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Conduta no trabalho de parto e no parto normal
... Nowadays in Brazil, although it is already a common practice, recent research shows the selective use of episiotomy is increasing (7) . As to the factors that influence the maternal perineal outcomes, we can report the following: parity, birth weight, maternal position in the parturition, professional that assisted the parturition, use of compresses, pre-natal perineal massage, directed labour, head flexion technique during the cephalic unfixing, age, race, use of analgesis and anaesthesia, use of hyaluronidases enzyme, and episiotomy (8)(9) . ...
... -Perineal result -the effects of parturition on the perineum and obstetric interventions done classified as: entire perineum, first and second-degree lacerations (8)(9) , episiotomy (9)(10) and position of perineal lacerations -categorized as: labial, paraurethral, vaginal, furcula and perineal body (9) . ...
... -Perineal result -the effects of parturition on the perineum and obstetric interventions done classified as: entire perineum, first and second-degree lacerations (8)(9) , episiotomy (9)(10) and position of perineal lacerations -categorized as: labial, paraurethral, vaginal, furcula and perineal body (9) . ...
OBJECTIVE: To evaluate the perineal outcomes in unconventional birth positions. METHOD: A randomized clinical study. Conducted in a birth centre in the city of Itapecerica da Serra, Brazil. A sample of 158 nulliparas, divided randomly into the left lateral position (81 experimental) and upright half-sitting (77 - control). RESULTS: Experimental group showed less vulvar edema, 13.6% vs. 29.9%, OR 2.71 (95% IC 1.22 -6.02), episiotomy, 16.0% vs. 35.1 OR 2,46 (95% IC 1, 27 - 4.74), and more labial lacerations 37,0% vs. 19,5% OR 2,43 (95% IC 1,18 5,51). The women who adopted the upright half-sitting position had a lower risk of first-degree laceration (37,7% versus 56,8%). However, they had a higher risk of second-degree laceration and frequency of episiotomy OR 2,11 (95% IC 1,02 4,35). The presence of vulvar edema increased the risk of spontaneous trauma and episiotomy OR 3,99 (95% IC 1,80 8,85). CONCLUSIONS: Our data confirmed the hypothesis that the left lateral position offers less risk of serious perineal traumas.
p class="abstract"> Background: The objective of the present study was to compare the effects of perineal massage, vaginal dilator and pelvic floor muscles training on the perineal integrity of primiparae women .
Methods: Primigravidae women over 18 years old will be selected, from the 32th gestational week and wishing to have a vaginal delivery . Pregnant women will be randomly allocated from a sequence generated by a computer program into three groups: perineal massage, vaginal dilator and pelvic floor muscles training. The technique should be practiced from the 34th week of pregnancy until the beginning of labor. Randomization will be done by a researcher who was not involved with the recruitment, assessment and treatment of the participants. All participants will undergo a clinical and functional assessment of the pelvic floor before the beginning of the technique practice, as well as a reassessment of these items and an assessment of perineal integrity between 45 and 60 days after delivery for a blind physiotherapist regarding the interventional procedures. The evaluative procedures will be done by a ‘blinded’ physiotherapist in relation to the intervention procedures. The outcome will be determined by the perineal integrity by the presence or absence of perineal laceration as well as their characteristics observed immediately after delivery .
Conclusions: The knowledge of the effects of antenatal pelvic floor preparation techniques on the perineal integrity and pelvic floor muscles function after delivery, will allow a better choice about which approach is the best to pregnant women to prevent perineal trauma.</p
Cross-sectional study, aiming at analyzing the distribution of vulvo-perineal lacerations and factors related to its location in anterior and posterior region of perineum in spontaneous birth. Sample was comprised of 317 women who had vaginal delivery without episiotomy and with perineal laceration. Data were collected in two centers of normal birth, in the cities of São Paulo and Itapecerica da Serra, in the state of São Paulo, Brazil, from 2001 to 2012. It integrates the database of five subprojects under the Perineal trauma in normal birth: prevention, morbidity and care project. There was predominance of lacerations in the posterior perineum region. There was no statistically significant difference in relation to the location of the perineal laceration and the maternal position during delivery, variety of fetal head position in the detachment, umbilical cord circular, and weight of the new-born, but there was significant difference concerning the kind of pushing. © 2014, Centro de Estudos da Faculdade de Enfermagem da UERJ. All rights reserved.
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