Selective vs routine midline episiotomy for the prevention of third- or fourth-degree lacerations in nulliparous women

Rodríguez, Arturo; Arenas, Edgar A.; Osorio, Alba L.; Mendez, Omar; Zuleta, John Jairo

doi:10.1016/j.ajog.2007.11.007

Cited by 49 publications

(33 citation statements)

References 8 publications

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“…23 The association between episiotomy and perineal protection in operative births (forceps and extracting vacuum) is the object of other studies. 17,18 However, in the sample studied, no births with the use of forceps were observed, due to their low incidence in the service. Sample size may imply a limitation for assessing some variables; this fact may be considered a limitation of the study.…”

Section: Discussionmentioning

confidence: 99%

“…A study assessing these variables found a statistically significant relation. 18 However, even the affirmation that episiotomy shortens the expulsive period is questionable. 19 could be assessed due to the study's design.…”

Section: Discussionmentioning

confidence: 99%

“…18 In this study labor over six hours (average for active phase of labor) and prolonged expulsion period (over 30 minutes) were assessed, with no significant association evidenced for the episiotomy performance.…”

Section: Discussionmentioning

confidence: 99%

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Prevalência e fatores associados à prática da episiotomia em maternidade escola do Recife, Pernambuco, Brasil

Carvalho¹,

Souza²,

Filho³

2010

Rev. Assoc. Med. Bras.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Prevalência e fatores associados à prática da episiotomia em maternidade escola do Recife, Pernambuco, Brasil

Carvalho¹,

Souza²,

Filho³

2010

Rev. Assoc. Med. Bras.

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“…A clinical trial conducted in Venezuela showed no advantage in the routine use of episiotomy in primiparas 12 and the subgroup analysis in a Cochrane systematic review also did not favor the practice of episiotomy in primiparous women 2 . A large population-based, retrospective study including 2,315 primiparas and 534 multiparas concluded that episiotomy protected primiparas but not multiparas from the risk of an anal sphincter lesion; however, the indications for performing this procedure should be restricted, since 909 episiotomies would have to be performed to avoid one single case of anal sphincter rupture.…”

Section: Resultsmentioning

confidence: 99%

Risk factors for episiotomy: a case-control study

Braga¹,

Clementino²,

Luz³

et al. 2014

Rev. Assoc. Med. Bras.

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Objective: obtaining information on the factors associated with episiotomy will be useful in sensitizing professionals to the need to minimize its incidence. Therefore, the objective of this study was to evaluate risk factors for episiotomy in pregnant women who had undergone vaginal delivery at a university maternity hospital in northeastern Brazil. Methods: a case-control study was conducted with pregnant women submitted to episiotomy (cases) and pregnant women not submitted to episiotomy (controls) between March 2009 and July 2010 at the Professor Fernando Figueira Integral Medicine Institute (IMIP) in Recife, Brazil, in a ratio of 1 case to 2 controls. The study variables consisted of: whether episiotomy was performed, demographic, obstetric and fetal characteristics (primiparity, analgesia, instrumental delivery, fetal distress, etc.), external factors (day and time of delivery, professional attending delivery) and factors directly related to delivery. Odds ratios (OR) and 95% confidence intervals (95%CI) were calculated. Multivariate analysis was performed to determine the adjusted risk of episiotomy. Results: a total of 522 women (173 cases and 349 controls) were included. It was found that deliveries with episiotomy were more likely to have been attended by staff physicians (OR = 1.88; 95%CI: 1.01 -3.48), to have required forceps (OR = 12.31; 95%CI: 4.9 -30.1) and to have occurred in primiparas (OR = 4.24; 95%CI: 2.61 -6.89). The likelihood of a nurse having attended the delivery with episiotomy was significantly lower (OR = 0.29; 95%CI: 0.16 -0.55). Conclusion: episiotomy was found to be strongly associated with deliveries attended by staff physicians, with primiparity, and with instrumental delivery, and was less common in deliveries attended by nurses.

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“…Su uso restrictivo ocasiona un menor riesgo de traumatismo perineal posterior, una menor necesidad de sutura del traumatismo perineal, y menores complicaciones en la cicatrización en el lapso de siete días (1,6) . Sin embargo, la política selectiva ocasiona un aumento de los desgarros de primer y segundo grado (7) , principalmente desgarros del periné anterior (1,8) , sin que se produzca un aumento de la tasa de desgarros de tercer y cuarto grado (6,8,9) . Con respecto a la morbilidad fetal debido al uso de la episiotomía selectiva, no se ha encontrado asociación entre su uso y malos resultados perinatales (5,7) como por ejemplo, el ápgar por debajo de 7 a los cinco minutos de vida (10)(11)(12) .…”

Section: Introductionunclassified

Factores que influyen en la realización de una episiotomía selectiva en mujeres nulíparas.

Pérez

López²,

Ramos³

et al. 2014

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Nº 35 Julio 2014Página 398 ENFERMERÍA Y PERSPECTIVA DE GÉNERO Factores que influyen en la realización de una episiotomía selectiva en mujeres nulíparasFactors affecting the performance of a selective episiotomy in nulliparous women *Hernández Pérez, Javier **Azón López, Esther ***Mir Ramos, Eduardo ****Peinado Berzosa, Ruth *****Val Lechuz, Belén ******Mérida Donoso, RESUMENObjetivo: Determinar los factores que influyen en la realización de una episiotomía selectiva en mujeres nulíparas. Material y método:Se realizó un estudio descriptivo transversal en el Hospital Universitario Miguel Servet (HUMS) de Zaragoza con una muestra de 568 mujeres nulíparas. Se comparó la existencia o no de episiotomía tras el parto con las variables: edad materna, nacionalidad, edad gestacional, peso fetal, hora de nacimiento, sexo fetal, analgesia empleada y profesional que asiste el parto, así como la existencia de desgarros y los resultados del pH de la arteria umbilical fetal.Resultados: La tasa de episiotomía en las mujeres nulíparas en el HUMS de Zaragoza es de un 62%. Entre los factores que influyen en la realización de una episiotomía se encuentran el mayor peso del feto (p =0,000), así como el criterio individual del profesional que asiste el parto. Otros factores como la edad gestacional, el sexo fetal, la analgesia epidural, la hora de nacimiento o la nacionalidad no influyen en su realización. El no hacer episiotomía incrementa los desgarros perineales de primer grado, y en menor medida los de segundo, sin que ocasione un mayor riesgo para el bienestar fetal.

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Selective vs routine midline episiotomy for the prevention of third- or fourth-degree lacerations in nulliparous women

Cited by 49 publications

References 8 publications

Prevalência e fatores associados à prática da episiotomia em maternidade escola do Recife, Pernambuco, Brasil

Prevalência e fatores associados à prática da episiotomia em maternidade escola do Recife, Pernambuco, Brasil

Risk factors for episiotomy: a case-control study

Factores que influyen en la realización de una episiotomía selectiva en mujeres nulíparas.

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