International Journal of Nursing

Effect of Utilizing Hands-on Versus off Method during Delivery of Fetal Head on Occurrence of Perineal Tear
Lamiaa Rabiekamel Goma, Nahed Fikry Hassan Khedr, Ahlam Mohammed Ibrahim Gouda

Abstract
Most vaginal births are associated with some forms of trauma to the genital tract. The morbidity associated with perineal tear is significant, especially when it comes to third- and fourth-degree tears. Different perineal techniques and interventions are being used to prevent perineal tear such as hands on and hands off techniques. Aim: This study was carried out to evaluate the effect of utilizing hands on versus off method during delivery of fetal head on occurrence of perineal tear. Design: Randomized clinical trial study design was used. Setting: This study was carried out at Sherbeen General Hospital, Dakahlia Governorate Egypt on 130 parturient women in the 2nd stage of labor, who were selected by purposive sample technique and divided into two equal sample size (65). In hands-on method group, the researcher put one hand above fetal head to maintain downward direction toward perineum and guarding the perineum by placing the other hand against it. In hands-off method group in which the delivery occurs without touching the fetal head or perineum. Two toolswere used to collect the necessary data namely socio-demographic and current obstetrical data, evaluation check list to clarify perineal condition after delivery. Results: 72.3% of hands on parturient women group had perineal tear during labor compared with 80% of hands off group, there was statistically significant difference between hands on and hands off groups regarding degree of perineal tear (p=0.033). This study concluded that hands-on technique had significant effect on decreasing rate, lowering degree of perineal tears and need to repair than hands-off technique. This study recommended that relevant nursing curriculum must entail a detailed portion about the correct manner of performing hands-on technique to increase the chance of perineal integrity during the second stage of labor.

Full Text: PDF     DOI: 10.15640/ijn.v7n2a7