Title: Metrics of perineal support (MOPS) study
Authors: Kališ, Vladimír
Rušavý, Zdeněk
Havelková, Linda
Zítka, Tomáš
Tolar, David
Ismail, Khaled M.
Citation: KALIŠ, V., RUŠAVÝ, Z., HAVELKOVÁ, L., ZÍTKA, T., TOLAR, D., ISMAIL, K. M. Metrics of perineal support (MOPS) study. BMC pregnancy and childbirth, 2020, roč. 20, č. 1. ISSN 1471-2393.
Issue Date: 2020
Publisher: BioMed Central
Document type: článek
URI: 2-s2.0-85086425114
ISSN: 1471-2393
Keywords in different language: Manual perineal protection;physiology;vaginal delivery;computational modelling;Finnish method;pressure;forces;duration;variability
Abstract in different language: Background: Manual perineal protection (MPP) is an intrapartum intervention suggested to protect perineal integrity during childbirth. Proper execution of MPP is complex and evaluation of its true contribution is difficult in the clinical setting because of the large number of obstetric variables, some of which are hardly quantifiable. In this study we aimed to gather initial data on the forces executed by the accoucheur's thumb, index and middle fingers during MPP at the time of fetal head expulsion, quantify the duration of the intervention and investigate the timely interaction of the different components of MPP. Methods: Two bespoke right-handed measurement gloves (MG), with built in sensors, were designed and produced. The MG allowed the electronic real-time measurement of applied forces during MPP and transferred this data wirelessly to an integrated computer system. Sterile gloves were worn over the MG when used at the time of birth. The study was undertaken between January and December 2019. Singleton, term pregnant women having their first vaginal birth who provided a valid written consent were enrolled into this prospective pilot study. All deliveries were undertaken by one of two obstetricians experienced in MPP Results: Twenty women were enrolled. The mean duration of execution of MPP during the last contraction was 13.6 s. In 20% it lasted < 5 s. The overall means of the mean and maximum forces of the thumb, index and middle fingers were 26.7 N; 25.5 N; 20.2 N and 34.3 N; 32.6 N; and 27.6 N respectively. The onset of fingers and thumb activity was simultaneous in 13 cases (65%), while in seven (35%) deliveries the middle finger's force activity was initiated later. Conclusions: MPP during fetal head expulsion happens over a short period of time. In the majority of cases the thumb and fingers actions started simultaneously. There were differences in the duration of application and the forces executed by the fingers and thumb between the two practitioners, however this was only significant for thumb measurements. The results obtained will aid in improving further MPP modeling studies to optimize the technique.
Rights: © BioMed Central
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