1. Birth and Regulation of head Extension to Guide Manual perineal Assistance (BREGMA) study
- Author
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Abdelrahman Abouelhassan, Vladimir Kalis, Marc Schüssler, Hassan Awwad, Rania Hassan, and Khaled M Ismail
- Abstract
Introduction and Hypothesis: The exact positioning of the dominant hand at the time of manual perineal protection is not clearly specified. The overarching aim of this work was to collect data on the bregma to posterior fourchette distance (BFD), as a surrogate measure for the degree of fetal head extension, and maternal perineal body length (PBL) at the time of manual perineal protection (MPP). Methods: This was a two-center study. Term cephalic singleton nulliparous women having spontaneous vaginal delivery were considered eligible for recruitment into the study. Once crowning was diagnosed and just prior the initiation of manual perineal protection (MPP) or cutting an episiotomy, the BFD and PBL were measured using a standardized measurement protocol.Results: A total of 100 women (50 women in each center) were recruited into the study. The overall mean BFD was 2.8 ± 0.5 cm. The overall mean PBL was 4.4 ± 0.8 cm. There were no statistically significant differences between the measurements taken in both units regarding BFD or PBL (p = 0.81 and 0.10 respectively). There was a weak correlation between both measurements.Conclusion: This is the first study to generate data on the bregma to fourchette distance and the perineal body length just prior to fetal head expulsion. This information will probably be useful to inform future biomechanical computational modeling studies to optimize hands and fingers placement during manual perineal protection.
- Published
- 2022