Porodni položaji za preprečevanje hujših raztrganin presredka in potrebe po epiziotomiji : diplomsko delo

Banko, Zala (avtor), Prelec, Anita (mentor), Petročnik, Petra (recenzent)

Uvod: Ženske so med vaginalnim porodom izpostavljene velikem tveganju za poškodbe presredka. Do le te lahko pride zaradi spontane raztrganine tkiva ali namernega prereza presredka oziroma epiziotomije. Najpogostejša težava, s katero se ženske s poškodbo presredka srečujejo, je perinealna bolečina oziroma bolečina presredka. Zaradi pogoste pojavnosti teh težav pri ženskah v poporodnem obdobju so strokovnjaki pričeli z iskanjem metod, ki bi pripomogle k zmanjšanju pojavnosti poškodb presredka. Ena od metod, ki so jo z raziskavami dokazali za uspešno, je tudi uporaba porodnih položajev med porodom. Namen: Namen diplomskega dela je bil s pomočjo pregleda strokovne literature ugotoviti, kako lahko uporaba porodnih položajev v drugi porodni dobi vpliva na zmanjšano pojavnost epiziotomij ter hujših raztrganin presredka. Metode dela: Za raziskovalni del diplomske naloge smo izvedli sistematični pregled slovenske in tuje literature. Literatura je bila izbrana s pomočjo strokovne knjižnice Univerze v Ljubljani na Zdravstveni fakulteti ter iskanja v različnih podatkovnih bazah: COBISS, DiKUL, PubMed, Wiley Online Library ter Google Schoolar. Za iskanje literature smo uporabili ključne besede v slovenskem jeziku: »alternativni porodni položaji«, »položaji v drugi porodni dobi«, »preprečevanje epiziotomije« ter v angleškem jeziku: »positions for labour«, »alternative birth positions«, »epiziotomy in birthing positions«, »birthing positions during second stage of labour«. Rezultati: S pomočjo PRIZMA diagrama smo prikazali shematski prikaz pridobljene literature, kjer smo s pomočjo ključnih besed, omejitvenih kriterijev in postopnega izločevanja prišli do 28 besedil primernih za končno analizo. Nato smo literaturo prikazali še tabelarično glede na avtorja in leto objave, raziskovalni dizajn, namen strokovnega besedila, vzorec in državo raziskave ter ključne ugotovitve raziskav. Za tem smo razdelili literaturo tudi po kodah in kategorijah. Razprava in zaključek: S pomočjo pregleda literature smo odkrili številne pozitivne učinke, ki jih ima lahko uporaba alternativnih porodnih položajev na telo porodnice. Ob uporabi porodnih položajev lahko namreč dokazano zmanjšamo potrebo po epiziotomiji, instrumentalnem dokončanju poroda, znižamo možnost hujših raztrganin presredka, skrajšamo drugo porodno dobo, omogočimo manj boleč porod ter tudi manj boleče in prijetnejše okrevanje po porodu in posledično večje zadovoljstvo ženske s svojo porodno izkušnjo. Po številnih svetovnih priporočilih, bi morala imeti babica veliko znanja o porodnih položajih, njihovi koristi in izvedbi, saj smo kot strokovnjaki obporodne prakse primorani ženski svetovati ter jo voditi glede na njene želje in pričakovanja.

• Jezik: Slovenski jezik
• Ključne besede: diplomska dela, babištvo, alternativni porodni položaji, položaji v drugi porodni dobi, epiziotomija, raztrganine presredka
• Vrsta gradiva: Diplomsko delo/naloga
• Tipologija: 2.11 - Diplomsko delo
• Organizacija: ZF - Zdravstvena fakulteta
• Kraj izida: Ljubljana
• Založnik: [Z. Banko]
• Leto izida: 2020
• Št. strani: 42 str.
• PID: 20.500.12556/RUL-122500
• UDK: 618.2/.7
• COBISS.SI-ID: 45539075
• Datum objave v RUL: 13.12.2020

Sekundarni jezik

• Jezik: Angleški jezik
• Naslov: Birthing positions to prevent major perineum tears and the need for episiotomy : diploma work

Izvleček

Introduction: Women are at high risk for perineal injuries during vaginal birth. This can occur due to spontaneous tissue rupture or performance of episiotomy. The most common problem that women with perineal injury face is perineal pain. Due to the frequent occurrence of these problems in women in the postpartum period, experts have begun to look for methods that would help reduce the incidence of perineal injuries. One of the methods that has been proven successful through research is the use of birthing positions during labour. Purpose: The purpose of this diploma was to determine, through a review of the professional literature, how can the use of birth positions in the second stage of labour help reduce the incidence of episiotomies and severe perineal ruptures. Methods: For the research part of the diploma, we performed a systematic review of Slovenian and foreign literature. The literature was selected with the help of the library of the University of Ljubljana at the Faculty of Medicine and searches in various databases: COBISS, DiKUL, PubMed, Wiley Online Library and Google Schoolar. Search keywords were: »positions for labour«, »alternative birth positions«, »episiotomy in birthing positions«, »birthing positions during second stage of labour«. Results: With the help of the PRISMA diagram, we presented a schematic presentation of the found literature, and with the use of keywords, restrictive criteria and elimination we came to 28 texts suitable for the final analysis. We analyzed the literature according to the author and year of publication, research design, purpose of the research, sample and country of research, and key research findings, after which we divided the literature by codes and categories. Discussion and conclusion: Through this review, we discovered a number of positive effects that the use of alternative delivery positions can have on the mother’s body. By using childbirth positions, we can reduce the need for episiotomy, instrumental assisted labor, reduce the possibility of severe ruptures of the perineum, shorten the second stage of labour, enable less painful childbirth and pleasant recovery after childbirth and also give women a greater satisfaction with their birth experience. According to many global recommendations, midwives should have a lot of knowledge about birthing positions their purpose and benefits, as we are experts in midwifery practice, and should be able to give advise and guide woman during labour according to their wishes and expectations.

• Ključne besede: diploma theses, midwifery, alternative birth positions, positions for second stage of labour, episiotomy, perineal injuries