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Effects of two methods ,do not touch the perineum and maneuver Ritgen on second stage in managing the outcoms of labor
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Fatemeh Salmani *   1, Azam Froghipour2 , Soheila Riyahinejhad2 |
1- islamic azad university of najaf abad branch , f-salmani@iaun.ac.ir
2- islamic azad university of najaf abad branch |
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Abstract: (21199 Views) |
| Introduction: The objective of the present study is to evaluate the effect of the two methods of delivery " hands-on" versus "hand-poised" on perineal trauma and delivery outcome in primiparous women. hands-on method or Ritgen’s maneuver, used to control fetal head is associated with higher need for episiotomy and perineal traumas. Thus, hand-poised method, which is done without touching the perineum in the second labor stage, is preferred.
Materials & Methods: This is a clinical trial in which 100 low risk primiparous parturients were randomly assigned to two groups hands-on and hand-poised (hands-off). In the hands-on group, in the second stage of labor hands-on method was used to control fetal head, i.e., the fingers of one hand supports fetal occiput and the other hand applies slight pressure on the head to control the delivery of the head during the crowning process. In the hands-off group, the midwife observes the parturient and do not touch perineum during the second labor stage while fetal head is delivering. Then, the two groups were compared in terms of perineal trauma, as well as delivery outcome.
Findings: The findings demonstrated that the two groups were significantly different in terms of perineal trauma resulted from episiotomy, and the need for episiotomy was smaller in the hands-off group (p<0.001) as 16% of participants in hand-on group and 60% in hands-poised group did not need episiotomy. first degree tears in hands-on and hands-poised groups were 22% and 34%, respectively. The two groups were not significantly different considering second degree tears (26% and 22% for hands-on and hands-off groups, respectively) . However, 82% of hands-on group participants did not have hemorrhage or hematoma at the site of episiotomy, while in the hands-off group the frequency was 74%.
Discussion & Conclusion: It seems that hands-off method is associated with less perineal trauma, particularly lower need for episiotomy, and less perineal tear. |
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| Keywords: Hand-poised method, Hands-on method, Perineal trauma, Delivery outcome |
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Full-Text [PDF 335 kb]
(3576 Downloads)
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Type of Study: Research |
Subject:
midwifery
Received: 2011/08/15 | Accepted: 2013/10/15 | Published: 2013/10/15
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