![]() ![]() Additionally, you may also consider posting on r/legaladvice for legal advice. Always consult a professional in these matters. Commenters should not offer medical or legal advice. Do not ask if something is legal/illegal, if you should call the police, engage an attorney, or call child welfare agencies. Do not ask about symptoms, post pictures, or ask if you should seek a medical professional. Support for established medical and legal situations is allowed. Reddit and the internet, in general, are not the best places to get or give medical or legal advice.Reporting posts that violate this rule is the best way to get it noticed by the moderation team. Bullying, including baiting/antagonizing, and brigading of either individual users or subreddits will not be tolerated. ![]() Remember the Human! Disagree but remain respectful don’t insult people or their children, name-call, or be intentionally rude. ![]() Non-parents/guardians that still have pressing questions for parents can utilize the weekly "Ask Parents Anything" thread in this sub or visit r/AskParents. Indicate you're a parent or guardian, or self-select your user flair, to avoid confusion/accidental moderation. However, it’s okay for anyone to comment, provided it’s on-topic and within rules. Parents/guardians are any person who has substantial decision-making authority in a child's life.Only Parents or Guardians May Create New Posts.We also recommend /r/relationships, /r/legaladvice and /r/family. r/Parenting is a subreddit for anything related to the controlled chaos we call parenting.ĭo you have a question for parents? Head over to /r/AskParents.ĭid your kid say something awesome? Join us at /r/thingsmykidsaid.Īre you a caregiver or nanny? Check out /r/nanny. Hands-off hands-on perineal lacerations second stage vaginal delivery.Make this subreddit a better place! Vote and participate in the new section and report rule violations. Key Message A hands-on technique during vaginal delivery results in similar incidence of severe lacerations compared to hands-off. The incidence of third-degree lacerations and of episiotomy increases with the hands-on technique. Hands-on technique during spontaneous vaginal delivery of singleton gestations results in similar incidence of several perineal traumas compared to a hands-off technique. Hands-on technique was associated with increased risk of third-degree lacerations (2.6 versus 0.7% RR 3.41, 95% CI 1.39-8.37) and of episiotomy (13.6 versus 9.8%, RR 1.59, 95% CI 1.14-2.22) compared to the hands-off technique. There was no significant between-group difference in the incidence of intact perineum, first-, second- and fourth-degree laceration. Women randomized to the hands-on technique had similar incidence of severe perineal trauma (1.5 versus 1.3% RR 2.00, 95% CI 0.56-7.15). All studies included singleton gestations with cephalic presentation at term undergoing spontaneous vaginal delivery. The meta-analysis was performed using the random effects model of DerSimonian and Laird, to produce summary treatment effects in terms of relative risk (RR) with 95% confidence interval (CI).įive trials, including 7287 women, were analyzed. The primary outcome was severe perineal trauma, defined as either third- or fourth-degree lacerations. Hands-on was defined as involving one hand on the fetal head, applying pressure to control expulsion, with the other hand applying pressure on the maternal perineum. control group) were included in the meta-analysis. ![]() intervention group) with a hands-off technique (i.e. Randomized controlled trials comparing a hands-on technique of perineal support during vaginal delivery (i.e. The reference lists of identified articles were examined to identify studies not captured by electronic searches. No restrictions for language or geographic location were applied. The aim of this systematic review with meta-analysis was to evaluate whether a hands-on technique during vaginal delivery results in less incidence of perineal trauma than a hands-off technique.Įlectronic databases were searched from their inception until June 2018. Perineal trauma at the time of vaginal delivery is common, and when the anal sphincter is included, these injuries can be associated with additional morbidity including incontinence, pelvic pain, and sexual dysfunction. ![]()
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