DOĞUMDA PERİNEAL TRAVMA VE ONARIMI: KANIT TEMELLİ YAKLAŞIMLAR

Yıl 2019, Cilt: 4 Sayı: 3, 1 - 11, 31.12.2019

Meltem AYDIN BEŞEN Gülay RATHFISCH

Öz

Vajinal doğum sırasında kadınların %85'inin çeşitli boyutlarda perineal travma yaşayacağı tahmin edilmektedir. Kadınların maruz kaldıkları bu travma nedeniyle yaşam kaliteleri negatif etkilenmekte, yenidoğan bakımı ve emzirme büyük ölçüde kesintiye uğramaktadır. Ayrıca doğum sonu perineal ağrı, disparoni ve estetik kaygılar kadınların normal vajinal doğumdan kaçınmalarına, elektif sezaryene yönelmelerine neden olabilmektedir. Ebeler kanıt temelli girişimler ile perineal travma ve ağrının potansiyel kısa ve uzun dönem etkilerini en aza indirmelidir.

Anahtar Kelimeler

Ebelik, perineal travma, epizyotomi

Kaynakça

• 1. Skodic Zaksek T. Sexology in midwifery, sexual activity during pregnancy in childbirth and after childbirth. 2015. Date: 24.02.2018. Available: http://repository.embuni.ac.ke/bitstream/handle/123456789/1184/Sexology%20in%20Midwifery%20ed.%20by%20Ana%20Polona%20Mivcek[Kalinel.DU].pdf?sequence=1. DOI: 10.5772/59496. 2. East CE, Sherburn M, Nagle C, Said J, Forster D. Perineal pain following childbirth: Prevalence, effects on postnatal recovery and analgesia usage. Midwifery. 2012; 28(1): 93-7. 3. Moore E, Moorhead C. Promoting normality in the management of the perineum during the second stage of labour. British Journal of Midwifery. 2013; 21(9): 616-620. 4. Webb S, Sherburn M, Ismail KMK. Managing perineal trauma after childbirth. BMJ. 2014; 349. 5. Frolich J, Kettle C. Perineal care. Clinical Evidence. 2015; 3 :1401 6. Aguiar M, Farley A, Hope L, Amin A, Shah P, Manaseki‑Holland S. Birth-related perineal trauma in low- and middle-ıncome countries: A Systematic Review and Meta-analysis. Maternal and Child Health Journal. 2019; 23: 1048–1070. 7. Abedzadeh-Kalahroudi M, Talebian A, Sadat Z, Mesdaghinia E. Perineal trauma: incidence and its risk factors. J Obstet Gynaecol. 2019; 39(2): 1-6. 8. Royal College of Obstetricians and Gynaecologists (RCOG) Guideline. Methods and materıals used in perıneal repaır 2004. No. 23. Date: 12.02.2019. Available: http://unmfm.pbworks.com/w/file/fetch/81069629/perineal_repair-RCOG.pdf. 9. Fernando RJ. Risk factors and management of obstetric perineal injury. Obstetrıcs, Gynaecology and Reproductıve Medıcıne. 2007; 176 (8): 238-43. 10. Oliveira LS. Brito LGO, Quintana SM, Duarte G, Marcolin AC. Perineal trauma after vaginal delivery in healthy pregnant women. Sao Paulo Med J. 2014; 132(4): 231-8. 11. Dahlen HG, Dowling H, Tracy M, Scmied V, Tracy S. Maternal and perinatal outcomes amongst low risk women giving birth in water compared to six birth positions on land. A descriptive cross sectional in a birth centre over 12 years. Midwifery. 2013; 29: 759–764. 12. World Health Organization (WHO). WHO recommendations: intrapartum care for a positive childbirth experience. 2018. Date: 12.11.2019. Available: https://apps.who.int/iris/bitstream/handle/10665/260178/9789241550215-eng.pdf?sequence=1 13. Aasheim V, Nilsen ABV, Reinar LM, Lukasse M. Perineal techniques during the second stage of labour for reducing perineal trauma. Cochrane Database of Systematic Reviews. 2017; 6; Art. No.: CD006672. 14. National Institute for Health and Care Excellence (UK) (NICE). Intrapartum care for healthy women and their babies during childbirth. 2017. Clinical Guidelines 190. Date: 12.11.2019. Available: https://www.nice.org.uk/guidance/cg190/resources/intrapartum-care-for-healthy-women-and-babies-pdf-35109866447557. 15. Latthe P, Latthe M, Say L. Gulmezoglu M, Khan KS. WHO systematic review of prevalence of chronic pelvic pain: a neglected reproductive health morbidity. BMC Public Health. 2006; 6(177): 1-7. 16. American College of Obstetricians and Gynecologists (ACOG). Prevention and management of obstetric lacerations at vaginal delivery. Practice Bulletin No. 165. Obstet Gynecol. 2016; 128: 1–15. 17. Friedman AM, Ananth CV, Prendergast E, D'Alton ME, Wright JD. Evaluation of third-degree and fourth-degree laceration rates as quality indicators. Obstet Gynecol. 2015; 125(4): 927-37. 18. Lowdermilk DL, Perry SE. Maternıty Nursing. 7th Edition. St.Louıs: Elsevier Mosby; 2006. 