Hands-on in hands-off tehnika varovanja presredka med drugo porodno dobo : diplomsko delo

Cerar, Ana (author), Jug Došler, Anita (mentor), Petročnik, Petra (comentor)

Uvod: Ženske, ki rodijo vaginalno, pogosto utrpijo poškodbe porodne poti. Te so lahko posledica spontanih raztrganin, kirurškega prereza presredka ali obojega. Tehnika varovanja presredka ima pri preprečevanju raztrganin pomembno vlogo. Širše gledano ločimo hands-on in hand-off pristop varovanja presredka. Namen: Namen diplomskega dela je prikazati različne metode ohranitve presredka v nosečnosti in med porodom ter predstaviti hands-on in hands-off tehniko varovanja presredka. Z diplomskim delom želimo ugotoviti, katera tehnika varovanja presredka je za žensko ugodnejša. Metode dela: V diplomskem delu smo uporabili deskriptivno metodo pregleda znanstvene in strokovne literature. Literatura je bila iskana v angleškem jeziku s ključnimi besedami »hands on, hands off, perineal laceration, positions for labour«, v podatkovnih bazah CINAHL, COBISS, Cohrane Library, DiKUL, MEDLINE, PubMed, ScienceDirect in Springer Link. Pri iskanju literature smo se osredotočili na slovenski in angleški jezik ter časovno obdobje, ki ni presegalo zadnjih deset let. Rezultati: Večina poškodb presredka se pojavi ob koncu druge porodne dobe. Pri hands-on tehniki se pojavi večja stopnja epiziotomije, bolečina po porodu je večja. Glede pojavnosti raztrganin porodne poti, stopnje bolečine med dobo iztisa in pojavnostjo poporodnih krvavitev spoznanja analiziranih raziskav niso enotna. Razprava in zaključek: Pomanjkanje informacij v analiziranih raziskavah nas vodi k temu, da ne moremo jasno zaključiti, kateri pristop k varovanju presredka je za žensko ugodnejši. Definicije posameznih pristopov si med seboj niso enotne, zato jih je težko primerjati. Poleg tehnike varovanja presredka imajo pri preprečevanju raztrganin pomembno vlogo tudi porodni položaji, način pritiskanja, masaža presredka ter vloga zdravstvenega osebja. Študente babištva je potrebno informirati z različnimi tehnikami, da bodo v delovnem okolju lahko predstavili različne pristope varovanja presredka ženskam in skupaj z njimi sprejemali informirane odločitve.

• Language: Slovenian
• Keywords: hands-on tehnika, hands-off tehnika, raztrganine presredka, varovanje presredka
• Work type: Bachelor thesis/paper
• Organization: ZF - Faculty of Health Sciences
• Year: 2017
• PID: 20.500.12556/RUL-95303
• COBISS.SI-ID: 5324395
• Publication date in RUL: 20.09.2017

Secondary language

• Language: English
• Title: Hands-on versus hands-off technique in the second stage of labour : bachelor thesis

Abstract

Introduction: Women who give birth often suffer injuries of the genital tract. Perineal trauma can occur spontaneously, with the use of surgical episiotomy, or both. Perineal protection techniques are an important factor in perineal protection, the most common being the "hands-on" and "hands-off" technique. Purpose: The objective of this thesis is to present various methods for perineal protection, including the “hands-on” and “hands-off” technique of perineal management. We want to find out which protection technique is more favorable for a woman. Methods: This bachelor's thesis is based on a descriptive method of examining scientific and profesional literature. The literature search in English was acquired by searcing for the keywords "hands on", "hands off", "perineal laceration", "positions for labour" in the databases CINAHL, COBISS, Cohrane Library, DiKUL, MEDLINE, PubMed, ScienceDirect and Springer Link, in English and Slovene, the date of publication of the sources did not exceed ten years. Results: The majority perineal trauma occur at the end of the second stage of labour. The "hands on" technique results in higher frequency of episiotomy and perineal pain. Regarding the incidence of perineal lacerations, perineal pain in the second stage of labour and incidence of postpartum hemorrhage, the results of including studies are not uniform. Discussion and conclusion: A lack of information in relevant areas of research leads us to fail to determine which approach toward perineal protection is more favorable to a woman. Due to variance in definition, these two approaches are difficult to compare. Besides perineal protection techniques there are many other techniques that play an important role in perineal tear prevention, such as birthing positions, pushing techniques, perineal massage and support of medical personnel. Midwifery students need to be informed about various techniques so they can present in the working environment different approaches to protecting perineum during childbirth and make informed decisions together with women in labour.

• Keywords: "hands on" technique, hands off" technique, perineal lacerations, perineal protection