Risk of Episiotomy and Perineal Lacerations Recurring After First Delivery

Galán, Sebastián Manzanares; Cobo, Davinia; Moreno-Martínez, Maria Dolores; Sánchez-Gila, Mar; Pineda, Alicia

doi:10.1111/birt.12077

Cited by 14 publications

(12 citation statements)

References 13 publications

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“…Additionally, prolonged labor and a newborn weight of >3.5kg were found to increase the rate of performance of episiotomy 6.4 and 2.5 times respectively. Once episiotomy is performed because factors such as primiparity, prolonged labor, birth weight and the like; there can be increased risk of a spontaneous perineal tear or an episiotomy in the second delivery according to a study conducted in Granada, Spain [26]. Therefore, preventive methods such as perineal massage before delivery [27] as well as trainings and awareness creation programs for health professionals might be mandatory to reduce episiotomy rate and to promote evidence based restrictive episiotomy practice [28].…”

Section: Discussionmentioning

confidence: 99%

Prevalence of Episiotomy and Its Associated Factors in University of Gondar Comprehensive Specialized Referral Hospital: A Retrospective Study from Ethiopia

Teshome¹,

Ayenew²,

Sisay³

et al. 2020

AJLS

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Background: Episiotomy is a surgical incision of the perineum during delivery to enlarge the vaginal orifice. It is one of the most commonly performed obstetric intervention world widely. The magnitude of episiotomy varies from population to population. Limited information exists related to the practice of episiotomy in Ethiopia. This study aimed to assess the prevalence of episiotomy and its associated factors in University of Gondar Comprehensive Specialized Referral Hospital, Ethiopia. Methods: Institution based retrospective cross-sectional study was undertaken from March to June 2014 on 306 mothers who had a vaginal delivery in the Hospital. Systematic random sampling technique was employed to select study units. The data were collected using pretested cheek list. Proportion of patients who had episiotomy was calculated and the association between dependent and independent variables was checked using both binary and multiple logistic regression and Chi-square. Results: Prevalence of episiotomy in University of Gondar Comprehensive specialized Referral Hospital was 47.7% (n = 146). Majority (89.5%) of the delivery was spontaneous vaginal delivery while vacuum, forceps and destructive delivery were 4.6%, 4.6%, and 1.3% respectively. During pregnancy and delivery, 84% of mothers had no associated diseases while 8% had hypertensive disorder, 5% diabetes mellitus and 3% of them has other diseases. After multivariate analysis episiotomy was significantly associated with maternal age (15-24 years) (p = 0.041, AOR (CI 95%) 1.65 (1.02-2.66)), primiparity (p =0.010, AOR (CI 95%) 2.61 (1.54-4.44)), prolonged labor (p = 0.001, COR (CI 95%) 6.45 (2.89-14.38)), and weight of newborn (p = 0.044, COR (CI 95%) 2.48 (1.16, 5.31)). Conclusion: Prevalence of episiotomies in the institution was 47.7% and variables that remained associated significantly with episiotomy were maternal age, primiparity, prolonged labor, and newborn weight.

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Section: Discussionmentioning

confidence: 99%

Prevalence of Episiotomy and Its Associated Factors in University of Gondar Comprehensive Specialized Referral Hospital: A Retrospective Study from Ethiopia

Teshome¹,

Ayenew²,

Sisay³

et al. 2020

AJLS

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“…Today, the fundamental approach related to pregnancy and childbirth is that childbirth is a physiological process and requires minimum level of medical intervention [2]. Childbirth and all the interventions performed during childbirth, with their dimensions and effects, are the great and important experiences that may lead to differences in the quality of life of the women and their families [3]- [6]. However, as a result of auspicious efforts and researches that will make normal childbirth safer and more qualified, a number of unnecessary interventions that are not appropriate, practiced inconveniently or do not help normal childbirth are being practiced [2].…”

Section: Introductionmentioning

confidence: 99%

“…These unnecessary interventions performed may cause perineal traumas that will accompany pre-and-post short and long term morbidity and may influence women's physical, psychological and social welfare [2] [6]- [10]. Besides, the perineal pain experienced as a result of birth lacerations may affect intra-family functions and daily life activities [3] [5] [6] [11]. Therefore, important changes have occurred in normal childbirth practices in last 30 years.…”

Section: Introductionmentioning

confidence: 99%

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Effects of Prenatal Perineal Massage and Kegel Exercises on the Integrity of Postnatal Perine

