubmed; já com a expressão – “( perineal trauma OR perineal injury OR perineal tear OR perineal laceration ) AND massage AND ( labor OR delivery ) obteve-se 278 artigos na B-on e 41 na Cinahl, ficando no total com 372 artigos. Após aplicação dos critérios de inclusão do tempo, língua e livre acesso ficaram 110 artigos. De seguida, considerou-se a repetição dos artigos ficando com 85 artigos. Após leitura do título e resumo foram selecionados 11 artigos. Foram assim encontrados 6 artigos agrupados em função do método de pesquisa. Dos resultados encontrados verificou-se que existem benefícios na utilização da massagem perineal durante o trabalho de parto. Conclui-se que a realização de massagem perineal durante o trabalho de parto reduz o número de lacerações no períneo, a necessidade de episiotomia, a duração do trabalho de parto, bem como, a dor após o parto. No entanto, é necessário realizar mais estudos. 

Perineal Injury and Its Association with Postpartum Sexual Dysfunction among First Delivery Women

2021 ◽  
Vol 2 (3) ◽  
pp. 34-39
Author(s):  
Z. Nusee ◽  
M. N. Ainy ◽  
P. Hafizah
Keyword(s):  
Sexual Dysfunction ◽  
Vaginal Delivery ◽  
Female Sexual Dysfunction ◽  
Family Income ◽  
Mode Of Delivery ◽  
Sexually Active ◽  
Perineal Tear ◽  
Health Clinics ◽  
Perineal Injury ◽  
Significant Difference

Background: Female sexual dysfunction (FSD) following childbirth imposes significant burden to the marital institution around the world. The perineal injury may potentially be one of the main risk factors contributing to postpartum female sexual dysfunction (PPFSD). The study aimed to determine the effect of perineal injury and patients’ characteristics on PPFSD. Methodology: This cross-sectional questionnaire study was conducted in six different health clinics in the district of Kuantan from April 2019 to October 2019. Eligible women who came to the family health clinics at 6 months postpartum were recruited as study population. The participants completed their biodata and socio-demographic form and the Malay-validated Female Sexual Function Index (MVFSFI) questionnaire given. A cut-off point of 26.55 and below on MVFSFI scoring system was used as a measure of the primary outcome of sexual dysfunction. Results: Out of 240 women who delivered vaginally, 34 (14%) had intact perineum, 107 (44.6%) sustained 1st degree perineal tear, 96 (40%) 2nd degree tear and three (1.25%) 3rd degree tear. Among the respondents, 60.9% of the sexually active respondents who had vaginal delivery, reported to have PPFSD. The timing of sexual resumption does not correlate with the severity of perineal tear. The severity of perineal tear is significantly associated with age (p=0.018), duration of marriage (p=0.008), body mass index (BMI) (p=0.019) and instrumental delivery (p=0.025). The level of personnel skill whom performed the repair were also found to have a significant relationship to PPFSD (p= 0.001). The relationship of participants’ mean age (p=0.271), marriage duration (p=0.903), race (p=0.928), religion (p=0.852), education level (p=0.549), employment status (p=0.102), family income (p=0.460) and BMI(p=0.159) with presence of PPFSD were all found to be statistically not significant. Conclusion: Occurrence of PPFSD is high among sexually active women who had vaginal delivery complicated by perineal tear, especially among those requiring instrumentation. The severity of perineal tear is associated with age, duration of marriage, BMI and mode of delivery. However, PPFSD does not significantly relate to the severity of perineal tear. None of the socio-demographic factors show a significant difference to sexual dysfunction.

scholarly journals EFFECTIVENESS OF HANDS OFF VERSUS HANDS ON TECHNIQUES ON PERINEAL TRAUMA AND PERINEAL PAIN AMONG PARTURIENT MOTHERS

2016 ◽  
Vol 9 (6) ◽  
pp. 179 ◽  
Author(s):  
Jayabharathi Bhaskaran
Keyword(s):  
Sampling Technique ◽  
Simple Random Sampling ◽  
Perineal Trauma ◽  
Perineal Pain ◽  
Study Group ◽  
Perineal Tear ◽  
Group I ◽  
Significant Difference ◽  
Hands On ◽  
The Mean

