title: Implementation of care practices to prevent and repair perineal trauma in childbirth.
abstract: OBJECTIVE
  To implement care practices for perineal trauma prevention and repairing in normal birth.
  
  
  METHODS
  Quasi-experimental study conducted at Hospital da Mulher Mãe-Luzia, in Macapá, AP, Brazil. Seventy-four (74) nurses and obstetricians and 70 post-partum women were interviewed and the records of 555 patients were analyzed. The study was conducted in three stages: pre-audit and baseline audit (phase 1); educational intervention and implementation of best practices (phase 2); post-implementation audit (phase 3). Data was analyzed by comparison of the results of phases 1 and 3.
  
  
  RESULTS
  Following the educational intervention, a lower number of health professionals encouraged directed pushing, performed episiotomies and repaired first-degree lacerations; more women reported lithotomy position; more patient records indicated the use of Vicryl™ to suture the perineal mucosa and skin.
  
  
  CONCLUSIONS
  The educational intervention improved birth care and perineal outcomes. Nevertheless, gaps were identified in the implementation of evidence, as well as inappropriate perineal care management.
authors.affiliation: Universidade Federal do Amapá (UFAP), Departamento de Ciências Biológicas e da Saúde. Macapá, Amapá, Brasil.
authors.forename: Rafael Cleison Silva Dos
authors.initials: RC
authors.lastname: Santos
authors.affiliation: Universidade de São Paulo (USP), Departamento de Enfermagem Materno-Infantil e Psiquiátrica. São Paulo, São Paulo, Brasil.
authors.forename: Maria Luiza Gonzalez
authors.initials: ML
authors.lastname: Riesco
mesh_terms: D036861:Delivery, Obstetric / Q000009:adverse effects* / Q000295:instrumentation / Q000379:methods; D004841:Episiotomy / Q000009:adverse effects; D019317:Evidence-Based Medicine; D005260:Female; D006801:Humans; D022125:Lacerations / Q000209:etiology / Q000517:prevention & control / Q000628:therapy; D008485:Medical Audit; D009773:Obstetric Nursing / Q000193:education*; D009774:Obstetrics / Q000193:education*; D056888:Patient Positioning; D017060:Patient Satisfaction; D010502:Perineum / Q000293:injuries*; D011098:Polyglactin 910; D049590:Postpartum Period / Q000523:psychology; D017410:Practice Guidelines as Topic; D057184:Practice Patterns, Nurses' / Q000706:statistics & numerical data; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D011247:Pregnancy; D013536:Suture Techniques; D013537:Sutures
chemical_list: D011098:Polyglactin 910