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International Urogynecology Journal

Published in:

01-01-2014 | Original Article

Modeling manual perineal protection during vaginal delivery

Authors: Magdalena Jansova, Vladimir Kalis, Zdenek Rusavy, Robert Zemcik, Libor Lobovsky, Katariina Laine

Published in: International Urogynecology Journal | Issue 1/2014

Abstract

Introduction and hypothesis

We compared hands-on manual perineal protection (MPP) and hands-off delivery techniques using the basic principles of mechanics and assessed the tension of perineal structures using a novel biomechanical model of the perineum. We also measured the effect of the thumb and index finger of the accoucheur’s dominant-posterior hand on perineal tissue tension when a modified Viennese method of MPP is performed.

Methods

Hands-off and two variations of hands-on manual perineal protection during vaginal delivery were simulated using a biomechanical model, with the main outcome measure being strain/tension throughout the perineal body during vaginal delivery.

Results

Stress distribution with the hands-on model shows that when using MPP, the value of highest stress was decreased by 39 % (model B) and by 30 % (model C) compared with the hands-off model A. On the cross section there is a significant decrease in areas of equal tension throughout the perineal body in both hands-on models. Simulation of the modified Viennese MPP significantly reduces the maximum tension on the inner surface of the perineum measured at intervals of 2 mm from the posterior fourchette.

Conclusions

In a biomechanical assessment with a finite element model of vaginal delivery, appropriate application of the thumb and index finger of the accoucheur’s dominant-posterior hand to the surface of the perineum during the second stage of delivery significantly reduces tissue tension throughout the entire thickness of the perineum; thus, this intervention might help reduce obstetric perineal trauma.

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Title: Modeling manual perineal protection during vaginal delivery
Authors: Magdalena Jansova
Vladimir Kalis
Zdenek Rusavy
Robert Zemcik
Libor Lobovsky
Katariina Laine
Publication date: 01-01-2014
Publisher: Springer London
Published in: International Urogynecology Journal / Issue 1/2014
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI: https://doi.org/10.1007/s00192-013-2164-1

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Modeling manual perineal protection during vaginal delivery

Abstract

Introduction and hypothesis

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction and hypothesis

Methods

Results

Conclusions

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