Obstetrical Soft Tissue Trauma during Spontaneous Vaginal Birth in the Romanian Adolescent Population—Multicentric Comparative Study with Adult Population

Romania is a country with high rates of adolescent births, associating scarce comprehensive obstetrical management with this specific population. This research aims to assess soft tissue trauma after vaginal birth in teenage mothers compared to their adult counterparts. A retrospective case-control study was conducted for one year in two hospitals. All vaginal deliveries were considered; the age cut-off value was considered at 20 years old for case and control groups. Lacerations were divided into three subgroups, considering the involved anatomical region; group I: labial and periurethral lacerations, group II: vaginal and perineal lacerations, and group III: cervical lacerations. There were 1498 women included in the study: 298 young mothers and 1200 adults. Teenagers were more likely to have an episiotomy during vaginal delivery compared to adult women: 56% versus 26.7% (p = 0.00, Pearson Chi-square) and a 1.89 times increased risk for developing additional group II lacerations: p = 0.01, Pearson Chi-square test with Bonferroni correction: OR = 1.89, 95% CI: 1.18–3.02. Group II lacerations were the most frequent type of birth trauma in both study groups. Fetal weight ≥4000 g was associated with a two times higher risk for vaginal and perineal lacerations when age criterion was not considered (OR = 1.98, 95% CI: 1.13–3.47, p = 0.01). The incidence of group I and II lacerations increased with age: from 0% and 9.1% between 10 and 14 years old to 6% and 26.2% between 18 and 19 years old. All groups of lacerations were more often identified in the case group, compared to the adult group. Fetal macrosomia and spontaneously ruptured membranes at admission could not be documented as risk factors for obstetrical injury in young mothers. Episiotomy performed in teenagers was not a protective procedure for group II lacerations.

Perineal Lacerations: A Retrospective Study in a Habitual-Risk Public Maternity

Objective In around 85% of vaginal births, the parturients undergo perineal lacerations and/or episiotomy. The present study aimed to determine the incidence of lacerations and episiotomies among parturients in 2018 in a habitual-risk public maternity hospital in southern Brazil, and to determine the risk and protective factors for such events. Methodology A retrospective cross-sectional study. Data were obtained from medical records and analyzed using the Stata software. Univariate and multivariate logistic regressions were performed. Values of p < 0.05 were considered significant. Results In 2018, there were 525 vaginal births, 27.8% of which were attended by obstetricians, 70.7% by obstetric nurses, and 1.5% evolved without assistance. Overall, 55.2% of the parturients had some degree of laceration. The professional who attended the birth was a significant variable: a greater number of first- and second-degree lacerations, as well as more severe cases, occurred in births attended by nurses (odds ratio [OR]: 2,95; 95% confidence interval [95%CI]: 1,74 to 5,03). Positions at birth that did not enable perineal protection techniques (expulsive period with the “hands-off” method), when analyzed in isolation, determined the risk; however, in the final regression model, this relationship was not confirmed. Although reported in the literature, there were no associations between the occurrence of laceration and age, skin color, or birth weight. In 24% of the births, episiotomy was performed, and doctors performed 63.5% of them. Conclusion Births attended by nurses resulted in an increased risk of perineal lacerations, of varying degrees. In turn, those assisted by physicians had a higher occurrence of episiotomy.

Efektivitas Pemberian Ikan Gabus Kukus Terhadap Penyembuhan Laserasi Perineum Pada Ibu Postpartum

Postpartum, also called the puerperium or puerperium, is the time since the baby is born and the placenta is separated from the uterus until the next 6 (six) weeks, accompanied by the recovery of the organs associated with the womb, which have undergone changes related to childbirth. The changes that occur during the puerperium include all systems including the reproductive organs such as the uterus and vulva, from physiological to pathological changes as a result of complications during the puerperium. Complications of the puerperium are abnormal conditions during the puerperium caused by the entry of germs to the genetalia during labor and the puerperium, one of the complications of the puerperium, namely a rupture, is also called a perineal tear or laceration. This study aims to analyze the effectiveness of giving boiled snakehead fish on the healing of perineal lacerations in postpartum mothers in Samarinda City. In this study, the authors used a quasi-experimental method with a post-test only control group design in which the measurement of variables was given a special intervention, namely giving 100 g of steamed fish a day for 10 days, then observing its effect on post-partum maternal wound healing. As a comparison, also a control group without treatment with inclusion and exclusion criteria. The research location is at Kartika Jaya Clinic, Samarinda City. In this study, the samples were selected using purposive sampling. Data collection methods used in two ways, namely through interviews and observations. The test used Mann Whitney. The results of data analysis using the Mann-Whitney obtained the sig (2-tiled) value of 0.000 <0.05 with the average healing time of the experimental group was 7 days. Meanwhile, the average healing time for the control group was 10 days. So it can be concluded that there is an effect of giving steamed cork fish on the healing of perineal lacerations in postpartum mothers with a difference of 3.2 days. The conclusion of this study is that the administration of steamed snakehead fish is more effective in treating perineal lacerations of postpartum mothers

Efektivitas Metode Pembelajaran Continuity Of Care Terhadap Peningkatan Kompetensi Pemberian Asuhan Kebidanan

Postpartum, also called the puerperium or puerperium, is the time since the baby is born and the placenta is separated from the uterus until the next 6 (six) weeks, accompanied by the recovery of the organs associated with the womb, which have undergone changes related to childbirth. The changes that occur during the puerperium include all systems including the reproductive organs such as the uterus and vulva, from physiological to pathological changes as a result of complications during the puerperium. Complications of the puerperium are abnormal conditions during the puerperium caused by the entry of germs to the genetalia during labor and the puerperium, one of the complications of the puerperium, namely a rupture, is also called a perineal tear or laceration. This study aims to analyze the effectiveness of giving boiled snakehead fish on the healing of perineal lacerations in postpartum mothers in Samarinda City. In this study, the authors used a quasi-experimental method with a post-test only control group design in which the measurement of variables was given a special intervention, namely giving 100 g of steamed fish a day for 10 days, then observing its effect on post-partum maternal wound healing. As a comparison, also a control group without treatment with inclusion and exclusion criteria. The research location is at Kartika Jaya Clinic, Samarinda City. In this study, the samples were selected using purposive sampling. Data collection methods used in two ways, namely through interviews and observations. The test used Mann Whitney. The results of data analysis using the Mann-Whitney obtained the sig (2-tiled) value of 0.000 <0.05 with the average healing time of the experimental group was 7 days. Meanwhile, the average healing time for the control group was 10 days. So it can be concluded that there is an effect of giving steamed cork fish on the healing of perineal lacerations in postpartum mothers with a difference of 3.2 days. The conclusion of this study is that the administration of steamed snakehead fish is more effective in treating perineal lacerations of postpartum mothers. Student competency results obtained through the pre-test and post-test showed that the difference between the pre-test and the final test for the two groups was significantly different. This is indicated by the results of the t test obtained by t count = 0.001 <t table = 0.05, which means that H0 is rejected. With the rejection of H0, this means that the results of student competence in providing midwifery care using the Continuity of Care learning method are better than those using the ordinary practicum method. The difference in competency results between the control class and the experimental class occurs because the experimental class uses Continuty of Care learning and the control class uses the ordinary practicum method