Episiotomy and perineal tear risk factors in a group of 4493 women

ABSTRACT Episiotomy belongs to the most frequent procedures carried out during delivery. Performing episiotomy should be reduced as there is scientific evidence indicating that it can cause pain, sexual problems, and serious, long-term health consequences. The aim of the researchers is to identify factors associated with episiotomy and the perineal tear. Analyses were performed using a model of a logistic regression. The study involved 4493 women. The episiotomy risk was related to: a birth weight exceeding 3500 grams, an instrumental delivery by means of forceps or vacuum extraction. The decrease of episiotomy rate increased the rate of perineal tear of first and second degree. The study has shown that episiotomy protects women from third- and fourth-degree perineal tear.

[1]  C. Clesse,et al.  Statistical trends of episiotomy around the world: Comparative systematic review of changing practices , 2018, Health care for women international.

[2]  G. Demir,et al.  Retrospective analysis of episiotomy prevalence , 2017, Journal of the Turkish German Gynecological Association.

[3]  Hong Jiang,et al.  Selective versus routine use of episiotomy for vaginal birth , 2017, The Cochrane database of systematic reviews.

[4]  D. Hodžić,et al.  Effect of Delivery and Episiotomy on the Emergence of Urinary Incontinence in Women: Review of Literature , 2016, Acta clinica Croatica.

[5]  I. Hildingsson,et al.  Perineal injuries and birth positions among 2992 women with a low risk pregnancy who opted for a homebirth , 2016, BMC Pregnancy and Childbirth.

[6]  M. Gissler,et al.  Variations in rates of severe perineal tears and episiotomies in 20 European countries: a study based on routine national data in Euro‐Peristat Project , 2016, Acta obstetricia et gynecologica Scandinavica.

[7]  R. Passini Júnior,et al.  Selective Episiotomy: Indications, Techinique, and Association with Severe Perineal Lacerations , 2016, Revista Brasileira de Ginecologia e Obstetrícia / RBGO Gynecology and Obstetrics.

[8]  M. Canteras-Jordana,et al.  Episiotomy and its relationship to various clinical variables that influence its performance , 2016, Revista latino-americana de enfermagem.

[9]  B. S. Dhillon,et al.  Pattern of episiotomy use & its immediate complications among vaginal deliveries in 18 tertiary care hospitals in India , 2016, The Indian journal of medical research.

[10]  E. McDonald,et al.  Dyspareunia and childbirth: a prospective cohort study , 2015, BJOG : an international journal of obstetrics and gynaecology.

[11]  D. Doherty,et al.  Risk factors for severe perineal trauma during vaginal childbirth: a Western Australian retrospective cohort study. , 2015, Women and birth : journal of the Australian College of Midwives.

[12]  Jason D. Wright,et al.  Variation in and factors associated with use of episiotomy. , 2015, JAMA.

[13]  C. Liang,et al.  Prevalence and contributing factors of severe perineal damage following episiotomy-assisted vaginal delivery. , 2014, Taiwanese journal of obstetrics & gynecology.

[14]  C. Chigbu,et al.  Prevalence and Predictors of Episiotomy Among Women at First Birth in Enugu, South-East Nigeria , 2014, Annals of medical and health sciences research.

[15]  Antonio-Miguel Hernández-Martínez,et al.  Variabilidad en la tasa de episiotomías y su relación con desgarros perineales graves y morbilidad neonatal , 2014 .

[16]  A. Rane,et al.  Perineal outcome and the risk of pelvic floor dysfunction: A cohort study of primiparous women , 2014, The Australian & New Zealand journal of obstetrics & gynaecology.

[17]  Z. Saadia Rates and Indicators for Episiotomy in Modern Obstetrics – a study from Saudi Arabia , 2014, Materia socio-medica.

[18]  A. Hernández-Martínez,et al.  [Variability in the rate of episiotomies and its relation to severe perineal tears and neonatal morbility]. , 2014, Enfermeria clinica.

[19]  I. Gurol-Urganci,et al.  Third‐ and fourth‐degree perineal tears among primiparous women in England between 2000 and 2012: time trends and risk factors , 2013, BJOG : an international journal of obstetrics and gynaecology.

[20]  D. Murphy,et al.  Morbidity experienced by women before and after operative vaginal delivery: prospective cohort study nested within a two‐centre randomised controlled trial of restrictive versus routine use of episiotomy , 2013, BJOG : an international journal of obstetrics and gynaecology.

[21]  A. Caughey,et al.  Morbidity experienced by women before and after operative vaginal delivery: prospective cohort study nested within a two‐centre randomised controlled trial of restrictive versus routine use of episiotomy , 2013, BJOG : an international journal of obstetrics and gynaecology.

[22]  C. Roberts,et al.  Episiotomy rate in Vietnamese-born women in Australia: support for a change in obstetric practice in Viet Nam. , 2013, Bulletin of the World Health Organization.

