scholarly journals Effect of perineal massage in the second stage of labour, on the incidence of episiotomy and perineal tears

Author(s):  
Abinaya Raja ◽  
Pallavee P. ◽  
Rupal Samal

Background: This study aimed to investigate whether perineal massage during second stage of labour could decrease perineal trauma in the form of episiotomy and perineal tears.Methods: One hundred and fifty term antenatal women in labour were randomly assigned to two groups, one of which received perineal massage and the other received routine care during the second stage. Frequency of episiotomies, perineal tears, intact perineums, degrees of perineal tears, duration of second stage of labour and perineal pain after 24 hours was compared.Results: Perineal massage was efficient in reducing incidence of episiotomy, duration of second stage of labour and perineal pain assessed 24 hours after delivery. The frequency of perineal tears and intact perineums did not differ significantly. Perineal massage was protective against severe form of third degree perineal tears.Conclusions: Authors suggest that perineal massage can be routinely practiced by health professionals to improve quality of life in women post vaginal delivery.

2021 ◽  
Vol 22 (4) ◽  
pp. 1980
Author(s):  
Mariarita Laforgia ◽  
Carmelo Laface ◽  
Concetta Calabrò ◽  
Simona Ferraiuolo ◽  
Valentina Ungaro ◽  
...  

Peripheral neurologic complications are frequent adverse events during oncologic treatments and often lead to dose reduction, administration delays with time elongation of the therapeutic plan and, not least, worsening of patients’ quality of life. Experience skills are required to recognize symptoms and clinical evidences and the collaboration between different health professionals, in particular oncologists and hospital pharmacists, grants a correct management of this undesirable occurrence. Some classes of drugs (platinates, vinca alkaloids, taxanes) typically develop this kind of side effect, but the genesis of chemotherapy-induced peripheral neuropathy is not linked to a single mechanism. This paper aims from one side at summarizing and explaining all the scattering mechanisms of chemotherapy-induced peripheral neuropathy through a detailed literature revision, on the other side at finding new approaches to possible treatments, in order to facilitate the collaboration between oncologists, hematologists and hospital pharmacists.


2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Zohal Faiz ◽  
Eline M. Van ’t Hof ◽  
Gerard J. Colenbrander ◽  
Ralf Lippes ◽  
Petra C.A.M. Bakker

Abstract Objectives The aim of this study is to determine the quality of the foetal heart rate (FHR) recording, defined as signal loss, during preterm labour below 28 weeks gestational age (GA) and contribute to the discussion if cardiotocography (CTG) is of value for the extreme preterm foetus. Methods From January 2010 to December 2019 a retrospective study was conducted with data of 95 FHR recordings of singletons born between 24 and 28 weeks GA at the Amsterdam University Medical Centre, location VUmc. FHR tracings had a duration of at least 30 min and were obtained via external ultrasound mode. Data of all recordings were divided in two groups according to gestation (24–26 weeks and 26–28 weeks). Signal loss was analysed. Statistical significance was calculated by non-parametric tests and chi-square tests. The median signal loss and the proportion of cases exceeding the International Federation of Gynaecology and Obstetrics Guidelines (FIGO) threshold of 20% signal loss were calculated. Results One-third of the recordings exceeded the 20% FIGO-criterion for adequate signal quality during the first stage of labour. In the second stage, this was nearly 75%. Similarly, the median signal loss was 13% during the first and 30% during the second stage of labour (p<0.01). Conclusions The quality of FHR monitoring in the extreme preterm foetus is inadequate in a large proportion of the foetuses, especially during the second stage. FHR monitoring is therefore controversial and should be used with caution.


Author(s):  
Anjali Dabral ◽  
Pallavi Pawar ◽  
Rekha Bharti ◽  
Archana Kumari ◽  
Achla Batra ◽  
...  

Background: Women delivering in upright position have shorter labour due to efficient and stronger contractions with faster descent of foetal head. The present study aimed to find out effect of upright kneeling position in the second stage of labour on maternal and foetal outcome and assess patients’ satisfaction.Methods: The study was carried out in a tertiary care hospital of North India from October 2012 to February 2014. Low risk women admitted in early labour were divided into two groups, women delivering in kneeling position and in supine position. The outcome measures studied were, duration of second stage of labour, mode of delivery, 2nd degree perineal tears, Apgar scores at 5 minutes, NICU admission rate and patient satisfaction.Results: The mean duration of second stage of labour in kneeling group was shorter by 14.901 minutes. The rate of vaginal delivery was comparable for both primigravidas and multigravida in kneeling and supine groups, RR: 2.275, 95% CI (0.7872-6.5831) and RR: 1.633, 95% CI (0.393-6.775). Primigravidas had more 2nd degree perineal tears in kneeling group as compared to supine, RR 4.191, 95% CI (1.54 to 11.41). No difference in Apgar scores >7 at 5 minutes was observed in both groups, however, significantly lesser babies in kneeling group were admitted in NICU, RR 0.246, 95% CI (0.079 to 0.761). There was no difference on comparing satisfaction scores of primigravidas and multigravida in both supine and kneeling position.Conclusions: Kneeling position reduces the duration of second stage of labour and NICU admissions.


