Influencia de la política pública y la episiotomía selectiva en el parto normal en Ecuador

Abstract

Introduction: Episiotomy was considered an obstetric procedure applied routinely to facilitate the expulsive period. Currently, several studies, regulations and protocols indicate that its use should be restricted and its benefits are questioned. Objective: To know the influence of the regulations issued on the selective use of episiotomy in the establishments of the Ministry of Public Health when comparing the year 2007 with 2017. Methods: An analytic epidemiological study of secondary source (medical records of normal delivery) and primary source (surveys to professionals) was carried out. It was carried out in the health units of the MSP-EC: Historic Center Health Center, Enrique Garcés Hospital, and Isidro Ayora Gineco-Obstetric Hospital, medical care centers in which the 0.51 form of the medical records was reviewed and a report was recorded. instrument predesigned for the study. With the compiled information, the database was organized to establish significant differences, the Chi square test was used between the affirmative data of episiotomy action in the two years compared. Results: The application of episiotomy presented a notable change when comparing the year 2007 with 29.2% and 8.7% in 2017. It should be noted that primiparous women were the group in which the highest number of episiotomies was performed. Conclusion: The aspect that most influenced the reduction in the number of episiotomies was the training given to professionals graduated after 2008, included in the MSP-EC regulations for the selective application of episiotomy.