Third- and fourth-degree perineal laceration in vaginal delivery

Chia, Chun-Chieh; Huang, Soon-Cen

doi:10.1016/j.tjog.2012.01.035

Cited by 16 publications

(12 citation statements)

References 30 publications

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“…However, there is no clear indication for episiotomy when an instrumental delivery is performed; it is believed to result in an increase in severe lacerations of the perineum, with possible damage to anal function. But the role of routine episiotomy in instrumented birth is not well studied and requires more research 18 Some authors have suggested that episiotomy may not be absolutely necessary in childbirth. 39…”

Section: Discussionmentioning

confidence: 99%

“…10 , 16 , 17 In addition, episiotomy has been associated with an increased risk of anal postpartum incontinence, dyspareunia, increased discomfort, severe bleeding, wound hematoma, and infection, implying minimal practice. 17 , 18 Therefore, indications for routine episiotomy are not well supported, restrictive use of episiotomy is advocated. 19 , 20 The Royal College of Obstetricians and Gynecologists (RCOG) sets a conservative episiotomy policy guideline that is: <30% in general, < 50% for primiparous, <10% for multiparas.…”

Section: Introductionmentioning

confidence: 99%

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<p>Factors Associated with Episiotomy Practices in Bahirdar City, Ethiopia: A Cross-Sectional Study</p>

Beyene¹,

Nigussie²,

Limenih³

et al. 2020

RMHP

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Background Episiotomy is the surgical enlargement of the vaginal orifice during the last part of the second stage of labor or childbirth by an incision to the perineum. The World Health Organization advises the use of episiotomy on a restricted and selective basis. Indeed, the rate of episiotomy in developed countries is decreasing, but in developing countries, including Ethiopia, it still remains high. Therefore, this study tried to assess the proportion and factors associated with episiotomy among women who gave birth at Felege Hiwot Referral Hospital, Bahir Dar City, North West Ethiopia, 2017. Methods An institution-based cross-sectional study was conducted among 411 mothers from February to April 2017. Data were collected through face-to-face interviews and supported by observation using standard checklist with systematic random sampling technique. Data was entered by Epi Info and analyzed by SPSS version 23. The association between variables was analyzed using bivariable and multivariable logistic regression model. P-value <0.05 at 95% CI was considered to be statistically significant. Results The proportion of episiotomy was 41.1% with 95% CI (36.5%, 46.2%). Multivariable logistic regression showed that primiparity (AOR=6.026, 95% CI (3.542,10.253)), prolonged second stage of labor (AOR=4.612, 95% CI (2.247,9.465)), instrument delivery (AOR =3.933, 95% CI (1.526,10.141)), using oxytocin (AOR=2.608, 95% CI (1.431,4.751)), medical resident attendant (AOR =3.225, 95% CI (1.409,7.382)) and birth weight ≥4000 grams (AOR=5.127,95% Cl (1.106,23.772)) were significantly associated with episiotomy practice. Conclusion The proportion of episiotomy was high. Parity, using oxytocin, second-stage labor duration, instrument delivery, birth weight, and delivery attendant were statistically significant factors for episiotomy practice. Therefore, as per our findings, we suggest awareness creation, and the setting and use of new national guidelines, the practice of routine episiotomy should be abandoned, and selective and restrictive use of episiotomy is highly advised.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

<p>Factors Associated with Episiotomy Practices in Bahirdar City, Ethiopia: A Cross-Sectional Study</p>

Beyene¹,

Nigussie²,

Limenih³

et al. 2020

RMHP

View full text Add to dashboard Cite

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“…The role of routine episiotomy in instrumented birth is not well studied and requires more research. It seems that its use is justified by the decrease of perineal tears, especially when forceps are used ( 13 ) .…”

Section: Discussionmentioning

confidence: 99%

Episiotomy and its relationship to various clinical variables that influence its performance

