Evaluation of a policy of restrictive episiotomy on the incidence of perineal tears among women with spontaneous vaginal delivery: A ten-year retrospective study.

Journal of Gynecology Obstetrics and Human Reproduction
Pauline Blanc-PetitjeanLaurent Mandelbrot

Abstract

Routine episiotomy is no longer recommended to limit obstetrical anal sphincter injuries (OASIs). We aimed to evaluate the effect of a restrictive policy of episiotomy on the risk of OASIs during spontaneous vaginal deliveries. We performed a retrospective single-center observational study among women with a term singleton cephalic fetus, with spontaneous vaginal delivery. The occurrence of episiotomy, intact perineum, first, second, third or fourth-degree (OASIs) perineal tears were compared before (period A, from 01/01/2006 to 12/31/2008) and after (period B, from 01/01/2012 to 12/31/2016) implementation of the restrictive policy. Odds of perineal tear were estimated using multivariable logistic regression models, stratified by parity. From 2006-2016, the rate of episiotomy decreased, from 14.9 % (n/N=200/1141) to 4.7 % (94/1912). In period B (N=8984) vs A (N=8984), the rates of episiotomy were, 12.9 vs 26.6 % for nulliparas (p<0.01) and 2.3 vs 6.8 % for multiparas (p<0.01). Odds of OASIs were not different in period B vs A, both for nulliparas (0.9 vs 0.8 %, AOR=0.88(0.38-2.05)) and multiparas (0.4 vs 0.2 %, AOR=2.28(0.63-8.29). Odds of second-degree tear were higher in period B vs A, both for nulliparas (39.8 vs 17.4 %, AOR...Continue Reading

References

Apr 17, 2001·American Journal of Obstetrics and Gynecology·L B SignorelloJ T Repke
Apr 20, 2006·Gynécologie, obstétrique & fertilité·UNKNOWN CNGOF
Sep 13, 2006·The Journal of Maternal-fetal & Neonatal Medicine : the Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians·Yvonne W ChengAaron B Caughey
Nov 28, 2008·BJOG : an International Journal of Obstetrics and Gynaecology·D J MurphyB Strachan
Dec 27, 2011·Journal de gynécologie, obstétrique et biologie de la reproduction·B BlondelUNKNOWN Coordination nationale des Enquêtes Nationales Périnatales
Feb 15, 2013·The Australian & New Zealand Journal of Obstetrics & Gynaecology·Amanda J AmptJonathan M Morris
Mar 19, 2013·BMC Pregnancy and Childbirth·Lesley A SmithEthel E Burns
Jul 10, 2013·BJOG : an International Journal of Obstetrics and Gynaecology·I Gurol-UrganciJ H van der Meulen
Aug 3, 2013·Journal de gynécologie, obstétrique et biologie de la reproduction·M ChehabD Riethmuller
Aug 8, 2013·Obstetrics and Gynecology·Camille Le RayFrançois Goffinet
Feb 18, 2014·International Journal of Gynaecology and Obstetrics : the Official Organ of the International Federation of Gynaecology and Obstetrics·Vasileios PergialiotisGeorgios Vlachos
May 31, 2014·Journal of Perinatology : Official Journal of the California Perinatal Association·E HirschM G Adams
Sep 15, 2014·European Journal of Obstetrics, Gynecology, and Reproductive Biology·Thomas SchmitzOlivier Sibony
Feb 26, 2015·Journal of Midwifery & Women's Health·Allison LaCrossArlene Smaldone
Aug 1, 2015·International Urogynecology Journal·Marilene Vale de Castro MonteiroZilma Silveira Nogueira Reis
Mar 22, 2016·Journal de gynécologie, obstétrique et biologie de la reproduction·A-L ChuilonB Blondel
Mar 29, 2016·The Journal of Maternal-fetal & Neonatal Medicine : the Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians·Anat ShmueliAmir Aviram
Apr 27, 2016·The Journal of Maternal-fetal & Neonatal Medicine : the Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians·Bülent DoğanMurat Muhçu
Oct 17, 2017·Journal of Gynecology Obstetrics and Human Reproduction·B BlondelUNKNOWN National Coordination Group of the National Perinatal Surveys
Nov 21, 2017·American Journal of Obstetrics and Gynecology·Hanna JangöAbelone Saske
Jun 6, 2018·BMC Pregnancy and Childbirth·Karine GoueslardCatherine Quantin
Dec 16, 2018·Journal of Gynecology Obstetrics and Human Reproduction·G DucarmeX Fritel
May 29, 2019·Simulation in Healthcare : Journal of the Society for Simulation in Healthcare·Emily K MarkoG Larry Maxwell
Jun 27, 2019·European Journal of Obstetrics, Gynecology, and Reproductive Biology·Giulia MagogaVincenzo Berghella

❮ Previous
Next ❯

Citations

Jan 14, 2021·International Urogynecology Journal·Lena Sagi-DainShlomi Sagi
Aug 16, 2021·Journal of Gynecology Obstetrics and Human Reproduction·Pauline Blanc-PetitjeanLaurent Mandelbrot

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.