EFFECT OF UTILIZING HANDS-ON VERSUS OFF METHOD DURING DELIVERY OF FETAL HEAD ON OCCURRENCE OF PERINEAL TEAR

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 tothird- and fourth-degree tears. Different perineal techniques and interventions are beingused to prevent perineal tear such as hands on and hands off techniques. Aim: This studywas carried out to evaluate the effect of utilizing hands on versus off method duringdelivery of fetal head on occurrence of perineal tear. Design: Randomized clinical trialstudy 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 wereselected by purposive sample technique and divided into two equal sample size (65). Inhands-on method group, the researcher put one hand above fetal head to maintaindownward direction toward perineum and guarding the perineum by placing the otherhand against it. In hands-off method group in which the delivery occurs without touchingthe fetal head or perineum. Two tools were used to collect the necessary data namely sociodemographicand current obstetrical data, evaluation check list to clarify perinealcondition after delivery. Results: 72.3% of hands on parturient women group had perinealtear during labor compared with 80% of hands off group, there was statistically significantdifference 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 ondecreasing rate, lowering degree of perineal tears and need to repair than hands-offtechnique. This study recommended that relevant nursing curriculum must entail a detailedportion about the correct manner of performing hands-on technique to increase the chanceof perineal integrity during the second stage of labor.