Doğum eylemi süresini kısaltmada ve vajinal perine bütünlüğünü korumada obstetrik jel uygulamasının etkinliği: prospektif gözlemsel çalışma

Yıl 2023, Cilt: 20 Sayı: 2, 1723 - 1729, 03.07.2023

Derya Burkankulu Özlem Moraloğlu Tekin Sevgi Koç Ayça Nazlı Bulut

https://doi.org/10.38136/jgon.1192217

Öz

Amaç: Bu çalışmanın amacı, obstetrik jel uygulamasının doğum eylemi sonuçlarına etkisini belirlemektir.
Gereç ve Yöntem: Bu randomize olmayan kontrollü çalışma, Ocak 2019 ile Haziran 2019 tarihleri arasında üçüncü basamak bir hastanede gerçekleştirildi. Düşük riskli, verteks pozisyonunda, 16-40 yaş arası, tahmini fetal ağırlığı 2500-4000 gram, gebelik haftası 37-41 hafta arasında olan nullipar gebeler çalışmaya dahil edildi. Çalışma grubunun (n=142) vajinal kanalına, doğumun ilk aşamasında (5 cm servikal açılmadan önce) 3-5 ml hidroksietil selüloz jel aplikatör ile uygulandı. İşlem bebeğin doğumuna kadar her iki saatte bir tekrarlandı. Kontrol grubu (n=191) standart antenatal bakım aldı.
Bulgular: Epizyotomi ihtiyacı çalışma grubunda kontrol grubuna göre anlamlı olarak daha düşüktü (n=72 (%50.7) ve n=175 (%91.6)) (Z=18.902, p<0.001). Ayrıca, çalışma grubundaki kadınların vajinal perineal bütünlüğün korunması açısından anlamlı derecede daha iyi sonuçlara sahip oldukları bulundu (n=53 (%37,3) ve n=160 (%83,7)) (Z=134,893, P<0,001) . Ayrıca çalışma grubunda doğumun ikinci evresinde kontrol grubuna göre (36.68~34.37 dk ve 58.03~30.35 dk) anlamlı kısalma gözlendi (p<0.001).
Sonuç: Obstetrik jel kullanımı doğumun birinci ve ikinci aşamalarını kısaltmakta, epizyotomi ihtiyacını azaltmakta ve perine bütünlüğünün korunmasına yardımcı olmaktadır. Bu nedenle nullipar normal vajinal doğumlarda uygulandığında maliyet etkin olabilir ve yaşam kalitesine olumlu katkı sağlayabilir.

Anahtar Kelimeler

Doğum, Perine bütünlüğü, ikinci aşama

The effectiveness of obstetric gel application in shortening labor duration and preserving vaginal perineal integrity: prospective observational study

Öz

Aim: The aim of this study to determine the effects of obstetric gel application on labor outcomes.
Materials and Method: This nonrandomized controlled study was carried out between January 2019 and June 2019 in a tertiary-care hospital. Nulliparous pregnant women with low risk, vertex position, between the ages of 16-40 years, with an estimated fetal weight of 2500-4000 grams and a gestational week between 37-41 weeks were included in the study. Using an applicator, 3-5 ml of a hydroxyethyl cellulose gel was applied to the vaginal canal of the study group (n=142) at the first stage of labor (before 5 cm cervical opening). The procedure was repeated every two hours until the birth of the baby. The control group (n=191) received standard antenatal care.
Results: The need for episiotomy was significantly lower in the study group compared to the control group (n=72 (50.7%) vs. n=175 (91.6%)) (Z=18.902, p<0.001). Moreover, it was found that women in the study group had significantly better outcomes concerning the preservation of the vaginal perineal integrity (n=53 (37.3%) vs. n=160 (83.7%)) (Z=134.893, P<0.001). Also, significant shortening was observed in the second stage of labor in the study group compared to the control group (36.6834.37 min vs. 58.0330.35 min) (p<0.001).
Conclusion: The use of obstetric gel shortens the first and second stages of labor, reduces the need for episiotomy, and helps preserve perineal integrity. Thus, it can be cost-effective and contribute positively to life quality if administered in nulliparous normal vaginal deliveries

Anahtar Kelimeler

Labor, Perineal integrity, second stage

Kaynakça

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