Perineal Care

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PERINEAL CARE = DOH launched UNANG YAKAP campaign

(AIM: decrease infant mortality rate by at


= also called PERI-CARE or PERINEAL-
least half)
GENITAL CARE
- Perineal Area is conducive to the
growth of pathogenic organism 4 Time-Bound Procedures
because it warm and moist
1. Immediate drying – stimulate
breathing and provide warmth
2. Early uninterrupted skin-to-skin
PURPOSE:
contact – promotes warmth,
1. To prevent or eliminate infection, bonding, prevent infection
odor and promote healing 3. Delayed cord clamping – reduce
2. To remove secretions and provide anemia, intraventricular
comfort hemorrhages (IVH), and transfusion
in preterm
4. Breastfeeding within the 1st hour of
VAGINAL DOUCHING life – facilitate initiation of early
breastfeeding through sustained
- Washing or cleaning out the inside
contact
of the vagina with water or other
mixtures of fluids
INDICATION: Non Time-Bound Procedures

 To clean the vagina after menses or *Done after the 1st full breastfeeding
before or after sexual intercourse,
1. Immunization
 To prevent or ameliorate an odor,
 To prevent or treat vaginal 2. Eye care (Crede’s prophylaxis)
symptoms such as itching and
3. Vitamin K Administration
discharge,
 Less commonly, to prevent 4. Weighing
pregnancy or sexually transmitted
5. Washing / Bathing (postponed up to 6
diseases
hours)
- Hinders crawling reflex
ESSENTIAL INTRAPARTUM AND NEWBORN
CARE (EINC)
= December 7, 2009
New Trends ❑Communicate with the mother. Inform
her the progress of labor, give reassurance
❑Position: position of comfort*
and encouragement
❑No NPO
❑Active stage of labor: starts at 5cm
❑Light meals are allowed

❑ No IV unless CS Woman already in the DR – preparing for


❑ No Shaving delivery

❑ No fundal push/pressure 1. Check the temperature in the DR area. It


should be 25-28 degrees Celsius.
❑ No routine episiotomy
2. Ask the woman if she is comfortable in
❑ Companion of choice during labor semi-upright position.

❑ Mobility during labor (within reason) 3. Ensure the woman’s privacy

❑ Non-pharmacologic pain relief before 4. Remove all jewelries, wash hands.


offering anesthesia 5. Prepare a clear, clean newborn
resuscitation area. Check if equipment is
clean, functional, and within easy reach.
Unnecessary procedures
6. Arrange materials/supplies in linear
❑Suctioning sequence (gloves, dry linen, bonnet,
oxytocin injection, plastic clamp, instrument
❑Separation for observation
clamp, scissors, 2 kidney basins, eye
❑Administration of pre-lacteals ointment, stethoscope, vitamin K, Hepatitis
B and BCG vaccine, and cotton balls)
❑Water formula
7. Clean the perineum with antiseptic
❑Foot printing solution.
❑Application of substances to the cord 8. Wash hands and put on 2 pairs of sterile
gloves aseptically (if same worker handles
perineum and cord)
PROCEDURE
Prior to women transfer to DR
At the time of delivery
❑Ensure that the mother is in her POSITION
9. Encourage woman to push as desired.
OF CHOICE
10. Drape the clean, dry linen over the
❑ASK the mother if she wishes to eat/drink mother’s abdomen or arms in preparation
or void for drying the baby.
11. Apply perineal support and control 22. Perform the remaining steps of AMTSL
delivery of the head. (Wait for strong uterine contraction then
apply controlled cord traction and counter
12. Call out time of birth and gender of the
traction on the uterus (Brandt-Andrews
baby. Inform the outcome to the mother.
Maneuver and Crede’s Maneuver), continue
until placenta was delivered. Massage the
uterus until it is firm.
Within the 1st 30 secs – baby out… call out
time of birth 23. Inspect the lower vagina and perineum
for laceration.
13. Thoroughly dry the baby for at least 30
seconds, starting from the face and head, 24. Examine the placenta for completeness
going down to the trunk and extremities and abnormalities. (Schultz or Duncan
while performing a quick check for Presentation)
breathing.
25. Clean the mother.
Immediate Thorough Drying
26. Check baby’s color and breathing. Check
if mother is comfortable and uterus is
contracted.
1-3 minutes – after delivery
27. Dispose the placenta in a leak-proof
14. Remove wet cloth
container or plastic bag.
15. Place baby in skin-to-skin contact on the
28. Decontaminate (0.5% chlorine solution)
mother’s abdomen or chest.
instruments before cleaning and
16. Cover baby with a dry cloth and baby’s decontaminate second pair of gloves before
head with a bonnet. disposal.

17. Use wet cloth to wipe the soiled gloves,


then dispose wet cloth properly.
Within 90 minutes of age
18. Remove first set of gloves and
29. Advise mother to maintain skin-to-skin
decontaminate them properly (0.5%
contact. Baby should be prone on mother’s
chlorine solution for at least 10 minutes).
chest in between the breasts with head
19. Palpate umbilical cord to check for turned to one side.
pulsations. After pulsations stopped, clamp
the cord using plastic clamp or cord tie 2cm
from the base. 15-90 minutes – after delivery

20. Place the instrument clamp 5 cm from 30. Advise mother to observe for feeding
the base and then clamp. cues. Support mother and instruct her on
positioning and attachment.
21. Cut near plastic clamp (not midway).
31. After a complete breastfeeding,
administer eye ointment, thorough physical
exam, and then do injection of vitamin K,
Hepatitis B and BCG vaccine injections.
32. Advise optional/delayed bathing of
baby.
33. Complete all records.

Temperature Check
Room: 25-28 °C
Baby: 36.5 – 37.5 °C

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