- 作者：L. Aceituno Velasco ; M.T. S¨¢nchez Barroso ; M. Huertas Segura Garc¨ªa ; E. Ruiz Mart¨ªnez ; M.P. Gregorio Alvarez
- 关键词：Episiotomí ; a ; Perineo/lesiones ; Fó ; rceps obsté ; trico ; Extracció ; n Obsté ; trica por Aspiració ; n
- 刊名：Cl¨ªnica e Investigaci¨®n en Ginecolog¨ªa y Obstetricia
- 出版年：2013
- 出版时间：July-August, 2013
- 年：2013
- 卷：40
- 期：4
- 页码：154-161
- 全文大小：317 K
lass=""h4"">Objective
The primary objective of this paper is to present the evolution of the episiotomy rate between the years 2003-2009, following a policy of restrictive use and its possible influence on the rate of severe lacerations and perinatal morbidity in the short term.
lass=""h4"">Methods
This is a retrospective study based on a cohort made up of women who gave birth in our hospital (9023 women). The valued parameters are: changes in the episiotomy rate, percentage of severe perineal tears according to the use of episiotomy or not. Normal vaginal deliveries versus instrumental ones and the type of instrumental delivery. Apgar score below 7 at five minutes. A multivariable logistic regression was performed in order to assess the relationship between risk factors and the incidence of severe tears.
lass=""h4"">Results
The episiotomy rate ranged between 40.37 % in 2003 and 8 % in 2009, the downward trend was statistically significant. The rate of severe tears remained between 0.49 % and 1.04 % that change was not statistically significant. There was no significant variation in the rate of Apgar score less than 7 at 5 minutes. The odds ratio (OR) of having a serious perineal tear is 2.99 (95 % CI 1.47 to 6.05) in women who had an episiotomy compared with those that did not have it, the 2.40 (95 % CI 1.16 to 4.99) in the instrumental delivery versus eutocic delivery and the 6.43 (95 % CI 1.50 to 27.49) in forceps deliveries compared with vacuum deliveries.
lass=""h4"">Conclusions
Over a period of 7 years the episiotomy rate was reduced by 80 % without modifying the rate of serious perineal tears, and the short-term perinatal morbidity remained constant.