Estrategia para disminuir la incidencia de patología grave del periné durante el parto

Aceituno, L.; Segura, M.H.; Ruiz, E.; Sánchez-Barroso, M.T.; Acosta, Valois González; Delgado, Luis; Barqueros, A.I.

doi:10.1016/j.gine.2009.12.005

Cited by 4 publications

(3 citation statements)

References 35 publications

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“…Such control consists of instructing the woman not to push, although it is the moment at which she feels the greatest need to push (9) . This delay slows the exit of the foetal scalp, which, along with the previously mentioned method, favours a decrease in anal sphincter tears (19) . It also allows the expulsion of the head between contractions and not during them, which has proven to be a protective factor in both primiparous and multiparous women (1)(2) .…”

Section: Discussionmentioning

confidence: 93%

“…Due to the effect of gravity, the following results are achieved: "a decrease in the risks of aortocaval compression and, therefore, the consequent improvement of acid-base results in newborns. It also enables stronger and more efficient uterine contractions and better accommodation of the foetus for its passage through the pelvis due to the increase in pelvic diameters" (19) . Another very important fact is that this position allows greater comfort and autonomy for the mother, which allows the necessary synchronization with the midwife so that the delivery of the foetal head occurs slowly, smoothly and between contractions (which constitutes another protective element, as discussed below) (2) .…”

Section: Discussionmentioning

confidence: 99%

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Perineal protection methods: knowledge and use

Martínez¹,

Sáez

Sánchez

et al. 2021

Rev. esc. enferm. USP

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Objective: To analyse the knowledge and use of perineal protection methods during the expulsive stage by health professionals involved in childbirth and whether they correspond to the World Health Organization’s recommendations. Method: This was a cross-sectional descriptive study aimed at health workers involved in births in Spain. Results: Fifty-seven professionals participated in the study: midwives (47%), gynaecologists (25%), nurse residents (14%) and resident physicians (14%) in obstetrics and gynaecology. The degree of knowledge and use of perineal protection methods differed according to the position held and was very limited among gynaecologists and resident physicians. The only method recognized by all positions was “hands on” (p = 0.05). “Hands off ” (p = 0.002), “delayed pushing” (p = 0.0001) and “maternal posture” (p = 0.03) were only known to midwives and nurse residents. “Flexion technique” (p = 0.035) and “delayed pushing” (p = 0.011) were used effectively by midwives and nurse residents. “Episiotomy” was erroneously identified as a method to protect the perineum by gynaecologists and resident physicians (p = 0.003). Conclusion: The degree of knowledge and use of perineal protection methods by health care professionals does not correspond to the recommendations of the World Health Organization.

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Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Perineal protection methods: knowledge and use

Martínez¹,

Sáez

Sánchez

et al. 2021

Rev. esc. enferm. USP

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“…3,4,6 Múltiples investigadores la relacionan con el incremento de la primera y segunda fases del parto, uso de analgesia epidural y oxitocina, así como, mayores tasas de episiotomías, lesiones del esfínter anal, partos instrumentales, cesáreas y pérdida de sangre superior a 500 ml. 3,4,[6][7][8][9][10] La ecografía abdominal es el método diagnóstico de elección, 4,11 aunque el examen clínico por tacto vaginal tiene una fiabilidad del 85,7%, siendo recomendado durante el parto, especialmente en unidades de partos con dificultad para la realización de ecografía. [12][13][14] Determinadas posturas adoptadas por la mujer durante el parto, como el decúbito lateral (DL), pueden favorecer la rotación fetal espontánea a OA, ayudadas por la fuerza de la gravedad sobre el feto, su flotabilidad en el líquido amniótico y la contracción uterina intermitente.…”

Section: Introductionunclassified

Eficacia de la postura materna manos-rodillas para corregir la posición fetal occipitoposterior en el parto

Molina-Reyes¹,

Muñoz-Martínez²,

Martínez-García³

et al. 2014

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Resumen AbstractObjetivo principal: Valorar la rotación fetal de posición occipitoposterior (OP) a occipitoanterior (OA) durante el parto con la postura "manos-rodillas" (MR) frente a la postura "decúbito lateral (DL) hacia la espalda fetal". Metodología: Ensayo clínico multicéntrico. Mediante asignación aleatoria, 65 gestantes con posición fetal OP adoptaron la postura MR (grupo MR) y 70 gestantes la postura DL hacia la espalda fetal (grupo DL) durante 30 minutos. Resultados principales: Similar rotación fetal a OA durante la intervención del grupo MR frente al grupo DL (55,4% vs. 54,3%; Odds Ratio de 1,04 para un intervalo de confianza al 95%:0,53-2,06). Tampoco hubo diferencias estadísti-camente significativas para los resultados de duración y tipo de terminación del parto entre los grupos. Conclusión principal: Para mejorar los resultados de los partos con posición fetal occipitoposterior recomendamos la adopción de las posturas MR y DL hacia la espalda fetal durante el parto, pues ambas tienen similar eficacia de rotación fetal a occipitoanterior. Palabras clave: Parto. Rotación fetal. Postura lateral. Postura manos-rodillas. Posición occipitoposterior. EFFICACY OF HANDS AND KNEES MATERNAL POSTURE TO CORRECT THE OCCIPITOPOSTERIOR FETAL POSITION DURING LABORObjective: To evaluate the efficacy of hands and knees (HK) maternal posture during labor thus promoting fetal rotation from occipitoposterior to occipitoanterior and to compare the results with the lateral toward the fetal back posture. Methods: Multicenter clinical trial. By simple randomization and for at least 30 minutes, 65 women with a single fetus in occipitoposterior position took the HK posture (HK group) and 70 women took the "lateral toward the fetal back" posture (lateral group). Results: HK group and lateral group have similar fetal rotation to occipitoanterior during the intervention (55.4% vs. 54.3%, odds ratio of 1.04 for a confidence level of 95%: 0.53-2.06). There were no statistically significant differences for the results of duration and type of birth between groups. Conclusions: To improve birth outcomes, We recommend that pregnant women with occipitoposterior fetal position adopt HK posture and lateral toward the fetal back posture during labor, because both postures have similar efficacy of fetal rotation to occipitoanterior.

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