2017 ◽  
Vol 2017 ◽  
pp. 1-3
Author(s):  
J. O. Awoleke ◽  
O. M. Ipinnimo

Even though they are quite uncommon, puerperal genital haematomas can be associated with serious maternal morbidity. Key findings are significant perineal pain and, depending on the location, visible swelling. However, attention can be drawn to its progression by the rare occurrence of persistent painful “bearing down” efforts, even after the successful delivery of the baby. The final size of this haematoma and the rare presentation make it truly uncommon. The primary goals of treatment include the prevention of further blood loss, minimizing tissue damage, relieving pain, and reducing the risk of infection. Management is generally conservative for small collections, but surgery is indispensable when they acutely expand in size or are large with worsening symptoms.


1977 ◽  
Vol 74 (3) ◽  
pp. 487-497 ◽  
Author(s):  
J. J. LEGROS ◽  
G. PEETERS ◽  
S. MARCUS ◽  
W. DE GROOT ◽  
R. REYNAERT

SUMMARY Bovine neurophysin I and neurophysin II (bNpI and bNpII) have been assayed by radioimmunoassay in the jugular venous blood of cows during parturition. In general, low bNpI levels were detected on the day before labour began and during the first stage of labour. Neurophysin I was present in appreciable quantities in blood taken during the second stage of labour and in most cows the concentrations rose to a maximum during the expulsive stage. After delivery, the concentration of bNpI in the blood diminished. This pattern of release is similar to that reported for oxytocin at parturition in cows. As with bNpI, maximum levels of bNpII occurred during the expulsive stage of labour in some animals. In others, bNpII concentrations were very low or absent. Low concentrations of bNpII were found at the other stages of labour. Examination of the results from individual animals indicated that the release of the two neurophysins can be independent.


2017 ◽  
Vol 22 (01) ◽  
pp. 060-067 ◽  
Author(s):  
Luciana Maximino ◽  
Ticiana Zambonato ◽  
Mirela Picolini-Pereira ◽  
Camila Castro Corrêa ◽  
Mariza Feniman ◽  
...  

Introduction Cleft lip and cleft palate can result in impairments in communication, specifically in hearing, making the use of technological resources such as blogs a fundamental guideline for health professionals. Objective The aim of this study was to prepare and analyze the access to a blog about cleft lip and cleft palate and hearing as a pedagogical tool for health professionals. Methods The first stage for the development of the blog was the selection of the content that would be addressed and the respective illustrations. The second stage was making the blog available through the WordPress platform, and the third stage included the evaluation of the blog, of the access to the WordPress statistical features, and of the quality of the blog through the Emory questionnaire, which was answered by 75 professionals. Results The blog, titled “Fissure and Hearing”, was developed with the architecture of a digital information environment containing a system of organization, navigation, labeling and search (first stage). The address hosting the blog was: http://fissuraeaudicao.wordpress.com (second stage). The result of the third stage included 56,269 views of the blog from different countries, and Brazil was the country with the highest viewing. Regarding the assessment by the Emory questionnaire, we found that for most of the major issues, the percentages obtained were or equal to 90%, while the analysis of the scales, navigation and structure presented the lowest scores. Conclusion The blog was developed and enabled greater access to information available on the web about cleft lip and cleft palate and hearing.


Author(s):  
. Neelam ◽  
Kiran Batool ◽  
Sadia Kadir ◽  
Kaneez Fatima ◽  
Afshan Nadeem ◽  
...  

Objective: To compare the frequency of perineal tears (3rd and 4th degree) with and without episiotomy in primigravida women. Setting: Department of Obstetrics and Gynecology at peoples Medical College Hospital (PMCH) Nawabshah. Duration of Study: Six month from March 2015 to September 2015. Study Design: Randomized control trial. Subject and Methods: In this study 322 primigravida women with singleton pregnancy and cephalic presentation were included. The patients were kept in labour room till the second stage of labour. The patients were divided into two groups equally. In Groups-A, right mediolateral episiotomy was performed after infiltration with local anaesthesia at the time of crowing. The Group B in which episiotomy was not given. After delivery, patients were examined for extension of episiotomy in Group A and 3rd and 4th degree perineal tear in both groups. Results:  Mean age was 27.83±6.27 years in group A and 27.60±4.93 years in group B (p=0.724). Mean gestational age was 38.17±1.25 weeks was in group A and 38.11±119 weeks in group B (p=0.644). The rate of 3rd and 4th degree perineal tear was significantly higher in group A as compare to group B [60.87% vs. 47.83% p=0.019] and [39.13% vs. 26.09% p=0.013] respectively. Conclusion: Episiotomy was found to be an important risk factor for extension of the perineal tear. It should be practiced only where it is indicated like rigid perineum, any instrumental delivery and shoulder dystocia.


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