Perineal protection to reduce stretch marks

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    Perineal protection to reduce stretch marks

    Under förlossningen så vill man skydda mellangården från bristningar. Detta gör barnmorskan eller förlossningsläkaren via något som kallas perinealskydd, vilket har som mål att framfödanet av bebis ska gå långsamt till så att kvinnans vävnader kan töjas långsamt.

    Vad är egentligen perinealskydd för något?

    Det innebär bland annat att barnmorskan eller förlossningsläkaren tar hjälp av sina händer! Det finns flera olika sätt att hålla ett perinealskydd med hjälp av händerna, men något särskilt handgrepp sticker inte ut i forskningen som bevis för att minska risken för bristning.

    Minska risken för sfinkterskador

    Forskning har dock visat att risken för sfinkterskador (bristning som involverar ringmuskeln) minskar om barnets huvud och axlar framföds under två värkar. Det här innebär att huvudet glider ut i slutet av en värk eller under värkpaus, och att axlarna sedan framföds under nästkommande värk. Här gäller det att personalen gör en individuell bedömning i hur fort barnet behöver födas. Det enda skyddet som har hög vetenskaplig evidens mot bristningar är värme mot mellangården.

    Perinealskyddet innefattar även kommunikation och val av förlossningsställning. De flesta förlossningsställningar möjliggör att barnmorskan har bra uppsikt över mellangården, förutom om den födande sitter på huk. Om det skulle vara svårt för barnmorskan att hålla uppsikt över mellangården bör hon berätta det och föreslå en mer fördelaktig förlossningsställning i samråd med den födande.

    Såhär fungerar perinealskyddet

    Barnmorskan inspekterar också vävnadens färg, elasticitet, eventuell svullnad och blödning. Om risker för bristning identifieras kan åtgärder sättas in såsom exempelvis att byta ställning, för att avlasta vävnaderna och optimera cirkulationen i mellangården. För att vävnaderna ska hinna tänjas i lagom takt är det gynnsamt om huvudet får glida tillbaka under värkpaus i krystskedet.

    Självklart tas kvinnans önskemål i beaktande och den födande både informeras om syftet med perinealskyddet och får vara delaktig i rekommendationerna som ges. Observera att de flesta får någon form av bristning efter en förlossning.

    Vill du läsa fler artiklar om förlossning? Klicka here!

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