Normal Doğum Sonrası Perinenin Değerlendirilmesi

Vajinal doğum sırasında kadının ıkınmasına bağlı olarak oluşan mekanik etki, travmatik veya müdahaleli doğumlar pelvik tabanın sinir, kas, fasya ve ligament yapılarında gerilmeye ve zorlanmaya neden olur. Bu durumda pelvik tabanda yapısal ve fonksiyonel değişikliklere yol açar. Primiparite, epizyotomi, forseps/vakum uygulaması, ıkınma tekniği, iri bebek, bebekte pozisyon ve prezantasyon bozukluğu, doğum eyleminin hızlı seyretmesi, ikinci evrenin uzaması ve doğum sayısı gibi faktörler perine travma riskini artırır. Perine travması kadınları, do- ğumdan sonraki periyotta ve uzun vadede fi ziksel, psikolojik ve sosyal olarak etkilemektedir. Perineal travma sonucu ortaya çıkan olası sorunların erken dönemde tespitinde ve komplikasyonların önlenmesinde perinenin sistematik olarak değerlendirilmesi önem taşımaktadır. Perineal değerlendirmeyi yapacak hekim, hemşire ya da ebenin öncelikle perineal değerlendirme konusunda deneyimli ve yeterli değerlendirme becerisine sahip olması gerekmektedir.

Perineal Assessment After Normal Birth

Mechanical effects may develop depending on straining during vaginal delivery, and traumatic or assisted deliveries can cause strain and stress on nerves, muscles, fascia and ligaments of the pelvic fl oor. This may also lead to structural and functional changes of the pelvic fl oor. Factors such as primiparity, episiotomy, using forceps/vacuum, straining techniques, a large baby, position and presentation of baby, rapid labor, extension of second phase of labor, and the number of previous births increase the risk of perineal trauma. Perineal trauma can affect a woman physically, psychologically and socially in the fi rst period after childbirth and in the long term. A systematic evaluation of the perinea is important in order to prevent complications and problems which occur due to perineal trauma. The physician, nurse or midwife who is evaluating the perinea must have experience and be adequately skilled in perineal evaluation.

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