Need for episiotomy in a subsequent delivery following previous delivery with episiotomy

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• 作者：Samuel Lurie (1) (2)
  Daniel Kedar (2)
  Mona Boaz (2) (3)
  Abraham Golan (1)
  Oscar Sadan (1) (2)
  
• 关键词：Episiotomy ; Perineal tear ; Vaginal delivery
• 刊名：Archives of Gynecology and Obstetrics
• 出版年：2013
• 出版时间：February 2013
• 年：2013
• 卷：287
• 期：2
• 页码：201-204
• 全文大小：162KB
• 参考文献：1. Ould F (1742) Treatise of midwifery. Nelson & Connor, Dublin
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  14. Lurie S, Boaz M, Sadan O (2005) Using anovaginal distance at the beginning of labor to predict the likelihood of instrumental delivery. J Reprod Med 50:759-63
  
• 作者单位：Samuel Lurie (1) (2)
  Daniel Kedar (2)
  Mona Boaz (2) (3)
  Abraham Golan (1)
  Oscar Sadan (1) (2)
  
  1. Department of Obstetrics and Gynecology, Edith Wolfson Medical Center, Holon, Israel
  2. Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
  3. Epidemiology and Statistics Unit, Edith Wolfson Medical Center, Holon, Israel
  
• ISSN：1432-0711

文摘

Purpose To assess the need of episiotomy in a subsequent delivery in women with previous primiparous vaginal delivery with episiotomy. Methods In this historical prospective study, we followed primiparous women who had an episiotomy at a normal vaginal delivery. The study group included parturient women (n?=?201) who underwent an episiotomy at a vaginal delivery during a 2-year period (2001-002). Inclusion criteria were: primiparity, term singleton vaginal delivery, episiotomy, and a subsequent vaginal delivery in Edith Wolfson Medical Center. Exclusion criteria were instrumental delivery at the index delivery, preterm delivery or twins at the subsequent delivery. Episiotomy in the enrolled parturient women was done when it is thought that failure to perform episiotomy would result in perineal tears. The control group (n?=?201) was formed from the same time period and included women who had a spontaneous vaginal delivery without episiotomy. Results Of the 201 women with episiotomy at the index delivery, 48 (23.9?%) had episiotomy at the subsequent delivery compared to only 20 women (10.0?%) out of the 201 women without an episiotomy at index delivery (p?<?0.05). Having an episiotomy at the index delivery significantly increased odds of a subsequent episiotomy (OR 2.84, 95?% CI 1.62-.99, p?<?0.05) and the risk of spontaneous perineal tears (59.2 vs. 23.4?%, p?<?0.05) at the subsequent delivery. Conclusion Episiotomy at first vaginal delivery significantly and independently increased the risk of repeated episiotomy and spontaneous perineal tears in a subsequent delivery.