Dönmez¹,

Kavlak²

2015

Health

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Aim: This randomize controlled experimental study has been carried out to investigate the effects on the integrity of perine of perineal massage and Kegel exercises applied prenatally to women who experienced vaginal delivery. Methods: Research was carried out between January 2012 and 2013, with a total of 101 pregnant women who referred to Ege University Hospital in İzmir. Data Collection Form, Kegel Exercise Training Brochure, Practice Observation Form and Prenatal Perinea Massage Learning Guide for Implementer were used. Researcher continued to perform this massage once a week until delivery. Kegel exercises were asked to perform exercises at home and also to register them until delivery. When exercise group came to weekly controls or when they were contacted at home they were asked if they have performed daily exercise or not. The pregnant women in control group did not receive any application. One to one interview was performed during delivery and postnatal 24 hours at the hospital and a telephone interview was performed 15 days postnatal, so three groups were evaluated. The chi-square, Mann-Whitney U test and Kruskal Wallis test were used. Results: A statistically significant difference was found between study and control groups in terms of episiotomy rates, laceration, postnatal 24 hours and 15 days perineal pain and improvement (p < 0.05). Conclusion: It was found that perineal massage and Kegel exercises are important in maintaining the integrity of perineal significantly. It is thought that when the perineal massage and Kegel exercise being performed during pregnancy is supported by health professional, it will play a significant role in women's quality of life.

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“…The use of endoanal ultrasound in second-degree tears or after episiotomy as a means of identifying injuries which may otherwise have been missed is, in theory, a good means of ensuring that patients receive the best possible standard of care: primary repair of their injury. However, it is incredibly labour intensive, with around 77% of primiparous women requiring episiotomy 21 and requiring the presence of a clinician trained in the interpretation of endoanal ultrasonographic appearances. Further studies are needed to stratify the risk-benefit ratio and to determine which patients should be imaged prior to perineal repair or in the early postpartum period.…”

Section: Discussionmentioning

confidence: 99%

Does a missed obstetric anal sphincter injury at time of delivery affect short-term functional outcome?

Ramage

Yen

Qiu

et al. 2018

annals

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Introduction This study aimed to ascertain whether missed obstetric anal sphincter injury at delivery had worse functional and quality of life outcomes than primary repair immediately following delivery. Materials and methods Two to one propensity matching was undertaken of patients presenting to a tertiary pelvic floor unit with ultrasound evidence of missed obstetric anal sphincter injury within 24 months of delivery with patients who underwent primary repair at the time of delivery by parity, grade of injury and time to assessment. Outcomes compared included Birmingham Bowel, Bladder and Urinary Symptom Questionnaire (BBUSQ), Wexner Incontinence Score, Short Form-36, Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire and anorectal physiology results. Results Thirty-two missed anal sphincter injuries were matched two to one with sixty-two patients who underwent primary repair of an anal sphincter defect. Mean time to follow-up was 9.31 ± 6.79 months. Patients with a missed anal sphincter injury had suffered more incontinence, as seen in higher the Birmingham Bowel, Bladder and Urinary Symptom Questionnaire (BBUSQ; 30.56% ± 14.41% vs. 19.75% ± 15.65%, P = 0.002) and Wexner scores (6.00 ± 3.76 vs. 3.67 ± 4.06, P = 0.009). They also had a worse BBUSQ urinary domain score (28.25% ± 14.9% vs. 17.01 ± 13.87%, P = 0.001) and worse physical functioning as measured by the Short Form-36 questionnaire (P = 0.045). There were no differences in other outcomes compared, including anorectal physiology and sexual function. Discussion In the short-term, patients with a missed obstetric anal sphincter injury had significantly worse faecal incontinence and urinary function scores, however quality of life and sexual function were largely comparable between groups. Conclusions Longer-term follow-up is needed to assess the effects of missed obstetric anal sphincter injury over time.

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Risk of Episiotomy and Perineal Lacerations Recurring After First Delivery

Abstract: The risk of undergoing a spontaneous perineal tear or an episiotomy in the second delivery is increased by the practice of episiotomy in the first one.

Cited by 14 publications

References 13 publications

Prevalence of Episiotomy and Its Associated Factors in University of Gondar Comprehensive Specialized Referral Hospital: A Retrospective Study from Ethiopia

Prevalence of Episiotomy and Its Associated Factors in University of Gondar Comprehensive Specialized Referral Hospital: A Retrospective Study from Ethiopia

Effects of Prenatal Perineal Massage and Kegel Exercises on the Integrity of Postnatal Perine

Does a missed obstetric anal sphincter injury at time of delivery affect short-term functional outcome?

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