Warm perineal compresses during the second stage of laborfor reducing perineal trauma: A meta-analysis

سال انتشار: 1401
نوع سند: مقاله کنفرانسی
زبان: انگلیسی
مشاهده: 104

نسخه کامل این مقاله ارائه نشده است و در دسترس نمی باشد

استخراج به نرم افزارهای پژوهشی:

لینک ثابت به این مقاله:

شناسه ملی سند علمی:

RPMR01_007

تاریخ نمایه سازی: 4 فروردین 1402

چکیده مقاله:

The incidence of perineal trauma after vaginal birth can vary considerably, with between۵۳–۷۹% of women experiencing some type of perineal trauma. Most are first and second-degreetears, whereas around ۳.۳% of women have a third-degree tear and about ۱.۱% have a fourth degreetear. Severe perineal tears, though uncommon, may have a negative impact in a woman’s life asthey have been associated with perineal pain, urinary and fecal incontinence and sexualdysfunction. Prevention of perineal trauma, and third and fourth-degree lacerations in particular istherefore essential. Different techniques have being reported to prevent perineal lacerations,including perineal massage , hands-on technique, Ritgen’s maneuver, use of lubricant gel andwarm compresses. Metuods: This review was performed according to a protocol designed a prioriand recommended for systematic reviews of interventions . Electronic databases (i.e. MEDLINE,Scopus, ClinicalTrials.gov, EMBASE, Sciencedirect, the Cochrane Library at the CENTRALRegister of Controlled Trials, Scielo) were searched from inception of each database to May ۲۰۱۹.Search terms used were the following text words: “cesarean,” OR “caesarean”, OR “warmcompression”, OR “warm packs”, OR “warm compresses”, OR “second stage”, OR “labor”, OR“labour”, OR “vaginal delivery,” OR “perineum,” OR “perineal,” OR “episiotomy,” OR “perinealtrauma,” OR “perineal lacerations”, OR “perineal tears. Results : One trial blinded the assessor forthe perineal trauma. Statistical heterogeneity within the trials ranged from low to high with an I ۲= ۸۷% for the primary outcome. All trials included pregnant women planning to have aspontaneous vaginal birth at term with a singleton in a cephalic presentation. Women assigned tothe intervention group received warm compresses made from clean washcloths or perineal padsimmersed in warm tap water. In one of the trials a moist warm and dry warm compress were used(only data for the moist pack was analyzed). Compresses were held against the patient’s perineumduring second stage of labor and changed as needed to maintain warmth and cleanliness. Warmcompresses usually started when the baby’s head began to distend the perineum or when there wasactive fetal descent in the second stage of labor. Discussion &Conclusion: Our review of sevenRCTs showed that warm compresses used in the second stage of labor was associated with anhigher rate of intact perineum, and lower rate of perineal trauma not requiring suturing, and ofepisiotomy. The study was limited by the low number of the included women, variations intemperature of the water, timing and length of application and variations in technique used insecond stage management (i.e. Ritgens Maneuver). The temperature of the water used was of particular concern as some studies reported temperatures of up to ۷۰ C. There was alsoinconsistency in when and for how long the warm packs were applied, with some just appliedwhen the fetal head distended the perineum and others applied as soon as second stage commenced.Only one study [۸] followed women up postnatally to three months following birth. : Warmcompresses applied during the second stage of labor

نویسندگان

سارا شایگان نسب

کمیته تحقیقات دانشجویی، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی شیراز، شیراز، ایران

رضوان خان بابایی

کمیته تحقیقات دانشجویی، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی شیراز، شیراز، ایران