Perineal techniques during the second stage of labour for reducing perineal trauma

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

“…Their results are consistent with the study of McCandlish et al (1998) and the two recent small systematic reviews (Kettle and Tohill, 2011;Aasheim et al, 2012), which did not find any differences regarding the risk of perineal trauma. No significant differences were found between the groups regarding intact perineum.…”

“…This finding is comparable with conclusions of two earlier systematic reviews (Kettle and Tohill, 2011;Aasheim et al, 2012) that indicated lower rates of episiotomies in the hands-poised technique. It is usually more difficult for a midwife to perform the handson technique or an episiotomy when a woman adopts an upright position and midwives should encourage labouring women to adopt the position that suits them best.…”

“…Another factor that can lead to severe perineal trauma is fundal pressure, where the pressure towards the vagina increases and the forced expulsion can cause severe perineal rupture (Murray and Huelsmann, 2009). On the other hand, the use of warm compresses during labour contributes to a significant reduction of third and fourth degree tears (Aasheim et al, 2012). Beckmann and Garrett (2006) showed that antenatal massage of the perineum has a beneficial effect on the perineum, as it enables the perineal tissue to expand easily.…”

Bekkenbodemproblematiek in en na de zwangerschap

“…Een warme washand op het perineum, en het hoofd geboren laten worden tussen twee weeën tijdens de partus en het perineum rekken tijdens de uitdrijving geven een significante reductie van de bekkenbodemschade [24].…”

Potenzialanalyse zur aufrechten Gebärhaltung bei physiologischen Geburten in deutschen Kreißsälen

“…Spätestens durch den auf den Mastdarm reflektorisch einsetzenden Pressdrang beginnt die Mutter, das Kind aktiv zu gebären. Die Hebamme versucht in dieser Zeit, die Kräfte von Mutter und Kind weitgehend zu schonen und natürliches Einreißen oder operatives Schneiden des Dammes durch Verlangsamung der unmittelbar bevorstehenden Geburt des kindlichen Kopfes zu verhindern [21]. Einen direkten Einfluss darauf haben die mütterliche Gebär-position und die effektive Ausnutzung des mütterlichen Pressdrangs zum Schutz des Dammes.…”