Background:  Labor is the process by which the fetus and the placenta leave the uterus. Delivery can occur in two ways, vaginally or by a cesarean delivery. The majority of women who have a vaginal birth will sustain perineal trauma from a spontaneous perineal tear or episiotomy or both.Aim: This study aims to assess the effectiveness of hands off versus hands on techniques on perineal trauma and perineal pain among parturient mothers in selected hospitals, Kerala.Methods: The research design adopted in this study was true experimental post test only design. The study was conducted in 3 hospitals at Kerala such as Karothukuzhiyil hospital Pvt, Lakshmi hospital Pvt and Carmal hospital Pvt. Sample size was computed by power analysis based on the previous studies and it would be a total of 90 samples, with 30 parturient mothers in each groups. Simple random sampling technique (Lottery method) was adopted for the selection of parturient mothers into the study. Perineal trauma was assessed by the scale given by Royal College of Obstetrics and Gynaecology (RCOG), 2001, and visual analogue scale (Combined numerical and categorical pain scale) was used to assess the perineal pain of parturient mothers.Results:  The results showed that, there was extremely significant difference found in perineal trauma and perineal pain of parturient mothers between study group I and study II at  p=0.000 level. The mean scores of study group I was lesser than the mean scores of study group II. Conclusion: Different perineal techniques and interventions such as hands on technique, hands off technique, perineal massage, warm compresses etc can be widely used by midwives and birth attendants to prevent perineal trauma during labour.  Key words:  hands off  technique, hands on technique, perineal trauma and perineal pain

scholarly journals Use of 2D and multislice transperineal ultrasonography to describe the degree of perineal laceration following vaginal delivery

2018 ◽  
Vol 27 (2) ◽  
Author(s):  
Budi I. Santoso ◽  
Suskhan Djusad ◽  
Surahman Hakim ◽  
Fernandi Moegni ◽  
Alfa P. Meutia ◽  
...  
Keyword(s):  
Vaginal Delivery ◽  
Clinical Examination ◽  
Evaluation Method ◽  
Cross Sectional Study ◽  
Perineal Laceration ◽  
Perineal Tear ◽  
Cross Sectional ◽  
Measurement Variation ◽  
The Mean ◽  
Primiparous Women

Background: Perineal tear is the most common complication after vaginal delivery. Pill-rolling test is a widely used clinical evaluation method to determine the degree of perineal tear. However, the evaluation results of anal sphincter complex (ASC) differ between clinical examination and 2D/multislice transperineal ultrasonography (TPUS). This study aims to describe measurement variation between these modalities.Methods: This cross-sectional study was conducted at Cipto Mangunkusumo Hospital from November 2015 to May 2016. Subjects were primiparous women after vaginal delivery. Clinical examination using pill-rolling test was performed to determine the degree of perineal laceration. Suture was conducted accordingly. The subjects were subjected to 2D/multislice TPUS 72 hours after delivery to evaluate the integrity of internal and external anal sphincters. Data were collected and analyzed to determine compatibility between these examinations.Results: Among 70 prospective primiparous women, five were excluded due to unavailability to undergo 2D/multislice TPUS 72 hours after delivery. The mean duration to perform 2D/multislice TPUS was 4.5 minutes, and pain was tolerable during the examination. The compatibility values of clinical examination with 2D and multislice TPUS were 0.98 and 0.93, respectively, with Cohen’s kappa of 0.92 (95% CI 0.81–1.00) and 0.79 (95% CI 0.58–0.99), respectively.Conclusion: Clinical examination is compatible with 2D/multislice TPUS for determining the degree of perineal tear after vaginal delivery.

scholarly journals Perineal trauma during vaginal birth in Slovenia

2018 ◽  
Vol 52 (3) ◽  
Author(s):  
Petra Petročnik ◽  
Ana Polona Mivšek ◽  
Teja Škodič Zakšek ◽  
Ivan Verdenik ◽  
Anita Jug Došler
Keyword(s):  
Information System ◽  
Health Professionals ◽  
Perineal Trauma ◽  
Descriptive Statistics ◽  
Perineal Tear ◽  
Fourth Degree ◽  
Perineal Tears ◽  
Maternity Hospitals ◽  
Severe Perineal Trauma ◽  
Third Degree Tears

Introduction: The aim of this retrospective study was to examine the rates of perineal tears during childbirth in Slovenian  maternity hospitals in the period from 2013 to 2015.Methods: A causal non-experimental method of quantitative empirical approach was conducted. Data were pooled from the Slovenian National Perinatal Information System and analysed for the period of 2013 to 2015. Data analysis was performed with the use of frequency distribution of attributive variables and the basic descriptive statistics of numerical variables.Results: The incidence of perineal trauma during childbirth in all the 14 maternity hospitals varies from the "perineum without injury" to the "fourth degree perineal tear". Overall, 26.1 % of women sustained a first degree perineal tear, whereas 4.8 % of women had a second degree perineal tear. Severe perineal trauma included 0.8 % of third degree tears and 0.1 % of fourth degree tears.Discussion and conclusion: Perineal trauma varies between Slovenian maternity hospitals. Women who have sustained tears that cut into their bowels may face serious health problems and should be given relevant advice regarding the state of their pelvic floor after childbirth. It is of great importance to appropriately recognise the severity of the perineal trauma. Moreover, health professionals should be familiar with the perineal trauma classification and the factors that may cause the perineum to tear during childbirth.

