<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>1695-6141</journal-id>
<journal-title><![CDATA[Enfermería Global]]></journal-title>
<abbrev-journal-title><![CDATA[Enferm. glob.]]></abbrev-journal-title>
<issn>1695-6141</issn>
<publisher>
<publisher-name><![CDATA[Universidad de Murcia]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S1695-61412017000300539</article-id>
<article-id pub-id-type="doi">10.6018/eglobal.16.3.252131</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Prevención del trauma perineal: una revisión integradora de la literatura]]></article-title>
<article-title xml:lang="en"><![CDATA[Trauma perineal prevention: an integrative literature review]]></article-title>
<article-title xml:lang="pt"><![CDATA[Prevenção do traumatismo perineal: uma revisão integrativa da literatura]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Ferreira-Couto]]></surname>
<given-names><![CDATA[Cristina Manuela]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Fernandes-Carneiro]]></surname>
<given-names><![CDATA[Marinha do Nascimento]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Centro Hospitalario Tâmega e Sousa, EPE Enfermería de Salud Materna y Obstetricia ]]></institution>
<addr-line><![CDATA[Penafiel ]]></addr-line>
<country>Portugal</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Escuela Superior de Enfermería de Oporto Enfermería de Salud Materna y Obstétrica ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>Portugal</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>00</month>
<year>2017</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>00</month>
<year>2017</year>
</pub-date>
<volume>16</volume>
<numero>47</numero>
<fpage>539</fpage>
<lpage>575</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_arttext&amp;pid=S1695-61412017000300539&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_abstract&amp;pid=S1695-61412017000300539&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_pdf&amp;pid=S1695-61412017000300539&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[RESUMEN Este artículo describe las estrategias que pueden ser desarrolladas por la matrona con el objetivo de mantener la integridad del perineo materno, durante la fase activa del segundo periodo del trabajo de parto.  Objetivo  Determinar la evidencia disponible sobre las intervenciones de la matrona para la prevención del trauma perineal.  Método  Identificación de artículos incorporando las evidencias científicas sobre la prevención del trauma perineal, recurriendo a un conjunto de bases de datos de la salud: Medline, Elsevier, Nursing Reference, Cochrane Database of Systematic Reviews, resultante en 14 artículos.  Resultados/Discusión  La actuación de la matrona en la prevención del trauma perineal debe seguir un conjunto secuencial de intervenciones: incentivar el ejercicio físico moderado, tres veces por semana, durante el embarazo; incentivar a la mujer para la realización del masaje perineal, desde la 30ª semana de gestación; promover la restricción de la manipulación perineal durante el trabajo de parto, haciendo solamente masaje suave, alentando el tirón espontáneo y el cambio de posición de la madre y, además, proceder a la aplicación de gasas calientes en el perineo, y preferir el apoyo perineal simple cuando se aplica la maniobra de Ritgen. En todo el proceso, promover el empoderamiento de la mujer mediante el apoyo y la confianza.  Conclusión  Las intervenciones son señaladas como beneficiosas en la prevención del trauma perineal. No obstante, su aplicación exige más evidencia, así como una efectiva divulgación de sus resultados por parte de los equipos multidisciplinares y de la comunidad con la presentación de los beneficios para la salud de la mujer, la familia y la sociedad.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[ABSTRACT This article describes the strategies that can be developed by the midwife in order to maintain the integrity of the maternal perineum and prevent the practice of episiotomy during the active phase of the second period of labor.  Objective  To assess the available scientific evidence about the midwife&#8217;s interventions in order to prevent perineal trauma.  Method  Identification of articles that incorporate scientific evidence on preventing perineal trauma, using the following databases: Medline, Elsevier, Nursing Reference, Cochrane Database of Systematic Reviews, which resulted in 14 articles.  Results/Discussion  The performance of the midwife in the prevention of perineal trauma must follow a sequential set of interventions: to encourage moderate exercise three times a week during pregnancy; to encourage women to perform the perineal massage from the 30th week of pregnancy; to promote the restriction of perineal manipulation during labor, doing only a gentle massage, encouraging spontaneous pushing, changing the position of the mother, applying hot dressings in the perineum, and preferring a simple perineal support when Ritgen maneuver is applied. During all this process, to promote the empowerment of the mother, by giving support and confidence.  Conclusion  The aforementioned interventions are referred as beneficial to the prevention of perineal trauma and to the practice of episiotomy. However, their application requires more evidence, as well as an effective divulgation of the results by the multidisciplinary teams and community with the presentation of the benefits to the health of women, family and society.]]></p></abstract>
<abstract abstract-type="short" xml:lang="pt"><p><![CDATA[RESUMO Este artigo descreve as estratégias que podem ser desenvolvidas pela parteira na preservação do trauma perineal, durante o segundo período do trabalho de parto.  Objetivo  Determinar a evidência científica disponível sobre as intervenções da parteira para prevenir o trauma perineal.  Método  Identificação de artigos incorporando as evidências científicas sobre a prevenção do trauma perineal utilizando as bases de dados: Medline, Elsevier, Nursing Reference, Cochrane Database of Systematic Reviews, resultando numa amostra de 14 artigos.  Resultados/Discussão  A intervenção da parteira na prevenção do trauma perineal deve atender a um conjunto sequencial de intervenções: Incentivar o exercício físico moderado, no mínimo três vezes por semana, desde que constatada a gravidez; Educar e incentivar a mulher à realização da massagem perineal, desde a 30ª semana de gestação; Promover a mudança postural ao longo do trabalho de parto, com possibilidade de deambulação; Incentivar e apoiar a mulher ao puxo espontâneo, ao longo da fase ativa do segundo período do trabalho de parto; Promover a restrição da manipulação perineal, permitindo a adaptação, lenta e gradual, dos tecidos à apresentação fetal; Proceder à aplicação de compressas quentes no períneo, durante o segundo período do trabalho de parto; Efetuar massagem perineal suave, usando um lubrificante; Preferir o apoio perineal simples aquando da aplicação da manobra de Ritgen, em prol da sua versão modificada, sendo esta mais interventiva.  Conclusões  As intervenções são apontadas como contributos na prevenção do trauma perineal. Contudo, a sua aplicação exige a disponibilidade de mais evidência, bem como uma efetiva divulgação dos seus resultados junto das equipas multidisciplinares e da comunidade, com apresentação dos ganhos em saúde para a mulher família e sociedade.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Embarazo]]></kwd>
<kwd lng="es"><![CDATA[Parto]]></kwd>
<kwd lng="es"><![CDATA[Perineo]]></kwd>
<kwd lng="es"><![CDATA[Matrona]]></kwd>
<kwd lng="en"><![CDATA[Pregnancy]]></kwd>
<kwd lng="en"><![CDATA[Delivery]]></kwd>
<kwd lng="en"><![CDATA[Perineum]]></kwd>
<kwd lng="en"><![CDATA[Nurse Midwives]]></kwd>
<kwd lng="pt"><![CDATA[Gravidez]]></kwd>
<kwd lng="pt"><![CDATA[Parto]]></kwd>
<kwd lng="pt"><![CDATA[Períneo]]></kwd>
<kwd lng="pt"><![CDATA[Parteira]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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