[23]  Lesley Smith,et al.  Incidence of and risk factors for perineal trauma: a prospective observational study , 2013, BMC Pregnancy and Childbirth.

[24]  A. Staff,et al.  Are obstetric anal sphincter ruptures preventable?– Large and consistent rupture rate variations between the Nordic countries and between delivery units in Norway , 2013, Acta obstetricia et gynecologica Scandinavica.

[25]  M. Dreyfus,et al.  De l’impact des RPC pour réduire le taux d’épisiotomie , 2012 .

[26]  R. Morello,et al.  [From the impact of French guidelines to reduce episiotomy's rate]. , 2012, Journal de gynecologie, obstetrique et biologie de la reproduction.

[27]  C. East,et al.  Perineal pain following childbirth: prevalence, effects on postnatal recovery and analgesia usage. , 2012, Midwifery.

[28]  D. Bick,et al.  Women's experiences of perineal pain during the immediate postnatal period: a cross-sectional study in Brazil. , 2011, Midwifery.

[29]  A. D. Shahraki,et al.  A comparison between early maternal and neonatal complications of restrictive episiotomy and routine episiotomy in primiparous vaginal delivery , 2011, Journal of research in medical sciences : the official journal of Isfahan University of Medical Sciences.

[30]  A. Kadıoğlu,et al.  Effects of perineal trauma on postpartum sexual function. , 2010, Journal of advanced nursing.

[31]  E. Baghestan,et al.  Trends in Risk Factors for Obstetric Anal Sphincter Injuries in Norway , 2010, Obstetrics and gynecology.

[32]  G. Collet,et al.  Évaluation d’une politique restrictive d’épisiotomie avant et après les recommandations du Collège national des gynécologues obstétriciens français , 2010 .

[33]  R. Ramanah,et al.  [Evaluating a policy of restrictive episiotomy before and after practice guidelines by the French College of Obstetricians and Gynecologists]. , 2010, Journal de gynecologie, obstetrique et biologie de la reproduction.

[34]  R. Rogers,et al.  Postpartum perineal pain in a low episiotomy setting: association with severity of genital trauma, labor care, and birth variables. , 2009, Birth.

[35]  R. Liston,et al.  Outcomes of planned home birth with registered midwife versus planned hospital birth with midwife or physician , 2009, Canadian Medical Association Journal.

[36]  D. Samarasekera,et al.  Risk factors for anal sphincter disruption during child birth , 2009, Langenbeck's Archives of Surgery.

[37]  B. Strachan,et al.  A prospective cohort study of maternal and neonatal morbidity in relation to use of episiotomy at operative vaginal delivery , 2008, BJOG : an international journal of obstetrics and gynaecology.

[38]  R. Sokol,et al.  Trends in major modifiable risk factors for severe perineal trauma, 1996–2006 , 2008, International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics.

[39]  J. Zuleta,et al.  Selective vs routine midline episiotomy for the prevention of third- or fourth-degree lacerations in nulliparous women. , 2008, American journal of obstetrics and gynecology.

[40]  J. de Leeuw,et al.  Long‐term effects of anal sphincter rupture during vaginal delivery: faecal incontinence and sexual complaints , 2007, BJOG : an international journal of obstetrics and gynaecology.

[41]  M. Krohn,et al.  Risk factors for primary and subsequent anal sphincter lacerations: a comparison of cohorts by parity and prior mode of delivery. , 2007, American journal of obstetrics and gynecology.

[42]  M. B. Brown,et al.  Risk Factors for Anal Sphincter Tear During Vaginal Delivery , 2007, Obstetrics and gynecology.

[43]  P. Marés,et al.  [Episiotomy and prevention of perineal and pelvic floor injuries]. , 2006, Journal de gynecologie, obstetrique et biologie de la reproduction.

[44]  F. Althabe,et al.  Episiotomy rates from eleven developing countries , 2005, International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics.

[45]  D. Bereczki,et al.  The Cochrane Database of Systematic Reviews , 2003 .

[46]  W. Gilbert,et al.  Obstetric Anal Sphincter Lacerations , 2001, Obstetrics and Gynecology.

[47]  H. Wallenburg,et al.  Risk factors for third degree perineal ruptures during delivery , 2001, BJOG : an international journal of obstetrics and gynaecology.

[48]  L. Mignini,et al.  Episiotomy for vaginal birth. , 1999, Birth.

[49]  Maternal Care in normal birth : a practical guide : report of a technical working group , 1996 .

[50]  J. L. Reynolds Reducing the frequency of episiotomies through a continuous quality improvement program. , 1995, CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne.

[51]  Fielding Ould A treatise of midwifry, in three parts. , 1995 .

[52]  L. Longo A treatise of midwifry, in three parts. , 1995, American journal of obstetrics and gynecology.

[53]  S. Thacker,et al.  Benefits and risks of episiotomy: an interpretative review of the English language literature, 1860-1980. , 1983, Obstetrical & gynecological survey.

[54]  Delee The Prophylactic Forceps Operation , 1921 .