scholarly journals The use of liquid petroleum jelly in the prevention of perineal lacerations during birth

2008 ◽  
Vol 16 (3) ◽  
pp. 375-381 ◽  
Author(s):  
Natalúcia Matos Araújo ◽  
Sonia Maria Junqueira Vasconcellos de Oliveira
Keyword(s):  
Genital Tract ◽  
Randomized Study ◽  
Perineal Trauma ◽  
Petroleum Jelly ◽  
Perineal Laceration ◽  
Birth Center ◽  
Nulliparous Women ◽  
Perineal Region ◽  
And Control ◽  
Experimental Group

Most of vaginal births are accompanied by lacerations in the genital tract. This was a randomized study carried out in a Birth Center located in São Paulo city to evaluate the efficacy of liquid petroleum jelly in reducing perineal laceration. The sample was composed of 38 nulliparous women per group (experimental and control). In the experimental group was used 30 ml of the petroleum jelly in the perineal region during the expulsive period. The parturient were allowed to push spontaneously during the delivery and remained in the left side position. The frequency of perineal laceration was similar in both groups (experimental 63.2% versus control 60.5%). The posterior perineum region presented the highest frequency of trauma (53.2%). Of the total cases of perineal trauma, 72.3% were first-degree lacerations. The use of liquid petroleum jelly of perineal protection does not reduce the frequency neither the degree of lacerations in childbirth.

scholarly journals Lubricant for Reducing Perineal Trauma: A Systematic Review and Meta-analysis of Randomized Controlled Trials

2022 ◽  
Author(s):  
Qiuyu Yang ◽  
Xiao Cao ◽  
Shasha Hu ◽  
Mingyao Sun ◽  
Honghao Lai ◽  
...  
Keyword(s):  
Randomized Controlled Trials ◽  
Vaginal Delivery ◽  
Standard Care ◽  
Meta Analysis ◽  
Perineal Trauma ◽  
Controlled Trials ◽  
Perineal Laceration ◽  
Second Stage ◽  
Randomized Controlled ◽  
Second Stage Labor

Background Different techniques have been reported to prevent perineal lacerations, but the effects of the use of lubricant have been unclear and is still subject of debate. Objective To assess the effect of lubricants on reducing perineal trauma during vaginal delivery. Search strategy PubMed, Embase, the Cochrane Library, CINAHL, China National Knowledge Infrastructure (CNKI), China Biology Medicine disc (CBM), WanFang databases, ClinicalTrials.gov in 25 June 2021. Selection criteria Randomized controlled trials published in English or Chinese that compared the vaginal application of lubricant with standard care in women with cephalic presentation at vaginal delivery were included . Data collection and analysis Two independent reviewers selected eligible trials and extracted data on perineal trauma, duration of the second-stage labor, postpartum hemorrhage and Apgar score for meta-analysis. Main results Nineteen trials enrolling 5445 pregnant women were included. Compared with standard care, women using lubricants had a lower incidence of perineal trauma (RR 0.84, 95%CI 0.76 to 0.93), second-degree perineal laceration (RR 0.72, 95%CI 0.64 to 0.82) and episiotomy (RR 0.77, 95%CI 0.62 to 0.96), had a shorter duration of the second-stage labor (MD -13.72 minutes, 95%CI -22.68 to -4.77). Subgroup analysis indicated that women with obstetric gel had a shorter duration of the second-stage (MD -16.9 minutes, 95%CI -27.03 to -6.78 vs MD -8.38 minutes, 95%CI -11.11 to -5.65; P interaction=0.02) when compared with liquid wax. Conclusions Compared with standard care, lubricants could reduce the incidence of perineal trauma, especially second-degree perineal laceration, and shorten the duration of the second-stage labor.

