Midwives' approach to the prevention and repair of obstetric perineal trauma in Spain.

Autor: Laderas Díaz E; Department of Obstetrics & Gynecology, La Mancha Centro General Hospital, Alcázar de San Juan, Ciudad Real, Spain., Rodríguez-Almagro J; Department of Nursing, Physiotherapy and Occupational Therapy, Ciudad Real Faculty of Nursing, University of Castilla-La Mancha, Ciudad Real, Spain., Picón Rodríguez R; Department of General and Digestive Surgery, Santa Bárbara Hospital, Puertollano, Ciudad Real, Spain., Martínez Galiano JM; Department of Nursing, Jaen University, Jaen, Spain.; Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain., Martínez Rodríguez S; Department of Nursing, Physiotherapy and Occupational Therapy, Ciudad Real Faculty of Nursing, University of Castilla-La Mancha, Ciudad Real, Spain., Hernández-Martínez A; Department of Nursing, Physiotherapy and Occupational Therapy, Ciudad Real Faculty of Nursing, University of Castilla-La Mancha, Ciudad Real, Spain.
Jazyk: angličtina
Zdroj: Nursing open [Nurs Open] 2024 Apr; Vol. 11 (4), pp. e2160.
DOI: 10.1002/nop2.2160
Abstrakt: Aim: Different clinical practice guidelines include recommendations on how to prevent and repair obstetric perineal trauma, as well as the use of episiotomy. To evaluate the variability in midwives' professional practices for preventing and repairing perineal trauma, as well as the professional factors that may be associated with the restrictive use of episiotomy.
Design: Observational cross-sectional study.
Methods: Three hundred five midwives completed an anonymous questionnaire developed by the authors and distributed across various midwifery scientific societies. The main outcomes measured were the frequencies of adopting specific practices related to perineal injury prevention and repair, episiotomy technique and restrictive episiotomy use (<10%). Odds ratios (OR) and adjusted odds ratios (aOR) with 95% confidence intervals were estimated.
Results: Intrapartum perineal massage was not normally used by 253 (83%) of midwives, and 186 (61%) applied compresses soaked in warm water to the perineum. Regarding episiotomy, there was a great deal of variability, noting that 129 (42.3%) adopted a restrictive use of this procedure, 125 (41%) performed it between 10% and 20%, while 51 midwives (16.7%) performed it in more than 20% of cases. In addition, 165 (54.1%) midwives followed an incision angle of 60º. Concerning tears, 155 (50.8%) usually sutured first-degree tears and 273 (89.5%) always sutured second-degree tears. Midwives attending home births (aOR = 6.5; 95% CI: 2.69-15.69), working at a teaching hospital (aOR = 3.69; 95% CI: 1.39-9.84), and the ones who recently completed their professional training (aOR = 3.58; 95% CI: 1.46-8.79) were significantly more likely to adopt a restrictive use of episiotomy.
Conclusions: There is a significant variability in Spanish midwives' practices for preventing and repairing perineal tears. Moreover, the restrictive use of episiotomy is associated with midwives attending home births, working in teaching hospitals and having recent professional training.
Patient or Public Contribution: No patient or public contribution.
(© 2024 The Authors. Nursing Open published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
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