Ballesteros-Meseguer

Carrillo‐Garcia

Pedro

et al. 2016

Rev. Latino-Am. Enfermagem

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Objective:to understand the episiotomy rate and its relationship with various clinical variables. Method:a descriptive, cross-sectional, analytic study of 12,093 births in a tertiary hospital. Variables: Parity, gestational age, start of labor, use of epidural analgesia, oxytocin usage, position during fetal explusion, weight of neonate, and completion of birth. The analysis was performed with SPSS 19.0. Results:the global percentage of episiotomies was 50%. The clinical variables that presented a significant association were primiparity (RR=2.98), gestational age >41 weeks (RR=1.2), augmented or induced labor (RR=1.33), epidural analgesia use (RR=1,95), oxytocin use (RR=1.58), lithotomy position during fetal expulsion (RR=6.4), and instrumentation (RR=1.84). Furthermore, maternal age ≥35 years (RR=0.85) and neonatal weight <2500 g (RR=0.8) were associated with a lower incidence of episiotomy. Conclusions:episiotomy is dependent on obstetric interventions performed during labor. If we wish to reduce the episiotomy rate, it will be necessary to bear in mind these risk factors when establishing policies for reducing this procedure.

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“…As lacerações graves apresentam incidência de 0,8% a 3% e estão associadas a prejuízo significativo na qualidade de vida das pacientes, incluindo incontinência fecal e urinária, prolapso genital, dor perineal crônica, disfunção sexual, infecções e fístula retovaginal (Chia & Huang, 2012;Jallad, Steele, & Barber, 2016). Além de todas as consequências físicas, uma lesão grave durante o parto vaginal e o nascimento podem afetar psicologicamente as mulheres e causar problemas sociais, comprometendo inclusive, sua autoestima (Garcia-Lausin et al, 2019).…”

Section: Introductionunclassified

Frequência de lacerações perineais e episiotomia em um hospital universitário na região serrana no Rio de Janeiro

Grecca

Ribeiro

Vitoi

et al. 2020

RSD

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A laceração perineal é a complicação mais comum no parto, ocorrendo em 85% dos partos vaginais e, para evitá-la, a episiotomia foi um procedimento utilizado rotineiramente durante muito tempo. Contudo, a episiotomia tem sido desencorajada devido a ausência de comprovação de seu benefício e de sua associação com diversas complicações. O objetivo deste estudo foi analisar a frequência de lacerações perineais e a realização de episiotomia em um hospital universitário na região serrana no Rio de Janeiro, Brasil. Foram incluídos no estudo prontuários de gestantes cujo parto normal foi realizado no período de dezembro de 2018 a março de 2019. Dados sobre presença de lesões perineais, incluindo seu grau, localização, necessidade de rafia, realização de episiotomia e peso do recém-nascido foram coletados. O setor estatístico do hospital forneceu dados sobre a realização de episiotomia nos últimos 10 anos e uma curva de tendência foi elaborada. Teste qui-quadrado de Pearson foi aplicado. Foram elegíveis 137 prontuários de gestantes com idade entre 19-38 anos. Observou-se frequência de56,9% lacerações perineais, com 2,5% de lesões graves, necessidade de rafia em 78,2% dos casos e 22,6% procedimentos de episiotomia, devido, principalmente, ao períneo ser estreito e não complacente. O peso dos recém-nascidos variou entre 875g a 3890g e maioria foi classificada como peso normal (n = 119, 87,5%). Elevada frequência de lacerações perineais, principalmente de gravidade leve foi encontrada, bem como, elevada frequência de episiotomia. Contudo, os dados demonstram redução desse procedimento nos últimos dez anos.

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Third- and fourth-degree perineal laceration in vaginal delivery

Cited by 16 publications

References 30 publications

<p>Factors Associated with Episiotomy Practices in Bahirdar City, Ethiopia: A Cross-Sectional Study</p>

<p>Factors Associated with Episiotomy Practices in Bahirdar City, Ethiopia: A Cross-Sectional Study</p>

Episiotomy and its relationship to various clinical variables that influence its performance

Frequência de lacerações perineais e episiotomia em um hospital universitário na região serrana no Rio de Janeiro

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