Perineal outcomes after delivery in 179 mothers with IBD compared to 31,258 controls - a single centre cohort study

2021 ◽  
Author(s):  
Gillian Lever ◽  
Hlupe Chipeta ◽  
Tracey Glanville ◽  
Christian Selinger
Keyword(s):  
Anal Sphincter ◽  
Pelvic Floor Dysfunction ◽  
Perineal Trauma ◽  
Obstetric Outcomes ◽  
Single Centre ◽  
Perineal Tear ◽  
Increased Risk ◽  
Clinically Significant ◽  
Singleton Pregnancies

Abstract Background Patients with IBD have an increased risk for caesarean section (CS) in women but perineal obstetric outcomes, which may have significant consequences for women with IBD, have not been previously studied. Method Maternal outcomes in singleton pregnancies of IBD and non-IBD patients (2014-2018) in a single centre were studied. Results In 31,528 Non-IBD and 179 IBD patients delivery by CS was more likely in IBD patients (p=0.0021, RR 1.45, CI 1.16-1.81). Elective CS in IBD patients occurred in 40% for IBD indications, all in accordance with current international guidelines. Perineal trauma, including tears involving the anal sphincter, were equally uncommon in IBD (2.23%) and Non-IBD patients (3.40%; p=0.35, RR 0.64, CI 0.24-1.68). Of the four IBD patients with clinically significant tears, none had pelvic floor dysfunction or incontinence at follow-up in a specialist postnatal perineal trauma clinic. One IBD patient who had a clinically non-significant second degree perineal tear reported incontinence a year after giving birth. Previous perianal disease was not associated with significant perineal trauma. Conclusion The low rate of perineal trauma is reassuring for promotion of vaginal delivery in most IBD patients. In those who experienced tears involving the anal sphincter no continence issues occurred. Women with IBD had greater incidence of delivery by CS only partially explained by IBD indications.

scholarly journals Maternal Morbidity in Vaginal Delivery with or without Episiotomy in Nulliparous Women

2017 ◽  
Vol 16 (2) ◽  
pp. 41-46
Author(s):  
Sumana Thapa ◽  
Indira Acharya ◽  
Meeta Singh ◽  
Josie Baral
Keyword(s):  
Vaginal Delivery ◽  
Maternal Morbidity ◽  
Surgical Repair ◽  
Perineal Laceration ◽  
Perineal Tear ◽  
Second Stage ◽  
Mediolateral Episiotomy ◽  
Obstetrics And Gynaecology ◽  
Nulliparous Women ◽  
Prospective Comparative Study

Introduction: Episiotomy incision is the most common surgical procedure around the globe and in many countries, it became a routine policy. Episiotomy in all women with vaginal delivery has no benefit. Rate of episiotomy varies widely around the globe, while in Nepal all nulliparous and primi-parous hospital deliveries are given routine episiotomy. So, this study aimed to compare the maternal morbidity during first vaginal birth in women with or without episiotomy.Methods: This is a hospital based randomized prospective comparative study conducted in the Obstetrics and Gynaecology department of a teaching hospital. The subjects were divided into episiotomy group and no episiotomy group. Under local anaesthesia mediolateral episiotomy was given in the second stage with crowning of the head in episiotomy group. Nature of morbidity seen were recorded in both the groups immediately after delivery, after 6 hours and after 1 week and compared.Results: In no episiotomy group intact perineum 26.3%, laceration 10.5%, spontaneous perineal tear (first and second degree) 63.1% was observed. Total perineal surgical repair was 81.55%. Intact perineum was high among no episiotomy group. Third degree tear, vulval haematoma, wound gaping, perineal oedema were seen in episiotomy group.Conclusion: Anterior perineal laceration rate was high in no episiotomy group than episiotomy group but overall few morbidities were in no episiotomy group than in episiotomy group. So, episiotomy should not be considered to prevent insignificant anterior perineal lacerations.

EPISIOTOMY : A CHALLENGING OBSTETRIC INTERVENTION

2003 ◽  
Vol 42 (145) ◽  
pp. 54-58
Author(s):  
D S Malla
Keyword(s):  
Blood Loss ◽  
Pelvic Floor ◽  
Anal Sphincter ◽  
Intracranial Haemorrhage ◽  
Perineal Tear ◽  
Obstetric Intervention ◽  
Anal Sphincter Damage

ABSTRACTThe professional literatures on the development of widely practiced procedure, episiotomy through theyears from the first publication in 1742 are reviewed. It reveals the change in number of publication as wellas the contributors to the development of perception about episiotomy. So it consisted expression of opinionof doctors initially then the co-workers like nurses and researchers and clients or consumers themselvestoo. It concludes that episiotomies prevent anterior perineal tear but fails to accomplish other benefitstraditionally ascribed to pelvic floor damage and relaxation including its sequel and also protection ofnewboin from intracranial haemorrhage and intrapartum asphyxia. Episiotomy substantially increasematernal blood loss during delivery and risk of anal sphincter damage with their long term morbidity.There is an urgent need to restrict the use of episiotomy in vaginal delivery.Key Words: Episiotomy, Perineal tear, anal sphincter damage.

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