Hands-poised technique: The future technique for perineal management of second stage of labour? A modified systematic literature review

Petročnik, Petra; Marshall, Jayne

doi:10.1016/j.midw.2014.10.004

Cited by 20 publications

(14 citation statements)

References 16 publications

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“…Overall ‘hands‐on’ techniques appear to be associated with a higher incidence of episiotomy, postpartum pain and postpartum haemorrhage . There is little evidence about acceptability of hands‐on versus hands‐off techniques to women.…”

Section: Resultsmentioning

confidence: 99%

Third‐ and fourth‐degree tears: A review of the current evidence for prevention and management

Wilson

Homer

2020

Aust NZ J Obst Gynaeco

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Background: Third-and fourth-degree tears are associated with significant pain, discomfort and impact on quality of life and intimate relationships. Australian women experience comparatively higher rates of third-and fourth-degree tears relative to countries of similar economic development. Aims:We aimed to conduct a comprehensive review of the literature, published over the past five years, to identify the best ways to prevent and manage third-and fourth-degree perineal tears in Australian maternity centres. Materials and Methods:We searched the literature using the Cochrane Database of Systematic Reviews, EMBASE, MEDLINE, Maternity and Infant Care Database and Google Scholar for articles published since 2013 using key search terms. A review of reviews was undertaken given the extensive amount of literature on this topic. Results: Twenty-six systematic reviews were identified. The most common risk factors reported in the literature for third-and fourth-degree tears included primiparity, mother's ethnicity, large for gestational age infants and certain interventions used in labour and birth, such as instrumental deliveries. Preventive practices with varying degrees of effectiveness and often dependant on parity included: antenatal perineal massage, different maternal birthing positions, water births, warm compresses, protection of the perineum and episiotomy for instrumental births.Conclusions: Third-and fourth-degree perineal tears are associated with immediate and long-term implications for women and health systems. Evidence-based approaches can reduce the number of women who sustain a severe perineal tear and alleviate the associated disease burden for those who do. K E Y W O R D Schild birth, obstetric labour complications, perineal tears, perineum, pregnancy SUPPORTING INFORMATIONAdditional supporting information may be found online in the Supporting Information section at the end of the article. Table S1. Systematic reviews.

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Section: Resultsmentioning

confidence: 99%

Third‐ and fourth‐degree tears: A review of the current evidence for prevention and management

Wilson

Homer

2020

Aust NZ J Obst Gynaeco

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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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“…The occurrence of perineal lacerations of any degree and the need for episiotomy were lower in women in whom the hands off technique was applied. 31 From this, the two techniques can be applied during the period of delivery to facilitate normal delivery spontaneous. Attention should be paid only to the hands-on technique, controlling the fetal cephalic pole descent and not performing directed pulling.…”

Section:  Strategies For the Prevention Of Perineal Lacerationsmentioning

confidence: 99%

Prevenção de lacerações perineais e episiotomia: evidências para a prática clínica

Rocha

Zamberlan

2018

Rev enferm UFPE on line.

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RESUMOObjetivo: analisar as produções científicas sobre a prática clínica em Enfermagem Obstétrica na prevenção de lacerações perineais e redução da episiotomia de rotina. Método: revisão integrativa, realizada no período de março a abril de 2017, nas bases de dados Lilacs e PubMed/MEDLINE. O recorte temporal delimitado foi de cinco anos, totalizando 18 artigos para constituir o corpus da análise classificados quanto ao nível de evidência científica. Os dados foram analisados por meio da técnica de Análise de Conteúdo, na modalidade Análise Categorial. Resultados: emergiram as categorias <<Fatores relacionados à prática da episiotomia e ocorrência de lacerações perineais e indicações para a realização>>; <<Abordagem do profissional que presta assistência ao parto normal>> e <<Estratégias para a prevenção de lacerações perineais>>. Conclusão: a literatura elencada direciona para a redução da prática da episiotomia de rotina e utilização, cada vez mais frequente, de métodos para a prevenção de lacerações perineais. Além disso, os estudos demonstram a importância da assistência prestada por enfermeiras obstétricas, pois essas profissionais utilizam muito mais as boas práticas de atenção ao parto e nascimento em relação à classe médica. Descritores: Enfermagem Obstétrica; Enfermagem Baseada em Evidências; Períneo; Episiotomia; Lacerações; Revisão.ABSTRACT Objective: to analyze the scientific productions about the clinical practice in Obstetric Nursing in the prevention of perineal lacerations and reduction of routine episiotomy. Method: integrative review, carried out from March to April 2017, in Lilacs and PubMed / MEDLINE databases. The delimited temporal cut was five years, totaling 18 articles to constitute the corpus of the analysis, classified according to the level of scientific evidence. Data were analyzed using the Content Analysis Technique, in the Categorical Analysis modality. Results: three categories emerged: << Factors related to the practice of episiotomy and the occurrence of perineal lacerations and indications for performance >>; << Approach of the professional who provides assistance to normal childbirth >> and << Strategies for the prevention of perineal lacerations>>. Conclusion: the literature indicates the reduction of routine episiotomy practice and the increasingly frequent use of methods to prevent perineal lacerations. In addition, the studies demonstrate the importance of the care provided by obstetrical nurses, since these professionals use much more good practices of attention to childbirth and birth, in relation to the medical class. Descriptors: Obstetric Nursing; Evidence - Based Nursing; Perineum; Episiotomy; Lacerations; Review.RESUMEN Objetivo: analizar las producciones científicas sobre la práctica clínica en Enfermería Obstétrica en la prevención de las laceraciones perineales y reducción de la episiotomía de rutina. Método: revisión integrativa, realizada en el período de marzo/ abril de 2017, en las bases de datos Lilacs y PubMed / MEDLINE. El recorte temporal delimitado fue de cinco años, totalizando 18 artículos para constituir el corpus del análisis, clasificado en cuanto al nivel de evidencia científica. Los datos fueron analizados por medio de la técnica de Análisis de Contenido, en la modalidad Análisis Categorial. Resultados: surgieron las categorías: << Factores relacionados a la práctica de la episiotomía y ocurrencia de laceraciones perineales e indicaciones para la realización >>;<< Abordaje del profesional que presta asistencia al parto normal >> y << Estrategias para la prevención de las laceraciones perineales> >. Conclusión: la literatura elaborada dirige para la reducción de la práctica de la episiotomía de rutina y el uso, cada vez más frecuente de métodos para prevenir las laceraciones perineales. Además, los estudios demuestran la importancia de la asistencia prestada por enfermeras obstétricas, pues estas profesionales utilizan mucho más las buenas prácticas de atención al parto y nacimiento, en detrimento de la clase médica. Descriptores: Enfermería Obstétrica; Enfermería Basada em la Evidencia; Perineo; Episiotomía; Laceraciones; Revisión.

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Hands-poised technique: The future technique for perineal management of second stage of labour? A modified systematic literature review

Cited by 20 publications

References 16 publications

Third‐ and fourth‐degree tears: A review of the current evidence for prevention and management

Third‐ and fourth‐degree tears: A review of the current evidence for prevention and management

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

Prevenção de lacerações perineais e episiotomia: evidências para a prática clínica

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