19. Queensland Maternity and Neonatal Clinical Guidelines. Perineal care. 2018. Date: 12.11.2019. Available: www.health.qld.gov.au/qcg. 20. Memon HU, Handa VL. Vaginal childbirth and pelvic floor disorders. Womens Health (Lond). 2013; 9(3): 265-77. 21. Jiang H, Qian X, Carroli G, Garner P. Selective versus routine use of episiotomy for vaginal birth. Cochrane Database of Systematic Reviews. 2017; 2: Art. No.: CD000081. 22. Carroli G, Mignini L. Episiotomy for vaginal birth. Cochrane Database of Systematic Reviews. 2009; 1: Art. No: CD000081. 23. Tayrac R, Panel L, Masson G, Mares P. Episiotomy and prevention of perineal and pelvic floor injuries. J Gynecol Obstet Biol Reprod (Paris). 2006; 35(1): 24-31. 24. Coutada S, Silva CN, Rocha A. Episiotomy: early maternal and neonatal outcomes of selective versus routine use. Acta Obstet Ginecol Port. 2014; 8(2): 126-134. 25. National Guideline Clearinghouse (NGC). Operative vaginal delivery. 2011. Date: 12.09.2018. Available: https://www.guideline.gov/summaries/summary/25669. 26. Royal College of Obstetricians and Gynaecologists (RCOG) Guideline. The management of third- and fourth-degree perineal tears 2004. No. 29. Date: 12.09.2018. Available: https://www.rcog.org.uk/globalassets/documents/guidelines/gtg-29.pdf. 27. Shen YC, Sim WC, Caughey AB, Howard DH. Can major systematic reviews influence practice patterns? A case study of episiotomy trends. Arch Gynecol Obstet. 2013; 288: 1285–1293. 28. Blondel B. et al. Variations in rates of severe perineal tears and episiotomies in 20 European countries: A study based on routine national data in Euro-Peristat Project. Acta Obstet Gynecol Scand. 2016; 95: 746–754. 29. Karaahmet AY, Yazıcı S. Epizyotomide Güncel Durum. HSP. 2017; 4(1): 57-63. 30. American College of Obstetricians and Gynecologists (ACOG). Episiotomy. Practice Bulletin No. 71. Obstet Gynecol. 2006; 107: 957-62. 31. Sultan AH, Thakar R, Fenner DE. Perineal and anal sphincter trauma: Diagnosis and clinical management. London: Springer-Verlag; 2007. 32. Fleming VE, Hagen S, Niven C. Does perineal suturing make a difference? The SUNS trial. BJOG. 2003; 110: 684–9. 33. Elharmeel SM, Chaudhary Y, Tan S, Scheermeyer E, Hanafy A, Driel ML. Surgical repair of spontaneous perineal tears that occur during childbirth versus no ıntervention. Cochrane Database Systematic Reviews. 2011; 10(8): CD008534. 34. Royal College of Midwives (RCM). evidence based guidelines for midwifery-led care in labour suturing the perineum. 2012. Date: 12.09.2018. Available: https://www.rcm.org.uk/sites/default/files/Suturing%20the%20Perineum.pdf. 35. Oboro VO, Tabowei TO, Loto OM, Bosah JO. A multicentre evaluation of the two-layered repair of postpartum perineal trauma. Journal of Obstetrics and Gynaecology. 2003; 23(1): 5-8. 36. Seijmonsbergen SAE, Sahami S, Lucas C, AD. Nonsuturing or skin adhesives versus suturing of the perineal skin after childbirth: A systematic review. BIRTH. 2015; 42(2): 100-15. 37. Arulkumaran S, Penne LK, Rao KB. The management of labour. 2. Edıtıon. Chennai: Orient Longman Private Ltd; 2005. p251-55. 38. Kettle C, Dowswell T, Ismail KMK. Continuous and interrupted suturing techniques for repair of episiotomy or second degree tears. Cochrane Database of Systematic Reviews. 2012; 11: Art.No.CD000947. 39. Kettle C. Hills RK, Jones P, Darby L, Gray R, Johanson R. Continuous versus interrupted perineal repair with standard or rapidly absorbed sutures after spontaneous vaginal birth: a randomised controlled trial. Lancet. 2002; 359: 2217–23. 40. Kettle C. Hills RK, Jones P, Darby L, Gray R, Johanson R. Continuous versus interrupted perineal repair with standard or rapidly absorbed sutures after spontaneous vaginal birth: a randomised controlled trial. Lancet. 2002; 359: 2217–23. 41. Gundogmus U, Ozkara E, Mete S. Nursıng and mıdwıfery malpractıce in Turkey based on the hıgher health councıl records. Nursing Ethics. 2004; 11 (5): 489-99. 42. Sagi-Dain L, Sagi S. Episiotomy knowledge, attitudes and practice: A cross-sectional survey of four Public Israeli Hospitals and review of the literature. Evidence Based Midwifery. 2015; 13(4): 138-142. 43. Celebi N, Guler H. Opinions of midwives and obstetricians about the episiotomy. IOSR Journal of Nursing and Health Science. 2018; 7(3): 41-47.