Reducing perineal trauma through perineal massage with vaseline in second stage of labor.

PURPOSE: Maintaining an intact perineum is a highly regarded aim in delivery procedures today. Since perineal massage is a common practice during delivery, the present study aims to investigate the effect of perineal massage with Vaseline on perineal trauma (rate of episiotomy procedures and perineal tears). METHOD: Ninety primiparous women (aged between 18 and 30 years with gestational age of 38-42 weeks) were selected sequentially in Tehran in 2009. Once participants' characteristics were registered, they were randomly assigned to the intervention (perineal massage with Vaseline) or control groups. In the massage group, perineal massage was performed in the second stage of delivery once the genitalia were treated with sterilized Vaseline. The perineum was examined after the delivery in terms of episiotomy or tear and its severity degree. RESULTS: The two groups were homogeneous in terms of demographic data, weight gain during pregnancy, gestational age, abortion history and fetal weight. The second stage of delivery was significantly shorter in the massage group than the control group and the massage group had significantly more intact perineum (P = 0.004). In addition, lower episiotomy and higher first- and second-degree perineal tears were seen in the massage group in comparison with the control one (P < 0.001). Neither of the groups suffered from third- and fourth-degree tears. CONCLUSION: The findings showed that the perineal massage with Vaseline in the second stage of labor increases perineal integrity and decreases perineal traumas (episiotomy and tears). So, it seems that the perineal massage could be an effective way to preserve an intact perineum in labor.

Adults with auditory neuropathy: comparison of auditory steady-state response and pure-tone audiometry.

BACKGROUND: The relation between the auditory steady-state response (ASSR) and behavioral audiometric thresholds requires further clarification in the case of adults with auditory neuropathy/auditory dys-synchrony (AN/AD). PURPOSE: The aim of this study was to compare pure-tone audiometric threshold (PTAT) and ASSR in adults with AN/AD. STUDY SAMPLE: Sixteen adult participants (32 ears) with AN/AD, ranging in age from 14 to 34 years. DATA COLLECTION AND ANALYSIS: PTAT and ASSR with high-rate stimulus modulation were measured at four octave frequencies, 500, 1000, 2000, and 4000 Hz, in each ear. The behavioral auditory thresholds were compared with ASSR estimated thresholds at each frequency. Analyses included comparison of group means and coefficients of correlation. RESULTS: The average pure-tone thresholds revealed a moderate hearing loss in the AN/AD patients with a focus on the low frequencies. Low-frequency loss audiograms were observed in almost two-thirds of the participants. The estimated auditory thresholds measured by ASSR at all frequencies were substantially higher than the PTAT measures. There were no significant correlations between the PTAT and ASSR measurements at the 1000, 2000, and 4000 Hz frequencies (p > .05); the correlation between the two measures at 500 Hz (p = .029, r = 0.39) was weak but significant. CONCLUSION: There was no significant correlation between the PTAT and ASSR results at the majority of the frequencies usually tested in adults with AN/AD. Although ASSR is not a suitable method to estimate auditory thresholds in this group of patients, perhaps it can be utilized as an adjunct technique for the differential diagnosis of this disorder.