Estudio clínico aleatorizado multicéntrico de la eficacia de la detención controlada de la cabeza fetal para evitar el desgarro del periné

Abstract

Background: The protection of the perineum during delivery, has been recommended in several books of obstetrics, for this performing various maneuvers as controlled stopping of the fetal head and modified Ritgen maneuver, which have not been evaluated deeply, more research should be conducted clinics randomized to recommend its use and thus perform episiotomies narrowly. The goal of this study is to determine the efficacy of controlled stopping of the fetal head compared with modified Ritgen maneuver to avoid perineal tear in the second stage of nulliparous.

Methods and Techniques: We conducted a multicenter randomized clinical trial, double blind, carried out in Vicente Corral Moscoso and Jose Carrasco Arteaga Hospitals at Cuenca-Ecuador. The study group was make up 59 nulliparous, which was run controlled stopping of the fetal head, and 57 nulliparous control group in which to perform the modified Ritgen maneuver, in total 116 patients.

Results: The incidence of perineal tear in the experimental group was 46 patients with a total of 59, while in the control group were 42 of 57 patients was estimated RR 1.05, 95% CI (0.86-1.28) and a p value 0.590.

Conclusions: There is less likely to occur with perineal tears maneuver Ritgen modified, not statistically significant, therefore the implications for clinical practice they're right for the two groups is both types of maneuvers can be used in order to prevent tearing of the perineum.

KEYWORDS: ANATOMY, UROGENITAL SYSTEM, GENITALS, FEMALE GENITALS, VAGINA, VULVA, PERINEAL TEAR, CONTROLLED STOPPING OF THE FETAL HEAD, MODIFIED RITGEN MANEUVER, RANDOMIZED TRIAL.