手把手和手 poised 方法进行会阴控制对会阴创伤和分娩结局的影响。 注：这里的“hand-poised”不太准确，可能是特定语境下的专业表述，推测是“手随时准备着（有准备姿势）”之类意思的表述，但按要求仅按原文翻译。
The effect of perineal control with hands-on and hand-poised methods on perineal trauma and delivery outcome.
作者信息
Foroughipour Azam, Firuzeh Farah, Ghahiri Ataolah, Norbakhsh Vajihe, Heidari Tayebeh
机构信息
Department of Midwifery, Najaf Abad Branch, Islamic Azad University, Isfahan, Iran.
出版信息
J Res Med Sci. 2011 Aug;16(8):1040-6.
BACKGROUND
The objective of the present study was to evaluate the effect of the two methods of delivery, "hands-on" vs. "hands poised", on perineal trauma and delivery outcome in primiparous women referred to Shariati Hospital of Isfahan during 2007-2008.
METHODS
In a clinical trial study, 100 low risk primiparous pregnant women were randomly assigned to two hands-on and hand-poised (hands-off) groups. In the hands-on group, this method was used to control fetal head in the second stage of labor. It means that the fingers of one hand supported fetal occiput and the other hand applied slight pressure on the head to control the delivery of the head during the crowning process. In the hands-poised group, midwife observed the parturient woman and do not touch perineum during the second labor stage while fetal head was delivering. Then, the two groups were compared in terms of perineal trauma, as well as neonatal and delivery outcome.
RESULTS
Demographic characteristics of all studied women were similar in two groups. The rate of episiotomy was higher in hands-on group (84% vs. 40%, p = 0.001). The rate of postpartum hemorrhage (4(th) stage) was higher in hands-on group (12% vs. 4%, p = 0.04). The rate of mild and moderate postpartum pain in hands-on group was higher than hands-off group (70% vs. 58% and 29% vs. 10%, p < 0.001) but sever pain was not different in two groups.
CONCLUSIONS
It seems that hands-poised method is associated with less perineal trauma, particularly regarding the lower need for episiotomy and postpartum hemorrhage.
背景
本研究的目的是评估2007 - 2008年期间转诊至伊斯法罕沙里亚蒂医院的初产妇中，“手把手”与“手悬置”这两种分娩方式对会阴创伤和分娩结局的影响。
方法
在一项临床试验研究中，100名低风险初产妇被随机分为“手把手”组和“手悬置（放手）”组。在“手把手”组中，该方法用于在第二产程中控制胎儿头部。这意味着一只手的手指支撑胎儿枕部，另一只手在胎头着冠过程中对头部施加轻微压力以控制胎头娩出。在“手悬置”组中，助产士在第二产程胎儿头部娩出时观察产妇且不触碰会阴。然后，比较两组的会阴创伤以及新生儿和分娩结局。
结果
两组所有研究女性的人口统计学特征相似。“手把手”组的会阴切开术发生率更高（84%对40%，p = 0.001）。“手把手”组产后出血（第4阶段）发生率更高（12%对4%，p = 0.04）。“手把手”组轻度和中度产后疼痛发生率高于“放手”组（70%对58%以及29%对10%，p < 0.001），但两组严重疼痛发生率无差异。
结论
似乎“手悬置”方法与会阴创伤较小相关，特别是在会阴切开术需求较低和产后出血方面。
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