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Background and purpose: Perineal lacerations are common complications of normal vaginal delivery which influence maternal health and quality of life of mothers. This study aimed at comparing perineal protection using hands on and hands off techniques on perineal lacerations during delivery. Material and Methods: This clinical trial included 600 nulliparous women who were randomly divided into hands on and hands off groups (n=300 per group). In hands on technique when the head was crowning, a midwife placed her index, middle, ring and little fingers on the infant’s occiput, simultaneously she placed her other hand (index finger and thumb) in a “u” shape exerting pressure on the posterior region of the perineum. In hands off technique during expulsive period the midwife’s conduct was expectant, as she only observed the successive movement of external rotation, delivery of shoulder and remainder of the body. The data was analyzed using chi –square and independent T-Test in SPSSV.16. Results: The rate of Perineal lacerations was not different between the two groups (P=0.7). In both groups first degree lacerations were more dominant. Three degree lacerations (P=0.01) and episiotomy (P=0.003) were significantly lower in hands off group but the rate of periurethral lacerations was significantly higher in hands-off group (P=0.01). Second stage of labor and neonatal outcomes were similar in both groups. Conclusion: In present study the use of hands off technique reduced the rate of episiotomy and three degree lacerations of birth canal, therefore, it could be recommended as a safe method during labor.

Keywords: Labor, perineal lacerations, hands on, hands off

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