The Effect of Ritgen's Maneuver and Hand-poised on Perineal Trauma During Delivery

Perineal trauma during natural vaginal delivery is associated with short and long term morbidity for women. Interventions to increase the possibility for an intact perineum are needed. This study aimed to compare the effects of Ritgen’s maneuver and hand-poised on perineal lacerations during delivery. This clinical trial study was performed on 70 nulliparous women who referred to Amol Emam Ali teaching center for normal delivery. They were randomly participating in Ritgen group (35 cases) or hand-poised group (35 cases). In Ritgen group, this method was used to control fetal head in the second stage of labor. It means that fingers of one hand supported fetal occiput and the other hand applied slight pressure on the head to control the delivery of the head. In the hand-poised group, perineum wasn’t touched during the second stage of labor while fetal head was delivering. At last we compared the rate of intact perineum, episiotomy and laceration, mean duration of second stage of labor and Apgar score in 1 and 5 minute between two groups. In Ritgen group, intact perineum, episiotomy and laceration were: 85.7% (30), 74.3% (26), 14.3% (5) respectively. In hande-poised group, intact perineum, episiotomy and laceration were: 80% (28), 82.9%(29), 5.8%(2) respectively. This difference was not statistically significant. In Ritgen group, first degree laceration was 14.3% (5). In hand-poised group, first degree laceration was 20% (7).This difference was not statistically significant. In Ritgen and hand-poised groups, second, third and fourth degree laceration were not occurred. The use of hand-poised method as technicque for perineal control is safe based on labour criteria and woman’s preference during delivery.