A Comparison of the “Hands-Off” and “Hands-On” Methods to Reduce Perineal Lacerations: A Randomised Clinical Trial

Rezaei, Rozita; Saatsaz, Sussan; Chan, Yiong Huak; Nia, Hamid Sharif

doi:10.1007/s13224-014-0535-2

Cited by 23 publications

(14 citation statements)

References 9 publications

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“…There was also a change in obstetric practice in a randomized controlled clinical trial with 600 nulliparous women in Iran comparing perineal protection techniques (hands onintervention technique of perineal protection and hands off -expectant technique of perineal protection) by the reduction of perineal traumas. The authors concluded that there were www.ee.usp.br/reeusp Implementation methodology of practices based on scientific evidence for assistance in natural delivery: a pilot study more cases of episiotomy and third-degree perineal lacerations with the hands on technique than hands off (15) . An analysis of the medical records showed that the practicing of non-pharmacological pain relief methods was adopted more after the intervention.…”

Section: Discussionmentioning

confidence: 99%

Implementation methodology of practices based on scientific evidence for assistance in natural delivery: a pilot study

Côrtes

Santos

Caroci

et al. 2015

Rev. esc. enferm. USP

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Objective: Presenting methodology for transferring knowledge to improve maternal outcomes in natural delivery based on scientific evidence. Method: An intervention study conducted in the maternity hospital of Itapecerica da Serra, SP, with 50 puerperal women and 102 medical records from July to November 2014. The PACES tool from Joanna Briggs Institute, consisting of pre-clinical audit (phase 1), implementation of best practice (phase 2) and Follow-up Clinical Audit (phase 3) was used. Data were analyzed by comparing results of phases 1 and 3 with Fisher's exact test and a significance level of 5%. Results: The vertical position was adopted by the majority of puerperal women with statistical difference between phases 1 and 3. A significant increase in bathing/showering, walking and massages for pain relief was found from the medical records. No statistical difference was found in other practices and outcomes. Barriers and difficulties in the implementation of evidence-based practices have been identified. Variables were refined, techniques and data collection instruments were verified, and an intervention proposal was made. Conclusion: The study found possibilities for implementing a methodology of practices based on scientific evidence for assistance in natural delivery.

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Section: Discussionmentioning

confidence: 99%

Implementation methodology of practices based on scientific evidence for assistance in natural delivery: a pilot study

Côrtes

Santos

Caroci

et al. 2015

Rev. esc. enferm. USP

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“…The advancement of the fetal head, and stretching of the perineum in the minutes before giving birth, are accompanied by pain that can be severe. [16] Midwives utilize a variety of non-pharmacological methods in the second stage of labor, in the belief that these may help lower genital tract trauma and perineal pain including: Hands-on or Hands-off, [17,18] perineal massage, [19] and warm packs. [15] Perineal warm packs or warm compresses have been advocated for many years in the belief that they reduce perineal trauma and increase comfort during late second stage.…”

Section: Introductionmentioning

confidence: 99%

Effect of second stage perineal warm compresses on perineal pain and outcome among primiparae

Essa

Ismail

2015

JNEP

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The aim of this study was to determine the effect of second stage perineal warm compresses on perineal pain and outcome among primiparae. A non-randomized controlled clinical trial was utilized at the labor and delivery unit of National Medical Institution in Damanhour, Albehera Governorate, Egypt. Research was carried out from beginning May 2014 till the end of October 2014, with a total of 160 parturients in their second stage of labor. They were equally randomly divided into study (N = 80) and control (N = 80) groups. Four tools were utilized to collect the necessary data. The first tool was a Socio-demographic and clinical data structured interview schedule. The second tool was a Numerical Pain Rating Score (NPRS), to estimate the subjective level of pain intensity. The third tool was a modified Behavioral Pain Scale (BPS), to measure the behavioral responses to pain. The fourth tool was the second stage and perineal outcome assessment tool: to assess duration of the second stage of labor, mode of delivery, need for pain relief during 2nd stage, baby birth weight, perineal condition, degrees of perineal tear and need to repair. The results revealed that perineal pain intensity did statistically significantly decrease among the study group after the intervention (P = .000). On the other hand, it was slightly increased among the control group after the intervention (P = .106). There was a statistically significant difference between the study and control groups in favor of the former in relation to perineal tear, vaginal tear, degree of perineal tear and need to repair where P = .000. The study concluded that second stage perineal warm compresses had better effects on perineal pain and perineal outcome. It resulted in less perineal pain and less genital tract trauma as well as decrease needs to repair. Consequently, it is recommended that perineal warm compresses should be incorporated into pain relief and perineal maintaining options available to women during second stage of labor.

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“…Application of the "hands-off" method for vaginal delivery has a positive effect on the mother's health because of the reduction of episiotomy and third-degree tearing. Therefore, it is concluded that the "hands-off" method offers a safer alternative for perineal control during labor [14].…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of Hands Off Versus Hands on Techniques on Perineal Trauma and Perineal Pain Among Parturient Mothers

Bhaskaran

2016

Asian J Pharm Clin Res

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Objective: Labor is the process by which the fetus and the placenta leave the uterus. Delivery can occur in two ways, vaginally or by cesarean delivery. The majority of women who underwent vaginal birth may sustain perineal trauma from a spontaneous perineal tear or episiotomy or both. 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 for this study was true experimental post-test only design. The study was conducted in three hospitals at Kerala such as Karothukuzhiyil hospital, Lakshmi hospital, and Carmal hospital. The 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 group. 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, 2001, and visual analog 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 were lesser than the mean scores of study Group II. The parturient mothers in study Group I (hands-off technique) had less perineal trauma and perineal pain than study Group II (hands-on technique). Conclusion:Different perineal techniques and interventions such as hands-on technique, hands-off technique, perineal massage, and warm compresses can be widely used by midwives and birth attendants to prevent perineal trauma during labor.

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A Comparison of the “Hands-Off” and “Hands-On” Methods to Reduce Perineal Lacerations: A Randomised Clinical Trial

Cited by 23 publications

References 9 publications

Implementation methodology of practices based on scientific evidence for assistance in natural delivery: a pilot study

Implementation methodology of practices based on scientific evidence for assistance in natural delivery: a pilot study

Effect of second stage perineal warm compresses on perineal pain and outcome among primiparae

Effectiveness of Hands Off Versus Hands on Techniques on Perineal Trauma and Perineal Pain Among Parturient Mothers

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