APPROACHES IN PREVENTION OF PERINEAL TRAUMA IN VAGINAL BIRTH ACTION

Abstract

Perineal trauma is a problem that can occur in the genital area spontaneously or after episiotomy during the intervention period, which can occur even after birth and sometimes lasts 3 months after birth. It is very common in our lives. often encountered. In the vaginal delivery, the misplaced birth position, the impetus without giving birth to its own course, the large infant, especially the routine episiotomy applied to each primipara woman and the routine, unnecessary interventions are some of the applications that cause perineal trauma. Negative effects such as painful sexual intercourse, stool, and urinary incontinence, perineal pain negativities, delayed breastfeeding and delayed involution of the mother in the long term negatively affect the daily lives of women. Extraction techniques taught in the latent phase, hot-cold compresses to be applied to perineum, perineal massages, manual protection of perineum, avoiding a routine episiotomy and steep birth position are some of the interventions that have an effect on preventing perineal trauma. The midwives who play an active role in a vaginal delivery are those who have a great responsibility and importance in implementing these interventions that prevent perineal trauma.

Keywords

• Perineal trauma,vaginal delivery,midwifery approach

VAJİNAL DOĞUM EYLEMİNDE PERİNEAL TRAVMANIN ÖNLENMESİNDE YAKLAŞIMLAR

Abstract

Perineal travma, müdahaleli doğum esnasında genital bölgede kendiliğinden veya epizyotomi nedeniyle ortaya çıkan hasar olarak tanımlanan doğum sonrasında karşılaşılan ve bazen doğumdan 3 ay sonraya kadar bile sürebilen bir problemdir. Vajinal doğum eyleminde doğum pozisyonu yanlışlığı,doğumun kendi seyrine bırakılmadan aceleci davranılması,iri bebek,özellikle her primipar kadına uygulanan rutin epizyotomi ve rutin,gereksiz girişimler perineal travmaya neden olan uygulamalardan bazılarıdır.Vajinal doğum yapan kadınların %85‟inde perineal travma bulunduğu kanıtlanmıştır. Kadınların günlük yaşamlarını olumsuz etkileyen ve uzun vadede ağrılı cinsel ilişki,gaita ve üriner inkontinans,perine ağrısı olumsuzluklarının yanında anne ve bebeği geç bağlanma,emzirmenin gecikmesi,annenin kendini geç toparlaması gibi olumsuz etkilere sebep olmaktadır. Latent fazda öğretilen ıkınma teknikleri,perineye uygulanacak sıcak-soğuk kompresler, perine masajları, perinenin elle korunması, rutin epizyotomiden kaçınmak ve dik doğum pozisyonu perineal travmayı önlemekte etkisi olan girişimlerden bazılarıdır. Vajinal doğum eyleminde aktif rol oynayan ebeler perineal travmayı önleyen bu girişimleri uygulamakta büyük sorumluluğa ve öneme sahip kişilerdir.

Keywords

• Perineal travma,vajinal doğum,ebelik yaklaşımı

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